I am in the middle of an attack of gout. It seems to me that this is in some way governed by the simplified reversible reaction:
–
C5H3O3N4– (aq) + Na+(aq) ⇌ C5H3O3N4Na(s)
–
In which sodium urate crystals are deposited in the tissues of my foot. There will be a multitude of other equilibria and pH dependent equations. It is obvious to me that increasing [C5H3O3N4–] and [Na+] will drive the reaction to the right, simplistically. Higher concentration means more pain.
Gout is not fun!!
Yet the concentration of sodium ions is not mentioned in the swathe of articles I have read this morning. Am I missing something? Why is this not factored in? Am I being picky?
Medical research always seems a tad vague to my sensibilities. Yet the conclusions are acted upon.
There is a lot of anecdotal stuff about gout, cut and pasted, all over the internet. Victorian stereotypes persist. People read things and don’t question provenance. Maybe I should get a tin foil hat just in case. Where can I buy a reputable bottle of snake oil? Which has the best Trustpilot rating? If 87% of 75 people said it works, it must be true, after all we are worth it.
My urate ion concentrations are less than 10% above the norms yet my C reactive protein is moderately elevated consistent with significant inflammation. It could be gout but I also wonder if something more exotic is being missed.
The GP has prescribed for me a poison, which has no antidote, to combat the symptoms. The margin between effective dosage and toxicity is small. In the tablets are an anti-convulsive and opium powder to offset the possible side effects of the toxin.
If I stick to the prescription, I will be on low dose opium for a month. I am also prescribed allopurinol with the aim of reducing my serum urate levels to the bottom end of the “normal” amounts.
Tomorrow, I see a podiatrist to discuss an orthopaedic sole to compensate for the fact that my left, titanium pinned leg, is shorter than my right. I will also discuss bilateral hip replacement in March. I have a COPD linked follow up with a lung doctor and a colorectal cancer endoscopy pencilled in for late spring. I have a working hypothesis that all these medical issues are a reminder to never incarnate again.
I have what are called co-morbidities and this reduces the available medical play book.
I am not entirely happy with the notion of a very mild opium fog.
Hmnn…
Dreamyoga 