In my head, I am rehearsing a conversation with my General Practitioner. Again. I guess it is a sign I am anxious about meeting him in five days time. Basically I will be telling him about my self-diagnosis of gout. I have found that generally it is not a good thing to tell doctors what they jobs are (or anybody else for that matter) unless you can claim some sort of expertise in the area. People often find my point of view annoying probably because of my inability to “sugar-coat” things or perhaps because I do not communicate clearly. Well it was clear in my head, but not their’s apparently.  I self-diagnosed chronic depression and then autism. I have been banging on for years (decades perhaps) about my joints hurting.

Actually banging on is not my style. For a time I gave up mentioning my joint pain because it seemed to be ignored by the medical profession in favour of the state of my liver or kidneys or mind, I suppose. It didn’t appear that it was even worth writing anything into my notes though perhaps they did when I left the room. I guess it is like always having headaches. There seems to be little anybody can do. Recently, I have tried to accept that it is probably my autistic hypersensitivities that lead to these chronic low-grade things. An over sensitivity to light for my headaches. An over sensitivity to internal pain that highlights the wear in my joints.

When though does a small amount of pain that is constantly there trump an acute attack of overwhelming pain. Generally there is no win for the small constant guy, unless of course the pain is connected. My interpretation is that the low grade pain in my joints is caused by the same issue that my wake-up-at-2am-with-unbearable-toe-pain is. I have gout. And by giving the pain a name, a description that explains its cause (though not necessarily why gout developed), I have something that may be taken more seriously and may be treated in some manner.

I am also aware though that both joint and head pains are chronic conditions and as such, any long term care would be a prophylactic to prevent acute episodes. That usually means taking more pills, and if there is one thing I hate, it is the need to constantly overload my body with high levels of manufactured chemicals. The body, my body is a remarkable organism that is impossible to fully comprehend. Every moment it is finely tuning its function, its balance of chemical building blocks to keep me alive. And twice a day, I take what must be like a tsunami of drugs to keep me alive too. I don’t think our sledge hammer approach whether it be so-called “natural” remedies or manufactured drugs is good. We need to be able to fine tune our medical interventions better and at least we are seeing great progress in that direction. But I digress, basically I don’t want to add to my cocktail of drugs.

So what is it that I want to achieve by seeing the doctor. Is it just to say, “I told you so”? Or do I hope that my joint pain comments will be taken more seriously? I would like to say that it is just about getting access to some more potent drugs to deal with the pain when it occurs. I am not naïve enough to think that gout can be cured. But I suspect that yes, there is a need to vent a bit. I want to show that I do have expertise when it comes to my body. I don’t think I will show it, but I do believe I have some anger over this. I also think though, that the anger is a bit of a smoke-screen. I want my GP to look after me, to be that parent that says everything is going to be okay. To understand that though I deal with pain remarkably well, a bit of me is terrified about having another attack. A bit of me is terrified that each attack is destroying my joints and that this is only going to get worse as time goes on. A bit of me is terrified about what the future might bring.

A physiotherapist told me at the games in the summer that transplant recipients have a remarkable high pain threshold. She had been digging her thumb into a torn thigh muscle at the time and could see no recognition of pain on my face. My personal theory is that the journey one goes through that ends up in an organ transplant means that you learn to deal with pain. I also believe that being autistic means that I am also used to dealing with pain mainly though sensory overload. Looking back, I have been coping with the gout pain for many years. There were times when I couldn’t walk very well, times when I couldn’t use my hands as a whole, times when I couldn’t tumble turn in the swimming pool. I thought these were caused by acute tendonitis at the time but it seems the joints were the source of the pain.

Pain is part of my existence I suppose and there is no sign of that ever changing. I have coped okay so far. There is no reason not to assume that I won’t cope okay in the future. It would be nice if emotional brain would accept that though.