The affliction of kings brings an editor down low

by Brian Clarey

I’m in agony. My left foot is swollen like a fat man’s fist, the big toe full as a sausage and the ball underneath throbbing like an alien pulse. When I stand and the blood rushes to my appendage it reawakens raw nerve endings and brings the kind of pain that makes my hands shake. When I try to walk each step conveys a thousand needles that jab into the ligatures connecting my toe to its foot. I have considered home amputation of this toe – how I would do it, where I would make the first cut – and then passed out in fevered pain. It’s been like this for five days now, and it’s my own damn fault. Like Ben Franklin, Thomas Jefferson, King Henry VIII and my own father, I suffer from occasional flare-ups of gout. And the pain is incredible, enough so that when talking about this malady I give it the respect of a definite article – I call it “the gout.” I’ve broken bones, endured concussions and cuttings, been bitten by spiders and stung by bees. I’ve torn off toenails, had my fingers smashed in doors, had my mouth and nose bashed in for me a time or two and, once, years ago, took a tumble down a hill on the Georgetown University campus that scraped all the skin from one side of my face. The gout makes pikers of all these insults and injuries. It is the purest form of pain I’ve ever endured. They call the gout the “rich man’s disease,” the “affliction of kings,” because its onset is preceded by… overzealous… ingestion of red meat, alcohol, shellfish, sugar – all that good stuff. To fully understand the disease, one must harken back to rudimentary biology: the pH scale and the principles of acidity and alkalinity. Rich foods are generally acidic in nature, and their consumption lowers the pH assignation of the consuming body. When the bloodstream becomes overly acidic, it cannot fully absorb uric acid, an organic waste compound of carbon, nitrogen, oxygen and hydrogen (C5H4N4O3). Undissolved uric acid then collects in the form of crystals in the bottom joint of the big toe. The effect is threefold: The sharp crystals more or less shred the cartilage and tendons in the toe joint; then the area swells and becomes sensitive to touch, pressure, even a good breeze; finally, in prolonged afflictions, the muscles in the area begin to cramp and sieze, and you can’t massage them… because of the gout. I first became afflicted with this form of arthritis about 10 years ago, when most of my work was done on my feet, and I blamed the pain and swelling on hard labor and improper footwear. My wife, a naturopath, identified it as gout about five years ago and showed me how easily controlled it was by reducing my intake of booze, cigarettes, coffee, red meat, processed foods and other things I love. I am not a chronic sufferer – I have had three bouts in these last five years, and the one against which I now clench my jaw is not even the worst. I’ll tell you about it: It was four years ago, when I was doing a lot of travel writing, and the pain grew worse over four days. I brought it with me on assignment to Harkers Island for a boating story I was writing and spent the day crunching ibuprofen and leaning on my cane. Yes, my cane. From Wikipedia: “Gout was traditionally viewed as a disease of the decadent and indolent, because the foods which contribute to its development were only available in quantity to the wealthy. The stereotypical victim was a lazy, obese middle-aged man who habitually overindulged in rich foods and alcohol, with port wine consumption often cited as a specific cause. This stereotype is especially evident when gout is referred to as ‘The Disease of Kings.'” Kings my ass. These days, I’d argue, the gout is more prevalent among those who eat cheeseburgers and drink domestic beer, available in quantity to just about everybody. In the United States it’s twice as common in African-American males as Caucasians, and occurs with some frequency in New Zealand and the Pacific Islands. Maybe because they eat so much Spam? But I hardly consider myself a prime candidate. I exercise. I eat raw food. I eat red meat maybe three times a week and I weigh less than I did after my freshman year of college. But then…. My affinity for beer is well known, as is my love of cigarettes and roast beef. Also, at 37 years old, I could technically be considered middle-aged, as horrifying as it is to think of myself as such. And for most of my life I didn’t take very good care of myself because, let’s face it, I didn’t think I was going to live this long. No matter. For now I’m drinking cherry juice and staying off the booze. I’m keeping still enough so that the uric acid crystals in my toe don’t do further damage to the joint. I’ve got a list of alkaline foods and I’m eating them – last night I had a raw organic beet for dinner. And from now on I’m gonna accord the gout the respect it’s due.