Friday, April 06, 2007

Pain: Gout Explained

What's your name, my name is Pain
Where do you live, I live anyplace
Where were you born, in the state of fear
How old are you, nineteen hundred and ninety four years

What's your plan, my plan is
When will you leave, I'll never go away
How will you breathe, you'll give me life
How will you see, sitting in the temple right between your eyes

My name is
Pain, you belong to me
You're all I wanted, I'm all you'll ever be
From the beginning in a world without end
I am the air, I am

Pain is love, Pain is pure
Pain is sickness, Pain is the cure
Pain is death, Pain is religion
Pain is life, Pain is television

Pain walks, Pain crawls
Pain is peace, Pain is war
Where were you born, in the state of fear
How old are you, nineteen hundred and ninety four years

My name is
Pain, you belong to me
You're all I ever wanted, I'm all you'll ever be
From the beginning in a world without end
I am the air, I am

-- Elton John, Made in England (1995)

I had done some Google referencing and reading for I was planning to comment on some recent development. Unfortunately, it is disrupted by a gout attack.

When you are down with it, you are just handling pain and left everything aside. After a good long dip in iced water this morning, my ankle is beginning to move and I decided to end my April Blogging hiatus to explain about gout and its misconception. Its a different turn from my usual socio-politico-econo interest.

Gout, said to be “disease of kings” or rich men disease, is a metabolic arthritic disorder due to under-excretion or over-production of uric acid. It’s basically a body chemical issue and got nothing to do with your bank account.

The uric acid reacts to become monosodium urate salt and its deposited in the cartilage of joints and certain tissue like tendon. Usually it happens at the big toe. In my case, it is usually the ankle, although I’ve had a case at my right wrist. Those salt crystal makes moving excruciating and swelling is just a reaction. Worse cases of gout could have nodes all over the limbs and bodies and in those nodes are crystals of salt. Imagine the pain.

Chemical structure of Uric Acid from Wikipedia

What is gout pain like?

Let me tell ye. Have you had a case of ankle sprain? It’s usually a sharp pain followed by discomfort from perhaps a swollen ankle. Imagine having that pain constantly for a couple of days periodically heighten by bouts of throbbing. There is also the extreme discomfort from the swollen big toe or joint.

I would usually be able to sense the symptoms and do the necessary precautions. By morning, it is usually over. This time around it is unavoidable.

I accidentally slipped and sprained my ankle entering the PUTRA train during a crowded peak hour at the KLCC station two days ago. This is a usual recurring ankle injury from my sporting days. It shouldn’t be so bad if I had got seated. What do you expect in a rush hour? So I was standing all the way and even continued standing in the feeder bus. By the time I reached home, my ankle had already swelled.

For one with gout, any physical stress, fatigue and inflammation at the joint invite the friendly gout attack. It’s like inflaming an area that is susceptible to inflammation. A gout patient with a weight problem is in a vicious cycle of no return; limitation to endure physical excercise and dieting increase uric acid in the blood.

There is no cure for gout.

So you take prevention to avoid frequent attacks and having it advance to more chronic stages through dieting and medical prescription. The mainstay is allopurinol or its popular local brand, zyloric, to help reduce the production of uric acid.

Other than the popular belief to avoid excess consumption of seafood or meat, other food groups do raise the body uric acid level. It is essentially produced when purines are broken down by enzymes in the liver. Purines are complex chemical compound generated by the breakdown of cells in normal cellular turnover or ingested in purine-rich foods.

Complex Chemical Structure of Purine from Wikipedia

Food rich in purine ranges from red meat, organs, seafood, freshwater fish, sardine, and anchovies, to legumes, asparagus, spinach, mushroom, and cauliflower. Practically all food contains purine, so you should know the food with different level of purine. A good habit to acquire is to consume lots of water. It helps to excrete uric acid in the system.

During gout attack, thats important. In addition, I’d stop taking allopurinol for it worsen the attack and switch to colchicine, a granulation inhibitor. To reduce inflammation, one could use a Non-Steroidal Anti Inflamationary Drug or NSAID. My remedy is usually to ice it down. If you can't stand the pain, pop in a pain killer. Colchicine or pain killer have long term effect on your kidney, so do so with care. Finally, lots of rest. What else could one do with the pain and discomfort?

Is there any natural remedy?

I’ve attempted to go natural to replace allopurinol with celery seeds pills and other natural remedy claims. Frankly, it is not that useful. By the time I eventually had my gout attack, it happened too frequent. Gout is a body chemistry problem, so know your bio-chemistry. If anyone can't explain their suggested remedy, just ignore it.

Nevertheless, its a good habit to consume fresh vegetable, fruits and herbs. There are purine-neutralizing and helps to reduce inflamation like berries, cherries, and celery juice. Local misai kucing have been found useful as diuretic to balance bodily fluid with enhance urine excretion. Some doctors recommend distilled water but I doubt it's any better than normal water to dissolve low solubility coeficient organic salt.

Lets be philosophical about gout or any illness we acquired. Its a nice reminder to hold back and take life in moderation.

Pain is love, Pain is pure
Pain is sickness, Pain is the cure
Pain is death, Pain is religion
Pain is life, Pain is television

Thats deep man, deep.

I am the air, I am Pain.

A Voice
Kuala Lumpur
April 6th, 2007 12:00 p.m.


Anonymous said...

aiyoyo, poor a voice.

please take care of yourself k? :)

Anonymous said...

A voice,

Hope everything is well now.


Anonymous said...


No steak. No seafood. No kacang ngan yin. No steak. No lamb chops. No seafood.

Go to your annual resort & spa aka Ampang Puti Hospital. Get medical help.

Anonymous said...

Bro "Raden" Voice,

I wanted to congratulate you for the superb comment you left at Rocky's under the most recent Johor royalty posting.So imagine my dismay to have read this post. Berat mata memandang, berat lagi bahu memikul. And though i dont suffer from gout, I have my share of physical ailments, some that makes sense and some that dont, so i understand how it can really put you off...In fact I'd say the incessant pain is even more annoying than reading uneducated racist generalizations on Malays by a certain infamous commentator who has special rights in one particular popular, no,no... on hindsight the blog owner's cronism is definitely more irritating than all my pains...hahaha

BUT on a more serious note.

Though you say that gout is not curable, BUT if i remember correctly, the late MGG Pillei' had gout and it was either cured or far more easily managed after being treated by one Ghani Ismail.He was formerly of the Nst,a former UM lecturer in the 70's, a former aide of Tengku li, extremely lucid and will explain your problem and the remedy , if it exist that is, in bio-chemical terms.He is 67 now, so he belongs to that dwindling group of true Malay gentlemen.Additionaly,and most importantly, though he is the uncle of a certain Rectum Rashid, nonetheless,he is a true nationalist and also a gifted writer.Infact, while alluding to his writing flair on Zorro's posting about the Rectum, Kadir Jasin mentions his name alongside Salleh Ben Jonid.

So search him out Voice.Or maybe prior to that you should ask about him...Just dont be put of by any negetive comments- like many gifted people, he is extremely idiosyncratic, so people who cant appreciate that may not have anything nice to say.

BUT he may be able to help you voice.And if he cant, at the very least, you might enjoy his company.

On my side i will try to search his contact nomber or something.If i get it i will just leave the nomber in one of your comment section.Just give me a bit of time.

Chins up.


tunku said...

and also no bayam, no liqour(hehehe).
well for this gout its only continuous medication and "pantang".
take care.cheers

Rockybru said...

just to read this posting is a pain. i hope you get well soon. and i also heard that mi rebus is good for gout.
ok, ok. i lied. actually, i don't know. mi rebus could actually be good for gout, y'know. will you google on it and tell us?
anyway, in the event that mi rebus does not do anything - good or bad - to gout, you can be assured that the company at kak maria's is always good.
pak saad has been asking about you, man.

monsterball said...

They say go to mosque..confess your sins sincerely..especially try not to disunite my lovely friendship with Sheih will reduce your gout problem.
I had a matter how nice you treat him..he treated others like suckers.
Gout creeped into his life...yet never change....died very young age.
So do not fool with life..twisting and turning messages to disunite good friends..especially disuniting malays against malays in UMNO!! No everyone can be a TDM...having long life. Watch your bad khammars!!

Anonymous said...

Hoi Telur Raksaksa Jahat,

Tak hormat ka orang dalam sakit? Dengan orang sedang sakit pun engkau nak cari gaduh?

Memang kau buta hati betul! Tiada adab langsung. Nama saja tua, pengalaman sosial sesama manusia, sifar.

Orang lain memberikan pesanan agar A Voice semakin baik.

Engkau ni perasan nak mampus. Sheih umpat kau, sikit punya baik depan kami, setiap kali! Kau ingat Sheih tu sayang pada kau ka?

Dia kesianlah pada engkau,tua kutuk bersendirian, tahun baru cina pun tak da sedara, ngok betul!

A Voice said...

Ah ah ah ah hahahhahha Aku kena mintak maaf di masjid? Melalui pak imam belakang tabir? Atau sujud pada Pak Bilal dengan colok ke?

Jangan marah, kalau anda berugama lain. Hanya ketawa dengan kejahilannya tentang cara orang Islam. Kami mohon maaf dalam sembahyang 5 kali sehari. Tak perlu melalui sesapa dan tak mesti di masjid.

Hairan dia mengajak orang supaya jadi bangsa Malaysia tetapi dia tidak tahu langsung adat resam dan bahasa utama bagi bangsa teramai di Malaysia. Bahasa kebangsaan pulak tu?

For someone who pass up a lot of racist remark agst Malay and UMNO, isn't it strange to hear him being defensive of UMNO?

Anyway people, this is not the usual me in my blog.

To know this strange character, shd read Monsterball's rude and obnoxious repeated posting of cursing and obtuse mind in Biggum's blog posting abt himself and another posting on NSTP.

A Voice said...

politikus, anonymous, aisha, mat hubris, rocky, shar and biggum

Tks for dropping by and for yr good thoughts.

monsterball said...

Good...Big fat dog has come to rescue a gout sick man..both now true Malaysians talking a language ..putting me at a disadvantag to battle it matter!!
This and your big dog site is where we battle it out man...if you both are gentlemen.... and not be jealous maggots to rojak Sheih's site.
mine mine mine..a voice..look at all the photos you put out in your post. As much as one needs to criticise the injustices done by Pak Lah's sole intention is to belittle clear.
Your whole self is written with a character to see malays do not unite as one.. and Malaysians must be disunited as much as possible. YOU SUFFER FROM GOUT?? CANNOT EAT THIS OR THAT??
Laugh as much as you want.BOTH OF YOU ARE LIVING IN HELL's lives!!!
The older you get...the worst you both will become. Mark my words!!
hi smart ass lecturer....say something sensible ...why pretend to laugh...when most of the time you suffer days and nights with swallon feet??

monsterball said...

Fat ugly big baboon love to say a malaysian must be able to read and write bahasa...lets debate on that.
Braggard shar101 love to behave like a son of Mahathir..saying I must gain respects from malays to be a malaysian...LETS DEBATE ON THAT.
Worst of all...a voice.. lecturer in a University call me a racialist. Lets debate on that.
If you three monkies dare not debate ...then come suck my huge ball for three.....hahahahaha

monsterball said...

For a leaerned man like you..a sure know how to twist and turn to make the less smarter blokes beleive in you.
I am disunity malays and UMNO??
Look at your are clearly one sided ...all anti present government. And you LIKE to disrupt my loving friendship with Sheih IS VERY CLEAR TO PROVE YOU HATE TO SEE A CHINESE CLOSE TO A MALAY. I am your chosen target? GOOD.
I have posted for and against government...never stereo type like you and alot of Malaysians of all races recogise me as a true malaysian. Why...are your eyes akso getting blind?
No need for me to disunite all malays with political agendas are doing a fine job. ALL THE WELL EDUCATED MALAYS that do not play politics KNOW THIS IS YOUR OWN DIRTY RACE MINDSETS.
No need other races to help are doing fine.
T.Razeleigh said the mindsets of malays must change. Who made them that way...CHINESE?
At least as he grew older he knew he himself have contributed somewaht to that and now speaking against it.
So a voice...don't try to be too smart to keep bluffing others with your idiotic logics.

Anonymous said...

Bodoh betul Telur Raksaksa Jahat ni!

Sekali menunjukan kebodohan dari analisa sempit yang silap.

Bila masa A Voice ini mengaku sebagai pensyarah?

Bila masa A Voice in bersifat anti Kerajaan?

Bila masa A Voice ini bersifat anti Cina kepada yang rapat dengan Melayu?

Bila masa Sheih padam habis posting aku dalam blognya?

Banggang betul ko ni!

monsterball said...

hi FAT BULKY ULGY DOG...My itchy bitchy hound dog with 8 juicy long tits is pastering me everyday...when can she meet you?
Having described that you have a small dick....the only thing you can do for a female is lick suck...lick..suck...and she is damn crazy about you.
Have you got ticks on your body? Go check it out..especially the hairs surrounding your small when she returns you the same will really love her.
How on earth you can be converted as a she tried and was chased a devil. I took pity on her and she is waiting day and night for lucky devil you!! POSTED BY IDIOT MONSTERBALL...hahahahahaha

monsterball said...

a voice...You want to know my character? So many months with more than a hundred messages..still do not know my character? Why type of lecturer re you?
It's call VERSATILITY lah.

Clark Gable of Pulau Duyong said...

Dear Voice,
Sorry about your predicament,tough one you got there,no one is envious of you.

Kind of funny to see Raksasa and BD battling on your blog...thru all the unbuckled innuendoes, the exchange repertoire of panavision variety denote familiarity much adored by both. My assumption is that they must be the best of friends if only they know each other better.

Tak kenal maka tak cinta.

Have a good rest Mr Voice, go slow on NSAID,luke perut they say.

monsterball said...

This is to give "a voice" a taste of his medicine...supporting those idiots to give rotten rojaks at Sheih's site!
Why there..why not here?

tunku said...

a voice,
who is this moron monsterball,
is it from hospital bahagia tanjung rambutan?

monsterball said...

wah wah wah ...a Tunku callimg me a moron...betul kurang ajah.
ME?..The obi-wan...dearest frontliner..uncle monty to dozens of commentators...respected wise one...and few more a moron?? What type of idiot tunku are you?? No wonder Mahathir said so many malays are half past six and Tunku Razaleigh said most of you all have funny mindsets ....yet call me moron?
How do you know I live in lovely Tanjong Rambutan town? You got crystal ball ah..real bodoh you.I live in a mad house owned by Sheih lah....hahahahaha. Betul betul bodoh. Tunku...balls!! I Wan Monsterball Jr. bin Wan Haji Monsterball fool.

Anonymous said...

Hey brother, have you

Tried fresh vegetable and fruit juice? A glass of a mixture of carrot, green apple, celery and bitter gourd twice a day for 3 months plus exercise of course. Sitting in front of the PC writing stuff is NOT an exercise.

Or you can just try overdosing on the alopurinol. Heard its got little or no side effect. At least it make your system discharges more uric acid. Please check it out first.

tokasid said...

Salam to voice.
Sorry to hear you had a gouty attack.Hope you are doing fine and recovering well.

Do be careful with what you eat.And matbe a walking stick will be handy.


Anonymous said...

your post:
"I Wan Monsterball Jr. bin Wan Haji Monsterball fool."

If you want to use malay name go ahead and use it, but a Haji is a title which you should not use. Go and ask Sheih about it.

Please do not insult other people's religion. I don't care about your fight with big dog or a voice but i feel very offended when you use the word Haji to your name.

Thank you.

monsterball said...

anon 8.21pm...If you feel offended..I we are taught not to get offended if a person puts out with no intention to belittle the religion or race...but to emphasise points that person feels fit for the receiver to read. I also consulted my old 'wan' friend ..and he said same thing....and he has a licence to James Bond.
Somehow alot of malays are sensitive and will protect everything and anything about their race...yet keep silence on injustice done to other races by their race in BLOGGINGS....NOT DAILY LIVES. Why is that so? Is this the mindset that Tunku Razaleigh was asking malays to change?

BaitiBadarudin said...

Lah, kesiannya, missed u all last tuesday, came late, get well!

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