Sam

Age at interview: 41

Brief Outline: Sam’s gout started a few years ago and she take allopurinol to reduce the number of attacks. She feels a bit embarrassed about being a woman with gout and would like to be able to talk to other women with the condition.

Background: Sam is married and lives with her husband, son and daughter. She works as a secretary in a charity for adults with learning disabilities. Ethnic background/nationality: White Welsh.

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Sam’s gout began a few years ago when she was on holiday. The doctor she saw thought that gout was unlikely but the blood tests showed a high uric acid level. She started taking allopurinol and still takes it. Although she does not like the idea of being on long-term medication, it is preferable to the pain of the first attack.
 
Sam gets one to two bouts of gout a year. It mostly affects her foot, but she has also been having trouble with her elbow and hand, although this may be related to her work. She takes paracetamol or Nurofen for the pain, but has to take other medication to counteract the side effects of Nurofen.  She tries to avoid certain foods that she thinks trigger an attack and also tries to keep her weight down. She lost a lot of weight and cut down alcohol before she was diagnosed with gout, so is not sure why she got it. Her grandfather had gout and her parents have other forms of arthritis but she does not know if this is linked to her gout.
 
She tries not to let it interfere with her life. She hasn’t had much time off work, and her manager has been sympathetic and flexible. Her husband helps by doing the ironing and more of the manual housework. She has had to buy wide-fit shoes.
 
Sam found some information online but would have liked more information. She feels as though she is the only woman with gout and would like to talk to other women with the condition. She doesn’t generally talk to other people about it as she feels embarrassed.
 
She sometimes worries about the future with gout and is also concerned about whether her children will get it.

Sam’s GP did not think that she would have gout but tests showed that her uric acid levels were high.

It was around February 2011, I'd been to the GP previously, because I've had this continuous swelling in my left foot. So I'd been - I'd had blood tests in the past for diabetes, but this particular foot I'd broken years before and I'd also done the ligaments and different things, so we just assumed there was sort of progression of arthritis in the joint. 

But - and both my parents have been diagnosed with rheumatoid arthritis, so it started off being, looking at that sort of thing. But then kind of about the - well in the August we went on holidays and I was really ill when we were abroad on holidays. My foot - I was in horrendous pain as if somebody was jabbing me with needles. So when I came home then, I went to the GP and explained all the symptoms. And she sort of said to me then, she said, “Well I don’t think you’ve got gout”, she said, “But I'd better test you for it because your symptoms are sort of connected with that.” And she said, “Well it's very unlikely because - female, and your age, and you're not particularly overweight, or anything, but we'll test anyway.” And my - when it came back I'd had the bloods done the beginning of October and a week later the bloods came back that my uric acid level was high.

After recently changing to a healthier diet and doing more exercise, Sam was baffled when she discovered that she had gout.

My exercise was more intense then so I would have thought the impact of the joints, I would have maybe have developed it earlier if I was going to develop it. So I don't know - I'd love to be able to pinpoint why it actually came on me then really, but I'm never going to know I know, but you know I was walking everywhere, gym, and swimming is obviously not a high impact on the joints, but I was doing you know a lot of cardio and things like that which would cause a lot of impact and, nothing back then. 

And did you add anything sort of in particular into your diet that you'd never eaten before or was it more just changing quantities and…?

I suppose I started eating more fruit than I had done before which was a major thing and obviously more vegetables, and probably more of the citrusy fruits, because they weren't at the time when you were looking into research and that, they would burn off fat quicker because of the acid in them. So I suppose I did eat a lot of tangerines and oranges, and obviously the vitamin C level, but apart from that, like I'd cut down on the red meat. I ate more white meat or I ate more fish, oily fish, which was another thing, I mean that’s supposed to be really good for the joints and - so I can't - apart from that it was all good, I cut down on my alcohol, because that’s part of the healthy eating programme, and - because I love my chocolate I only limit myself to one small bar a day, but for me to be able to have the chocolate on the diet plan I’d have to cut out the alcohol. And the days I had the alcohol I'd give up the chocolate and that kind of thing, so I was eating a really, really healthy diet, small meals often, to keep the metabolism going, plus like I said keeping active. So it was really…I was completely gobsmacked because when I went on then and looked at the typical person with gout men in their late fifties, portly, you know, portly fellows, rich living, I was thinking, no, that's not me [laughs].

Sam felt that having gout as a woman was not normal. She did not like talking about it to other people.

I was kind of thinking - and I suppose you do don’t you – that, “God, I'm a bit of a freak really” because you know, you talk to people, “Oh my god my grandfather got that, you can't have that surely?” And it's like well - and it was all men. I was thinking “Oh my god, am I half man or something?” You know [laughs]. “Testosterone overload or something?” But yeah so I kind of - sort of put it to the - because I was thinking, “Oh I am - must be some sort of freak because no other women I know have got it” so I kind of don’t end up talking about it anymore much to people. 

Sam’s pain felt similar to the pain of childbirth and having an epidural. She felt like she would try anything to get rid of it.

My foot was swollen but the intense pain when I was on holiday was in my big toe. And it was - it's an awful thing to describe, it was like the pain I felt when I had an epidural, when I had my son, and it's the type of pain you never forget and it did literally feel like somebody was stabbing me and I was wrapping my foot up thinking I wanted to put it up, but then that was too intense, I could not put my foot up, I put my foot up, and I just couldn't get comfortable at all.

I think you'll try anything because always in the back of my mind is, “I don’t want a flare up like I had before”. I mean - and I've given birth to two children, one birth was quite traumatic, and I would say that that pain is on a par with the childbirth, the initial flare, where it, you know, it takes your breath away - so I will try anything if I think it'll work to be honest.

Sam would have liked the opportunity to discuss possible long-term effects with her doctor.

She just said that I'd start off on the lower dose, see how I go with that, and if needs be they'd pop me up but there was nothing - there was nothing on what the long term effects then could be. But then I suppose they - every case is different and you know you play it by ear really. But I would have liked to have known a bit more because then I could have asked questions there and then, rather than go on the net and look and think, “Oh my god, am I going to be like this? Is this how it's going to end up? And how long is it going to be” and I think if they were able to set my mind at ease a bit more, rather than have to read up on things.