“I cry. I shout—a lot. As in every move I make, sasakit siya ng sobrang sakit. Tapos even the pulse beats cause too much pain especially during the first two days,” says Juan Carlos De Leon, 29, who works for a real estate company as an administrative personnel. “I can’t compare it to any other type of pain but it makes me immobile for a week.”
Architectural consultant Ervin Cariaso, 35, relates to the pain that De Leon is talking about. “It was just last May. As in major attack ‘to and I had to take a two-day rest. Hindi [ako] makalakad, eh. This was right after our company’s dinner and dance where I was part of the musical presentation. Imagine kung umatake yun during the night of the event, ‘di ba? Paano kung may important kang lakad o may vacation trip ka tapos in the middle of your vacation ay umatake yun? Eh di sira ang lakad mo. And not only that, yung mga kasama mo, mag-aalala pa sa’yo so pati bakasyon nila, nasira.”
De Leon and Cariaso are talking about an ailment that they both have been suffering from for some years now: gout, an episodic painful form of inflammatory arthritis due to increased uric acid. Decades ago you would have only heard about gout from your aging parents, but these days the disease appears to be the ultimate party pooper to your enjoyment of food and drink and, increasingly, your youth.
“There is an observation that there seems to be younger patients who get afflicted [with gout],” says Philippine Rheumatology Association President Heizel Reyes. “Those with family history are also at an increased risk. Patients with comorbid diseases such as kidney impairment, blood disorders, or heart disease are also at higher risks by virtue of the disease itself or the medications used for these.”
'Patients with comorbid diseases such as kidney impairment, blood disorders, or heart disease are also at higher risks by virtue of the disease itself or the medications used for these'
Data from a 2015 PRA study show that there are 1.6 million Filipinos suffering from gout. Then-PRA president Eric Amante said that they even expected the number to continue to increase because of people’s unhealthy lifestyles. “It’s 1.6 million. But if you look at the prevalence in the Philippines, it’s increasing in the past two decades. We have a lot of breadwinners who have gout and I think it’s very important to remember that this is a chronic illness,” Amante said. “Chronic” means it stays with you— for a long time.
The signs of gout
If there is one thing that Cariaso has learned from his gout, it is to be a more thinking netizen in the age of social media. “This is how I got my gout: Nagkaroon ng trend noon, yung pag-inom ng soya milk. As in every morning bago ako pumasok sa office, umiinom ako nun. Ang alam ko naman kasi is healthy naman ang soya milk.””
That’s what he thought—until he started feeling its effects. “After a year of drinking soya milk, bigla na lang sumakit yung paa ko. Doon sa may joint ng big toe. At first I thought na-sprain o napilayan lang ako. Kaso every day, lalong sumasakit siya at mas naging swollen talaga yung paa ko.”
Too much of something was also the case of De Leon. He’s been suffering from gout for a decade now. “Liver was my ultimate [favorite food] then, and huge servings of monggo. Yun, paborito ko talaga. Tapos I also occasionally drink, eh beer triggers gout.”
“When it first hits you, you wouldn’t know immediately that you have gout,” says rheumatologist Dr. Isagani Gabonada. “You’ll most probably think that it’s just a normal body pain caused by exhaustion from your activities.”
“Pina-massage ko pero ayaw mawala nung pain. Mas lalo pang naging worse ang condition,” Cariaso recalls.
“One morning, habang papasok ako sa office, my colleague asked me kung bakit iika-ika ako maglakad. Then sabi niya na maybe it’s gout. So ni-research ko agad what gout is. Hanggang sa nagpasuri na ako sa doctor, and that was when he confirmed to me my fear then, na ayun nga, gout hit me.”
'Gout is caused by hyperuricemia, when there is too much uric acid in the body. According to the Centers for Disease Control & Prevention, the body makes uric acid when it breaks down purines, which are found in the body and the food that you eat'
Meanwhile, De Leon is quite confident that he got his from his excessive love of monggo and liver. “Doctors said high uric acid is caused by eating too much food that are rich in purine like beans, meat, deep-sea fishes, and innards like internal organs like liver. Eh di ba nga, paborito ko talaga nun ang liver tapos monggo pa.”
Cariaso considers himself still lucky that his gout attacks don’t happen often. There are times when symptoms get worse, known as “flares,” and there are times when there are no symptoms at all, known as “remission.” You can never know when flares will attack. As scary as it may sound, it will happen when it happens.
“Minsan hindi mo talaga mararamdaman na may gout ka eh. Bihira lang ako atakihin, twice a year lang. Pero kapag inatake naman ako, one month yun before totally mawala ang sakit,” Cariaso says.
The causes and effects
Gout is caused by hyperuricemia, when there is too much uric acid in the body. According to the Centers for Disease Control & Prevention, the body makes uric acid when it breaks down purines, which are found in the body and the food that you eat. When you have too much uric acid, monosodium urate can build up in joints, fluids, and tissues within the body. These urate “crystals” cause the pain, which some describe as like walking on broken glass.
Gout has often been referenced as a “rich man’s disease” because you get a lot of uric acid when you eat hearty, often meat-based dishes, that the common folk usually don’t get to dig into. But modern society has changed all that. In the age of fast-food and food processing, we are all susceptible to the disease.
To read more on this story, grab a copy of the Decmber 2017 issue of FHM Philippines