I'm limping around Madrid, walking very gingerly up and down stairs. My knee is swollen and hot to the touch.
About four years ago, as I was training for the marathon one season and increasing my mileage, I suddenly acquired a pretty painful spot on my left foot. My diagnosis was "stress fracture" and I did all the things to cure what I thought was a simple injury due to increasing my mileage too quickly. For three weeks, I limped around and even asked Dorothy, Sam and Kai's babysitter from the neighborhood, if I could borrow her late husband's cane.
Pam said, call Jeff, our physician, and have him take a look at it. "No," said I, "it is just a stress fracture and rest will heal it." But it didn't. The pain got worse and worse. Pam said again, "Call Jeff."
So, I finally called Jeff. His first question was, "where is the pain?"
"Oh, right at the intersection of the first metatarsal and first phalangeal bones." (At the base of my big toe.)
The second question was, "Have you changed your diet?"
"What in the world does that have to do with my stress fracture?"
"Have you started eating anything different recently?"
"Well yes," I said, "I have been adding protein powder into my fruit drinks since I've been lifting a lot."
"Well," said Jeff, "you have gout."
Seems my kidneys are not so good at getting rid of uric acid, which is a result of the breakdown of a type of protein called purines. Also, carrying some extra kilos is linked to high uric acid levels. By adding protein powder to my diet, I had upped my purine intake and boosted my uric acid level to the point where it was crystalizing into glass-like shards in my joints.
Over the last years the bouts of gout have become more and more frequent, now occurring in my knees. The problem is that if I don't change my diet and lose some weight, these gouty attacks can turn into chronic arthritis and the uric acid crystals actually destroy the cartilage in my knee, requiring a knee replacement.
So, henceforth, no organ meats, no alcohol, no sardines or mussels and extra water each day. It is time to start the off-season, long slow weight loss. Hopefully in the next few days my knee will stop aching. No beer? No wine? I hate it when health matters steal a little joy from life. Anyway, I'll save discussion on the long off season weight loss plan for another post.