Gout under the microscope - needles of urate crystals! OUCH!
Gout is one of the oldest diseases in the medical literature; it has been around since the first recorded case in the time of the ancient Greeks. I always thought that it was one of those “old people” diseases often depicted in comedic sketches or on Saturday Night Live. I clearly didn’t know that Gout was truly not a laughing matter, but a debilitating condition that can cause immense pain and discomfort.
It is now something I suffer from occasionally as a side effect of the diuretics I take for my heart, and the first attack came in the hospital days after the LVAD was implanted. More than likely a result of the rapid filtration process I had to undergo to get rid of the 40+ pounds of edema from my body prior to the LVAD being implanted.
Gout is inflammation caused by monosodium urate monohydrate (MSU) crystals. Urate initially precipitates in the form of needlelike crystals. Under a microscope, the light-retarding (phase-shifting) characteristics of urate crystals allow them to be recognized by polarizing microscopy (as shown in the photo). That is also what it feels like in the area being attacked. In my case it typically starts in the joint of the first “knuckle” of the big toe on my left foot. It then spreads to the top of my foot and up to the ankle. My whole leg usually then becomes sore as I try to compensate for the foot pain and limp or favor my right leg. It helps to put my foot up, but only if immobilized. If I shift my foot in my sleep the pain will wake me up.
If Gout is left untreated, the crystals can actually destroy the joints where they have infiltrated. Not a fun thought when I have other issues to worry about! I need to officially apologize to anyone that I chided as being a “baby” over plantar fasciitis I now understand your pain!
There are several treatments for Gout. Most being of the steroidal variety and a nifty little pill called Cochisine that does wonders in clearing attacks up for me. Natural options are to make sure you are hydrating properly and urinating regularly to excrete the acids. Also, many foods containing purines are said to increase the chance of flare-ups and that a diet that reduces purines can aid in fending off attacks. Some of the high-purine foods to avoid are: beer, yeast, sardines, herring, organ meats (livers, kidneys, sweetbreads, legumes, meat extracts (consommés & gravies), asparagus, mushrooms, cauliflower, and spinach. As I always like to say in dieting: with all things – moderation. Have you had problems with gout? Please share below.
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