Sunday, November 6, 2011

If I was living like a King, perhaps I could understand why this is happening to me.

Since we moved to California from Colorado, I've had a couple of weird things happen with my joints. In fact, throughout my life there has been many issues. Dozens of dislocations, mostly of the shoulder, but also an elbow, patella and a couple fingers. The only surgery (besides wisdom teeth removal) was a shoulder reconstruction deemed necessary from all the dislocations. In July, before school started I came down with an attack of gout in my large toe of my right foot. I was drinking a few glasses of wine most nights, but other than that I really wasn't engaging in overt gout promoting behavior. It put me down for 3 or 4 days though. There have been a few other times where my knee would swell up, and since it correlated to a coldish, stormish front moving through I chalked it up to one more thing that confirms my old-fartness. Well, if I needed one more confirmatory episode I was handed a whopper over the last few days. I had another gout attack, except this time it was in my knee. And, again, I really had not engaged in overly suspect activities this past week. As I have been preparing for my exams I wasn't drinking alcohol at all and, if anything I had more cheese than I might normally, but it's not as if I ate a few pounds of the stuff. Today, the pain got to the point where I actually visited the emergency room.

I wasn't completely sure it was gout, but since there was not trauma to point to and no obvious paths of infection to cause what appeared to be a swollen, cellulitic knee I figured I should be seen. If nothing else I was going to need a doctor's note if I could not even move or walk for my practicals that are scheduled on Monday and Tuesday. The doctor in the ER did not identify gout right away, and said he really wasn't considering it until I told him about the attack I had in July. I guess I feel a little better about that, as that means he didn't see me as a prime gout patient, but on the other hand, why am I being struck with this horrible, utterly tortuous affliction? I even told my wife that if I could ward off another attack I would gladly give up all meats, fish and yes, even beer and wine. That is how bad a gout attack is.To think I thought the toe was painful, well, I learned my lesson and now know that the knee trumps the toe, multiple times over.

Thankfully, I was provided a large dose or prednisone at the hospital, which allowed for significant pain reduction within the hour, I was given a script for the rest of the week. I was also given a mild antibiotic (a 1st generation cephalosporin, for those that care meaning that he suspected a gram (+) bug if any at all) in case there was any infective process at work. All I know is that that was a continuous pain, that disallowed me to sleep or think straight for nearly 2 days straight.

As I was preparing to leave and the nurse was chatting with us, she learned that I was a first semester medical student. She said something to the affect that I should've just diagnosed myself. Well, I did, but since I have a few years until I'm writing scripts I figured I should still be seen. Nothing like a Bout of Gout to Sprout Doubt and make one Shout.

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