The Agony and the Ecstasy

He first felt the pain on a Friday evening. It was a stabbing, acute swelling in the metatarsal-phalangeal joint at the base of the big toe. As was his custom, however, he ignored it and assumed that it was the result of shoes that were perhaps softer, or maybe a tad larger, than his usual oxfords. Throwing all caution to the winds, he awoke the following morning and put on his badminton garb, noting with just the barest of trepidation that the right shoe felt a bit tighter. But off to the courts he went. Late into that Saturday afternoon, the pangs increased in intensity, and for but a brief moment, he considered the notion that something was afoot. Was this inflammation the result of some minute fracture or spur, or, more disturbingly, the crystallization of monosodium urates which had deposited themselves in his extremities? Espying a bottle of garlic-flavoured peanuts, he unscrewed the lid and munched on a handful, as he thoughtfully weighed the possibilities. It was a valiant, if misguided, effort to convince himself that it was the former. He might as well have shot himself in the foot. Sunday brought no relief. He could barely wear his widest sneakers, sockless at that, and in less than two hours, he had to unshoe and slide into slippers, but even that was a painstakingly herculean effort. The balance of the day was spent in horizontal mode, ice packs on the foot to stem the agony. In keeping with his obstinacy, he proceeded drive himself to work on Monday, this time, forcing his near-elephantine foot into an immense looking Doc Martens lace-up that, while seemingly no longer fashionable, was absolutely necessary if he had to put pedal to metal. But once in the office, he could not withstand the pain any longer, and asked to be driven to a clinic within the immediate vicinity, renowned more for its inaccurate lab results than for its healing, but the nearest place of solace nonetheless. Traipsing gingerly into the doctors office, he removed the shoe with great anguish to show the swollen joint to the most disinterested physician the world has ever seen, who then recommended both a blood test to determine the uric acid level, and a foot x-ray to see if indeed the pain had a podiatric origin. Showing the results of the tests later, the doctor concluded that she could not possibly reach a conclusion, and suggested that he consult an internist or an orthopaedic surgeon. That he noted from her prescription pad that she was an obstetrician-gynecologist seemed to be either irrelevant at that precise moment, or a sorry fact that somehow paled in comparison to his torment. Seeing that the uric acid level was double the outer parameter of the normal range, he told himself Nuts! Ill have to get rid of all my pecans and pistachios! He forthwith sent a text message to his anxious wife, instructing her to gather all existing supplies of nuts and nut-like substances in the house, and distribute them to the poor and hungry. But the following day, a wave of suspicion overcame him, and he took another blood test from a nearby hospital. The result was a uric acid level within the normal range - it was enough to drive him nuts! Immediately, he sent another text message to his wife, nullifying his previous mandate, and advising her instead to hold on to his nuts.

His Wednesday appointment with an orthopaedic surgeon confirmed his worst fears. Its not a fracture, the doctor opined, shoving his x-ray results aside dismissively, which showed the presence of spurs. Secretly, he had wished that his problem was a fracture, as it could obviously be healed, whereas a pronouncement of gout seemed like a life sentence. He would then have to be confined, reclusion perpetua, in a totally nutfree environment. The doctor stared at him from head to toe, then promptly dashed his hopes You have the onset of gout, but most men experience it in their forties, so consider yourself fortunate. It was enough to knock him off his feet. What a Nutty Professor, he mused. He was prescribed Colchicine, the standard medicine for this affliction, which would indubitably complicate his life with a gastrointestinal impact. But of course, there was always Immodium. He was commanded to jettison all nuts in his possession, avoid red meat, shun beans and tofu, and eliminate all tuna and salmon from his diet. Youve got to toe the line, he was warned. So, in a nutshell, heres his current situation. The swelling has subsided, and hes back on his toes. What ecstasy! Hes had to make more than the usual unscheduled trips to the bathroom, but all of that is a minor inconvenience now that his oxfords fit again. He has a suitable excuse for eschewing lentils and cabbages. All deep-sea fish are now in freeze mode. And yes, he occasionally pines for nuts.