Bikram & Gout

Last summer I stopped doing Bikram Yoga because I wasn't near any Bikram studios for a good chunk of the season. For most of the prior year I had no gout flare ups - a couple of attempted sneak attacks in the left ankle or right big toe, an elbow mini flare once in a while, but nothing major and certainly not crippling.

Around mid-August, like clockwork whenever I pause from entering the hot room, my left toe flared, followed quickly by my ankle and soon I was in full blown attack mode. Limping around the cottage, moaning (literally) in pain at night, feeling lethargic and sorry for myself. I wouldn't wish gout on one's worst enemy. Having seen this movie way too many times before, I had my doc at MGH prescribe me the heavy, super explosive, mess-with-your-organs-and-head meds and within a week (a really, really long week) it subsided.

September brought a lot of work (and some fun) travel and "dining occasions" (which usually are accompanied by a beer or two) and less Bikram than planned. And sure enough, in early October, another attack hit in the left toe and ankle, with swelling up into the calves. This one was the worst I could remember since the episode I chronicled a few years ago here. Crutches for a day, sleepless nights Googling "gout" (as though something new will show up), moaning in pain, and as always feeling sorry for myself. Back to MGH, a new, more aggressive med plan was put into place. A long-term plan. As in for the rest of my life. There were no guarantees but if I could get my body to accept the early doses of Allopurinol, I might move back into a normal life where I could eat some meat and drink a beer or two without fear of waking up wishing I had a wheelchair next to the bed.

The Allopurinol took this time (I had tried on multiple occasions to no avail for 10 of the 16 years since I was diagnosed with this so-called "king's disease")

But the ongoing, low level pain in my toes, ankles, and at times knees and elbows continued - likely scarring and damage from so many attacks over the years. Not crippling, but painful, especially in the morning. Handrails have become critical to descending stairs over the past few years. My joints are tender to the touch. There are much worse afflictions in this world, I know, but this one does suck.

By November, I was back into my regular Bikram practice. The more I showed up, the more relief that followed. From November to February I practiced on average 17 times a month. After each class, I felt zero pain. Nothing. As though I had swallowed 4-5 Advils, maybe more. I would bend my toes and other joints in amazement.

8 hours after every practice, maybe 12, but definitely within 24, the pain was back. The Advil equivalent had worn off. Back to class. More pain relief. And on and on the cycle went. I felt good. Strong. Young, even.

In early March I had two small medical procedures, one being a minor surgery to remove a lipoma (benign). The initial recovery slowed me down for a week. Then I traveled, waiting for the wound to heal so I could head back into the hot room. Three weeks went by. Too long.

The attack came in quickly and savagely in late March. I was saddened because I knew this meant the Allopurinol was officially not my dream pill, my magic pill, the answer to my prayers as it is for so many other gout sufferers. Meat consumption quickly to zero. No beer. No alcohol. All good things, actually.

Add Colchicine to the meds list as April approached. No Prednisone yet, the one I always try to avoid unless truly obscene amounts of crystals have overtaken my joints. Colchicine would do the trick, and it did.

By April 4, though, I felt beaten. I couldn't work out, I had no energy, the meds were draining me.

And then one Friday, April 5, I got my ass back to class (as they like to say at Bikram). Painful, one breath at a time, I moved through that first 90 minute torture chamber in weeks, questioning and cursing to myself how I had come to find it so comfortable and helpful in at least half of the past 48 months since first trying it. I went again on April 6. A little better. I heard slight moaning coming from my being as I gasped for breath between postures, and the pain continued. Sunday the 7th, much better. No moaning. Some pain relief. Monday the 8th. Much, much better. Full day of pain relief followed. Felt strong. Shed some pounds. Energy back. Motivated. Things around me looked positive again. Work, family, extras, volunteer work, all good.

Then travel, conference, dining occasions, same old. Six days, back in the grind of building businesses. Could feel the toe make an effort to bring me down. Also, everyone seemed to be coughing wherever I went. I started to come down with something. Really, I thought?? Seriously? Are we heading into battle again?

Back to the studio in WRJ I went on Sunday, April 14 to yet again reestablish the routine. Hard, but ok.

The next day I traveled to Florida with the family. Toe threatening aggressive behavior following the flight (another trigger), but ankle ok. And here we are now with 3 days in Florida - were I did a class yesterday April 16 and then back again this morning, April 17. That's 7 in 17 days, in case you lost count.

Today's class was so hot. I gasped for air. It's always more humid in Florida classes, for obvious reasons. But despite the labor required to breathe "normally", I felt strong. And most importantly, pain-free. My concentration and focus were back, my motivation high, my sense of control of the things I care about most made a full comeback. Being present with family, being smart about prioritization of work while on vacation, a gnerally positive outlook on the future. I was back, and I snapped this photo with Maggie as we left the nondescript studio next to a furniture loan shop in a mini strip center off of Route 1 in Vero Beach.

Gout is the absolute worst. But I have to always remind myself (and others who will listen) that Bikram beats the living shit out of Gout (and a million other afflictions). You just have to do it, and that is 90% of the battle with Bikram... it's hard to show up! It's hard to imagine doing another 90 minute class in 105 degree heat. It can truly be tortuous. And not every class yields immediate results. And yet, it's the only thing I know that time and time again gets Gout to disappear. You can't stop doing it, of course, but neither can you stop exercising, eating right, sleeping well, treating people kindly, and everything else that brings long-term joy and happiness.

I should disclose that my wife Maggie has been a Bikram Yoga instructor since July 2016, and her passion for the practice and for yoga in general has been an inspiration and a motivator. I know a lot of people are skeptical about the heat, and about the man named Bikram (currently unable to return to the US for fear of arrest) who created the series we refer to as traditional Bikram yoga, but if you are in pain in any part of your body or mind, especially if its chronic, I highly suggest you give it a try. Not once, or twice, but once, twice or three times a week for 60 days to see if you emerge the better version of yourself as so many others I know have.