Harry
Harry was diagnosed with gout in 1966. He was prescribed colchicine, but had an allergic reaction to allopurinol. In 2010 he was referred to a specialist. Harry now takes febuxostat every day, and has not had an attack of gout since 2011.
Harry was diagnosed with gout in 1966 at the age of 31. The date sticks in his mind because his first severe attack occurred during the World Cup. Looking back, Harry now believes that he may have been experiencing symptoms of gout before his diagnosis. He regularly played sports like badminton, cricket and rugby, and often found that his toes were red and sore after playing. At the time, he attributed this to the exercise or believed that he had been kicked or injured himself, and the symptoms would disappear within two or three days. When Harry had what he describes as his first severe attack’ in his big toe joint, he visited his GP who told him that he had gout. He was prescribed colchicine tablets to take each time he had an attack. Harry found that taking colchicine on its own took a few days to have an effect, so he also took co-codamols as well.
When he was first diagnosed, Harry’s priority was to be pain free. He did not realise that gout was causing long term damage to his hands and feet, and he now finds it particularly difficult to grip with his fingers. He believes that people should be more aware of the long-term damage that gout can cause to joints if it is left untreated.
Initially, Harry was getting attacks around once every two years but the attacks became more severe and more frequent. Harry went back to the GP and was prescribed allopurinol. The day after starting allopurinol, Harry had an allergic reaction. The skin all over his body became red, and then peeled off. His GP advised him to stop taking allopurinol immediately. Harry’s GP then prescribed various medications, such as diclofenac and probenecid, but Harry felt that it was always just a firefighting exercise’ where he would have an attack, take tablets to deal with the attack, and then wait for the next attack.
Harry tried changing his diet, but what he ate did not seem to have any effect on his gout. He also tried various herbal remedies, but did not believe that any of them worked.
By 2009, Harry was having attacks of gout around every six months. He describes the pain as being excruciating, and like having his toes sawn off with a hacksaw, without anaesthetic. His attacks had increased in severity, as well as frequency, and he was experiencing symptoms in his hands and knees as well as his feet.
Harry felt that having gout affected both his leisure and social activities: he had to stop various sporting and social activities, and lost touch with friends and ex colleagues. Harry also felt that having gout affected the people around him, such as his partner, because he would become miserable and short tempered’. Other people wanted to help, but Harry would be reluctant for them to do so in case they touched him and caused him pain. He felt frustrated because he couldn’t walk or drive the car, and so he had to stay in the house. He also felt that his partner was more reluctant to go out because she did not want to leave him at home on his own.
In 2010, Harry developed what he believed to be an infection in his toe. However, his GP confirmed that it was a tophus caused by gout. At this point, the GP referred Harry to a specialist. Harry remembers having to wait quite a long time to see the specialist initially, but then saw him regularly for about two years, until his gout was under control. The specialist discussed the possibility of Harry starting on a very low dose of allopurinol and gradually building it up, to try and avoid the allergic reaction, but proposed that Harry started on febuxostat as an alternative. Harry wishes that he had seen the specialist earlier. He now takes febuxostat tablets every day, and feels that his gout is under control. He has not had an attack since the middle of 2011.
Harry was happy with the support he received from his GP and the specialist, but he feels that now his gout is under control, there is no follow up or monitoring. Harry suggests that regular annual or biennial reviews by his GP would be reassuring, to ensure there are no other issues arising from taking long-term medication.