Gout.
It has to be gout. I have never had it officially diagnosed, but I know what it is. Maybe I’m embarrassed to hear the official diagnosis. Maybe I’m pissed that I have something commonly known as “rich man’s disease” without actually being rich. Or maybe it’s just my penchant for not wanting to go to the doctor. But the pain in my left big toe is familiar to me – I’ve had this before.
About six years ago I had a friend from out of town come to visit me. We were walking around Boston and I began to feel an annoying pain in my toe. Sitting down at a local bar for lunch amidst a group, the pain became excruciating. It was so bad, that I had to excuse myself an go home. I didn’t know what it was, but coincidentally I had just purchased new shoes, and so I blamed it on them and thought nothing more of it.
A year later, the pain returned. This time it was unexplained, and I started googling things and came up with a self-diagnosis of “gout.” It’s a build-up of uric acid in the blood stream that crystalizes and causes excruciating pain in joints – usually the big toe. The word “excruciating” is certainly appropriate. At night, even if the sheet rests on my foot the wrong way, the toe screams out in pain. Sitting at my work desk with the distraction of a busy day, the pain is still omnipresent and will cause me at times to burst out in a random sweat. And running? Forget about it. I am lucky I can make it from my car to my desk in the morning.
After the initial flare-up six years ago, I had another two or three of them well-spaced out across the next few years. The worst of the pain typically lasts 2-3 days with a couple of days of annoying pain on both the front and the back end. I hadn’t had a flare-up in a long time – over two years. In that time frame, I’ve dropped about 60 pounds and got into marathon-shape. I thought that perhaps this disease was behind me, but apparently not.
The causes of this disease are typically vice-like in nature. Excessive alcohol consumption, high blood pressure, and eating shellfish to name a few. In trying to recreate what might have sparked this recent flare-up, I did notice an uptick in my recent alcohol consumption, likely compounded by my weaker tolerance given a year of marathon training and weight loss. I did have shellfish – albeit only one shrimp that I stole from my daughter’s shrimp cocktail. One day last week I drank 3 large Dunkin Iced Coffees – I don’t know what I was thinking, but all that caffeine could not have helped my blood pressure. On that note, my stress-levels are through the roof due to recent personal circumstances which probably don’t belong in the public domain.
Last Friday I felt the initial pain in my toe. I don’t like taking medicine unless it is absolutely necessary, so I iced it down Friday night and went to bed early. The next morning it was a very minor pain and I was even able to get a solid 5k run in during the afternoon. But then I put down a bottle of wine without properly rehydrating after the run and ate some wonderful tasting, but probably unhealthy food.
Sunday was going to be my reset, and I was in a good frame of mind to do it. I’m five months away from my back-to-back marathons and I had decided that this was going to be the official start of my “marathon training.” Setting my alarm for an early wake-up, I was planning a 10-mile long run. The alarm rang, I got up and was immediately invigorated, knowing that today was the day I was turning things around. I swung my feel off the bed, and immediately realized… “Oh shit, my toe hurts.” It wasn’t yet debilitating, but it was enough to keep me from hitting the pavement that day.
The pain was annoyingly present on Monday and Tuesday, and I went out and played golf on it Tuesday night. I swung the club gingerly, unable to transfer weight to my front toe, but I got around the course okay. Unfortunately, Tuesday night golf is generally followed up by Tuesday night dinner – a beer and a couple glasses of wine plus some calamari probably didn’t help things. When I woke up on Wednesday I was in a completely new realm of pain.
Perhaps I could have fought this thing off had I listened to my body when I got those first pangs of pain last Friday. Maybe rehydrating and eating healthy would have been enough to get me through. Marathon training? No longer a thought in my mind at this point – I just want to get back to walking without a limp. On Thursday, I looked up holistic treatments for gout – stay hydrated, eat lots of antioxidants like cherries, strawberries and cranberries. I am a big skeptic when it comes to the antioxidant/free radical movement, but at this point I was willing to try anything. I popped Advil like it was candy. I iced, I elevated, I slept.
The worst of the pain lasted two days – Wednesday and Thursday. Then it began to wane. It’s now Friday and I’m walking with a very slight and barely detectable limp. I’m still not ready to run but it’s getting close. I’ve gained some weight the past week – some from the lack of exercise and some from the resulting depression of not being able to start my training. But I'll get over it. The important thing is to keep my mind focused and ease into training when the pain subsides. I'm getting close...
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