After a painful attack of gout Danny Wallis is back doing the sports he loves.
The father of two, 45, had a bout of the form of inflammatory arthritis, which meant an unwanted break from surfing, rugby cycling and running.
But after three weeks of excruciating symptoms, Danny's back in the saddle and is training for a 100-mile charity bike ride.
'It's not just about too much port and cheese'
Danny has been frustrated at the perception gout can have, and he thinks the pain and serious effects of the condition make it no laughing matter.
He said: "People don't want to admit to this disease as it can be seen as an 'old man's condition' brought on by too much port and cheese.
"I think this misconception is a problem because younger people might not be inclined to open up about their gout and seek the help they need.
"When I talk to friends and colleagues, I find that a lot of people have gout.
"I've had three weeks of real pain and it's been horrible."
Gout making life difficult
As well as enjoying sports in his spare time, Danny's job as a self-employed architect takes him to building sites and means he's often on the go. Gout made both aspects of his life difficult.
He said: "My foot was really swollen. There were days when I found it difficult to get my shoe on and days when I had my shoe on I struggled to take it off.
"I was in a meeting and I must have looked in pain, because someone said 'you really don't look good'. It can be very depressing."
The day before Danny's attack he played rugby and his family thought he had picked up an injury on the rugby pitch.
"I think dehydration was a big factor for me," Danny said.
"I'm normally very good at drinking lots of water, but leading up to the gout attack I hadn't been drinking as much water as normal. I think that may have been a trigger."
Danny now drinks plenty of water, which he thinks has helped him.
Watching what you eat
Lifestyle and diet don't form the whole story when it comes to gout, but they can have a significant impact.
If you have gout, or are susceptible to it, it's important to watch what you eat and drink and to remain a healthy weight.
Danny has always enjoyed a sporty and active lifestyle, but after his recent bout of gout, he's taken his health and fitness even more seriously.
He said: "I cut my portion size down by about 30% and I've cut down on bad things.
"I now save the treats for the weekend – a bit of popcorn or a packet of crisps for Saturday film night with my lads.
"Same with alcohol, maybe two glasses of wine or two pints of beer on a Saturday night and that's it."
Danny has recently lost a stone-and-a-half through a healthy, low-fat, balanced and nutritious diet, and by exercising regularly.
There's a history of gout in Danny's family, which may have made him more susceptible to it.
What causes gout?
Gout is caused by too much uric acid (urate) in the body.
We all naturally have some level of urate in the body and it shouldn't cause any problems.
But if someone has too much urate or the body isn't good at getting rid of it, then it can form small, sharp crystals (sodium urate) which can settle in the joints and aggravate the joint lining, causing serious pain and swelling.
Urate is a natural waste product, produced by the breakdown of proteins called purines. Two thirds of the purines in our body are there naturally.
The food and drink we consume can increase the amount of purines in our body.
Foods and drinks high in purines include:
- red meat and offal – for example beef, kidney, liver, sweatbreads
- oily fish – fish roes, herring, mackerel, sardines
- foods rich in yeast extracts – Marmite, Bovril, Vegemite.
Drinking too much alcohol, especially beers and spirits, may increase urate levels.
Urate is flushed out of the body through the kidneys and then as urine. Problems arise if people have too much urate in the body, which reaches a saturation point and then causes the urate to form crystals.
This can happen if someone's body produces too much urate or if their kidneys aren't good at getting rid of it.
The larger a body is the more urate it will produce, and a common way for people to get gout is to be genetically susceptible it, and then to become overweight.
Gout can affect:
- joints in the feet
Gout is a serious condition
Despite the often light-hearted stereotype of gout being a condition which affected the aristocracy of the middle-ages due to their fine living, it should be taken seriously.
Gout affects more men than women, because men have more urate in the body. It can affect men of any age, but it rarely affects women before the menopause.
As well as the pain and discomfort on an attack of gout, the condition can leave people susceptible to serious health conditions.
Regular attacks of gout can cause severe and irreparable joint damage through osteoarthritis.
People who have higher levels of urate in their body are at an increased risk of developing heart disease, and there's growing evidence that high urate levels can also increase the risk of some cancers, particularly prostate cancer.
The serious nature of these conditions, and the likelihood that when someone has one attack of gout they will be prone to further attacks, means that people are now urged to take long-term urate-lowering treatment if they have an attack of gout.
The two most common drugs which can be prescribed in these circumstances are allopurinol and febuxostat. They're both normally effective and well tolerated.
Non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen or ibuprofen, are often prescribed alongside urate-lowering treatment to treat the symptoms of pain and swelling, at least to begin with.
If you have any of the symptoms of gout, it's important you see a doctor.
Joints affected by gout can be:
The skin over the affected joint often appears shiny and may peel. Attacks typically affect the big toe and usually start at night.
Danny is glad to be fighting fit again
For Danny being able to enjoy his sporty hobbies again and not be in constant pain is a relief.
He put his regained health and fitness to excellent use by taking part in a gruelling 100-mile bike ride to raise money for Arthritis Research UK, Children with Cancer and the Stroke Association.