Uncovering the culprits behind my recent gout flare-ups

Note: This column describes the author’s experiences with tacrolimus and prednisone. Not everyone will have the same response to treatment. Consult your doctor before starting or stopping a therapy.

I’ve been dealing with a different and unexpected symptom these past eight months, one that’s challenged my pain threshold on a whole new level.

It’s embarrassing to admit, but I’ve had five flares of gout this year. My big toe on my right foot and the joint attached to it have become swollen, red, hot to the touch, and they throb relentlessly. The pain has been so intense that it’s woken me from a deep sleep in the middle of the night.

A trip to my primary doctor confirmed that my symptoms were indeed gout, and he expressed empathy upon seeing the pain I was in.

Never in a million years did I think that I would get gout. Not that anyone does, but I’m not a textbook case. Statistics show gout is most prevalent in men, postmenopausal women, and African American and Hispanic ethnicities. I don’t check any of those boxes. Other risk factors are related to obesity or diet, with beer, high fructose corn syrup, and richer foods playing a role. Again, that’s not me; I eat healthy most of the time and don’t drink alcohol. I’ve also never struggled with obesity, as gaining weight has been a challenge for me due to cystic fibrosis.

So what gives?

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Figuring out the ‘why’ of gout

Well, apparently, gout can be prevalent among people who use tacrolimus, one of the anti-rejection medications I take following a double-lung transplant. The drug inhibits the body’s ability to clear the kidneys and expel excess uric acid. After nine years of taking this medication, my body is suddenly angry about uric acid.

Other risk factors I’ve found that apply to me are diabetes, high blood pressure, and kidney disease. I had kidney damage shortly after my transplant, resulting in stage 3 kidney disease, and taking prednisone and other medications has resulted in steroid-induced diabetes and high blood pressure. Boom. I found the culprits.

While I’m relieved to have some answers, it doesn’t change how hard these flares have been for me or how much they’ve impacted my life. I try to be active, and gout has left me barely able to walk. This setback has left me exhausted, depressed, and angry.

The most glaring frustration for me is that prednisone is the most effective intervention, but several rounds of it to alleviate the gout flares have resulted in sleepless nights, weird cravings, and mood swings that have taken a toll on my mental and emotional well-being. The body aches, adrenaline surges, and bloating have caused so much pain and discomfort on top of the gout flare itself. Despite all of these side effects, the prednisone has worked each time to alleviate the flares, thankfully.

Since my double-lung transplant nine years ago, life has continued to throw me curveballs. I thought that living with cystic fibrosis gave me enough framework for dealing with unexpected health crises, but I’m continually amazed at how exciting my life has become.

Sometimes, though, I’d like a break from all the surprises. But through it all, I continue to recalibrate my routine and give my body the care that it needs. I’m always learning, even when giving myself that grace and space is hard.

Note: Cystic Fibrosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Cystic Fibrosis News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to cystic fibrosis.