While in Big Bend Texas, I began to notice the big toe of my left foot was not feeling so great. It was kind of stiff and a bit painful. Trail and I had been hunkered down writing and preparing for Thanksgiving at the time so it was not an injury or a strain from hiking. By day two the pain had gotten more intense and it hurt to walk. Trail has experience with Gout and the symptoms matched her own trials with the condition.

If you don’t know, Gout is a disease in which crystals form in one or more of your joints causing pain. The most common location is the first joint of the large toe, right where it hit me. The common consensus is that elevated levels of uric acid are to blame. Once the crystals start forming, your immune system reacts causing swelling and pain. The immune response also seems to make it difficult to recover from the condition.

Rather than pictures of my foot, I thought bugs would be nice to look at. I love insects and take a lot of pictures of them.

Round 1: Gout Wins

Being the stout fellow I am and because we were around 4 hours drive from the nearest doctor or hospital we decided to have a go at home remedy. If you Google this subject you will find a small cottage industry in home Gout care. Front and center are dietary approaches. There are things you should not eat, and other things you should eat. Avoid: Alchohol, Red Meat, Oily Fish, and Fructose. Embrace sour Cherry Juice and copious amounts of water. These are the most common recommendations though there are many schools of thought. Outside of diet are the usual anti-inflammatory strategies such as elevating the foot and using cold compresses.

I adjusted down my intake of red meat and products loaded with fructose (of which many are). I drank water till my pee was crystal clear. I drank pints of sour cherry juice. I elevated and put cold compresses on my foot. A week later, it hurt worse than ever. It was clearly time for the marvels of modern medicine. The problem was still that 4 hour drive just to see a doctor and then the usual requirement for an exam and all the costs surrounding that kind of visit. It was time to try the marvels of remote consultation.

We see a ton of dragonflies. These ones were especially large and fun to photograph. Old nip-wing here was kind enough to sit still for me.

Who ya gonna call?

Trail had done some doctoring by internet shortly before we left Washington state. The University of Washington hospital has a nice program for it, but unfortunately, it’s for people actually in Washington state at the time of the consultation. They recommended I look for such a service in Texas. A Google search for that turned up two facts. Firstly: Texas was home to one of the leading remote doctor companies, Teledoc. Secondly: Texas had recently passed a law saying that you had to have an in-patient visit before you could get a prescription from a remote visit. More reading turned up there was a lawsuit blocking implementation of the law so I was in luck.

I set up an account with Teledoc. That was a little tricky as their website doesn’t make it all that easy. It focuses on people who have Teledoc service through their work. While they offer individual subscriptions, you have to root around on their website to find it, and the cookies I got from the corporate side kept messing up my application process for the individual plans. I called them but they could not register me by phone. Trail decided to take over and she figured out the problem, ate my cookies, and I had my one-month membership for about $20.

This was the first Walking Stick bug I’d ever seen in the wild. We found him on a sidewalk and gently helped him into the bushes where he wouldn’t get stepped on. He’s big, about 6 inches long.

Round 2: Gout is out!

Once you are a member you can call them up and talk to a doctor. Each call/consultation costs you $45 and you can do it by internet or phone. Unfortunately, the internet was awful in Lajitas so phone it was. It took a few tries to get a good connection but I was speaking with a doctor within an hour of requesting the appointment. I explained my problem, he asked a few questions to verify we were dealing with Gout, and he ordered a prescription. The nearest pharmacy was a “mere” two-hour drive from our location and by the time we arrived it had been filled.

I was prescribed a generic brand steroid that cost around $20 and sure enough, it worked like a charm. Within two days the pain was nearly gone, and by the end of the five-day regime, I felt top notch. Sorry sour cherry juice, you are tasty, but you just didn’t get the job done.

I was happy to be on my feet again and Trail was happy we could get out of the trailer and onto the trails in Big Bend. Overall, I was really pleased with the Teledoc outcome and price. I truly think that for common ailments for which there are fairly common solutions, this approach is great. It is so much more efficient than hauling down to the doctor’s office, waiting around, possibly having to do a physical and all that jazz. Not to mention, it is infinitely cheaper. Without using any insurance, I got my condition handled for $75. This is how I think routine medicine should be handled, efficiently and affordably.

This little fellow looked ready to join us on our adventure. When traveling there are big things to see, and small things. Both are pretty amazing.