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It was the summer of 1988. I was working in Germany and had met up with friends at a gite in the Loire Valley for our annual holiday. Usually quite an alcohol influenced holiday, both my wife and I enjoyed a glass or two of wine and the couple joining us also knew how to sink a drink or two. Especially after dinner when the brandy usually came out!

I was just 32 years old and with my newfound wealth, living and working in Germany with 30+ days holiday a year and a reasonable salary I had decided to lash out on my own windsurf board, rather than constantly pay the hire fees when away on holiday.

My friend and I decided, rather against our better judgment to take the board out on a particularly windy day as a first attempt with the new board. It was more an exercise in setting up the rigging than anything else, but almost as soon as we had the board rigged, the wind rose to what felt like hurricane proportions and I found myself catapulted over the mast no less than four times before I eventually managed to launch and stay upright.

The pressure on my left ankle was amazing and the speed of the board too was incredible. I can only liken it to that moment when as a novice skier I mistakenly headed straight downhill on my first red run, the acceleration was incredible and the thought of how to stop never even entered my head.

After a couple more catapults, we decided to call it a day and we derigged the board and headed back to the converted barn gite at which we were staying. We ate and drank well for dinner and planned an early start for a day by the coast at the mouth of the Loire river. But the next day I awoke to an aching ankle that turned to agony the moment I put weight on it. So painful was it that Alastair insisted on running me to Tours hospital, which I seem to recall was baout a half hour – maybe 40 minute drive away.

Once there the doctors wasted no time in putting me through what I can only describe as the most painful 50 minutes of my life – ever. I think they assumed (as I did ) that I had sprained my ankle, but could find no sprain. They twisted, they pulled, they X-Rayed, they pushed and poked at my left ankle. Eventually shrugging in that Gallic way as if that would be a great answer to my problem. Very sore and none the wiser, Alastair and I headed back having been fobbed off with a couple of strong pain killers – pethedine I think it may well have been. Although sore, I was flying for the rest of the day!

Next day – nothing. No pain, no swelling absolutely back to normal. For the rest of the holiday which included a very hairy session windsurfing at full speed out to sea against the incoming tide and going backwards for about an hour, followed by an inshore rescue by motor boat, absolutely no trouble whatsoever.

Fast forward three years to 1989, back in the UK and with 3 months off, working on the house before starting a new job. I was just halfway through building the patio when my right foot began to ache. I didn’t think too much of it until it also began to swell and it felt very hot. The early summer of 89 was very warm and I had set myself the target of getting that patio finished before July when I was due to start my new job. After a couple of days sitting amidst my building rubble and unfinished patio with my swollen sore foot in a cool box full of iced water, my wife decided I had been slacking enough and forced me to go to the doctors. By this time my foot appeared almost twice its usual size and I could not even bear to have a bed sheet touch it during the night.

I hobbled into my lady doctor’s surgery feeling very sorry for myself. I was in a lot of pain. Which was ok until she started to laugh. No really she actually laughed at my swollen bright red giant foot. I wasn’t really seeing the joke and politely asked what she reckoned was the trouble. “Well”, she said, “that is the most classic looking case of gout that I have ever seen.”

Whilst not quite seeing the funny side, I did feel a huge sense of relief. At least I had something that had a name and the doctor knew of. Surely now all my troubles would be over.

And to a certain extent and for a while they were. She prescribed Indomethacin – an anti-inflammatory drug three times a day to take care of the initial inflammation and allopurinol on a daily basis to prevent the build up of uric acid crystals, which is the basis of gout in the joints. To be fair, the Indomethacin was fabulous. My foot began to return to a more normal size after just one day and after the two week course, it was completely painless and normal size again.

Of course then I decided I had better find out what gout was, as I had succumbed to it at such an early age.

So, what is gout? Gout is a condition that is one of the many forms of arthritis. It can lead to arthritis in the joints, which is sometimes referred to as gouty arthritis. It is much more common in men than in women, and, particularly in older men. But that’s not to say that younger people and women can’t suffer from gout, because they can, and, often do as I can bear witness.

It is estimated that about 1% or so of people in The Western World will suffer gout during there lifetime. The symptoms of gout appear mostly in the base joint of the big toe approximately 65 – 75% of cases, but, gout can manifest itself in any joint. I was also told by my doctor that if untreated, the uric acid crystals that form in the joints and lead to gout, can also form in the organs of the body.

Gout arises from high levels of uric acid in the blood that form into uric acid crystals in the joints and surrounding tissue. These microscopic crystals appear to be needle shaped when viewed under a microscope. Gout is often considered to be one of the most painful of conditions and indeed those needle shaped crystals do feel like needles being inserted between the joints, during an attack.

The body’s natural defences try to defend against these ‘intruders’ and the result is an acute inflammatory reaction to the presence of the uric acid crystals. It’s this that causes the symptoms of gout such as inflammation, swelling, redness, stiffness, hot to touch, and, chronic pain. One male doctor told me that gout is more painful than childbirth. Quite how he could say that I still don’t know, but at the time it felt like he was right!

So gout is caused by elevated uric acid levels in the blood, but where does the uric acid come from? The uric acid is produced in the blood when ‘purines’, which are part of our chemical structure break down during the process of producing protein and energy for our bodies.

Unfortunately purines also exist in food. In my case, and particularly in the foods I enjoy, purines occur at very high levels. Other foods have relatively low purine levels whilst some have medium levels of purines. If you are considering controlling your gout through diet alone, this is crucial to your success.

But what causes these elevated uric acid levels to occur in the first place? Well, normally, your kidneys process the uric acid produced by the metabolizing of purines, and then flush excess uric acid out of your system, mainly through the urine, but a little through stools. Your body also produces an enzyme which also helps process the excess uric acid in the bloodstream.

However, sometimes your body will not be producing sufficient of this enzyme, or your kidneys may not be working as efficiently as they should, or they are fine but the purine levels in your blood are too high – maybe for dietary reasons and there is too much uric acid being produced for your kidneys to process as normal. The result is elevated uric acid levels in your blood, from which uric acid crystals are formed in the joints, resulting in the agonies of gout.

I managed for a couple of years to control my gout with the medicines that my doctor prescribed, but after a while I started to get a little careless with the daily Allopurinol and sure enough, when I lease expected it, the gout returned in the shape of an immense pain and slight swelling in my right knee. Whilst I was in little doubt as to the problem, I had not expected the severity of pain and the level of incapacitation caused. When your foot is suffering a gout attack, you can at least hobble about. You don’t want to knock the foot into anything, or have a sheet resting on it at night, but you can get about. With your knee, you can do absolutely nothing. Just tensing the knee in preparation for trying to move your leg is too painful to contemplate. You can’t lift your leg and so you can’t walk or hobble. But worse, you can’t lie on it either. The slightest pressure on the knee is too painful to bear. I ended up lying flat on my back for two days while the anti-inflammatories kicked in and only then could I begin, very carefully to move about again. The moral of this part of my story – if the doctor prescribes a daily medicine – take it!