I was stirred out of my dreams at 2 this morning by a throbbing in the joint of my big toe. It wasn’t an enormous amount of pain, but it was sufficient to make it difficult to get back to sleep. And, as I tossed and turned, there were definitely positions in which it was more comfortable and those in which it was less.

I was first diagnosed with high uric acid levels almost 20 years ago. I remember that the doctor was having difficulty recalling the word in English. He said he could remember it in German, so I asked him what it was. “Gicht,” came the answer. “Ah, I know that one,” I replied.

Gout. In Japanese, 痛風 (tsufu). I’d never had an episode despite being consistently diagnosed with high uric acid over the intervening years. Last year, at the doctor’s urging, I’d even made some progress just by drinking more water. But the lack of any symptoms had led me to be careless. Until now.

I hobbled to the doctor this morning (it’s not far, although walking with shoes was more difficult than hobbling around the home in slippers). He confirmed what I’d guessed. We had a talk and he ordered some blood tests.

Doctor stop

That’s Janglish for “Doctor’s orders.” He said no more alcohol. Drink a lot more water. He even told me that my recent trips to the gym could contribute: I’m sweating a lot and not necessarily drinking enough water to compensate. Meanwhile, ice three times a day. Take my usual painkillers. And come back tomorrow for the results of the blood testing.

And this time I mean it!

I’ve been playing at cutting down on the drinking and losing weight. Now I’ve got to be serious about it. A flare-up would leave me helpless during a scheduled ride — the Tour de Tohoku or lejog, for example. And the only way to prevent that is to be good, and to be good consistently.

Why couldn’t he have told me to give up water and drink more Scotch?