DEAR DR. DONOHUE: I have gout in my big toe, and it’s very, very painful. I have to walk in my socks. Are there any pills for gout? What food causes the pain? — L.K.
ANSWER: Gout results from too much uric acid in the blood. Uric acid is a byproduct of daily cell chemistry. When the uric-acid level rises, crystals of it penetrate the joint. The joint swells, the skin over it turns red, and the joint feels warm. It hurts beyond words. Early on, gout comes in attacks, with the intervals between attacks being free of pain. As time passes, the joint can hurt all the time. The joint at the base of the big toe is often the first joint affected, but it might not be the only joint. The heel, ankle, knee, fingers, wrists and elbows also can be targets.
Doctors make the diagnosis of gout by examining the affected joint and finding a high blood uric acid. The most telling evidence lies in looking at joint fluid through a microscope and seeing uric-acid crystals.
Are you positive it is gout that you have? Many conditions cause swollen, painful joints.
For acute gout attacks, nonsteroidal anti-inflammatory medicines like Indocin work well. Another time-honored gout medicine is colchicine. If neither of these works, cortisone drugs come to the rescue.
Zyloprim (allopurinol) turns off the production of uric acid and prevents gout attacks. Benemid (probenecid) facilitates the excretion of uric acid into the urine. It, too, prevents attacks.
Diet was the sole treatment of gout in the bad old days. Organ meats — liver, brain, sweetbreads and kidneys — are foods to avoid. Gravies are not good for those with gout. Beer should be restricted. Bing cherries can bring the blood level of uric acid down.
The gout pamphlet deals with this topic in greater detail. Readers can obtain a copy by writing: Dr. Donohue, No. 302W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I have wax buildup in my ear. The doctor told me that. He didn’t tell me what to do for it. Will you? — A.C.
ANSWER: Warm some baby oil or mineral oil. Put one or two drops in one ear and let it remain there for 10 minutes. This will soften the wax. Next, using a rubber-bulb syringe found in drugstores, gently flush the ear with warm water. Tilt the head to drain the water out of the ear, and the wax should come out with it. If it doesn’t, repeat the procedure.
Don’t do this procedure if you have a hole in your eardrum or an infection of the ear canal.
If this procedure is too much to handle, have the doctor do it.
DEAR DR. DONOHUE: Sometimes you hear that people who have a heart or liver transplant take on the personality of the person who donated the organ. Is this true or not? — N.N.
ANSWER: That’s fantasy, stuff of fictional literature. It doesn’t happen.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.