The story of Jimmy’s big toe

I HAPPENED to pop into the Spoeg & Spittle the other evening for a small one, with which to salute multi-million rand home renovations that miraculously escape the home owner’s notice (yes, I’m talking about Nkandla), and there I bumped into my
ol’ mate Jimmy.
Now, had you been in the Spoeg & Spittle at the same time, and sitting across the bar, you might have imagined that as we sipped our dops, Jimmy and I were discussing the President’s security upgrades at Nkandla, Land-Rover differentials, the Super 14, how short Oscar Pistorius is without his legs or Pamela Anderson’s cleavage. You would, therefore, have been puzzled if you’d noticed that suddenly Jimmy was unlacing his shoe.

You would have the right to be puzzled. Men do not take off their shoes in bars, or not in the bars that I have frequented. I have been going into bars for the best part of half a century and until last week had not encountered such a phenomenon as a man
removing his shoes. But let me tell you, there was a very valid reason why he was doing so, valid and related to the environment in which it was happening.

Jimmy removed his shoe and his sock and revealed a big toe so infected (or affected) with gout that I thought I was seeing a cartoon. So inflamed was his big toe that I estimate it was double its original size, and it was as red as a radish, and apparently it hurt like hell. You could have held up his toe at a traffic-lighted intersection, and cars would have stopped, and even taxis would have hesitated.
But gout, for reasons not fully understood, is one of those conditions that can be laughed at. You don’t get gout and sympathy, you get gout and advice about giving up, or at least cutting back on your drinking, ha, ha, Jimmy, that doesn’t look like fun, hey,
have another beer.
Yet gout, inflammatory arthritis, is an excruciatingly painful condition. Apparently Jimmy would feel that his toe is painfully throbbing, feeling almost as if it’s on fire, getting ready to explode, and the slightest touch is agony, and even the weight of the bed
sheet is too much to bear. And after all that, like I said, it’s a condition that can be laughed at. Like, for example:
This guy goes to the doctor with gout.The doctor gives him 200 Viagra tablets and tells him to take two every night before going to bed.
“Will this cure my gout?” the man asks.

“No,” says the doctor, “but it will keep the blankets off your foot!”
I think we laugh at gout because we believe it’s self inflicted, that the sufferer could have avoided it if he (it’s usually a “he” isn’t it?) had drunk less, especially less red wine, and eaten less red meat. I mean, he was asking for it, wasn’t he, the way he puts it back. But in fact, gout is apparently unrelated to those factors – they merely make it worse, as I understand it.
Jimmy is in fact suffering from podagra, which is specifically gout affecting the big toe, and it would seem that he is displaying symptoms typical of the disease.
The cause is high levels of uric acid in the blood. I don’t know anything about Jimmy’s lifestyle, but it probably doesn’t help his condition. I know, for instance, that he enjoys a dop, and the causes of gout include “a strong association with the consumption
of alcohol…”, as well as meat and seafood. I don’t imagine that Jimmy’s diet includes quantities of beans, peas, lentils, and spinach, and it doesn’t matter if it does. Those “purine-rich” vegetables, once thought to be associated with the causes of gout, apparently aren’t.
And here’s a thing: I thought that when it came to alcohol beverages that wine was the culprit when it came to sponsoring gout, but apparently beer and spirits carry a greater risk, and Jimmy drinks spirits.
Anyway, as I understand it, and I don’t, gout is caused by crystals of uric acid getting into the joints and playing merry hell with things.The uric acid crystallizes in the form of monosodium urate which is precipitated in joints and the surrounding tissues.
Why there and not harmlessly, say, in your facial hair, where it could be painlessly shaved off in the morning, I cannot say. And nor can the specialists.
In fact, there is a lot not understood about gout, and not only by me. One of the factors is apparently temperature, cold not being the gout sufferer’s pal. This factor might in part explain Jimmy’s big toe, in that the big toe is an extremity, probably more prone to the cold than the rest of his body, and the precipitation of monosodium urate increases at low temperatures.

Anyway, Jimmy has my sympathy. There but for lower

uric acid levels go I.