At first, I thought that, somehow, I’d broken my big toe. Not that I could recall any trauma, but our family had spent the afternoon mini-golfing. Instead of wearing sneakers like a practical person, I’d roamed the hilly course in strappy sandals to show off my newly pedicured toes. So when a sudden stab of pain woke me later that night, and my foot had tripled in size by morning, I figured the vanity gods were punishing my poor choice of footwear with the kind of torturous pain that would keep me in sturdy cross-trainers from now on.

My father, a doctor, told me that there wasn’t much to do for injured toes beyond toughing it out with ice and ibuprofen. Free advice is always good, but after a few days of hobbling around the house, unable to put any weight on my foot, which also meant I couldn’t drive, climb the stairs to my office, or exercise, I was more than ready for another opinion. Or at least some stronger meds. The last time I was in this much pain, I was given an epidural.

Instead, I got the surprise of my life.

“That –” said my primary doctor, giving my foot a quick glance, “is textbook gout.”

Gout? Seriously? I have gout? Isn’t that something fat, boozy, old codgers who never leave their Barcaloungers get? What kind of cruel joke was this? Yeah, okay, women do get gout. BUT NOT TILL AFTER MENOPAUSE! The last time I checked my driver’s license, I was still in my mid-forties. I had years before The Change really factored into my health. Besides, I’m healthy (or thought I was). There’s no family history. I’m reasonably active. I eat a near-vegetarian diet. I’m a size 0 for chrissake. Even the nurse was perplexed. “Damn!” she marveled. “We never see skinny people with gout.”

Thanks. Now I’m a medical oddity. This way to the Freak Show. Honestly, I could not be more embarrassed if I’d brought home herpes. I’d rather cop to that than admit to this stodgy ailment. At least that would suggest I’d been out there having some fun. Stupid, dangerous, fun. But still. What did gout suggest? Nothing sexy, that’s for sure. I have a healthy lifestyle. How do I have a lifestyle disease?

A quick Google search told me gout was a type of arthritis, so I contacted Nathan Wei, MD, a rheumatologist and director of The Arthritis Treatment Center in Frederick, Maryland, to find out more. (One of the perks of being a health writer is that you can call up random specialists for advice under the guise of “research.”)

“That is very, very weird,” he says when I explain my situation on the phone.

Nice. I can see my second career now: Gout Girl.

Gout develops when your body either makes too much uric acid or your kidneys aren’t very good at flushing out the uric acid your body makes. Either way, it’s an overabundance that causes urate crystals to form in a joint, usually at the base of the big toe (though they can also form in other parts of the feet, hands and elbows). Those babies are sharp, which is why gout feels like someone’s playing voodoo doll with your toe.

Doctors are seeing a lot more gout these days. Though it’s still very much a man’s disease — three to four times more guys get gout than women — women’s gout rate, while comparatively low, has nonetheless doubled over the last two decades, according to the Mayo Clinic’s Rochester Epidemiology Project. Dr. Wei thinks part of that is better detection. “We’re looking for it more,” he tells me. And a big reason docs are looking for and finding more gout is because it’s one of the many conditions that go along with being, well … fat. “The U.S. population is obese,” Dr. Wei says. “You see a fat person with high blood pressure, diabetes, elevated lipids, and they get gout. That’s all part of the package.”

The other reason: Age and meds. “Women are living longer,” he explains. “More women are entering menopause. And there’s tighter blood pressure control, so a lot of women are on thiazide diuretics to control hypertension, and that bumps uric acid up.”

That all made sense. But it still didn’t explain why I, a slender, active, premenopausal woman with blood pressure so low I could probably eat a salt lick without much fallout, have been so afflicted. I don’t get to say this about too many things these days, but I really am too young – about 15, 20, maybe even 25 years too young – for this. Estrogen, which helps the kidneys eliminate uric acid, is thought to be so protective, gout doesn’t really start to bother women till we hit our 60s.

Since I wasn’t a fat old man or a postmenopausal woman, Dr. Wei started quizzing me about my diet. As with many lifestyle diseases, diet is a huge factor in gout. Once upon a time, gout was even called “rich man’s disease” — payback, essentially, for overindulging in rich foods and drink. It’s the breakdown of amino acids called purines in things like organ meats, beef and pork that boost uric acid levels and lead to gout. But that didn’t apply to me — and not because of my tax bracket. I’m a low-fat dairy, whole grains and vegetables kinda gal. I don’t eat fast food. I don’t eat junk. For years, I was a near-vegan — till wild pregnancy cravings drove me to cross six lanes of traffic to get to Tony Roma’s for ribs. Post-baby, I ditched the meat, though I still eat fish. But c’mon. Low-fat dairy, whole grains, fruits, vegetables, lean proteins — that’s the foundation for good health. You want to live a long and healthy life and prevent things like heart disease, hypertension, high cholesterol, diabetes? That’s where you start.

W.T.F?

“You can also find purines in some vegetables — ” Dr. Wei was telling me.

Wait … What?

“…beans, peas, spinach, cauliflower, asparagus …”

Hold up a sec. I eat those vegetables every day. I can go through a bag of spinach, sautéed in garlic and olive oil, in one dinner alone.

“What about shellfish? You eat shellfish?”

Uh-oh. I nodded unhappily, thinking about the softball-sized crab cakes I’d devoured every night on a recent trip to Baltimore. Crab cakes. Shrimp. Scallops. These are my go-to foods when I’m tired of salmon. Turns out, tuna, another diet mainstay, is also brimming with purines. Come to think of it, in the weeks before my midnight gout flare, I’d gone on a bit of a tuna-polooza binge: tuna steak, tuna salad, tuna sushi rolls, seared ahi. Talk about payback for dietary excesses. I’d been practically mainlining purines. The way I’d stacked it, my “healthy” diet was as gout-promoting as gorging on sweetbreads, chopped liver and bacon-double-cheeseburgers.

“How about alcohol? Beer, hard liquor and wine, in that order, can elevate uric acid levels,” Dr. Wei continues.

Strike three. I admit, for a fortysomething mom, I can drink like a party girl.

And there it was: Through blind luck, I’d managed to cherry-pick enough “healthy” foods that, mixed with a few cocktails, added up to a big fat gout diagnosis. A “perfect storm” of factors, and I was the Andrea Gail. Jeeeez. How come I don’t have that kind of luck with lottery numbers?

“You know, if you just ate the shellfish and vegetables, you’d probably be okay,” Dr. Wei says delicately. “Maybe what tipped you over the edge was the alcohol.” He pauses. “It doesn’t take that much, really.” He’s trying to be diplomatic. But the data is on his side. Earlier this year, researchers at Boston University Medical School analyzed Framingham Heart Study data and found that more than five drinks a week – barely even the one cocktail a night that most health experts say is okay for women – will triple a woman’s risk for gout. Apparently, even before menopause, vodka can trump estrogen.

Sigh. Nearly 15 years of meticulously careful eating undone by dirty martinis. Woman plans; the body finds a way to sideline you on the couch, foot packed in ice, mumbling vague excuses about an old Jazzercise injury. (Like I want to be the poster gal for premenopausal gout?!?)

A day after my diagnosis (and three powerful anti-inflammatories — including a big ol’ shot in the ass — later) I was back on my feet.

But like anyone diagnosed with a chronic disease, I’ve had to make some lifestyle changes to avoid future flare-ups and the medications I’ll be forced to take if I get more than one or two attacks a year. Because apparently, I’ve already reached my quota for one year. A few months back, another mysterious injury to the same toe had me limping around for a day or so. I’d chalked it up to too many miles on the elliptical machine, popped some ibuprofen and promptly forgot all about it. Now, I realize, that was a warning.

So I’m trying to follow the rules. While I’m delighted to finally have a medically sanctioned excuse for the three mugs of Italian roast I drink in the mornings (coffee is associated with lower uric acid levels), I’ve also had to give up a few things too: asparagus, seared ahi, any kind of tuna sushi. And, oh yes, I finally accepted that I had to give my well-worn cocktail shaker a rest and climbed (albeit reluctantly) on the wagon. As a result, in the 18 months since my diagnosis, I haven’t had a single flare-up, not even a twinge of toe pain.

I believe that calls for a drink. Shirley Temples, anyone?

A version of this essay appears in the December2011/January 2012 issue of MORE magazine.