Vic

Age at interview: 75

Brief Outline: Vic’s gout began while on holiday around 25 years ago. He did not want to take allopurinol at first but began taking it after a very bad attack. He now feels more in control of his gout and tries to just get on with life.

Background: Vic is married and lives with his wife. He works as a self-employed lecturer. Ethnic background/nationality: White English.

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Vic’s gout began with a sore ankle, which progressed into pain and swelling, just before he was due to go on holiday. While on holiday, he stubbed his toe, which was so painful he went to see a local doctor. The doctor confirmed Vic’s thoughts – that it was gout – and gave him an injection and some tablets, which improved the pain. He didn’t have another attack for 4-5 years.
 
When the attacks started again, his GP suggested allopurinol. Vic was concerned about the side effects so didn’t want to take it, He used colchicine but this gave him terrible side effects. He eventually started using arthrotec, an anti-inflammatory. However, after one attack where his foot swelled really badly, he started taking allopurinol. He found that there were no side effects and is happy that he is controlling his gout.  He has since had only one very bad attack which he linked to eating too much seafood on holiday.
 
Vic had two great aunts who had gout. He recalls his father saying that they were very embarrassed about it, because they didn’t drink. Vic tries to avoid drinking bitter (beer) and eating too much seafood, but, other than that, does not feel restricted. He tries to get on with his life, considers work to be a diversion and has developed strategies, for example, for going up stairs.
 
He uses the internet for information but is aware that some of the information is contradictory and unhelpful. He would have liked more information on allopurinol, particularly around it being a relatively safe long-term solution. This might have encouraged him to start taking it earlier.

Vic tried colchicine and various NSAIDs but they gave him digestive problems. He was then prescribed Arthrotec.

It went on for some time, taking colchicine when it was really bad, but unfortunately the side effects of colchicine are even worse, in that vomiting and diarrhoea is the point at which you stop taking the medication. 

I’d started to take NSAIDs after that, because once the major problem’s gone it’s still painful for some time afterwards, but they gave me digestive problems. Eventually, we settled on a drug called Arthrotec, which is an NSAID, but it’s also got a gastric element to it, so you can take it and it doesn’t give you the side effects. 

Vic said the pain was the worst he’d ever had. He had to ‘work up the courage’ to put his foot down and take a step.

The worst pain I’ve ever had. I’ve broken bones that haven’t hurt as much. At its worst you can’t bear anything on it, not even a bed sheet. You have to kick off that end of the bed. So even in the freezing cold, that foot has got to be out of the blankets. Quite often, when it spreads up the leg, it’s very difficult to find a position where you can actually lay, that it doesn’t hurt. Even if it’s not touching anything, it’s still got to lay on something. It does tend to, pulse with the heartbeat, and so you don’t need to take your pulse, you can feel it. Yeah, that’s it. For a man I don’t think there’s a description, like the woman saying that, “it was worse than childbirth”. 

It’s painful. I mean I would get out of bed, and literally stand there, just working up the courage to take a step. Once you start taking the steps, after a few, it’s down to a level where you can carry on then, but that first two or three steps are – you think that if you put your foot down you’re going to fall over, because you can’t, you can’t stand it. 

Vic is mindful of time when he sees his doctors, though he knows they would make more time to talk if he needed it.

Is there anything that you can think of that would improve the experience of living with gout, either for you or for other people, in the future?

Knowing that the solution to it is not as dangerous in the long term, as I thought it was, much earlier on. So more information I think about what you can take and how long you can take it without seriously having side effects. I would’ve taken it much earlier. 

Is that something that you’ve ever had explained to you?

No. No, I – given that our doctors now are on a ten minute cycle, and you’ll get one longer than that if you really want to talk to him, he’ll talk for an hour, they all will. But you are conscious that outside the room there are five other people that should be in this room, and you should be long gone. So it does inhibit you in yourself, but they will talk if you want to. Once you’ve got a solution, what’s the point of going back? It’ll be something else you’ve got next time.