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Physio Detective Blog

Gout – my personal journey

This is not a typical blog post. This is about my personal suffering and pain (which is nothing in the big scheme of things). If you don't want to read it, I don't mind. I think part of me is writing this because I feel miserable right now.

It is 3am in the morning. I am in LA, here for the CrossFit games as a physiotherapist in support of Aussie athletes and to watch this awesome spectacle. I am also currently lying here awake because my foot feels like someone has a knife in it and it is sore just lying here doing nothing. I don't even have to move and it is sore.

But let me start at the beginning.

Gout is simply an inflammatory arthritis - Uric acid crystals form because it precipitates from the blood into my tissues. When it gets into the joints, those crystals cause pain and inflammation due to the immune response to deal with them. Now, I might be technically wrong here but that is how the doctor explained it to me.

Genetically, I have high Uric acid levels. That is against me. Secondly, the breakdown of purines produces Uric acid. That is basically eating meat :/

Now none of this is usually too much of a problem because you can take allopurinol and control the Uric acid levels...to a degree.

You see, it is the flow of Uric acid in or out (the gradient) that can cause the immune reaction and subsequent pain.

So, diet-wise I have tried all sorts of things but I am fat/overweight/obese. It is what it is. I am not being dramatic. I should be about 105kg (about 93kg lean body mass which I currently am and 12-15% fat...I would look like a weapon! Hahaha. But I am not. I am 125kg at the moment. I eat poorly because of laziness but there has been A LOT of negative reinforcement.

You see, I can eat junk food every day and I might ache a bit from the gout here or there but I am like an addict - I really can't find an in-between level of junk food. It is either clean or I start to slip back into bad eating.

Don't get me wrong, I am not blaming gout for my poor self discipline.

But since I was a kid, I have loved junk food. That is typical and normal. My parents fed me well and we had junk food for a treat. That is also normal. I was the stereotypical skinny Asian-looking kid. I didn't become bigger and taller until later. Then, I started eating a lot of junk food. Too much. And I began to put on too much weight.

But here is the thing, I can lose weight. I know how to. I can eat well. I know how to. I have lost 30kg before by doing the old weight watchers point system on my own at home (never been to a meeting). I was as weak as piss and couldn't do a bench press for 8reps at anything more than the 20kg bar. I was a cardio guy. I weighed 82kg and could 3 les mills classes back to back - body attack, body pump and body combat. No problem.

Even then, at my healthiest, I had Uric acid kidney stones. I had gout attacks.

Eventually, I put weight back on again because, remember, with me, it is all or nothing. I slowly put that weight back on just by starting with a can of drink here or a bit of chips there.

But my gout felt better.

And then the cycle continued. I would lose weight (I did vision PT) - I lost 15kg in 12 weeks but again, I would ache or get gout eating clean. And then I would fall off the wagon and I would feel better.

So then I started CrossFit. There was The Zone but lots of my friends were doing paleo. I lost 18kg in the first few months of CrossFit and maintained between 103-105 for over a year. But I would get gout attacks in my feet, toes, knees, hands. I was eating paleo but then wouldn't but then get back on the wagon again. It got to a point where I was suffering gout in one joint or another for months on end with only a week or so relief from the pain. I swear I think my coach thought I was lazy or something. It really interrupted my training.

Eventually a doctor who I was observing operate sat me down and set me straight about taking the meds and pushing ahead with eating better. I did and I was pretty good for a while but I wasn't eating clean. So I was still putting on weight. I was pretty proud of my 19:28mins in the CrossFit open wod 14.5 (thrusters and bar over bar-over-burpees). That was just below the average score of 19:30mins. I know fitter people than me who took longer than that! But do you know how hard it is to drag this rig up and down off the ground?

So those who saw me when I first started CrossFit will have seen me go from being pretty weak (80kg Deadlift was my first 1RM test) to being pretty strong for an average person but still slow...but getting stronger. I am currently 120kg and the strongest I have ever been but I have been eating poorly since a trip to the USA last sept/oct. Trying to come clean from that has been a nightmare.

Every time I try to go clean, BOOM! Gout attack. People have tried to help. But the bottom line is that every time I go clean, I get an attack.

Imagine every time you walk through a certain door, you get knifed in the body somewhere. That is basically what happens. I then use THAT as an excuse to continue to eat poorly because when I eat clean, I get headaches, I get gout, I feel lousy. If I keep eating the chemical shitstorm that is junk food, I actually feel RELATIVELY better.

I know that if I can just weather the storm, I can train better and continue to eat better. I can lose the fat and improve the fitness. But it seriously takes over a month or more of pain and I am not sure I had the will or the self discipline to do that.

It is embarrassing to be this weight.

I love my CrossFit. I love workouts. I want to run and do burpees and lift weights fast and quick and many times and I want more pull-ups and my first muscle up. I don't want took at photos and think that I should be fitter than I am. I have never been stronger than I am now. Ever. But they are "dirty gainz". I don't talk too much about it. I laugh about the fact I am built to lift and not run but secretly, I want to run and be that cardio guy again but with muscles and strength.

So, in the land of California, I thought I would come over and because I have a different routine, I will eat cleaner. And I have. Compared to what I normally eat, I am doing pretty well.

And now I lie here with what feels like a knife through my foot. It is now 4am and I resorted to taking prednisone before I wrote this blog because I am here to work and help people. And I am. But prednisone comes with side effects - insomnia (brilliant! Perfect with the jet lag I was just getting over :/), increased appetite and weight gain through bloating and too much food.

So I am going to try to stay clean. I know what will help...eating dirty again will help. It will tip those scales back to slowly increasing my blood concentration of Uric acid and the gradient between my blood levels and in the joints won't be so bad and I won't have such a bad reaction.

If I can't walk, I can't get around. I know what this week involves and it involves a lot of running around and stairs and walking to and from car parks and working on my athletes - all of which is fine, except when every step is painful.

So if you see me eating dirty, please understand that my life in the short term is just simpler that way. I know that if I have junk food for the next 3 days, I will be right. If I keep eating clean, I will be in pain and it won't let up. But junk food and prednisone is up to a 5kg gain almost in a week! Eating carbs and fried food helps my neck pain and headaches. I am a better Physio when I eat carbs, fat and meat but carbs and fat together, especially the junk food that works best, is not good for you...it seems the pro-inflammatory things I like to consume such as sugar and grains, are the very things that make me feel better.

So there you have it. Why do fat, overweight people who have gout keep doing the things that make them fat and overweight? I suspect for some, it is just like my story. Because I don't feel as bad as when I eat clean.

I am going to try weather the storm. I am going to see if I can put up with the pain. This is the better way, just a REALLY PAINFUL way.

If you have read this far, thank you. I hope one day I can write a story about how I am 12-15% fat, no gout symptoms and still strong.

The meds are kicking in...the pain is easing. It is 4.30am. It still hurts. So what? I will push on.

6 Responses

  1. Erika

    you have a great insignt into your own mind – one that many people don’t have or are too scared to develop. You see the truth, you know the reasons, and you understand both your mind and body to a degree that many people never will. I will pray for you, that God will give you the courage and strength to weather the storm and endure the pain (or better yet, for a miraculous healing!). You’re a tough guy and an inspiration to many. Perhaps ‘the valley of the shadow of death’ is a bit OTT, but I came to a realisation that psalm 23, rather than being a thing for funerals, is for the living. May he be with you in the valley!!!! Exxx

  2. Henna Horth

    Anthony,

    Thanks for sharing! Hope you are feeling better. I would say don’t be too hard on your self! ESP while away from home. Enjoy the games and enjoy being a great physio there helping people. Then come home and try to sort out how you need to eat. I’m no expert. ( I’m a clinical Pilates physio with 2 young kids who has discovered crossfit a year ago) and I’m sorry I have no experience with gout but what about while you’re in the US you could look up perfect health diet or talk to a biomedical dr?? http://perfecthealthdiet.com/category/disease/gout/

    Enjoy your trip 🙂

    Sent from my iPhone

    >

  3. Mary Egan

    Thanks for sharing Antony. What a dilemma! I really appreciate your posts and how transparent you are. I know you are a Christian and I will pray for you and your toe/foot.

  4. Anonymous

    have you been checked for MTHFR? It has something to do with uric acid metabolism along with many other aspects of health.

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