Ian

Ian was diagnosed with gout in 1996. He had attacks every few months in his knees, ankle, wrist and elbow, and managed these with diclofenac tablets and ice bags. In 2010 Ian started taking allopurinol, and has not had an attack of gout since.

In 1996, Ian woke up in the morning with severe pain in his big toe. He could hardly walk, and thought that he might have broken his toe. He went to see his GP who did some blood tests and prescribed diclofenac to reduce the pain and inflammation. The results of the blood tests came back two weeks later, and Ian’s GP told him that he had gout. Ian did not have much knowledge of gout, but was aware that his Uncle had suffered from it. He was relieved to have a diagnosis of gout rather than something more serious or life threatening. By the end of the first day of taking the diclofenac tablets, Ian’s pain had substantially reduced.

Ian continued to get attacks of gout every two or three months. Each time he would take diclofenac tablets. Initially the attacks were in his feet, but from 2000 onwards, he began to get attacks in other parts of his body. He had attacks in his knees, his ankle, his wrist and his elbow. He remembers the attacks in his wrist and hands as being particularly painful and difficult to manage.

Ian could recognise the pain of gout straightaway. It started as a dull pain and then grew in intensity over a period of two to four hours. The pain of gout was the worst pain that Ian can remember ever having. It was painful even to have a sheet resting on the affected joint, and felt like being stabbed by a knife. Walking was difficult and painful if Ian had an attack in his foot, and other attacks meant that Ian’s work activities like writing or typing were severely restricted. He was sometimes unable to drive.

Ian found that, as he had more attacks, the pain would take longer to stop. After taking diclofenac, the pain would dull progressively over time, but it would take at least three days for it to stop completely. Ian found putting a bag of ice on the area was helpful for pain relief. He tried to remain active during an attack, and felt that this helped him to recover more quickly.

In 2010, Ian went to see a different GP, who did a blood test and told Ian that his levels of uric acid were high. He suggested that Ian should consider taking allopurinol on a daily basis to prevent attacks of gout from occurring. Ian was initially concerned about taking a daily tablet because he believed it was better to try and have a healthy lifestyle and diet than to take medication. After discussing his concerns with his GP, Ian decided to start taking allopurinol and has not experienced any side effects. He now takes 300mg daily.

Ian has not changed his diet or consumption of alcohol, but believes that it is important to have a balanced healthy diet. In the past he tried eating celery and drinking cider vinegar, but did not find that they made a difference to the number of attacks he experienced.

Allopurinol has exceeded Ian’s expectations because he has now been taking it for three years and has not had an attack during that time. He still has concerns about the implications of being on a long-term medication, and has regular health checks with his GP to monitor his situation. The inevitability of getting an attack would play on Ian’s mind in the past, so it now gives him peace of mind to know that he is unlikely to get an attack.

Ian’s first few attacks were in his big toe joint. He then had attacks in his knees, ankle, wrist and elbow.

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Ian travelled to work in London despite the pain. Typing and writing were very difficult when he had attacks in his hands.

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Ian feels that GPs need to understand how painful gout is. They need to think about preventative treatments, not just treat the symptoms of an attack.

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Ian woke up one morning with severe pain in his toe. He made an appointment to see his GP even though he could hardly walk.

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Ian learnt to recognise the first signs of an attack. He used ice to cool his joint and found that moving around was helpful.

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Ian did not tell his first GP about all the attacks he was getting. He now wonders if he should have asked his GP for more information about treatments.

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Ian feels that allopurinol has been very effective for him. Gout no longer affects his everyday life.

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