sudden onset of severe joint pain with redness, swelling and tenderness of the joint. Pain usually restricts movement, and people experiencing a flare-up may keep their foot out of the bedsheets as even the pressure from the linens can illicit pain. They may still be able to walk but often with a lot of pain. Pain reaches peak intensity within 12 to 24 hours and usually resolves after a few days to a week. Many illnesses, including infection, rheumatoid arthritis, pseudogout and inflammatory conditions, can cause joint pain and inflammation. A physician can tentatively diagnose gout based on a physical examination and the person’s symptoms, but a definitive diagnosis comes after finding elevated uric acid in the joint fluid. Treatment: For acute attacks, the goal is to quickly and safely reduce pain, inflammation and disability. Medications usually depend on a person’s kidney function, risk of bleeding and response to previous treatments. Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first line treatment for people with no history of stomach ulcers or kidney disease. Start these medications as soon as possible after an attack, and continue taking them for a day or two after resolution. For people who are unable to take NSAIDs, a physician may prescribe corticosteroids such as prednisone. Prevention: Medications that decrease uric acid levels may help prevent gout attacks from occurring, and dietary changes and weight loss may lessen their frequency. People with gout should eat low-fat dairy, whole grains, brown rice, oats, vitamin C, cherries and moderate amounts of coffee. They should avoid beer, liquor, organ meats and foods containing high fructose corn syrup and limit serving sizes of beef, lamb, pork and seafood such as sardines, shellfish and mackerel. Impact on boating: The majority of people who suffer from gout or acute gout attacks can safely go boating, but they should make sure they have 118
their appropriate medications on board for any prolonged excursions.
