‘Gout is like having a foot full of glass shards’

Sue McDonagh has had ovarian cancer, two replacement hips and a heart attack. But nothing, she claims, has come close to the excruciating pain she experienced from 10 years of living with taste.

“It’s like having a foot full of glass shards and every time you stand on it, you’re in agony,” 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, keep my foot raised at all times and do nothing. I couldn’t work, couldn’t sleep. Even hobbling to the toilet at night on walking sticks was really painful.”

Gout is a form of inflammatory arthritis affecting one person in 40 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 surrounding joints and tissues. And yet, despite being the most common form of inflammatory arthritis, doctors are not always getting the treatment right.

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

Her first attack came 15 years ago after she’d been training intensively for a 10km walking event. “I felt an intense stabbing sensation in the big toe of my left foot, but at the hospital they just dismissed it as arthritic changes and sent me off with some ibuprofen,” she recalls. After a few more attacks over the course of the next year, her GP did a blood test and diagnosed gout, then simply gave McDonagh a dietary sheet and more painkillers, advising her to stop eating gravy. It took McDonagh lots of Googling and many more visits to the doctor to finally get her condition taken seriously.

“By that time, I felt like my life was defined by taste,” she says. “It would start with a tell-tale throb at 4am and then would last for about a week at a time. I’d feel feverish, unwell and so tired. It was awful.”

Gout has long been seen as a condition of port-swilling, venison-eating, gluttonous male sovereigns and, as such, has historically engendered little sympathy for its sufferers.

But research by the University of Nottingham in 2015 found the prevalence of people diagnosed with gout in the UK rose by 64 per cent between 1997 and 2012, driven by higher levels of obesity and diabetes. Numbers have dipped since, according to a 2021 study, in all likelihood due to underdiagnosis as patients have struggled to access healthcare during the pandemic.

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

She was eventually prescribed allopurinol, a tablet designed to lower the levels of uric acid in the blood to under the recommended 300 mmol per litre. She started at a low dose of 100mg a day and, over time, this was upped to 400mg – her current dose – which has stopped the gout attacks altogether.

“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’s been liberating.”

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