NEW YORK - His foot looked like a club, swollen and red and so indescribably painful that Maurice Cheeks couldn't put on a sneaker, much less a dress shoe. That he could stand on his left foot at all, given what the 76ers' coach knows now, was a minor miracle. The issue of fashionable footwear was really the least of Cheeks' concerns.
So for the Sixers' game in Atlanta on Feb. 4, Cheeks wore a shoe on his right foot and a matching dress sock on his left. He sat on the bench for much of the game, trying his best to deflect attention from the fact that he had become Shoeless Mo.
"It was bad," Cheeks said. "It was bad, bad. Yeah, it was bad."
Cheeks, 51, has gout, an arthritic condition characterized by sudden and severe episodes of pain, tenderness, redness, stiffness and swelling of joints that affects upward of five million Americans. It is a manageable condition, one caused by an increased level of uric acid in the body, but it's a condition that, left untreated, can have crippling long-term effects.
Like many people afflicted with gout, Cheeks said he thought his occasional bouts of tender feet and knees were simply a fact of life. Now, after signing on as a spokesman for Gout Awareness Day, he has learned that there is a treatment for his condition, although there is no cure.
"I didn't know a whole lot about it," Cheeks said yesterday after a news conference in Manhattan to promote the second-annual Gout Awareness Day, sponsored by the Gout & Uric Acid Education Society. "I just thought [gout] was something that would happen for X amount of days and then go away. I knew uric acid and crystals and all of that, but I didn't know the severity of it all until the past couple of days."
Cheeks had his first encounter with gout when he was the head coach of the Portland Trail Blazers. His left knee became swollen. Thinking little of it, Cheeks took an anti-inflammatory drug and suited up in his sneakers to play hoops. When he was finished, his knee was huge, and after a series of tests, including one in which crystals from his joints were extracted with a needle, Cheeks' gout was diagnosed.
He had a couple of episodes after becoming the Sixers' coach, but nothing as public as when he was in Atlanta earlier this year. The joint at the bottom of his big toe was swollen and red, and his entire foot throbbed. Lying in bed with a sheet over his foot hurt. Taking a shower was tricky.
A doctor told Cheeks to put his foot in a tub of hot water, which "I swear, that was the worst ever," Cheeks said.
For the game against the Hawks, Cheeks considered wearing a protective boot over his left foot, but even that was too tight. So he went shoeless. Standing was a victory.
"He's a pretty stoic person, and he's an athlete," said N. Lawrence Edwards, a doctor and the chief executive officer of the gout education society, who recently counseled Cheeks on the condition. "Most people, when it's that painful, won't even put weight on it. They won't put any pressure on it. They won't try to be up and around. He's more driven than most human beings, I think, and certainly he was doing fairly remarkable things given the pain he was in."
The Sixers lost that game to Atlanta, but then went on a five-game winning streak. Cheeks was shoeless for part of that stretch, and his players, who knew he had gout but didn't understand the severity of the condition, urged him to keep the one-shoe-on, one-shoe-off approach.
According to Edwards and Ralph Schumacher Jr., who is an expert on gout and a professor at the University of Pennsylvania School of Medicine, most early episodes of gout last between five and seven days. Cheeks' attack in February lasted for more than two weeks, in part because he kept working through the pain.
It was his fifth episode. As the condition intensifies, the time between attacks shortens, and the long-term ramifications grow.
"It's not just a nuisance," Schumacher said. "It's very serious at the time of the attack, and it can become disabling."
Left untreated, gout can cause deformity in joints in the hands, feet and knees, among other places, as well as kidney stones and impaired kidney function, Schumacher said. The good news is that gout is treatable with nonsteroidal anti-inflammatory drugs and medicines that block the production of uric acid and help take the acid out of the kidneys.
Cheeks is not on those medicines yet. Indeed, he just learned they exist.
"He should be on one of those uric-acid-lowering drugs sometime in the not-too-distant future to prevent more long-term problems from occurring," Edwards said.
With treatment, Cheeks should be able to focus all his energy on his young team's improvement next season. He'll soon head to Orlando for the NBA's predraft camp to search for a power forward. And he'll concentrate on free agency.
But yesterday, he rang the opening bell at the Nasdaq exchange and spent time talking about a condition few understand.
"I rarely do this kind of stuff," Cheeks said of being a spokesman for a cause, "so I didn't know it was this involved. Had I known, maybe I wouldn't have done it. But having said that, I'm glad I did it because I've learned so much about the condition that I wouldn't have known. I would've stayed being naive, like most people."