Unfortunately, the "fateful" day has finally come to me. Gout started its first attack on me this Wednesday morning. Since then my right big toe started to swell up, and the resulting pain became more and more acute, until I could not walk at all yesterday. Before I reached this stage, I succeeded to shlep myself somehow to my family doctor and receive some painkiller the day before yesterday, though I have not benn able to feel its effect very much.
Although I am not a medical doctor, I know exactly what has caused gout to me - daily consumption of a large quantity of alcohol: until this first attack I used to drink, at least in the last few years, 2-3 liters of beer every weekday and one bottle of red wine for each of the three Sabbath meals from Friday evening until Saturday late afternoon. When consumed in a large quantity, alcohol, especially beer, is known to elevate the level of uric acid in blood, which in turn crystallizes and deposits in joints, especially in those of big toes. And the result is a swollen joint and excruciating pain, which you would prefer never to know.
Having checked the archive of this blog of mine, I have found that actually in March 2007 one of my big toes got swollen a little, though there was not concomitant pain. Then I saw this as a kind of early warning of gout and decided to stop drinking beer and switch to red wine. This decision seems to have lasted only for about three years. Little by little I resumed drinking beer, and I also found myself drinking more and more beer daily on weekdays.
This time the attack was real. I had no choice but to make a resolution of stopping beer and allowing myself the pleasure of drinking red wine, but up to two glasses per meal, and that only on Sabbath and holidays. Since Wednesday I have not drunk any alcohol. I do not even remember when I refrained from drinking alcohol for two consecutive days last time. I have also reexamined my diet and other daily habits according to the recommendation by my family doctor and those by other experts I found online. Except for the exaggerated daily consumption of alcohol, I have not found anything wrong that must be changed fundamentally.
Another factor that is known to elevate the level of uric acid in blood is stress. I am afraid that it must have been another cause of my gout. Probably the worst kind of stress I feel in Israel is sociocultural both privately and occupationally. At least on sabbatical this year I am spared this sociocultural stress as the people I meet regularly are rabbis and other students at an American haredi yeshiva. But I am afraid that once this sabbatical has ended and I have returned to "normalcy", I may experience the same sociocultural stress even more intensively. Actually, one of the reasons for drinking was to relieve this stress, though I admit that this is not a healthy way. I have to start looking for other ways to cope with this stress as more than half of this sabbatical is over and I have no less than two more months at the yeshiva.