Gout...

…is an experience not to be recommended, but which frequently affects older people between the ages of 40 and 60, most often men, particularly those who are overweight or have a diet that is high in protein. During the 17th to 19th centuries the links with rich living were a target for laughter, caricature and cartoons. The great Dr Johnson suffered acutely from it. Even the public perception of gout today is not dissimilar – yet nobody who has suffered from this extremely painful condition finds it the least bit amusing. It is only rarely seen in pre-menopausal women and men under the age of 30, and rarely occurs in children.

It usually occurs as a persistent ache, often developing in a few hours and causing severe pain, typically but not exclusively in the big toe or other parts of the foot. A form of rheumatics, it may last several days, the joint extremely tender to the touch. Bed clothes at night can feel heavy and increase the pain, It is caused by an excess of uric acid, forming tiny grit-like crystals that irritate the tissues in the effected area. Normally the uric acid is removed when urinating, but among patients with a predisposition for gout, the uric acid accumulates in the blood. Among some of these patients, the concentration in the blood is so high that the uric acid 'overflows' and settles in the joints.

It may help to ease the pain if you raise your leg and use an ice pack (frozen peas can have a new use!) for about 20 minutes. Doctors often recommend anti-inflammatory painkillers which may reduce the swelling and ease the pain, although if you are regularly taking a low dose of aspirin every day this may not be a good idea. Drinking lots of water helps.

What causes it? Too much alcohol may result in the otherwise harmless uric acid to build up, as can sugar sweetened soft drinks. Obesity, high blood pressure, vascular disease and kidney damage can also be contributory factors. A blood specimen can confirm what may be happening and how serious it is. It is sometimes a recurring problem, although most people who are subject to gout may only have an attack now and then.

The UK Gout Society has an excellent website which contains much more specific medical information than I am equipped to provide. But back to my first sentence – Gout, I do not recommend it!

Bryan

' Let the elderly go first'....

…..said the young lad to his mates, as we got on board the bus. And they did. ‘Thank you’, I said as I moved forward and then muttered ‘you’ll be where we are one day’, which as my wife pointed out to me was much less gracious than he had been. It’s becoming a new experience, people’s concern for me! I was in Birmingham to see a friend last week and we had lunch at a self-service restaurant. ‘Can you manage that sir, or shall I help you’ said the kind woman as she loaded the tray with my food. And then later as I was standing in the crowded train coming home, a young man half stood up and said to me. ‘would you like my seat?’ I think it must be the walking stick that does it. I have taken to using it quite often. It’s not essential and I am in no way dependent on it, but it makes getting about that much easier. Is this then the defining sign of old age, walking with the aid of a stick!

There was a discussion on the radio the other day about descriptive usage. Various ways of describing older people were considered – ‘old’, ‘elderly’, ‘seniors’ , ‘ageing’ (my preferred term) were some of them. It’s all part of the current interest in older people, and, as less children are born and people live for longer, the numbers of older people will become both a social problem and a challenge. We have often touched on this in these blogs.

I see the Open University and the B.B.C. have produced a six part documentary on the issues raised by old age to be shown next month, with the awful title of ‘Silverville’. Apparently it focuses on Lovat Fields, a specially designed ‘extra care village’ situated in Milton Keynes. It is intended to be an intimate portrait of what it's like for an elderly person in the 21st. century, at a time when the over 85’s are the fastest growing age group in Great Britain.

Since July 2008, and with the input of two gerontologists (- horrible word -) Professor Sheila Pearce and Dr Caroline Holland, the online survey www.open2.net/caresurvey is gauging public interest in these issues, and responses have helped to form the programmes, which I shall make an effort to see. There is apparently a free booklet introducing the series obtainable on http://www.open2.net/, but I drew a blank when I tried to order it. Perhaps it will be available next month.

Meanwhile I shall go on walking with a stick sometimes and perhaps discovering more kind people in public places!

B.R.

' Too Old to Work '

This was the title of a Channel 4 TV programme I watched yesterday, exposing the ageism that is rife among employers and recruitment agencies. A series of people were interviewed with ages ranging from early fifties to seventy. All of them had lost their jobs and were finding it virtually impossible to find another. Affected by the present financial crash, many of them needed to continue working to enhance their pensions and to pay their mortgages. Mostly however they just wanted to go on working -‘I wasn’t ready to go’, said one.

An experienced accountant of 56 and his daughter of 26 training for the same qualification, applied for similar jobs : she was given an interview, he was told the CV he had submitted had been lost. Excuses often concealed the real reason for rejections : ‘you are too experienced’, ‘you might not be comfortable with this job’, ‘there would be cultural differences’ and – most disingenuous of all – ‘here we work hard and play hard –would you be willing to join the five aside football club?’’ There were many stories of people struggling to present themselves for work against the prejudice of employers. Knowledge and experience seemed of no importance.

The official age for retirement in the U.K. is 65, though I see this is being revised for some civil servants. The law was presumably intended to protect people from working longer than they want to, but is being interpreted by employers as a justification for obligatory retirement. The programme hinted at the wider economic and social issues raised here. It is estimated that by 2032 there will be six million more people over the age of 65 in the U.K., and this no doubt will be reflected in Spain and most other European countries. Many will not only want to work beyond the age of 65 but financially will need to.

What of young people who are trying to get work? Their situation can be dire with, for example, students still looking for work a year after they have graduated. But older people feel that the job market is unfairly slanted in the favour of the young. The average age of employees in the top hundred firms in Britain is 34. The programme challenged the idea that the younger you are the more effective you are. The deciding factor is fitness and attitude. As we get older, the brain shrinks, but at the same time adapts to the situation. Older people can be more productive than younger ones, who tend to be off work because of sickness.

Ironically the programme was narrated by Moira Stuart, for many years a newsreader for the B.B.C. Explaining why she had been sidelined at the age of 55, effectively forcing her to resign, the Director -General said that ‘different’ journalistic skills were now required. Another synonym for being ‘too old’?

Bryan