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This book is a story about Janice and John or at least a series of essays written by us. We have decided to restore a beautiful monastery complex deep in Umbria, Italy and open a special retreat serving special food and running special workshops. Part of this endeavour is this book and we have decided to call it all Metamorefosi, which is the best Anglo/Italian word we could conjure up for healthy change.

To live with gout and without gout

The things I recall below are my own experiences. I am not a doctor and some of the items may have been spelled differently over the years. References to gout and its mechanisms are found on the web.

As a point of interest the French word gout is translated to mean taste in English.

I was then 30 years old and a very active young man with a blossoming career and expanding range of assets. I woke up early one morning with a stabbing pain in my big left toe. It was weird because it was also difficult to walk because of the pain. Well I trotted off to work thinking this was damage from playing cricket over the weekend, I was a fast bowler and keen batsman and fielder. But it didn’t go away and it started to swell so putting on my left shoe was hard. Not so much trotting now, more of a hobble.

After a few days I decided time to go to the docs. He was a locum and after a brief inspection and chat, he said probably a sport injury, go and get an x-ray. This I did and when I went back we found a mark on the main bone of my big toe. I say we because I used to read x rays in my work as a professional engineer in the oil industry. So I said what do you think it is? Benign cyst he said. We could cut it out but let’s see if it goes away. So I did too.

Trouble was the pain and swelling didn’t go down, so preparing myself to go into hospital I went back to the doc. The locum had moved on and a young man recently graduated from Cardiff University was ensconced. Went over what had gone before. After inspection and chat he said, I know I shouldn’t say this but I think its gout. It never happens in young people and we all knew it was a disease of old clergy who tippled too much sherry and ate too much cheese. So I was sort of proud; I had arrived. Trouble was so had the pain. After finding out the young doc was really excited because he had studied gout for his thesis and he had discovered me, a wonderful rare specimen of gout at 30. What to do? Well he said we can get rid of the pain and swelling with butazolidin (American spelling). As one doesn’t, I didn’t ask any more questions because the doc was an expert on gout and with a medical degree. It worked in the sense the pain went away.

The doc was interested in my case (or foot) I suppose, so he asked if he could chart my progress. Although I wanted to get back to my sport and partying I was rather curious to find out more about gout and medicines.

Basically gout was sort of unique then, as the doc described it, with just one symptom and one effect. Raised uric acid level, uric acid crystals deposited in toe joint (they are reputably as hard as diamonds) manifestation, pain and swelling of big left toe. Hum seems simple enough get the uric acid level down. How is uric acid produced in the body? At that time the mechanism wasn’t as well know but now it’s believed when purine rich foods are taken into the body and metabolised the final breakdown product is uric acid and excess is discharged from the body as urine via the kidneys. So the answer is obvious don’t eat so many foods rich in purines. For many years I was told over and over again gout has nothing to do with diet..

What about the butazolidin, ah well that’s a blood thinner and the pain is caused because your thicker blood presses it way through the swelling, so let’s thin it to get it through. Great, my neck of the woods, real physics and engineering. Now I could ask questions. What about the heart and other organs that still like the blood to be a higher viscosity? Well you might have side effects. He was an expert so side effects must be ok.

Now I was living with gout. 30 years old partying, good income, lots of rich food and attacks of gout. I need to say now, the work I was doing was quite stressful at times too. Oil refineries are dangerous places, nasty gases, high pressures and temperatures, some deaths of workers too because of accidents like fires and chemical escapes. In those days the compensation for danger was good money.

I was also very fit, lots of exercise as well as activities so I decided to play around with my diet. Cut down on some of the stuff I really loved. Cheese, red wine, steak.

Seemed to help but attacks of gout from time to time, butazolidin got rid of pain within a day or two and then back to normal. Everyone is happy. Doctor has work to do. Drug company has sales, expensive rich foods being consumed. This is the way the economy expands and we all get richer. Trouble was the gout was spreading to other joints, could flare up almost anywhere and I had free earrings. Uric acid crystals appeared on my earlobes and I didn’t want my mates to think I was gay. Again my engineering brain kicked it. In an engine if hard materials get into an oil or other fluid system first wear and then failure. Was I going to be crippled?

Ok 10 years on. Now an International consultant in the oil industry and medicines move on. Butazolidin banned due to deaths in old people because of heart failure. Only a precaution of course, they were old anyway. What about me? How could I keep tripping the light fandango without butazolidin? Never mind this one’s better, life forever with allopurinol. Instead of drugs only when you get an attack you take these every single day for the rest of your life, cost lots more per annum. They regulate the uric acid level in the body. Nope didn’t want that. Now the blood thinners were not so aggressive and naproxen pills worked, so stayed on the tried and tested path.

By now at 40 started to meet people who also had gout. It wasn’t an old man’s thing anymore. More research and more talk it may be diet related but drug cocktail still the same. By now the joints were starting to creak, still good at golf and tennis but most other sports had to go. Could still party on one leg though.

At 50 odd, for various reasons I decided to become a monk with a cult know as Brahma Kumaris. Big changes now no booze and a vegetarian diet. Lots of meditation and a life mainly sheltered from the outside world. Well changes all round and energy levels shot up. Gout attacks much less frequent, say from half a dozen attacks per year down to a couple. Maybe it is diet after all. The BK’s helped me to realize many things but for the first time I really started to understand I had the power to make choices and with change, what you feel and think alters too. Now a new exiting side to gout: tophis. These are swellings you can get in parts of the body because the body needs to find other places to dump the uric acid crystals. No pain but ugly and no-one wants to touch them. Also noticed gout attacks usually came just after a stressful period or episode, as though the immune system had trouble dealing with the inflammation after a deposit of uric acid crystal, maybe impaired by anxiety.

I was now hooked on personal development but within the auspices of science, i.e. psychiatrists, therapists, nutritionists, body managers. More change and better living but soon I was drifting back into the fine wine, cheese and Brillat- Savarine 7 course dinners. My friends, the doctors, surgeons, psychiatrists etc were earning a lot per hour within the NHS and private practice. Lecturing and practicing in health and ethics yet living like everyone else except with lots more money and thus able to buy more expensive wine and richer fine food, I was back to spending and living it up again. And Oh well back to the gout; but the parties were good.

So now living with gout for 30 years. Decided to give up all the partying, stripped back culture and especially diet and embarked on restart in living and thinking, the second in the last decade. Met Janice, fell in love with a vegan and a range of ideas from another planet. Together we have been trying out combinations of food and drinks in terms of nutritional value, health, quality and quantity. Now we have real progress. Stomach back to shape as of 40 years ago, niggling ailments clearing up. Low and behold no gout. Tophi are all gone.

So living without gout.

If you want to find out more about health, food and making choices, come to Metamorefosi and Vaccaria. Visit our website for details.

And what about side effects? Quite a miracle really. If I make a list it will sound as if I was falling apart before and I suppose most would say it’s the process of getting old. I don’t believe it. The correct foods give the body and mind all the resources to repair, rejuvenate and maintain any part of the body.

It can take time and usually means lots of research and relying on experience, wisdom, observation, instinct and care. But isn’t this what life should be about, rather than just accepting our cultural habits and plethora of experts.

What has happened as well as the gout disappearing? My legs and feet began to reform. Initially toes straightened out, nails lost their brittleness and started to grow healthily. Fungus in one of the large nails (I tried allopathic chemicals for years without success) and so called athletes foot has gone. The amazing part is my shin bones seem to have started to straighten, I can’t be certain because I didn’t measure them before. I thought my bandy legs were the result of too much football and other games.

Since I was a kid I’ve had an infection in one of my ears, causing a bi-annual rupturing of the ear drum, thereby impairing hearing. Sometimes a benefit. Also my Eustachian tubes tended to become infected, glued up and again reduced the effectiveness of the ear drums. Year after year of ENT specialists has kept things bubbling along about the same, antihistamines and anti biotics. Amazingly with the right type of food and soothing herbs my ears are starting to work better and better, taste and smell coming back (not always an advantage).

I believe everything we need to stay healthy and active is available through what we eat. Occasionally extra help is needed from herbs and preparations also from natural unadulterated plants. It’s an amazing thing to know we all have the power and ability to look after ourselves.

John Lapin February 2012