A bout de gout...

Well here I am in the throes of another bout of suffering and self-pity. What started out as a very slight discomfort in the first metacarpal of my big toe a couple of weeks ago, eventually grew somewhat falteringly into a full-blown inflammation of my right foot, with all its attendant agony - hopefully reaching its final crescendo last night.

For those who have never suffered the affliction of gout, when the pain is at its peak (which invariably comes on during the night), it manifests at several levels. There's an all-pervading throb that emanates from the swollen joint, radiant with inflammation: this totally saps one's energy and is impossible to ignore - like a nagging toothache. And then there's the searing agony caused by the slightest movement or involuntary muscle spasm. And just to add to the fun, the effort of consciously trying to keep absolutely still often brings on a simultaneous attack of cramp!

When at its peak, even the best pain-killers only seem to take a little off the edge of the pain, and it's quite natural to irrationally fantasise about how much better a prospect amputation would be...

And one of the most annoying things about the whole thing is that there are no external agents to blame for the suffering - it's entirely due to the failing of one's own body chemistry. What happens is that urates in the blood produced by the digestive system start to form uric acid crystals in the soft tissues of vulnerable joints, prompting inflammation. As the crystals grow, any slight movement of the joint makes them tear at the inflamed tissues producing excruciating pain. Uric acid is relatively insoluble and so once formed the crystals take several days to disperse even if/when the blood urate level has returned to a tolerable level.

Particularly galling for me is that the factors that normally render someone vulnerable to gout are: being obese (okay I'm slightly over the "ideal" range for my height-weight bell curve); eating too much red meat (I'm vegetarian); and drinking too much ale and red wine (I'm a moderate cider drinker). Indeed my blood tests have indicated a relatively innocuous level of urates relative to that normally associated with the condition.

So it seems I'm one of those rare unlucky people who's prone to gout even with relatively normal urate levels. The consequence of which being that the benefit of preventative medications (such as allopurinol) which act by controlling blood urates is likely to be of questionable efficacy for me.

I will treat this latest episode as an incentive to lose a little of my excess weight and cut down more on the alcohol, but can't really start on that til I'm mobile again and in the mean time I'll just continue to feel sorry for myself... :-(

The Bad Samaritan

Many years ago I heard our front door bell chime late one February Saturday afternoon. At the door was a man in his late 30's who totally fitted the stereotypical look of a born-again Christian wearing a camel-hair coat over a tweed suit, along with a grey woollen scarf to keep out the winter's chill as it was overcast and bitterly cold. Accompanying him was a young boy of about 9 years old. The lad - presumably his son - was well wrapped up but it was nevertheless evident that he was really feeling the cold. He stood back behind his father shivering - just staring at the cold concrete path with only the occasional shuffle of his feet. Sure enough the man opened the conversation by asking me if I'd ever stopped to think about what life was all about and whether I was looking for a deeper meaning to my existence. He removed a pair of smart lined leather gloves to make it easier for him to flip through a Bible he'd been carrying to find the bookmarks he'd inserted to locate his favourite morsels of ancient wisdom.

While the man started to quote Biblical platitudes, I looked down at the child and wondered whether his knitted mittens would be so effective for keeping out the cold. I wondered whether to invite them into the warmth of the house, but then - it shames me to say - was struck by an intense wave of cynical irritation. "Has this guy just dragged the poor kid along for emotional blackmail - to goad his targets into letting them into their homes?", I wondered. "Well I'm certainly not falling for that!"

So I politely but curtly explained that I wasn't interested in his religion or his messages of salvation and bade him an assertive goodbye, whereupon he and the boy trudged off apologetically and somewhat dejectedly to the next house on the street.

Almost 20 years on I still feel bad about having let this cynicism win me over. I'm sure I would handle the situation very differently today. For a start, even if the lad was being used as an emotional pawn (and there's no evidence other than my own suspicion to suppose he was), it wasn't his fault: I should still have invited them in from the cold, made them drinks, offered them food, found the lad some books to read or TV programme to watch whilst I patiently listened to the man's beliefs before calmly explaining to him how much more meaning I find in the world by accepting - indeed relishing - its godlessness. I'm sure it would have given them both some cheer on that bleak afternoon even if they had struck zero on their successful conversion rate.

What is particularly poignant to me now is the fact that of all the Bible stories I was told during my childhood, only one really struck me as truly worthy: that of the good Samaritan. It's a story that really has nothing to do with God - it's just a simple tale of human compassion and how kindness to strangers can overcome adversity. I'd always believed that I would have been like that good Samaritan and extended the helping hand of friendship. Well hopefully next time...