May 23, 2008

Basketball Star Details His Struggle With Gout

FRIDAY, May 23 (HealthDay News) -- He's a 15-year veteran of the National Basketball Association, a four-time NBA All-Star, and head coach of the Philadelphia 76ers. He's basketball great Maurice Cheeks.

And he's got gout.

"I had no idea what gout was," Cheeks said, describing his first encounter -- at the age of 46 -- with the often-debilitating arthritic condition. "Never heard of it. Never talked to anyone about it, and then I started to find out that there were many other people with this condition."

Cheeks made his remarks at a press conference Thursday in New York City to mark the second annual National Gout Awareness Day, sponsored by the Gout & Uric Acid Education Society (GUAES). The goal is to draw attention to the risks, symptoms, and treatments associated with a condition that strikes between three million and five million adult Americans, and to debunk stereotypes about the so-called "disease of kings."

According to GUAES, gouty arthritis results from a condition known as hyperuricemia -- the build-up of abnormally high levels of uric acid in the blood. A normal waste product that forms from the breakdown of purines found in cells and a wide range of foods, uric acid is usually dissolved in the blood, passed through the kidney, and excreted through urine.

But in excess amounts, sodium urate can crystallize. In some cases, the resulting needle-like formations lodge and jab into joints, bringing about sudden and painful bouts of tenderness, redness, stiffness, and swelling in the big toe, instep, ankle, heel, knee, wrist, finger, or elbow.

People typically describe the pain as akin to the trauma of childbirth or breaking a bone.

"I don't think I can adequately express the pain," Cheeks said.

"I once had a severe ankle sprain, and in order for me to play, they had to wrap it and wrap it and wrap it, because any time I put my foot down, I was not able to play," he added. "But the game was so important. So I played, even though that was probably my worst pain ever. And that pain doesn't even compare to gout."

In February, Cheeks' fourth acute attack of gout triggered inflammation so severe he had to coach several 76ers games with one shoe on and one shoe off. For many people, an attack can turn the mere act of standing and walking into an unmanageable ordeal.

Today, gout is the most common form of arthritis among men over 40. Women also suffer from the condition, but typically after menopause, according to GUAES.

Obesity and the excessive consumption of purine-rich foods -- such as meats, shellfish, and hard liquor and beer -- have long been associated with a risk for gout. And portly figures of history, such as Henry VIII, Benjamin Franklin and Isaac Newton -- all suffered from gout, popularizing the view that it's an illness of the privileged and out-of-shape.

"But [Maurice Cheeks] defies the stereotypes," said Dr. N. Lawrence Edwards, chairman of GUAES, and vice chair of the department of medicine at the University of Florida, who spoke at the press conference.

While diet does play some role in who get gout, genetics is a major factor, with one in four people having a family history of gout, Edwards said.

"There is an assumption that this is a self-inflicted disease," noted Edwards. "That's the stereotype out there. But clearly Coach Cheeks represents none of this. It's an equal opportunity employer. It affects all strata of society."

Edwards agreed that lifestyle changes, such as keeping in shape and watching one's diet, could help somewhat reduce -- though probably not eliminate -- the risk for acute attacks among people with high levels of uric acid.

He stressed the importance of seeing a doctor and getting a uric acid reading for those who've experienced an attack -- with the aim of getting the serum acid level below the danger point of 6.8 mg/dL. And for many patients hovering above the cut-off, chronic daily medications may be the most effective way to fight back, he said.

"If any of you ever had [gout], you would know you would try to do everything possible to try and prevent it," Cheeks said with a wry smile. "Because once it's full-blown, there's not a whole lot you can do."

More information

To learn more, visit the Gout & Uric Acid Education Society.

SOURCES: Maurice Cheeks, head coach, Philadelphia 76ers; N. Lawrence Edwards, M.D., chairman, Gout & Uric Acid Education Society, and vice chair, department of medicine, University of Florida, Gainesville
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