Ashley Teixeira of Ewa Beach, Hawaii, first started experiencing pain when she was a 21-year-old college senior. It started in her foot and became so excruciating that she went to the emergency room. The diagnosis? Gout. She wasn’t completely surprised given her family history of gout, but she didn’t expect to develop the disease at such a young age. And she had no idea the impact that the disease would have throughout her life.
Gout is a systemic, inflammatory disease caused by too much uric acid in the blood, which can form tiny, needle-like crystals. These crystals can build up throughout the body and trigger painful gout flares that can last for hours or even days.[i] In a study from the University of Hawaiʻi at Mānoa, researchers found that, compared to White participants, Native Hawaiians had more than double the risk of developing gout as older adults.[ii]
Ashley’s primary care doctor prescribed her oral medications to manage her uric acid levels and prevent future flares. However, for 10 years, the flares continued and became more frequent, spreading to her knees, ankles, toes, and feet. She learned she was living with out-of-control gout, which is when symptoms continue and uric acid levels remain high, even with oral medications to lower uric acid.[iii]
“Many people know common symptoms of gout—painful, swollen, red joints,” says Brittany Panico, DO, Chief of Rheumatology at Summit Rheumatology. “But the impact of gout goes far beyond the bones and joints. Gout also raises the risk for several other diseases—including diabetes, chronic kidney disease (CKD), and heart disease.”[i]
In January 2021, a checkup and blood test indicated Ashley’s kidney function had decreased. Her doctor referred her to a kidney specialist (also known as a nephrologist), who quickly diagnosed Ashley with CKD, which is when the kidneys don’t work as well as they should.[iv] Ashley learned about the close connection between the two diseases. When someone has gout, uric acid can build up in the blood and form crystals that can damage the kidneys, leading to the development or progression of CKD.[v]
Now this 43-year-old kindergarten teacher wonders what would have happened differently had she acted sooner to get her gout under control. Because her gout puts her at a higher risk of her CKD worsening, she’s working closely with her nephrologist to lower her uric acid levels.[v]
“I try not to let it affect me in the classroom, but it does,” explains Ashley, whose pain also makes it difficult for her to drive to school. “My students know when I’m in pain because they can see me limping. They’re like, ‘Ms. T, are you okay?’ They’re kindergartners so all they want to do is be loved and learn. I want to be there for them, but it can be a challenge.”
Fortunately, Ashley has a built-in support system, from her thoughtful co-workers and students to her helpful friends and community. Plus, she lives with her mom and aunt, who understand what it’s like to live with gout.
Ashley chooses to maintain a positive outlook on life each day and hopes to pass along some of the lessons she’s learned on her health journey, including the importance of advocating for yourself.
“I’m happy that people are starting to talk about it because that’s what initiates the education—sharing your personal story,” she says. “In Hawaii, we have a thing called ‘talking story.’ I’m just going to talk story with you, and through this, me sharing my story, you’re going to share your story with me, and we’re going to help figure out how to get through this together.”
She advises, “If you have the slightest inkling that it’s gout, do not wait. Go see a doctor and get it checked out. Get educated on what gout is and what it can do.”
What’s the next step?
Don’t wait or dismiss signs of gout. Take immediate action to speak with a gout specialist about your risk.
“Gout is a lifelong journey, and it requires regular attention and management,” says Dr. Panico. “The earlier gout is diagnosed; the quicker steps can be taken to manage the disease before it becomes out of control. I always encourage patients to advocate for themselves and be proactive in seeking out care until they are able to find a solution.”
“Somebody you know is going through it, so let’s talk about it,” Ashley says. “Let’s air it out there. Let’s be aware, be educated, and let’s help each other get through this.”
Visit GoutRevealed.com today to learn more about uncontrolled gout and find a gout specialist.
References
[i] Dalbeth N, et al. Gout. Nat Rev Dis Primers. 2019;5(1):69.
[ii] Thompson M, et al. Modifiable Factors and Incident Gout Across Ethnicity Within a Large Multiethnic Cohort of Older Adults. The Journal of Rheumatology. 2022;49(5):504-512.
[iii] Refractory Gout. National Kidney Foundation. https://www.kidney.org/atoz/content/refractory-gout. Published 2017. Accessed April 24, 2023.
[iv] What Is Chronic Kidney Disease? – NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/what-is-chronic-kidney-disease. Published October 2016. Accessed April 24, 2023.
[v] Khanna P, et al. Systemic Urate Deposition: An Unrecognized Complication of Gout?. J Clin Med. 2019;9(10):3204.
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