WHEN A VEGAN GETS GOUT
A mysterious pain in my right ankle woke me up one summer morning as insistently as the fire department hammering on the front door. Tylenol did not help and by noon the ankle was the size of an eggplant, but bright pink. The pain felt like the worst sunburn you have ever had in your life combined with the sort of explosion of agony you feel when you bang your shin on a stone coffee table.
I lay on the floor, panting, sweating and staring up at the ceiling until the arrival of my partner at the time, a home health aide possessing the sort of physical strength you see in people tearing a car door off its hinges when it is about to explode. She threw me over a shoulder, walked down two flights of stairs, set me down in the back seat of her truck and drove me to a podiatrist’s office. There they took blood, X-rayed the ankle and did an MRI on the ligaments.
I sprawled diagonally in a reclining chair while the doctor prepared a cortisone shot for my ankle. “This is going to hurt,” she said. I nodded and looked away as she applied a numbing agent to the area.
“Are you in?” I asked after a moment. “Yes,” she answered. “Ha. This isn’t so bad.” She hit the bull’s-eye a second later and I let out a shriek like Robert Plant at the fade-out of “Whole Lotta Love.” But the swelling in my ankle ceased and the pain almost completely disappeared.
“You have gout, my friend.” she said. “I have what?” It seemed impossible — I had been vegan almost five years to the day my foot blew up. I had heard of gout, sure, listening to Ben Franklin’s character sing, “A farmer, a lawyer, and a sage/A bit gouty in the leg” on the “1776” Broadway cast album. But I thought it was something kings in the 18th century contracted from overdoing the mutton.
According to pamphlets my podiatrist gave me, though, gout is something some middle-aged people, mostly men, get from eating large amounts of red and organ meats, shellfish, consuming too much beer, not looking after their weight, or a combination thereof. None of this applied to me except the age thing. My blood test confirmed the doctor’s suspicions; monosodium urate monohydrate crystals had gathered at my ankle like unwanted relatives.
The cortisone allowed me to walk normally by the next morning and in my mind, the doctor had fixed the problem. But over the next three years I would suffer increasingly ferocious, unexpected attacks in both ankles, both big toes and both knees. The flare-ups sometimes lasted weeks despite flooding my body with as much water as I could hold, popping a daily crystal-busting allopurinol, and following a prescribed, puzzling diet.
No more quail or pigeon? Fine. But black beans, spinach, asparagus, raisins, chickpeas and hummus, all heart-healthy stuff I had been eating for years, had to go, too. The first cortisone shot I got was also my last, not only because of my memory of that needle, but because cortisone, used long-term, can cause problems, including damage to the cartilage near the injection, and I am a very active person, or was when I got my first attack. There was nothing to do, finally, but shake hands with this new, unplanned and unwelcome thing in my body, then fight it with everything I had.
I read all I could find about gout and pain management, following instructions to breathe, to be still, to “be with the pain,” to give it a name, a shape and a color — and to “center.” I got my daily exercise, too; when my knees, feet or ankles were swollen to three times their normal size, I used dumbbells to do curls, flies, military presses and other weighted exercises while seated on a bench, my cane on the floor next to me. I saw no choice — I had a life to live, articles to write, money to earn, songs to sing, family to see and friends to socialize with. I made no public announcement on any social network. I just felt I had to limp forward and not let gout destroy everything else in my life.
Sometimes centering worked, though, and sometimes it did not. I am a musician/performer and occasionally I wore my red fedora and did little hat-andcane dances at my live shows. At other times, alone in my car, I freaked out and screamed and cried at my knee or foot or toe. I imagined a red light down there and a traffic jam for miles, horns blowing, crystals getting out of their cars, arguing with each other and banging and kicking the walls of my joints in frustration. I wanted to saw the engorged limb off and throw it far, far away.
Going out in public required becoming hypersensitive to mobs at the supermarket or on the street. People, lost in their phones or thoughts, all seemed to head straight for me. At times I had to raise my voice or extend an arm as I could no longer instantly swerve, twist, back up or otherwise dodge those who emerged like jack-in-the-boxes out of stores or subway doors. People walking several dogs, skateboarders and the bicyclists zigzagging on sidewalks all had to be avoided, too. But in time I would notice them from a distance and take defensive action in advance, like you would when observing a clueless driver on the freeway. I did not expect the whole world to drop everything just because I had gout.
The disease taught me a few things. Involuntarily slowing down to a snail’s pace in public produced a new and different world before me, a world that included, for the first time, meeting the eyes of all the people like me, people on crutches, holding canes and getting around in wheelchairs, moving slowly through a tsunami of 100-milean-hour humanity that did not always notice or care if others were sick or lame.
When my gout blessedly receded a year ago, in what I hope is for the last time, I did not speed up right away. I was grateful to wake up each day, survey my body with my eyes closed and enjoy the exquisite awareness of being pain-free. I may not have learned to completely “be” with the gout during those times it set my joints aflame, but I came to appreciate the change of pace and attitude it required. It is more difficult to play a guitar solo at a slower tempo than a fast one, and there is much to be found in the spaces between the notes.