The attacks were so bad that he had to go under the knife twice, a gout patient reveals.
Oh my gout
He was 15 and at first, he thought the swelling and pain on his right foot was because he had sprained a toe. But a blood test revealed he had gout. "When you're so young, you don't expect it," said Mr Tan, now 40 and a manager in the IT line.
The diagnosis of gout when he was 15 did not come as a complete surprise to him. Other members of his family, including his father and paternal grandmother, also had gout, which is a hereditary ailment.
The gout attacks, especially in his right knee and toes, grew more severe when he was in his 20s and mid-30s. He suffered excruciating and throbbing pain even when he was seated or lying down. He had up to two attacks a month, each lasting three to five days. He struggled with the pain and had to limp to work, recalled Mr Tan.
He was prescribed medication like allopurinol to control his uric acid levels and colchicine to stem the inflammation. At times, the medicine did not work and the inflammation in his joints would cause them to swell from the accumulation of fluid. When that happened, he needed a doctor to draw the fluid from his joints with a needle. Sometimes, the swelling would be so severe that his right knee would end up totally "locked". Twice, he needed to have the fluid and crystals cleaned out surgically.
Mr Tan's gout is under control these days and he has not had a severe attack in the last four years. He takes his medication and watches his diet diligently. "I make sure I stay away from high-purine food such as animal organs, tofu and sardines," he said. The bachelor, who is overweight, also hopes to shed some kilos to stave off other chronic diseases.
Risk of kidney failure
Gout has been associated with various diseases. For example, patients with gout are at a higher risk of kidney problems. They tend to have higher uric acid levels which the body would need to excrete, said Dr Angeline Goh, a renal medicine consultant at Singapore General Hospital. With more acidic urine and most of the uric acid remaining in an insoluble form, this predisposes them to developing kidney stones. Up to a quarter of gout patients have associated kidney stones, said Dr Goh. High levels of uric acid in the body can lead to renal failure.
Gout and heart disease
Gout has also been associated with cardiovascular conditions and may be an early indicator of heart disease. A Dutch study published in the journal Family Practice in 2003 found that 43 per cent of gout sufferers had high blood pressure compared to 18 per cent in the non-gout group. The study also showed that the cholesterol level and diabetes incidence were higher in those with gout. However, there is no clear link that gout causes heart disease.
It has been difficult to study the exact impact of gout on the risk of heart attacks as some factors that cause gout, such as obesity and high blood pressure, also cause heart attacks, says a local doctor. What is important is to control the traditional risk factors for these diseases, such as hypertension, diabetes, smoking, cholesterol levels and being overweight, he says.
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