I think you might take flatbed trucking off your list as well . Lots of labor , climbing up on top of loads, tarping. Accordng to you , your Gout flares up 21 to 40 days every year . ( 3 to 4 times/ 7-10 days ) . That is quite a lot . Also not sure of the severity of pain concerning gout but climbing in and out of the truck may pose problems as well. Perhaps you can try
some meds and get it under control . good luck.