If I have got a problem with the gout, I ring up and make an appointment with the GP and hes, hes right onto it and, he knows and he gives me all the support I feel require, you know, and I can go there and talk with him and say, “Well, this is happening and I’ve taken this pill,” be it the new one. “It doesn’t seem to be working.” “Okay, well let’s look at the strength.” These are 500 milligram I think. This is just an example. If I want – if I was found the tablets weren’t taking away the gout or the pain of the gout, I can go to him and say, “I’ve had this effect. It’s not clearing it away as quickly as I would hope. What about changing the strength of the tablet, be it up or be it down?” you know. And hes, hes quite prepared to listen to you and, and take the appropriate action.

Unfortunately, I’ve struggled to see the same GP each time, which I think is one of the issues – that I’ve always been able to get appointments, but not necessarily with the same people, and so you often start again. I actually don’t feel they have a great un I think they understand what gout is, but I don’t think they have the understanding from a patient’s perspective. To me it’s like, Well, you’ve got gout. I’ll give you this drug. Bye-bye. Please don’t come back. That’s the feeling I get. And when I, I think I’m a disappointment when I come back and say, Well, it’s not really better. I think that really is I think that’s my feelings about it.

How many GPs, roughly, do you think you’ve seen in relation to your gout?

Five or six.

So at the point when you were in your third sort of episode, when it was going on for quite some time, you were seeing different.

Yeah. Each time I went, I saw somebody different who seemed to take a it was like, That drug’s not worked; I’ll give you one that will work. That was the message I got every time.

I find a lot of support with my rheumatologist but sometimes, you know, I cannot – I cannot take away from me that sometimes if I had an attack and go to the GP and ask for an off sick note, sometimes – which is I really don’t want because I really treasure my job as well – sometimes you’re a bit worried that they’re just thinking that you’re not really in pain, you know. Because theres people, I know that they know, but the thing is I’m not – I’m notit’s just like I’m quite worried as well that getting some, those kind of things that they consider me not fit to work, I really have to explain it to them always, every time I go to them, every time I went to them, I really need to explain them that, I can’t really handle to go to work so I need an off. I don’t know what they will think of me but the thing is, it’s the real thing, yeah, because I’m not only working – I’m not working at a table, in a – in a job that involves you only going to sit, but I need to work which I really have to do physical things inside a warehouse, soit’s quite – affecting me as well. Yeah.

So you worry that your GP doesn’t

Won’t believe me.

doesn’t believe you?

Yeah, yeah. I always think of that, that my GP won’t believe me, that I was really in pain, that I was only making an alibi or something like that.

I could easily see why people who aren’t aware of the causes of it actually making that sort of comment, that sort of diagnosis. That I think ought to – that ought to change. Yeah. Because theres – theres an assumption as well always when you’ve sort of got – when you’ve had a bout of gout that it’s – that it’s down to drinking too much. That is the immediate reaction. And then you get the questioning of the, you know, Well, how much do you drink and do you know what the guidelines are? and all the rest of it. And that I think, I think that should change really. But I suppose what I’m implying is that people – that the GPs aresort of unsympathetic, and maybe regard it as being a self-inflicted wound.

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, hell 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.

They don’t even say, Well that’s you, you’re going to get it for the rest of your life. It’ll come back periodically. No, they don’t. It’s just, You’ve got gout, heres a prescription. And that’s it. No. You’re not informed. Not, not even a leaflet.

The way that you’re treated it’s just, Heres your tablet get on with it. They’ll name it, You have gout. And that’s it. Here, take a tablet. You know, but what causes gout, you know, nothing like, This is the reason that you’ve got it or I’ve no idea. I don’t know if they know anything, you know.

I can’t complain at all, from the support that I’ve had, both from the GP who initially sent me to the specialist and from the specialist himself, my treatment has been superb – no complaints at all. They’ve all been most helpful while in the process of keeping it at bay, I’m reluctant to say curing the problem, I don’t think the problem is cured to be honest, I think it’s under control, but once it’s under control, then fine. I think that sometimes the aftercare may be a little sketchy. If for instance, even if it’s only say once a year, they were to say, Well well give you five minutes, how have you been? Have you had your blood tested? Yes, you’re doing all right, come and see me again in a year’s time. Just that sort of comfort factor that you haven’t gone right through the net. And if something were to flare up again that they’re there for you if needed.

I have the pill swallowing problem. I haven’t found doctors that have been really sympathetic. They say, “Well then, just melt the pill in water,” which is what I’m doing now because they’re saying, for example, for statins – my cholesterol is not good, related to the diabetes. And they – and I tell the doctor, “Look, see my sugar is getting better because I’m taking the, the sachet, the powdered stuff. I’m not taking the pill obviously because I really – I gag when I I’ve gagged with colchicine, and colchicine is the size of an aspirin. I have to melt my colchicine. So what about those pills that are this size, obviously I cannot. So they say, “Oh, then melt it.”

But the thing is, you know, it’s – okay, I’m in a restaurant, I have to take the pill. “Err waiter, can I get some warm water and an extra glass and a teaspoon, please?” in front of everyone because I need to melt my pill. So that’s what – and if they say, “Well, it’s so expensive in NHS,” well I think the thing is I say, “Well, my taxes go there, and actually I’ve computed I’m still paying for that properly with my taxes.” But then obviously that argument doesn’t win. So the thing is just for me it’s, it’s just good to – for some doctors to at least recognise that actually this person is taking different sorts of, of medication, you know. It’s part, I mean because then it’s either my cholesterol still is very bad, it is still very bad because I still don’t take statins, or, or they just give me something that I can actually take and then get on with my life. And they haven’t done that. And they don’t have an answer to me when I say, “Well, I really couldn’t swallow the pill. I need something,” and then they say, “Well, melt it.” That’s their best answer. So for gout it’s the same. It’s, “Melt the pill.”

The first doctor, he was a rheumatologist, top rheumatologist man. He was very, like I said, brilliant, absolutely tremendous. And then he said, I can’t do any more, and then he passed me over to the doctor I’m under now, and hes a – he specialises in gout. And I hes that good he I haven’t got an appointment, I mean, I’ve got a if I haven’t got an appointment and I’ve got it, I can pick the phone up because his secretary now, I know her now, I know her by name, pick the phone up, I phone his secretary, Hang on. Shell have a word with him and hell fit me in tomorrow or, I haven’t got an appointment, so, Just come and tell them. And hes smashing, really, really I said to him, If I paid to go private, £1m a year, I wouldn’t get as good a service as that, you know, that’s how, how good.

And does that make a difference?

It makes a hell of a difference, yeah, hell of a difference to… Because, some of the doctors I mean, they’re all doing a job, I’m not knocking them at all, but if I’ve got an appointment to see somebody in three months’ time, then the three months is three month. But I can pick the phone up now, I could phone his secretary and say, I’m having a bad, I’m really, really, and hed see me at his next clinic which is probably tomorrow. Tomorrow or the hes even given me I’ve got a number, a card with, his card and number. I can phone the day clinic up and just give them my name and they’ll have me in there and drain me off or yeah, it makes a hell of a difference to know theres somebody there who, is thinking, I’m not saying the other doctors aren’t, but he is, thinking about you and hell be there at a drop of a hat. Yeah, yeah.