DEAR DR. DONOHUE: My husband, who has been healthy all his life, suddenly came down with gout. He tells me that his doctor says he doesn’t need any special diet. I wonder if he’s telling me the truth, since he loves to eat. Is he? – C.J.

ANSWER: Uric acid crystals that pile up within a joint cause gout. The daily turnover of body cells releases a substance called purine, which is eventually degraded into uric acid. If the body makes too much uric acid or the kidneys become too sluggish in eliminating it, uric acid blood levels rise, and eventually the uric acid infiltrates joints and causes a gout attack.

We happen to be living in an era when there are many effective gout medicines. In bygone times, when there were no good gout medicines, diet played an important role in gout control. Now it has assumed a more minor role, but it is something that gout patients cannot blithely ignore.

High-purine foods are off the gout patient’s menu. Those foods include anchovies, sardines, scallops, gravies and organ meats like liver, kidney and brain. Foods with moderately high purine concentrations should be somewhat limited. In that category fall meat and seafood. They can be eaten but with some restraint. Some vegetables – asparagus, cauliflower, spinach, beans, peas and mushrooms (I know mushrooms are not vegetables, but let’s not quibble) – have a high purine content. Peculiarly, they do not, however, affect blood uric acid levels or the course of gout, so gout patients can still eat them.

Alcohol use should also be moderate. Beer is the alcoholic drink most likely to cause trouble, and wine is the one least likely to do so.

Low-fat dairy products protect against gout attacks. Drinking two glasses of skim milk a day is an insurance policy against a recurrent attack. Other low-fat dairy products work equally as well.

The gout story is told in the pamphlet of that name. Readers can obtain a copy by writing: Dr. Donohue – No. 302, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: The edge of my toenail is growing into the skin. It hurts. How do I take care of it? – C.G.

ANSWER: That’s an ingrown toenail, and it’s a very common problem. Quite often, improper nail cutting leads to it. Toenails should be cut straight across without any downward curve at the edges.

Your first order of business for treatment and prevention is to wear shoes and socks that give the toes plenty of room.

Your second order of business is to gently pry the ingrown nail out of the skin. Soak the foot in warm, soapy water for 20 minutes three times a day. After drying the foot and toes, carefully wedge a slip of cotton between the nail edge and the skin. Daily treatment for a week ought to free the trapped nail edge. If it doesn’t, or if the skin is infected, let your doctor handle the problem.

Incidentally, many readers wonder if cutting a V-slit in the top center of the nail will relieve pressure and allow the nail edge to work its way free from the skin. It doesn’t.

DEAR DR. DONOHUE: I am 83 and have had mumps three times. The last time was a year ago. I have three dogs and wonder if I could be getting it from them. – M.R.

ANSWER: Mumps is usually a one-time affair. Having the infection once usually bestows lifelong immunity.

I’m not so sure that what you had was mumps. Swollen salivary glands, the hallmark of mumps, can come from many other causes, like a stone blocking the salivary duct. Such stones can free themselves, and the swelling goes down. Next time you believe you have mumps, get to an ear, nose and throat doctor and then write me back.

You’re not getting mumps from your dogs. Humans are the only reservoir for the mumps virus.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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