Centre Medical International – Where I now have a GP.

Well, this diagnosis was completely unexpected. I thought I had an infection. WRONG.

Let me explain. As I mentioned in a previous blog entry, I have been experiencing some serious problems with my left foot. Let me recap a full 9 days with the following representative dialogues:
Day 3: “Hey Ben! Want to go to the supermarket?”  “Sure, but I can’t go far or fast.”
Day 5: “Hey Ben! Want to go out tonight?”  “I can barely make it to the kitchen on the 2nd floor and you want me to walk to a restaurant 30 minutes away with healthy, drunk 21 year olds?”
Day 8: “Hey Ben! How’s your foot?”  “Ohgodohgodohgodohgodohgod”
By Day 8 it was swollen, red, shaking, and completely unable to support weight. I couldn’t move or wiggle any of my toes. I was in major pain. I’d roll over in the middle of the night, touch it to the bed frame, and wake up gasping and sweating (the sweating is normal, but the gasping in pain? not so much). I could barely go anywhere, let alone get off my bed, without leaning heavily on something. I was getting really scared.
On Night 6 of this, just as I thought it was getting better, I had a dream that it was amputated. Day 7 I laughed about it. On Day 8, the only thing that kept me from hacking it off myself was that getting a prosthetic foot in Vietnam, in particular, seemed like a less-than-wise decision. Otherwise I was completely for the idea of amputation. It just hurt so, so much.
People had been telling me that it was very likely an infection, since they are rampant here, and that I needed to get it checked out – I held off because there was no point of entry, and I hadn’t suffered any major foot trauma that I recalled. On Day 9 I acquiesced, regardless of the cost, because holy shit. This was no way to live. I mean, I felt I was going to be ok if they said, “You know, we’d love for you to have two feet because you probably use them fairly often, but we’re going to take it off at the ankle just to be safe” – when I realized that I was semi-serious about AMPUTATION, for chrissakes, I knew it was time to see a professional. 
The thought of going to and communicating with a doctor in a foreign land was scary and unappealing, but my desire to cut the damn thing off to get rid of the pain made me realize how serious this could possibly be. I mean, I LIKE my feet.
It was once known as “The Rich Man’s Disease” because
of the rich meats and beer associated with it
After a preliminary diagnosis and two blood samples, the results of which came back Monday, I can now say for certain that I have a disease from another era: The Gout. This is what I always thought legionnaires got after crash landing their planes in Morocco in the 1800’s. In my mind it showed up in Camus and Dickens, but wasn’t it eradicated with Polio or whatever? NO. It wasn’t. In fact, rates of The Gout have been steadily increasing over the past few decades.
My French doctor says it like that every time: The Gout. It’s a complex form of arthritis (ARTHRITIS, WHAT, OMG) where uric acid builds up in your blood stream. According to him, it has several possible causes, many of which happened to me concurrently after moving to Vietnam:
  • My salt intake increased (damn you, delicious Asian condiments)
  • My water intake decreased (I require a lot of water anyway, and was sweating more on top of it)
  • I was eating roughly 500% more seafood and a billion times more pate than I’d ever had before
  • I was on a relatively low-calorie diet for most of June (although not on purpose)
  • I had some rapid weight loss – I lost about 15 pounds since I got here
  • I wasn’t enjoying beer too often, but had 3 nights in June where I drank a lot of it in one sitting. That probably didn’t help
  • I also have several family members with arthritis – a big component of it is genetic predisposition. Watch out, Sister!
These are all things that can mess up your purine levels, leading to the crystallization of uric acid in your bloodstream. These crystals will accumulate in joints, tendons, sometimes cause kidney stones (oh please god not again), and usually end up in the toe joints of your foot, causing, well, everything that I experienced.
The good news is that by taking mega-doses of Ibuprofen (or NSAIDs – Non-Steroidinal Anti-Inflammatory Drugs) and a drug called Colchicine (causes nausea, vomiting, and diarrhea… hoorayyyyy Vietnam) these symptoms can be reversed and, if I severely limit rich red meats, seafood, beer (!), and increase my water intake, I may never have a recurrence of this again. It’s already almost able to support weight again, and in a couple weeks this should be cleared up completely. I can’t wait to get back to running again.
I would rather have NO FEET than stop eating sandwiches
like this. Fact. This is not hyperbole. Look at this thing.
The fish and red meat I’ll miss greatly, but I can do without. The beer will be REALLY missed – I admit I depend on a little social lubricant in groups of people I don’t know, which these days is all the groups – but I can do it. I slowed way down on beer and liquor for my newest meds back in April, and I can decrease it even further now that I understand the immediate consequences. I can’t have as much tofu, which is a serious bummer – they really know how to cook tofu here, and I was excited to eat more, as well as learn to cook it.
Street food I’m not willing to compromise on, as my doctor suggested I do, but he also admitted that if I avoid all the other things consistently, I can still eat banh mi pretty much as usual (whew), as in once or twice a day. I’m seriously not ready to give up those amazing sandwiches. I would learn how to eat it while walking with a crutch and one foot, if necessary. Maybe even no feet. I’m having a hardcore love affair with that sandwich, and I’ve only scratched the surface. In a development that should surprise exactly no one, I’m still incredibly stubborn.
Anyway, that’s my Health Update from Ben. I have The Gout. I’m getting better now. I’ll be keeping an eye out for Bubonic Plague, Polio, and Smallpox.
Things are still weird here in Vietnam, don’t worry… but my health is no longer one of them.