When you start allopurinol, you take a course of other anti-gout medications to counteract the initial downside. Two weeks on from when I started it was all going swimmingly when my shins started to itch. That night was rather sleepless as I itched all night and, in the morning, I had an angry red rash and a couple of raw patches from my hysterical itching. A day later it was significantly worse.
After some consultation with Doctor Google, I went to my doctor (in the flesh). I asked her if the rash was a side effect from the allopurinol. She was emphatic that it wasn’t because “an allopurinol rash is more widespread”. She said, “they look infected” and gave me antibiotics.
The next day my legs looked terrible. They looked like they had been chewed and befouled by a pack of zombies. My wife was away that day at Auckland University. My daughter was staying over to support me.
When I asked her to come over and stay, she replied, “sure Dad so as long as we don’t end up in the Emergency Department like the last time I stayed over”. She took one look at my legs, took a photo of them and stealthily sent the photo to my wife. Sally rang me straight away and verbally down the phone, frog-marched me to the Emergency Department.
I felt like an imposter going to the ED, feeling like the condition of my legs didn’t necessitate an emergency. Being the stars they are at the Whangārei Base Hospital Emergency Department, they were diligent and methodical.
After lots of examination, consultation and a biopsy the diagnosis was leukocytoclastic vasculitis. It’s an auto-immune disorder where blood vessels attack themselves. It can be caused by a reaction to medications and one of them is, (you guessed it) allopurinol.
A good month later, my legs still look like the victims of an apocalyptic event. They are in bandages and shower time is every other day. (I am surprised my colleagues haven’t complained.)
This is because in order to keep them dry they have to be mummified in gladwrap encased in rubbish bags and then further wrapped in gladwrap then lashed in tape. The rubbish bags have a tendency to balloon with air, (I don’t know why but the ballooning makes it somehow more miserable). Such an arduous procedure can only be tolerated on alternate days.
They are getting better. I’m told this by the district nurses who regularly boost my optimism when they see me at work, twice a week. The service they provide is impeccable. They always have several hints and tips to aid the healing process, that range from elevating your feet to the use of compression stockings.
They do this chatty banter while kneeling on the office floor as they deftly clean and redress the bandages of the zombie aftermath, and then cheerfully say one of us will be seeing you in a few days.
To my mind, the district health nurses are some of the unsung heroes of our health system. Not only do they deliver dressings, medicine, treatments and fix ups, but they deliver an experienced eye, a strong stomach and a positive outlook. They not only help us, but they heal us by enhancing our mana in the process.
Jonny Wilkinson is the chief executive of Tiaho Trust - Disability A Matter of Perception, a Whangārei-based disability advocacy organisation.
