Gout before the age of 30! After the doctor himself diagnosed gout, the treatment experience is worth learning for everyone
When Chen Xizhe turned off the alarm clock on his mobile phone, sat up sleepily, and the moment his big toe touched the floor, a sharp pain hit him. His heart skipped a beat: Oops, I might have gout.
This year, he was only 22 years old.
Most people think that only the elderly will get gout, and gout is an "exclusive disease" for middle-aged and elderly people. But in fact, more and more young people in their 20s appear in the rheumatology and immunology clinics of hospitals.
01
At the age of 18, high uric acid came to my door
Chen Xizhe discovered that he had high uric acid because of a very accidental opportunity.
In August 2017, at the age of 18, he entered the clinical laboratory department of a hospital in Zhaoqing, Guangdong Province as an intern. At that time, the director of the department offered to help these interns do physical examinations. When the results of the physical examination came out, the column of uric acid showed impressively: 560μmol/L (μmol/L is the concentration unit, that is, micromol/liter, which refers to the amount of a certain substance contained in 1 liter of liquid), which is 140μmol/L higher than the normal value. L.
This result is equivalent to declaring that he has hyperuricemia (HUA), which is commonly known as high uric acid.
In medicine, hyperuricemia refers to a metabolic disease caused by an increase in uric acid in the blood due to a metabolic disorder of a substance called purine in the human body. Generally speaking, under normal conditions, uric acid levels are higher than 420 μmol/L for men and 360 μmol/L for women, which can be considered as excessive uric acid.
◎ Picture: In April this year, Chen Xizhe's blood test report showed that the uric acid level was still beyond the normal range. / Respondents provide
It is worth noting that there are no obvious symptoms in the early stage of high uric acid, and it is generally not easy to detect unless it is consciously and regularly tested. The "Guidelines for the Diagnosis and Treatment of Hyperuricemia and Gout in China (2019)" pointed out that the overall prevalence of hyperuricemia in mainland China is 13.3%, and the number of patients has exceeded 180 million, and the number of patients has even surpassed that of diabetes. High uric acid has become the "fourth highest" after hypertension, hyperlipidemia, and hyperglycemia .
In addition, hyperuricemia is getting younger and younger. A survey conducted in China on the blood uric acid levels of 1515 school-age children in Tianjin found that children with hyperuricemia accounted for 12.94%, of which the prevalence rate was 19.57% for boys and 5.67% for girls.
However, Chen Xizhe is still puzzled: I am not usually a person who overeats, why do I have high uric acid at such a young age? So he went to find a doctor to find out. The doctor explained that most people in the outside world know that high uric acid is greatly affected by dietary factors. In addition, it is also related to genetic factors.
In the end, the doctor gave Chen Xizhe "one more and three less" suggestions: drink more water; drink less soft drinks and beer, eat less seafood and other high-purine foods, and stay up late less.
◎ Picture: beer + seafood, netizens jokingly call it "gout meal"
After this consultation, Chen Xizhe consciously increased the amount of water he drank every day, and the uric acid level did drop a bit. However, because of his busy work in the laboratory department of the hospital, he had to work overtime and stay up late at night from time to time, his uric acid value kept repeating, sometimes dropped and then increased, and the control effect was not ideal.
The most shocking data finally appeared in front of Chen Xizhe: one day in August 2020, he measured the "highest" uric acid result in his personal history: 790μmol/L —almost twice the normal value of ordinary people.
This is equivalent to an "invisible bomb" planted in his body.
02
Gout, made him "miss many opportunities"
Last year, this "invisible bomb" suddenly exploded, catching Chen Xizhe off guard. That morning, when he woke up and sat up to go to work, the moment the toe of his right foot hit the floor, a sharp pain shot up from the toe joint. Although the toe joints did not appear red and swollen, because of the history of high uric acid, Chen Xizhe, who has some medical knowledge, knew that it was probably gout.
After returning to the hospital, he had a uric acid test: 540μmol/L. A doctor colleague prescribed gout medicine for him and gave him something to eat and drink.
Later, Chen Xizhe searched a lot of information on the treatment of gout on the Internet, but found that they were all the same and did not help him much. Under the introduction of his colleagues, he found another doctor who specialized in treating gout in the countryside, and prescribed some traditional Chinese medicine that was ground into powder and boiled in water, but the effect was minimal. At the end of the toss, he still stabilized his condition by taking the medicine prescribed by the original doctor.
◎ Picture: Chen Xizhe is currently taking the medicine for treating gout. / Respondents provide
In daily life, Chen Xizhe's gout would recur as long as he didn't pay attention, so he missed many "important moments in life":
He is a basketball enthusiast and has played power forward and center positions for a long time. In one game, the team tried their best to win the chance to advance to the semi-finals. In the evening, the team members had dinner together to celebrate. Chen Xizhe couldn't help drinking a few glasses of beer while he was happy. As a result, his gout attack immediately the next day, the pain was so painful that he couldn't even walk, and he lost the chance to play later. This made him regret it.
Until now, the toe joints of Chen Xizhe's feet still suffer from pain from time to time. Gout usually occurs when you get up in the morning, and the body returns to normal after the pain lasts for an hour or two. For Chen Xizhe, a very young 23-year-old, the pain is bearable and has little effect on walking.
But some patients are not so lucky. Someone once described a gout attack on the Internet like this: the bone-biting pain is like being bitten by a devil's joints, like a knife cut, like tearing, it makes people want to die. Even a gust of wind can aggravate the pain. An imposing seven-foot man will also be tortured to tears.
◎Picture: Gout is common in the metatarsophalangeal joints, ankle joints, wrist joints, knee joints, small joints of the hands, etc., and may cause symptoms such as redness, swelling, pain, and fever in the joints.
Because he felt that his gout was not too serious, Chen Xizhe thought for a while that he could try not to take medicine without taking it, but after practicing it, he found that he could not control the disease at all without taking medicine. Now he takes medicine every three or four days, and consumes about one box a month. Fortunately, the price of this kind of gout medicine is not high, and it costs about 60 yuan a month, which did not cause him too much financial burden.
03
Will the next generation continue to suffer from gout?
When he was 18 years old, he found out that he had high uric acid during a physical examination. Chen Xizhe told his family, and the elders in the family couldn't believe it——
"You have high uric acid at such a young age?" "You're only 18, how could you be like this?"
Because the hospital where he works is relatively close to his home, Chen Xizhe asked his family members to go for a test. It turned out that the uric acid levels of all the male elders in the family exceeded the standard. His father and an uncle still had symptoms of gout . Chen Xizhe recalled the explanations given by his teachers during the previous internship, and he was convinced that his hyperuricemia was probably caused by genetic factors—the poor function of the kidneys to excrete uric acid.
◎ A researcher analyzed the situation of gout patients who visited a certain hospital for the first time in the past 10 years, and concluded that the clinical characteristics of gout have changed significantly in the past 10 years, and these changes are related to the younger trend of gout.
Studies have shown that there are obvious gender differences in hyperuricemia, that is, "boy preference" . In the same age group, the blood uric acid level of men is significantly higher than that of women, and the prevalence of hyperuricemia in men is also significantly higher than that of women. In addition, through the family study of patients with hyperuricemia, it was found that hyperuricemia has a clear tendency of family aggregation.
Because of this uncontrollable factor, Chen Xizhe, who is still unmarried, has already begun to worry about the future generation: "What if my child inherits this disease?"
From the age of 18 to 23, Chen Xizhe has been struggling with high uric acid and gout for several years. He has been trying to master the skills of "living in peace" with this disease, and will try to avoid all factors that can cause gout attacks in his daily life. All he can think of now is to try to cultivate healthy eating habits for children in the future.