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Matthew Stanishewski, DO, is a specialist in rheumatology at Southwestern Vermont Medical Center.

Health Matters: Five Ways to Prevent Gout

By Matthew Stanishewski, DOPrint Story | Email Story

Did you know that Podagra was the name of an ill-tempered mythological virgin torturer of feet? Not coincidentally, it is also the name for the most common type of gout, which affects the big toe.  

Back in the 13th century, people used to think that gout was caused by a "drop of bad humor" in an inflamed joint. (In fact, the term "gout" is derived from the Latin "gutta," which means to “drop.”) Later, gout was called the "disease of kings," because it afflicted those who ate a diet of rich foods. Since then, doctors have discovered the actual causes of gout.

Gout, a painful, red, and inflamed joint, is a type of arthritis that occurs when uric acid crystals build up in the affected area. It is most common among people with a family history, especially men. The risk of getting gout increases with age, obesity, insulin resistance and high blood pressure.

The condition affects about 8.3 million people, or 4 percent of the U.S. population, each year. It can be painful and even debilitating, especially if risk factors go unchecked. The good news is that science has uncovered a few ways you can prevent gout and, at the same time, decrease your risk for other health problems.

Number 1: If you have had a gout attack, start by avoiding high-purine foods. These include scallops, mussels and other seafood, like herring, codfish and haddock. Venison, veal, turkey, bacon, liver and other organ meats also have a lot of purines.
 
While some of these foods are considered healthy and are highly recommended for those following a heart healthy Mediterranean diet, for instance, they should be limited among those who have had a gout attack.

Number 2: Moderate alcohol consumption. Alcohol decreases the kidneys' ability to filter uric acid. In addition, beer, for instance, is a high purine food. In that way, it is a double threat for those at risk of a gout attack. By limiting alcohol, you decrease your risk of many other health problems associated with it.

Number 3. Make healthy choices — like avoiding soda and other foods that contain high-fructose corn syrup; sugar, even naturally sweet juices; and salt. This can help people maintain their weight and avoid obesity, a gout risk factor. Often found in processed food items, high fructose corn syrup is, itself, a culprit in raising uric acid levels and increasing gout risk. So, the positive impact of avoiding high-fructose corn syrup is multiplied.

Number 4: Instead, drink plenty of water, especially in warm weather. Dehydration is a major risk factor for a gout attack. Staying hydrated literally decreases the concentration of purine in your blood. It will help you avoid painful kidney stones and provide a boost to your energy level, as well.

Number 5: Finally, wear proper-fitting shoes. Rubbing, pinching, or other trauma to the toes can actually cause gout flares among susceptible people.

Most who follow these tips will find they are less likely to get this painful condition. If gout strikes, see your primary care provider. In addition to food and lifestyle adjustments, your doctor can recommend therapies or medications or a referral to a rheumatologist to help you get your gout under control.

Matthew Stanishewski, DO, is a specialist in rheumatology at Southwestern Vermont Medical Center. "Health Matters" is a column meant to educate readers about their personal health, public health matters, and public policy as it affects health care. For this article and others like it, visit svhealthcare.org/wellnessconnection.





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Protecting Children and Others During a Measles Outbreak

Dr. Marie George

Once a common childhood disease, measles was almost an expected part of growing up. But it wasn't without consequence. Worldwide, up to 2.6 million people died annually from measles every year up until a vaccine was introduced in 1963.

In recent years, some parents have refused to vaccinate their children based on misinformation about side effects of the vaccine.  As a result, the number of unvaccinated children, teens and adults in our communities is on the rise. While those making the choice to not vaccinate believe they're making this decision solely on behalf of themselves or their children, they're actually impacting the health of others. Sometimes with deadly consequences.

How is it spread? Who is at risk?

The measles virus is highly contagious and spreads easily. Spread by close personal contact, coughing, or sneezing, the virus can remain active in the air or on a surface for up to two hours after it has been transmitted.

That means that any unvaccinated individual — including infants and those with compromised immune systems — can get sick when entering a space where an infected person was even hours before. Infected individuals can then go on to spread the illness days before they show any signs of the disease.

How to protect those at risk

Measles vaccines are by far the best possible protection you can give your child. Two doses are 97 percent effective and the potential side effects are rare and not nearly as scary as suggested by a lot of popular media. If they appear at all, side effects are usually a sore arm, a rash, or maybe a slight fever. Claims that the vaccine causes autism have been undeniably proven to be false.

As for when to get your child vaccinated, the American Academy of Pediatrics, the Centers for Disease Control and Prevention and the American Academy of Family Physicians all recommend children receive the measles vaccine at age 12 to 15 months and again at 4 to 6 years old. Children can receive the second dose earlier as long as it is at least 28 days after the first dose.

How about adults?

Because the risk of death from measles is higher for adults than it is for children, teens and adults who have not been vaccinated should take steps to protect themselves. "The vaccine can be provided in two doses within 28 days of each other. This is particularly important for those planning travel overseas or to areas in the United States where outbreaks are occurring.

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