GOUT!
The word alone causes grown men to cringe with pain.
Those who are fortunate enough to avoid this condition have no understanding
how painful swollen joints feel. Gout has been a part of my life off and on for
almost twenty years. Over the course of this time I have learned to discern the
warning signs of a flare-up. There is a strange tightness as the joint begins
to fill with a yellowish opaque fluid rich in uric acid. Gout usually attacks
the knee, ankle, and big toe, but not all at the same time.
The last gout attack came on quickly. Normally a
dose of 750mg of naproxen would arrest the swelling and then 500 mg every
twelve hours would resolve the attack. Unfortunately I didn’t have any naproxen.
Two weeks before I used my last pill I began to order more pills but they were
out of stock. Now a month later they are still out of stock.
The first morning of the attack I woke up in extreme
pain. The gout was flaring up in my knee, ankle and big toe. They were all
swollen to about twice their normal size. I tried to get down from the top bunk
but my leg would not bend on its own. Grabbing the leg I forced the knee to
bend and on a pain scale of 1 to 10 that move created a solid 10. Using upper
body strength and one good leg I was able to get down the ladder onto the cold
floor. The cold felt good.
Hobbling the meter across from the bunk to the
circular metal stool attached to the desk proved to be difficult and painful. Taking
a deep breath and thinking pleasant thoughts always seem to help situations. My
mind filled with wonderful images of my beautiful curvy wife and my great love
for her. After sitting at the desk for a while the pain subsided to an 8. The only
foot wear that would fit over the painful swollen joints was a pair of black
plastic shower shoes. After struggling to get them on I stood up. My leg was
like a fence post, stiff and unbending. Stepping out into the hallway I placed
my hands on either side to brace myself. Inch by inch I hobbled down to the end
and slowly limped across the dayroom to the guard station. After explaining my situation
to an uncaring guard I declared the situation a medical emergency. In prison if
you can’t get out of harm’s way and can’t think clearly due to overwhelming
pain you are a target waiting to be victimized. The guard called medical, no
answer. He made a few more calls and discovered they were all in a meeting. I would
have to wait until they were done; it should be about an hour, it was clear the
guard had never had gout. There was a green plastic chair about five feet from
the guard station door and I dragged myself to it and plopped down. My hip was
now hurting from the unusual angle I had used to hobble along. I put my head
back on the cold concrete wall, closed my eyes and filled my thoughts of my
loving wife. Upon opening my eyes and looking at the clock at the guard station
an hour had somehow passed. Using my arms and one good leg I stood up and
limped slowly to the guard door. The guard looked up at me and without saying a
word he pickup up the phone and dialed while I propped myself in the doorway. When
medical answered he told them my condition and said “he is declaring a medical emergency”.
He listened and then relayed a message that said there were not accepting my
emergency. I asked the guard how I could be denied. The rules clearly state I can
declare an emergency if I wanted to pay $5. He relays another message and asked
me if I have turned in a kite. A kite is a request for services. If you have a
headache or sore muscle or sore throat you can request help by turning in a
kite. A day or two after you turn in the kite they post a notice in the dayroom
acknowledging receipt. Then another day or two later they will post the day and
time of your appointment. A kite is not for an emergency. And this was clearly
an emergency.
I told the guard I hadn’t. He listened to the person
on the phone and told me to fill out a kite. The box to turn in the kite is
about 150 yards from the unit. There is no way for me to walk that distance. The
guard started to explain that to her but she hung up on him. The guard turned
to me and went on a verbal defensive. I held out my arms in a universal stop
gesture and told him to slow down. I explained my anger was not directed at him.
I appreciated all he had done but I had a problem and I needed help finding a
solution. He smiled and called the lieutenant. When the lieutenant arrived the guard apprised him of the situation. The Lieutenant
told me he could not make the nurse see me. I told him I was declaring an
emergency. He restated the position of not accepting my emergency. He told me I
needed to turn in a kite. He handed me a kite and told me he would turn it in
for me since I couldn’t make it to the box. I filled out the kite and then I made
my way awkwardly back down the long hallway to
my room. I dropped down on the desk stool because there was no way for me to
get back up on the top bunk.
By making a pile of books and papers I created
a place I could lay my head on my desk. I either passed out or went to sleep. When
I opened my eyes there was a call to chow over the intercom. In order to get to
chow you must walk a partial circle about 150 yards to the chow hall. After eating
you must continue on around the circle and return to your unit; a total
distance of 1/3 of a mile. There was no way I could walk that far as I had
extreme difficulty getting to the end of the hall. Even if it would have been
possible to walk that far it still would have been impossible to go. The chow
hall requires wearing boots or athletic shoes and my feet were too swollen to
get either one on. I did manage to get down the hall to the restroom. Upon
returning to the cell the pain scale was now at a good 9, I sat down at the
desk and went back to sleep.
I spent the night at the desk getting up
only to use the restroom. At 2:30 pm the following afternoon they called me to
go to medical. My feet are size 11.5 and my boots are a size 12. They don’t sell
half sizes in the larger boots. The swelling of my feet was now down enough to
squeeze into the boot. It was very tight and if it were possible it made my
foot hurt worse.
It took 30 minutes to get to medical, normally
a walk that would take 5 minutes if you walked slowly. After a short wait the
nurse came out to get me and we slowly walked back to her office. She asked a
lot of questions that were answered in my file, but I humored her. She asked me
what I took for gout. Since DOC has been giving me the medication for the past
8 years it seemed a silly question, but I told her naproxen. She told me I
could have 500mg twice a day at Medline. She would not give me any to keep in
my cell because they wanted us to buy our own off the canteen list. I explained
how I have tried for weeks but she didn’t care. I reminded her to get to Medline
required walking 1/3 of a mile twice a day. She told me if I really wanted the medicine
I would get there. It was clear she had never had gout and unclear why she was
a nurse.
I spent the night at my desk and got up
the next morning and made my way to the dayroom. Medical had told me to go to Medline
before going to breakfast. When they called chow I slowly made my way around to
Medline. When I finally arrived the guard asked my unit number. I told her and
she said she hadn’t called that unit and I would have to return to my unit. I explained
what was going on and I told her I was going to Medline before chow. She told
me there was a separate call for Medline and I would have to return to the
unit. She was unsympathetic regarding the pain in my leg. I arrived back to my
unit having completed 1/3 mile. When I got back to my unit I asked the guard
when they would call Medline. He explained that Medline had been called and was
now closed. The next Medline would be 7pm. After explaining my dilemma he said
he would call medical but it would be in an hour, they were all in a meeting.
I returned to my cell, put my head down
on my desk and passed out. At 7 pm I successfully navigated the labyrinth and received
500mg of naproxen. Twice each day I would be required to walk 1/3 mile. Pain overruled
hunger as by the time I arrived at Medline the time frame for my unit to go to chow
was closed, but turns out that’s a good thing because naproxen should be taken
on an empty stomach to get the greatest benefit. It took three days before I could
actually walk and another week before I actually felt ok.
Most US citizens believe inhumane treatment
only happens to prisoners in third world countries. They believe the only way
you are mistreated in the United States prisons is if you deserve it. That is
just not true. Our prisons are horrible places. The uneducated guards take
advantage of the power they weld to be as abusive as possible. There are a few
guards who are compassionate, but not many. Most of the guards work in a prison
because they aren’t employable in the real world. It doesn’t take long to
figure out why. Withholding medical treatment is inhumane. It is cruel and
unusual punishment. Someone once said you can tell the problems of a society,
not by the behavior of those they incarcerate, but the behaviors of those who
guard the incarcerated.
Todd