Taming The Toe Monster: How To Survive a Bout With Gout

”The Gout” by James Gillray. Published May 14, 1799. If this late 18th century depiction of a foot being assaulted by “The Toe Monster” looks scary, you can only imagine what an attack of gout must feel like.

During the most festive time of the year — the six weeks that begin tomorrow and lasts through New Year’s Day — the visions I have dancing in my head do not involve sugar plums. My delectable daydreams are of parties and family dinners where any kind of meat and fish are in abundance, the alcohol is flowing freely, and rich, delicious desserts are irresistible temptations.

At least I used to have such visions. They had to be expunged from my brain 16 years ago, after I was attacked by The Toe Monster.

That summer, the assault came without warning in the middle of the night. It engendered a pain the intensity of which I hadn’t experienced since having some teeth removed with pliers as a child. The area of this excruciating ache centered in my right big toe and made the spot so sensitive even a bed sheet slithering across it induced a blood-curdling scream.

By morning, I somehow managed to hobble to my podiatrist and my amateur diagnosis was a stress fracture, most likely a delayed reaction to a baseball injury suffered during a game the day before. Foot doctor scanned the surface of my toe and noticed that it was red, shiny, and felt hot to the touch. “No doubt,” he said, setting up his short but disturbing rhyme, “you have GOUT.”

Gout? Wait a minute, I thought. Isn’t gout a member of the ancient malady pantheon, right up there with rickets and scurvy, ailments people haven’t suffered since the days of King Henry VIII and Benjamin Franklin?

Apparently not. According to 2017 data published by the journal Arthritis and Rheumatology, there were approximately 41.2 million cases of gout worldwide. The National Kidney Foundation reports that gout is the most common type of inflammatory condition in adults and estimates that 39 percent of American adults — 6.1 million of them men 40-and-over — have bouts with gout.

Hundreds of years ago, gout was called “The Disease of Kings,” because it was associated with wealthy men who over-indulged in food and drink. Red meat (especially organ meats and the meat of wild game), fish (especially shellfish, sardines, trout, and tuna), vegetables (asparagus, spinach, and cauliflower), and beer and red wine, all contain purines. When the body breaks down purines it produces a…