‘Gout is like a foot full of glass shards’

Sue McDonagh has had ovarian cancer, two hip replacements and a heart attack. But nothing, she claims, comes close to the excruciating pain she experienced after living with gout for 10 years.

“It’s like having a foot full of shards of glass and every time you step on it you hurt,” explains McDonagh, 64, an artist from South Wales. “As soon as I had an attack, that was it. I had to stop what I was doing, always keep my foot up and do nothing. I couldn’t work, couldn’t sleep. Even stumbling to the toilet at night on walking sticks was really painful.”

Gout is a form of inflammatory arthritis that affects one in 40 people and four times more men than women. It is caused by high levels of uric acid in the blood, which form needle-shaped crystals in the surrounding joints and tissues. And yet, despite being the most common form of inflammatory arthritis, doctors don’t always get the right treatment.

A study recently published in The Lancet Regional Health found that most gout patients were not receiving drugs intended to lower urate levels, despite the drugs being cheap and highly effective. It took McDonagh 10 painful years to finally get the treatment she so desperately needed.

Her first bout came 15 years ago after she trained intensely for a 10km walking event. “I felt an intense stinging sensation in the big toe of my left foot, but in the hospital they just dismissed it as arthritic changes and sent me off on some ibuprofen,” she recalls. After a few more attacks over the next year, her GP did a blood test and diagnosed gout, then simply gave McDonagh a feeding schedule and more painkillers, advising to stop eating gravy. It took McDonagh a lot of Googling and many more visits to the doctor to finally take her condition seriously.

“By this time, I felt like my life was being defined by gout,” she says. “It started at 4 a.m. with a telltale knock and then lasted about a week at a time. I would feel feverish, unwell and so tired. It was horrible.”

Gout has long been thought of as a state of port-eating, wild-eating, voracious male monarchs, and as such has historically evoked little sympathy for its patients.

But research from the University of Nottingham in 2015 found that the prevalence of people diagnosed with gout in the UK increased by 64 per cent between 1997 and 2012, driven by higher levels of obesity and diabetes. According to a 2021 study, numbers have fallen since then, most likely due to underdiagnosis, as patients have struggled to access healthcare during the pandemic.

“I was surprised because I thought gout was something old men got – in fact, my father had it. My diet was quite healthy and at 80kg I wasn’t really overweight,” she says. “When I told people , they laughed and said things like ‘You want to stay off the harbor!’ but it wasn’t funny.”

She was eventually prescribed allopurinol, a tablet to lower blood uric acid levels below the recommended 300 mmol per litre. She started with a low dose of 100mg a day and over time increased this to 400mg – her current dose – which completely stopped the gout attacks.

“I’m a completely different person now,” she says. “I swim in the sea, I cycle and go to the gym twice a week. It has been liberating.”

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