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    Dad is heavy drinker. Now he's sick. It helps symptoms, but could it be the cause? 
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    Hello,

    This is my first post, and it might seem like a simple question that's been answered many times before, but my dad's pattern of drinking is very unusual, which has made it difficult for me to research this problem on my own. Long story short, he's been drinking heavily for the past 3 years, and recently, he's developed some unusual physical symptoms that seem to be alleviated by alcohol. However, I'm worried that his drinking might actually the underlying cause of his symptoms. Of course, I don't want to jump to that conclusion, because what if he stops drinking and then his symptoms get worse? I don't want to put him through more hell than he's already enduring. That's why I came here to ask for advice. Now for a little more detail...

    My dad has been taking methadone for chronic pain for over 20 years, but in 2014, new regulations placed significant limits on what pain management doctors were allowed to prescribe. About 3 years ago, he started drinking to help deal with his pain. Even though he didn't have a history of drinking, except for the rare social gathering, he seemed to have an instantly high tolerance. Within a couple months, I observed him drinking at least a half of liter of wine (12 every afternoon/evening. He would get drunk almost every evening, but the next day, he wouldn't remember it. I would show him cell phone videos, and it upset him to see the way he was behaving, but since he had no way of realizing when he was getting drunk until it was too late, it just kept happening over and over again. However, this past March, I asked him to let me set a timer between each glass he drank, and he agreed to this without hesitation. After some tinkering, we were actually able to keep him from getting drunk. In fact, he started drinking each glass more slowly, and he even started to be able to tell when I was close to getting drunk, and he would stop until his head cleared up. For the next for months, it seemed like everything was going good. Then everything went to hell!

    As of this past July, my dad was drinking 0.75 liter of wine every day. However, in August, he got sick, and he started drinking as soon as he got up in the morning. Even though he was still spacing out his drinks enough to avoid getting drunk, he was now drinking 1.5 liters every day. This sickness lasted about 2 weeks, but a couple of days before he got better, he started having a completely different set of symptoms that continue to this day. These new symptoms come and go throughout the day, and they seem to be partially alleviated by drinking wine. By the last week of August, he had begun having a couple of glasses between midnight and morning. In other words, he now drinks 1.5 liters slowly over a 24-hour period, without any significant pauses. During this time, he's been to several doctors and had several tests, but so far, they've found nothing to explain his symptoms. He's got more tests scheduled, but I'm beginning to worry that it's a lost cause.

    I have deliberately avoided describing my dad's symptoms (yet), and there's a good reason for that. It's natural that people (me included) would be inclined to hastily attribute his symptoms to his drinking. So instead, I first want to find out what kind of symptoms (if any) one would expect from his pattern of drinking. There's 3 things I'm curious about in particular, all of which relate to the fact the he drinks slow and heavy without any significant pauses, even during bedtime. First of all, could he be experiencing physical withdrawal symptoms, caused by the continuous fluctuation of his blood alcohol? I imagine it's a bit like a sine wave. Secondly, how likely is it that his blood alcohol level ever reaches zero, and if it doesn't, would this have any particular effect? Last but not least, since his liver is constantly metabolizing alcohol, I reckon he probably has some level of acetaldehyde in his system most of the time. I know this can make a person sick, but since he avoids drinking fast enough to get drunk, I don't know if his acetaldehyde level would ever peak enough to affect him, unless it accumulates faster than it can be metabolized into acetic acid.

    Thank you.



    PS: I'm not using "dad" as a substitute for "SWIM". I'm actually talking about my real dad. I'm very worried about him, and I want to help him in any way that I can.
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    Hey littleswimmer, welcome to bluelight.

    What it sounds like to me is your father is showing signs of alcoholisim. It's sounding like once he takes that first drink, he cannot stop. Whatever the case may be, taking that first drink to help with the pain, or like me in my story that first drink was because it was below freezing outdoors, and at the time i was homeless and told myself that first drink was to 'keep warm'.
    What i didn't know was that once i took it, I couldn't stop, i mean its not like i would chug the vodka, id take a pull and wait,maybe smoke a cig, when id feel better id take another pull, and by that time i am out moving around.

    What helped me was a trip to the hospital, bc i knew I my drinking habits wernt normal, everytime i drank id black out, and lose my shit.
    So I pretty much had an intervention with myself, and at this time I was drinking mouthwash like it were going out of style.
    So yeah, I was needing help, but scared.

    The hospital had a psych unit, and for afew days they were able to help with the DTs and they were there incase I had a seizure, bc it got bad.
    The meds helped, they gave me ativan and ambien for sleep, among other things.

    The issue was when I would get discharged, there wouldn't be a cloud on the horizon and I would find myself, once again, behind a family dollar chugging a bottle of mouthwash.

    Long story shory, what worked for me was first admitting i had a problem with drinking and needed help, so checked myself into rehab.
    Havn't had a drink now in over 2 years.

    Have you tried talking to your dad about possibly checking into a detox?
    If you have any questions, comments, or suggestions please feel free to send me a PM. here
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    The first thing I thought was that your father is experiencing alcohol withdrawals and that's what the sickness is. If he's drinking first thing in the morning, that's exactly what gets people physically addicted to alcohol. Alcohol withdrawals are very dangerous, so it's important that he not try to cold turkey, but rather to taper, or even seek medical help to detox. There's a lot of help available for alcoholics, fortunately.

    I hope your father will realize his problem and do something about it. Alcohol is a very toxic drug and if he continues drinking all day every day, it will destroy his liver and his mind over time.
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    #4
    I've thought a lot about the possibility of alcohol withdrawals, but that would raise several questions. First of all, is it possible for him to experience withdrawal symptoms within 2 hours of finishing a glass? Bear in mind that if he's drinking 1.5 liters of wine each day, and he separates it into 8 glasses at roughly equal intervals, then I wouldn't expect his BAC to drop significantly between each glass, especially given the fact that it takes a certain amount of time to absorb alcohol from the stomach/intestines into the blood. Then again, I read this case report about a man who was hospitalized for alcohol withdrawals, but lab tests revealed that his BAC was still very high, even as his symptoms worsened.

    My dad has two big problems that go hand-in-hand. The first one is a tremor, which started appearing some time around the end of 2017 or the beginning of 2018. It's hard to describe, but I'll do my best. It's not a fine tremor, like shivering. It's slower, broader, and more irregular, but it's also not a forceful jerk. If I saw a video of someone with a tremor like his, I would probably recognize it. However, the most unusual aspect of his tremor is that it is exacerbated by bowel movements, and it doesn't subside until at least 10 minutes later (very conservative estimate). Then again, he almost always gets a glass of wine during this time. Still, I don't see what on earth a bowel movement would have to do with tremors of any kind, alcohol-related or otherwise. In all my research, the only connection I've found is that bowel movements can stimulate the vagus nerve, which can slow heart rate and lower blood pressure. In rare cases, this may be significant enough to cause symptoms like tremor, lightheadedness, or even fainting, but as far as I've been able to tell, this effect only lasts for about a minute at most. Besides, I've checked his vitals during some these episodes, and they were usually pretty good. However, that makes me wonder. Could a drop in heart rate or blood pressure, even for a minute, somehow initiate or exacerbate alcohol withdrawal symptoms?

    My dad's other big problem didn't start until the middle of August, two weeks after he doubled his wine consumption and started drinking throughout the entire day. It's an indescribable feeling that he refers to as weakness or shakiness. He says he's never felt anything like it before in his entire life, but it's an intensely miserable feeling. During these episodes, his tremor is much worse than ever before (even making his voice a bit shaky), his breathing becomes labored (like what you would expect from someone in pain, as opposed to an actual respiratory problem), and he has a lot of trouble walking, due to a combination of dizziness and an apparent lack of strength and/or energy. As before, these episodes almost always happen after a bowel movement, but they do also happen at other times throughout the day.

    It's important to note that in the 3 years that he's been drinking, he never seemed to suffer any dizziness or motor problems when he got drunk. That is, not until June. By then, he was doing a much better job of trying not to get drunk, but something strange started happening. Even when he was only getting a little bit drunk, he would start having trouble walking. The strangest part is that it would happen spontaneously, often accompanied by a seemingly instant increase in the more familiar effects of intoxication, like slurred speech. In retrospect, these episodes seem very similar to the episodes he's been having since mid-August, except that now, he usually doesn't seem to be drunk at the time.

    Given the risk of long-term health problems, I really want him to stop drinking, but I do understand his POV. He doesn't believe it very likely that his current symptoms have anything to do with his drinking, but instead are the result of an unrelated health problem, and since wine helps alleviate his symptoms, why not wait until after he gets well and then stop drinking? So, if his drinking really is the cause of his problems, then in order for me to convince him to stop, I would first need to show him that there's some definitive link. For example, if there's something about his symptoms that's very particular to alcohol withdrawals, or if there's some kind of experiment I could get him to do.
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    I think you've gotten some pretty good feedback. I've been severely alcoholic for upwards of a decade, and I would be almost certain that these are symptoms of alcohol withdrawal. I didn't read the case study you linked to because I've lived it. I've been admitted to a hospital emergency room with alcohol withdrawal symptoms with a .44 blood alcohol with worsening symptoms. Alcohol is not metabolized like most other drugs. It doesn't have a half-life. Alcohol metabolization is a zero-order process, meaning its metabolization is strictly linear with time. If you remember your high school algebra, alcohol metabolization would appear as a straight line plotted on a graph versus having a logarithmic curve as is the case with drugs with a half-life. The body can only metabolize so much alcohol at a time, and once there is more alcohol in your system than your body can handle at any given moment, the drunker you get. That's why someone can have stopped drinking for a certain period of time, yet their BAC continues to rise as alcohol in their stomach and intestines continues to be absorbed. So applying this to your father's scenario, he may not be spacing his drinks as sufficiently as he thinks he is, ergo the symptoms of withdrawal manifesting.

    The likely causes of the lightheadedness is the opposite of the scenario you describe, i.e. the blood pressure is not exacerbating the alcohol WD symptoms, it's the other way around. Blood pressure naturally drops any time you stand as blood rushes toward the feet, but one of the most common symptoms of alcohol WD is high blood pressure, so when he stands (off the toilet), the vacillation in blood pressure is going to be more extreme, resulting in dizziness, lightheadedness etc.

    Three years of drinking at the rate he has been drinking, is a lot of alcohol. The loss of motor control comes as no surprise. Chronic drinking shrinks the brain, and the cerebellum is one of the more profoundly affected parts of the brain. It takes me about a month after a bender of anywhere from a week to several weeks to regain my balance.

    And finally, just because he doesn't appear to be as intoxicated doesn't mean anything. The brain is amazingly adaptive. Without going too much into the biology of what takes place with chronic drinking, the brain ends up needing much less GABA (an inhibitory neurotransmitter) but needs much more glutamate (an excitatory neurotransmitter) so that in a nutshell your body doesn't forget to breathe and keeps your heart beating. The tremors you describe are a consequence of an overactive nervous system since with a declining amount of alcohol, the balance between inhibitory-excitatory brain activity is disrupted.

    Long story short, I don't know that I've met any chronic alcoholics who appeared as intoxicated as they really were. I've been taken to an emergency room with a blood alcohol of .55, which not only would be fatal for most people, but the doctor couldn't believe I was actually conscious and [somewhat] able to communicate with him. Combine that with the zero order kinetics of alcohol metabolization and it's not difficult to understand why chronic alcoholics get to a point where in order to pass out, their blood alcohol has to be elevated to a point that still leaves them very much wasted and not just hungover the following morning.

    Bottom line, your father's drinking sounds as if it's reached a level where honestly, it's probably going to be too uncomfortable for him to taper down on his own, and he most definitely should not stop cold turkey. The current medically accepted way of detoxing someone off alcohol is by using long acting benzodiazepines such as diazepam (Valium) or chlordiazepoxide (Librium). He doesn't necessarily have to do it at a facility or hospital (although that is certainly the safest way to go) but it needs to be done under the supervision of a physician.
    Last edited by aihfl; 07-10-2018 at 03:32.
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    #6
    Thank you. This is very informative and helpful. I consider myself a skeptic, which is why I've been so reluctant to assume that my dad's problems were due to intoxication/withdrawals. I already strongly suspected that this was the case, especially given the fact that his neurological problems got worse so soon after he doubled his drinking (prompted by an apparent c.diff infection), as well as the fact that they so closely resembled the problems he often had when he got intoxicated in the months leading up to August, but I still had doubts, for the reasons I mentioned before. However, you've eliminated those doubts, and even though I refuse to assume anything with 100% certainty, I dare say I now have more than enough reason to believe that most his problems stem from his drinking, except for the c.diff infection. Combine that with the long-term health risks, significant financial burden, and the short duration of his (admittedly significant) pain/tremor relief, then it's clear that the wine's cons far outweigh its pros.

    There's one thing I must confess. In my first post, I said that my dad was drinking 0.75 liters a day, and then jumped to 1.5 liters. The truth is that he was already drinking 1.5 liters a day, and then jumped to 3 liters. The reason I lied was so that when he reads the responses, he will realize that even the amount he was drinking a few months was already capable of causing problems those he's having.

    Again, thank you all for your replies.
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    Glad we could help, your dad is lucky to have such a caring child. Be sure to post back here with any updated or needs for support. I do think it's very important for your dad to get some help for this. That level of constant alcohol consumption will lead to illness and eventually a painful death from the liver, pancreas, and general organ toxicity of alcohol.
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    Quote Originally Posted by LittleSwimmer View Post
    There's one thing I must confess. In my first post, I said that my dad was drinking 0.75 liters a day, and then jumped to 1.5 liters. The truth is that he was already drinking 1.5 liters a day, and then jumped to 3 liters.
    Three liters a day is extreme. If and when he decides to detox, it really needs to be done at a hospital or in a setting that is equipped to handle life-threatening medical emergencies. At that amount, the risk of seizures is profound and there is an increased risk of delirium tremens (which is quite a different thing from shakes, tremors and seizures altogether), although DTs are rare, relatively speaking, anymore (they were much more common when chronic alcoholics were forced to go cold turkey). I've gone through mild DTs, and the best way I can describe it is as living a nightmare where you are unable to distinguish reality from hallucinations, accompanied by fever and extreme high blood pressure and tachycardia.

    I'm not writing this to incite panic, just to illustrate the seriousness of the situation. I was once in a medical detox with a well-regarded attorney, who despite drinking a handle of 80 proof vodka every 1-3 days, remained functional. He was actively participating in group therapy and otherwise engaged, but he still went into cardiac arrest and died in full view of all the rest of us. And this was at a major university teaching hospital.
    Last edited by aihfl; 07-10-2018 at 18:57.
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