"It's the gout"

Wednesday, September 26, 2012
I began the day as I had the previous one…limping to the bathroom on a painful, big toe.  It wasn’t going away and so I emailed Nilesh describing the symptoms.  He answered quickly, suggesting an appointment time that afternoon.  I quickly rearranged my schedule to accommodate his time. 
I arrived in his Akron office about thirty minutes early hoping he’d see me sooner.  The plan worked and I was in.  I took off my shoe and sock and was pleased that it looked so awful.  I didn’t want to show up with nothing and seem like a whiner.  I had also told him how the pain in my elbow had returned and that my achilles was extremely sore.  I’d written that I was getting old.  In his reply, he commented that he couldn’t do much about ‘old’.  He’s almost funny.

He looked over the toe, squeezing in a couple of spots so he could watch me wince.
“I’m going to take an x-ray just to rule out advancing arthritis, but I think it’s gout,” he said and then began probing my elbow until he had me rising out of my seat when he found the tender spot.

As he examined my, he described what he was doing to an intern he had with him.  He then asked me a question I was sure he knew the answer to.  “Who’s your primary care physician again, John?”

“Umm…Nilesh Shah,” I answered.

They both began to laugh.  “Told you he’d say that.  You really need to get a primary care doc.  When’s the last time you had a general physical?” he asked

“That…would…be…umm…the last time you did one,” I said.

They laughed again.  “Told you he’d say that, too.  John…I’ve never done one on you.”

Okay…I knew that, too, but figured he was too busy to know.

“Why do I need that primary person when I’ve got you?” I asked, already knowing the answer.

He shook his head and went on to describe my therapy for the elbow, which would include a nitroglycerin patch and eccentric weight lifting.  He gave me something to do for the achilles and concluded by sending a prescription to my pharmacist for the anti-inflammatory drug I’d be taking for the toe.

“This stuff WILL eat a hole in your stomach, so take it with a full meal,” he said.

I drove straight to the pharmacist, purchased the drugs and returned home.  I ate a large meal and downed the pill, returning to my recliner to await the blessed relief.  By bed time it had still not happened and I spent a sleepless night with a toe that just wouldn’t quit throbbing.