Since my update on the weekend, my foot issues continued and got even worse mid-week. I went in to have a physio take a look at it to see what was going on (www.abbyphysio.com), and aside from everything in my foot and ankle being all jammed up, he didn't think I had a stress fracture or tear going on. After manipulating my foot a fair bit, movement felt pretty good. It was still tender to the touch and sensitive to pressure in the exact spot at the base of my second toe, but felt OK enough that I did a modified workout Tuesday evening.
That night, around 1:30 AM, I woke up with excruciating pain in my foot, to where I couldn't bear weight on it at all, and even letting it dangle unsupported hurt. THAT felt like a classic gout attack to me, but the worst one I can ever remember. I dosed myself up with my medication (dexamethasone, a corticosteroid, since I'm allergic to regular anti-inflammatories), and even ended up taking some pain medication (which I never do, as a rule). Even with that, no sleep for me all night, and I ended up in the ER for x-rays and blood testing in the morning. There was no stress fracture (good!), and sure enough my uric acid levels were WAY up, so the conclusion was that it was just a really severe gout attack, and from the x-ray it looked like my 2nd and 3rd metatarsals were just jammed together by the swelling.
Thankfully, by the late afternoon the medication finally started to take effect, and I could bear weight again. Today, I can even get my foot into a shoe. Clearly, though, what I have been doing to manage this condition is no longer sufficient.
So where does that leave me now? As much as I've tried to avoid it for the last several years, I may have no choice but to go on daily medication to suppress my uric acid levels. With (I think) four attacks in the past year, and the unusual severity and duration of this most recent attack, the risks outweigh my desire to not be on medication. Untreated, I could be risking kidney stones and other kidney issues, never mind the implications of chronic inflammation with regard to things like atherosclerosis, increasing risk of stroke, heart issues, etc. With how busy I am day in, day out between working full time (I'm on my lunch break as I write this!), running The BTG, and being an active, involved dad/husband, I can't afford to be laid low for a week by something like this either.
So, I'm officially an old man, going on a daily medication...BOOOO! I'll also need to have regular testing done to make sure my levels stay in an acceptable range, as there are some indications that too little uric acid in the blood can also be a problem.
If it lets me live my life and continue to train hard, then it's worth it in the long run.