The Reluctant HerbivoreBy Matthew Baldwin
December 02, 2010
One morning in early September I developed a small pain in my left foot while walking in to work. It felt like nothing more than one of the brief aches a habitual ambulator like myself occasionally experiences, and I figured it would subside after I’d sat at my desk for a bit. I was wrong. By mid-afternoon the pain was so intense I couldn’t keep a shoe on without wanting to scream. Aside from some very slight swelling above the arch there was nothing visibly wrong, but what felt alarmingly like a protrusion of bone had formed just under the skin. The slightest touch on the area sent fresh lancets of pain up my leg.
A friend drove me to an urgent care clinic after work, where the doctor on duty gently poked and prodded at my foot while I flinched and yelped. After x-rays and a blood test he concluded that the bones were fine, and diagnosed my ailment as a sprain of the joint between the metatarsals, exacerbated by a slight excess in body fat. He gave me a prescription for anti-inflammatories and some information on joint pain and sent me hobbling on my way.
Though I was relieved not be to suffering from something more severe, the treatment was hardly the cure I was hoping for. The medication (2400 milligrams of high-grade ibuprofen daily) did little for my immediate pain and, as an initial side effect, gave me indigestion and some deeply strange dreams. The only shoes I could wear with any degree of comfort were my Converse Chuck Taylors, but walking anywhere, for any length of time, continued to hurt. Despite this I started hitting the gym with regularity, as losing weight was an imperative part of my recovery; with some disciplined exercise and calorie-cutting I dropped about eighteen pounds between my initial diagnosis and the end of October. Until I became acclimated to the pain, that first week on the elliptical was a study in agony.
It worked, to a degree. The swelling subsided some, as did the pain. But not enough, and after seven weeks I went to my primary care physician for a follow-up exam. She concurred with the urgent care doc’s diagnosis, though she had me leave another blood sample with the lab for comparative analysis.
She contacted me less than a day later with the test results and a new diagnosis. My foot pain hadn’t been due to an injury, but rather was a symptom of a larger issue: hyperuricemia, elevated levels of uric acid in my bloodstream due to my kidney’s failure to excrete it out properly. These elevated levels can – and in my case, did – cause an attack of gout.
Uric acid is a waste product created by the digestion of purine; uric acid levels in the body are raised by the consumption of high-purine foods: meat, certain types of seafood, fructose, and alcohol. No problem for a normal renal system, which then filters it out, but with an under-performing one like mine, the leftover uric acid crystallizes in the joints and tendons. In the majority of cases hyperuricemia is genetic, so while the symptoms are preventable, there is no cure.
This diagnosis meant that I had to make some lifestyle changes, and quickly. Unless I want to suffer another one of these attacks, I have to switch to low-purine diet, meaning that I am now, for all intents and purposes, a vegetarian, and quite possibly a sober one at that.
This, to use the vernacular of our times, really fucking sucks the big one.
It’s been about a month now since I received this diagnosis, and my emotional response has alternately been one of depression and one of resentment, both due to my body having made such a determination without my input. At the risk of sounding petulant, the entire matter struck me as simply unfair; I was already exercising regularly, had been cutting back my meat consumption, and have never been a particularly heavy drinker. For fuck’s sake, I didn’t even start drinking until a few weeks shy of my twenty-first birthday.
I was in too much of a funk to even write for a while, and turned my attention instead to researching my affliction. There’s a maddening amount of conflicting information on gout nutrition out there, and parsing through it just increased my depression even more; the websites of major medical institutions like Kaiser-Permanente, Johns-Hopkins and the Mayo Clinic all contradict each other. Plus, there’s no way to determine what specifically triggered my attack, as unlike an allergy, there’s no clinical test for susceptibility. Tolerances vary from person to person, so avoiding an attack is pretty much an all-or-nothing deal.
It could be worse, I know; as annoying as it is, hyperuricemia isn’t fatal, and once my foot heals won’t impair my day-to-day activities. And technically speaking, I do have a choice in the matter: I can keep eating what I want, as long as I’m willing to live with the pain. But that doesn’t really amount to much of a choice, does it?
Understand that I have nothing against the vegetarian lifestyle, save for a small measure of scorn reserved for those who embrace it solely because it’s currently trendy to do so (this is exponentially increased in the case of trendy vegans). Several near and dear friends – not to mention a couple of past girlfriends – are vegetarian, and out of respect I’ve generally abided by their diet when around them. But I’ve never wanted to be one, cheerfully preferring the options available to me as a dedicated omnivore. Hell, I’ll admit it: I really, really enjoy eating meat. I can’t look at a pig without craving bacon.
Ultimately though, I’m too much of a Darwinist at heart; adapt, or die.
It’s been an uphill battle so far, mostly because the learning curve is pretty steep, and I’m proving to be a genuinely terrible vegetarian. I’ve never really cared much for vegetables, and know almost nothing about creating a balanced meal out of them. I make salads so dull even rabbits find them uninteresting, and a couple of weekends ago I managed to create an inedible mess out of a very straightforward recipe for butternut squash soup. My digestive system, long accustomed to extracting nutrition from bits of dead animal, is only begrudgingly adjusting to the increased amounts of plant matter I’m now consuming.
I’d be in even more dire straits if I weren’t graced with some very cool, very generous vegetarian friends both locally and abroad, all of whom went above and beyond in response to my clarion call for aid, providing me with advice, recipes, cookbooks, and some much-needed moral support. Thanks to them I now have a small (but expanding) repertoire of dishes that I enjoy eating, and have so far managed to avoid malnutrition.
I do have some flexibility in my diet: eggs are fine, and low-fat dairy is encouraged, as lactose helps neutralize the presence of uric acid. It also looks as if white fish such as mahi mahi and cod might be safe, though the ever-present threat of mercury poisoning that comes with eating too much seafood still remains. Recent research suggests that white meat poultry might be all right, if servings are kept small and infrequent – say, five ounces or less twice a week, though again this varies from person to person.
I’m not going to chance it, however, as I hope that by going the full vegetarian route I can continue to enjoy the occasional drink. I genuinely enjoy the taste of beer, and I live in a city that has seen a massive rise in excellent microbreweries in the last decade; to cut myself off from enjoying their wares just seems masochistically cruel.
And, more importantly, I’m not going to push the threshold of my diet because I’m still in pain. Three months have passed and my foot is not healing correctly. The initial teeth-clenching hurt has diminished but never completely dissipated, and the mysterious bony protrusion remains. The recent seasonal drop in temperature has caused the joint to ache in a myriad of new and unpredictable ways, and on the worst days, I limp. My doctor has effectively shrugged her shoulders and referred me to a specialist, who is not available to see me until two days before Christmas.
I’ve become acclimated to this ever-present pain, but I’m weary of it, and I’m beyond ready to wear shoes other than my Converse. If giving up meat – and if necessary, even alcohol – is what it takes, then so be it. I’ll take my place among the herbivorous, begrudgingly though it may be.
I really am going to miss bacon.