The Disease of Kings

So, what the fuck is gout anyway?
Gout is what happens when your body wants to punish you for eating and drinking like you're rich.  The amount you eat isn't so much the problem as the style.  I'll elaborate.  It all starts with purines.  Purines are a major part of our body chemistry, dna, rna, etc...and are released into the blood after a cell is damaged or dies.  Our bodies know about this already and have a metabolic cycle to get rid of the purines with uric acid as a byproduct.  That's smart, but here's where we humans get thrown what I call a nature curve.  I'll be using the term "nature curve" in future blogs, so I'll define it here.

Nature curve- when nature for no good goddamn reason decides a human being needs to be more complicated and/or less robust and capable than just about every other known organism.

The nature curve here is the fact that we humans have no enzyme to get rid of uric acid.  Just about every other animal has an enzyme but not us.  A virtually fail-safe way to get rid of this unavoidable and possibly dangerous pile of biological waste?  No, that would be too fucking close to right.  Instead we are told to rely on our kidneys to flush out the excess uric acid which amounts to about 2-6 miligrams.  This works fine...except when it doesn't.  You see, uric acid metabolism is a relatively slow process, so the animals we eat tend have higher levels of uric acid in their muscles and inner-organs.  When we eat these muscles and organs, especially the more delicious ones like liver, we tend to get extra uric acid.  Alcohol, pate, fresh sushi, shellfish, and host of other deliciously decadent treats can all result in excess uric acid.  We can also just produce more uric acid on our own or end up with more if our kidney's crap out.  The point is we get more uric acid in our blood than we our able to piss out.  The uric acid doesn't just float through the blood endlessly.  Eventually it collects in our joints and forms a kind of crust.  This is a problem but a completely unnoticeable problem.  Uric acid crystals are shaped like spears but are too small to harm us directly; however, they are just big enough and foreign enough to trigger an immune response.

The immune response is simple and direct, attack with everything you got.  White blood cells mobilize, your temperature can rise, the area around the crystals swells,...the typical immune all-out-blitz of overwhelming force.  This is of course completely useless in remove uric acid.  Uric acid isn't a virus, bacteria, or unnatural foreign agent; so it honestly doesn't give two shits about your immune response.  But this is when you notice you have a problem, because the inflammation this immune response causes triggers the pain.  Oh God, the PAIN.  So gout isn't really a disease at all.  It's the result of immune response, and as far as autoimmune diseases go it's pretty low on the disaster-meter.  However, it does cause inflammation, possible kidney damage, and a crippling pain that borders on the limits of human endurance.

How bad is the pain?
Bad enough to warrant it's own blog post, so for now I'll just say that it is considered the most painful form of arthritis by those who know.

So now you know what gout is, which is good, because the next blog will detail exactly when, how, and why this blog became "The Gout Letters".  Spoilers: It starts in Virginia...I've said too much.