Naresh was playing cricket in 1974 when he started to get pain in his toes. The pain began to get worse and he thought that it must be due to a physical injury. When Naresh got home he discovered that his foot was swollen so he made an appointment with his GP. The GP looked at Naresh’s foot and told him that it was probably gout. He arranged for Naresh to have a blood test to check his uric acid levels, and prescribed some painkillers. He also suggested that ice might help to relieve the pain.

Naresh did not know much about gout, but his GP told him that it was caused by uric acid crystals. He advised Naresh that it might be advisable to avoid certain foods, such as oily fish, and to drink plenty of water.

The blood tests showed that Naresh had high levels of uric acid. His symptoms were better after about 10 days, but three months later he had another attack. His GP prescribed colchicine, and later naproxen, for him to take during attacks, and allopurinol for him to take every day. Naresh did not like the idea of taking long term medication, but his GP told him that if he did not take anything it could cause permanent damage to his joints.

Naresh was born in Kenya, and had never heard of gout there. However, his father had gout when Naresh was a child. Naresh was shocked to be diagnosed with gout at the age of 25 because he thought it was associated with older people, and his father had been diagnosed when he was in his 50s.

Naresh made some changes to his diet. However, the dietary advice he was given in relation to his heart condition conflicted with the advice he was given about gout.
Naresh felt that the pain of gout was like someone poking a knife into him, and it was too painful to have a bed sheet on his foot. He was sometimes unable to attend social events such as family visits or weddings, and felt angry that he could not do the things he wanted to.

Naresh is now retired, but was working when he was diagnosed with gout. He sometimes had to have time off work, and felt under pressure from his employers. Naresh used to enjoy playing cricket, but could not play sports when he got attacks. He also began to get attacks in his knees and arms as well as in his feet.

Naresh has had three attacks of gout in the last 12 months. He takes 100mg of allopurinol every day, and manages his attacks by taking colchicine or naproxen.