It was a fine Sunday morning. Aisha (Name has been changed for confidentiality) woke up as usual at 4 am. Though Sundays are labelled as holidays, it was never for Aisha since her marriage. She was married to a joint family with ten members and was expected to be an obedient housewife who could look after the house in an organized way. She ignored her morning stiffness and tried to blame it on her lethargy. Soon after waking up Aisha used to do her morning routine of brushing her teeth and a quick prayer. While kneeling for prayer she usually felt pain over both her ankle joints. The typical female brain worked there too… “If I complain about such petty issues and sit somewhere, who will take care of my family?” She ignored the pain and went for a quick shower. While applying the soap she could feel the swelling over both ankles, which she knew was getting worse day by day. “I will take a rest once my chores get done. Which swelling doesn’t decrease on it?” She thought in her mind and ran to the kitchen without even bothering to dry her hair properly
By the time she reached the kitchen, her mother-in-law was already chopping down her favourite tapioca. “Mom, Doctor has advised you to take rest…Why do you do such tedious tasks? You already have pain in your palms…Go and take a rest.” Aisha sat down on the floor and took over the job of chopping down the tapiocas. Her own finger joints were paining, which she ignored keeping in mind that she was in her fifties.
“Sister, why is your ankle so swollen and red?” Aisha was woken up from her thoughts by her sister-in-law who was chopping meat. “Oh! It is just the usual one… It will go away after some time.” Said Aisha passing the vessel to the sister. “Let me go and wash the clothes meanwhile. You do the cooking part. They will be hungry.” Aisha started climbing the steps of her three-storied house to the terrace with two buckets full of clothes. Her ankle was aching since morning, yet her mind was not ready to accept the fact that it was time to see a doctor. By the time she finished washing her clothes and left them to dry on the cloth line, it was impossible for her to climb down the stairs. She somehow managed to reach the ground floor and sat down for a while. She could see that her toes had turned to brighter red than before. She decided to lie down for a bit thinking that the pain would subside just like every other day.
Aisha lay down in the bed for almost 2 hours hoping that the pain and swelling would vanish. But this time, it was so adamant that she even started panicking. She was startled when her son asked, “Why are you lying down at this time Mom?”
“I think I need to see a doctor. I am in pain,” cried Aisha.
That was when Aisha’s family decided to take her to hospital. The doctor could read from her face that she was in agony as soon as she entered the OPD.
“How long have you been suffering from this and tolerating this pain?” asked the Doctor in surprise.
“Almost one month. I thought it would go away by taking a rest. It used to subside on some days, but when I start doing chores like sweeping, washing clothes, or even standing for a long time in the kitchen, it shoots up. It’s like a dull ache always around my ankles and toes. Sometimes the pain also comes in the fingers of both hands, and it becomes difficult for me to hold the knife.” Said Aisha.
The Doctor inspected the areas to find it swollen up in blood red colour. “We will do a blood test. It’s a test to find out the Uric acid levels of your body.” said the doctor. By the time the nurse came and drew blood, the Doctor inquired about her dietary habits to find out that she was a die-hard fan of tapioca and red meat. She also used to have a habit of day sleeping which she used to do out of boredom.
On examination of results, the Uric acid level was found to be 6mg/dL which was high in the case of a female. Aisha was treated with internal medications like Punarnavadi Kashaya, Rasnaerandadi kashaya, Shaddharanam capsule, Kaishora guggulu, and Shallaki XT for 25 days along with the external application of Jadamayadi lepa mixed in milk over swollen areas. She was also advised to follow a diet containing more vegetables and fruits. She was also advised to include lime water in her diet. She was asked to avoid more protein-rich food items, dairy products, and red meat.
After the treatment, Aisha came to the OPD for follow-up, smiling, and walking freely without the presence of swelling or any signs of pain. Her Uric acid level also was found to be decreased with a value of 4.2 mg/dL.
The case was of Gouty arthritis which Ayurveda calls ‘Vata rakta’, which could be addressed on time. Gout usually occurs due to the impaired mechanism of excretion of Uric acid by the kidneys. It then accumulates as crystals in the body leading to its deposition over the base of the joints often leading to swelling and pain. Even though there is a familial inheritance, over-intake of red meat, tuberous food items, and seafood have been reported as aetiological factors. In severe cases, uric acid crystal deposits cause small lumps around joints called tophi. If treated in earlier stages, Ayurveda medications can help in effectively tackling its symptoms and restrict it from progressing to higher degrees. This is a typical case of Vatarakta, which could be managed with simple medications which not only reduced the symptoms, but also improved the quality of life of the patient.