Horror and Thriller Non-Fiction posted December 3, 2017

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The disease of kings

The Many Horrors of Gout

by Brett Matthew West


Okay, I will admit it. I have been fleshed out by a member of FanStory who will remain anonymous at this time. What occurred was they went online, and from somewhere in my checkered past discovered an ancient series of medical articles I penned in my Freelance Writing life that I called MedicalScene. Then, they challenged me to share at least one of these articles with my FanStory friends and readers. They should know me much better than to do something like that!

The one I chose to share was about an ailment I suffer from TREMENDOUSLY, and that is gout. The picture I used for this article is what you feel like when you are experiencing the pain associated with this ailment. I can testify to that. Been there. Done that. No fun!

The article, exactly as I originally penned it on April 6, 2011, follows. (I have taken the creative liberties of adding some personal comments along the way.) Indulge me if you would. But, most of all enjoy the article.


Gout is characterized by tender, red, hot, swollen joints and recurring attacks of acute inflammatory arthritis. Gout affects the metatarsal phalangeal joint at the base of the big toe in fifty percent of all cases. (Count me in on that one, specifically my left big toe.) In this location, gout is known as podagra, or uric acid arthropathy.

Gout produces joint pains that can last up to four (miserable) hours at a time, as well as during the night due to lower body temperatures then. Gout may manifest as kidney stones, urate nephropathy, renal insufficiency, hyperuricosuria, and uric acid tophus.

Additionally, high fevers, fatigue, chronic arthritis, bone erosions, and high levels of uric acid in the blood, heels, fingers, wrists, and knees may manifest. (My uric acid count was off the chart when I was first diagnosed with the ailment, and I suffer in all these aforementioned areas.)


-crystalized elevated levels of uric acid deposited in tissues, joints, tendons, and the blood. This may result from alcohol consumption (especially beer).

-insulin resistance, genetics, hypertension, obesity, diuretics, renal insufficiencies

-diets, underexcretion of uric acid salts, overproduction of urate, fructosed-sweetened drinks

-seafood, red meats, physical traumas, surgeries (I have had several of those in my time), Familial Juvenile Hyperuricemic Nephropathy

-super activity of the Tamm-Horsfall mucoprotein, the phosphoribosyl pyco phosphate synthetase protein, medullary cystic kidney disease

-the Lesch-Nyhan Syndrome, (Juvenile Gout), the Kelley-Seegmiller Syndrome (that forms stones in the urinary tract), deficiencies in the hypoxanthine-guanine phosphosibosyl transferase enzyme

-aspirin, niacin, Vitamin B3, Cyclosporine and Tacrolimus that are used in post-allogenic organ transplants

-Hydrochlorothiazide that prevents the kidneys from retaining water and to treat hypertension


The diagnosis of gout can be readily made once monosodium urate crystals have been identified in a tophus found in bones, cartilage, joints, the kidneys, nasal cartilages, and other locations throughout the body.

Gout can also be diagnosed in the synovial fluid of inflamed joints under polarized light microscopes. Other diagnostic tools for determining gout include the classic feature of hyperuricemia, through elevated white blood cell counts.

Renal malfunctions, electrolytes, erythrocyte sedimentation rates of red blood cells, the Biernacki Reaction Test, (that determines how much red blood cells sediment in one hour's time), and Synovial Fluid Gram Stains for bacterial organism classifications, can also be useful in diagnosis gout.


Options available for treating gout include non-steroidal anti-inflammatory medications. These are considered the first line treatments for gout. Ibuprofen, indomethacin (that prevents prostaglandis lipids from developing, reduces fevers, swelling, pain, and stiffness), and and protein pump inhibitors.

Another catch-all for treating gout is Calchicine. However, this medication contains some side effects that may limit its use. Gluccorticoids that regulate glucose metabolism, and Pegloticase IV injections (administered every other week), Febuxostat, that prevents xanthine oxidase enzyme activities in purine metabolism, and Probenecid, that increases uric acid excretement, may also be in the doctor's arsenal for combatting the ailment.

Other measures that may work wonders for sufferers of gout include hypourecemic medicines, decreasing meat and seafood intakes, increasing Vitamin C consumptions, avoiding obesity, and limiting alcohol and fructose.

Personally, I swear by Allopurinol for the treatment of my gout. This medicine blocks uric acid production and helps my pain subside. (A small marvel if ever there was one!)


A disorder of purine metabolism, combined with losses of uricase (that breaks down uric acid), gout may be triggered by rapid changes in uric acid levels, acidosis, and increased levels of acid in the blood. Extracellular matrix proteins, articular hydration, collagens, proteoglycans, chondroitin sulfate, chemotherapies, traumas, and a wide variety of surgeries may also trigger episodes of gout.

Acute gout typically subsides in about seven extremely painful days! However, without treatment as many as sixty percent of patients with the ailment will develop a second attack within a year's time. Additionally, all gout sufferers are at a higher risk for diabetes, hypertension, and renal failures.


Reaven's Syndrome (that places the patient at a higher risk of coronary artery diseases), Insulin Resistance Syndrome, Cadiometabolic Syndrome (that destroys joint surfaces), Chronic Gout, kidney stones, chronic renal dysfunctions, tophus in the Achilles tendons, helixes of the ears, and over the olecranon bones of the forearms behind the elbows, are all other "wondrous joys" gout sufferers are likely to endure.

An article I penned several years ago in a series I wrote entitled MedicalScene.

Kill, Kill, by Mr Jones, selected to complement my article.

So, thanks Mr Jones, for the use of your picture. It illustrates so convincingly how gout sufferers like me feel when we are experiencing the pain of our inflictions.

Mr jones is not a nit. He did not place a period after "Mr" so neither did I.
Pays one point and 2 member cents.

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© Copyright 2018. Brett Matthew West All rights reserved.
Brett Matthew West has granted FanStory.com, its affiliates and its syndicates non-exclusive rights to display this work.