Patient Continues to Insist He Suffers from “The Gouch,” Not Gout

NEW YORK, NY – Larry McCarthy is a 65-year-old gentleman who doesn’t believe in the classic food pyramid; he believes in meat and alcohol pyramids, just like his parents and his parents’ parents.  He developed podagra a few years ago and was found to have a serum uric acid level of 12 mg/dl and joint fluid with negatively-birefringent monosodium urate crystals.

goutBut don’t tell him he suffers from gout; he suffers from “the gouch.”

“I don’t know what is this ‘gout’ you keep talking about,” McCarthy told his primary care physician and rheumatologist once more.  This has gone on for years and McCarthy insists he doesn’t suffer from gout.  McCarthy has even threatened to fire his doctors if they started treating him for gout.  “You’re just making this stuff up.”

McCarthy says the gouch has been getting worse over the past three-to-four months.  His attacks are more frequent and seem to be progressing up his leg, affecting his ankle and knee on occasion.  He finds that heavy meat consumption (particularly end-organ meat like liver), alcohol consumption, cold weather, and shellfish are major triggers.  Interestingly, many of McCarthy’s family members have similar triggers for a similar condition.

But it’s not gout.

“There’s a reason it’s called ‘the gouch,’ you know,” explained McCarthy.  “Whenever it flares up and I try to walk, I go ‘Ouch!’  See?  Ouch… go-ouch… go-ouch; gouch!  If I tried to walk and could go out, then I’d gout and be fine.  This isn’t gout.”

McCarthy has taken nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, and even prednisone to help with his acute gouchy flare.  Though he finds all treatment modalities equally effective, he prefers to stay away from the colchicine.

“I don’t like colchicine because of the side effects,” said McCarthy.  “They’re terrible: belly pain, nausea, and vomicking.  I especially dislike the vomicking.”  GomerBlog asked McCarthy if he meant vomiting; he proceeded to yell, cuss, and scream at us before he angrily limped away.  McCarthy muttered under his breath for no one to hear, though we heard him pretty clearly: “Stupid GomerBlog, stupid doctors, and stupid gouch!”

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