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Providing non-judgmental and non-criticizing support for family and friends of end-stage alcoholics through one-on-one coaching, support groups, blog posts, workshops and public speaking.

Friday, November 4, 2011

No place like...

It is surprising how little medical doctors understand about alcoholism. Unless they attend special conferences, workshops, etc., they only receive about a week’s indoctrination into the world of alcoholism. To any doctors out there who specialize in alcoholism – please let me know if I’m correct or not. I’ve been looking for a doctor to write a post and give me a doctor’s perspective on end-stage alcoholism. Anyway…

Those of us dealing with the disease on a daily basis can probably tell our family doctors a thing or two about life with alcoholism. One thing I’ve found in writing these posts is that caretaking an end-stage or even mid-stage alcoholic is an educational experience. Even though we seem to be pushed aside, dismissed without acknowledgment, the truth is we know things – important things. The trick is learning how to have a strong vocal presence. Most of us are not bitches or bastards. We are not assholes. We are not wimps. But we need to learn to use all those traits to get us what we need – not what we want – what we need.

In this case, one of my readers is questioning her doctor’s decision to let her alcoholic husband detox at home. The doctor wants to prescribe the alcoholic Librium and visit him daily. After reading my page “The Truth About Detox,” the wife is not so sure it’s a good idea.

Librium is often used to aid alcohol withdrawal. It helps the brain’s ability to release a natural calming agent that is present in all our brains. The drug is a tranquilizer with a sedative effect. It is used to reduce anxiety, halt seizures, muscle relaxation, and as an aid to sleep.  Librium is used in alcohol withdrawal to reduce the unpleasant withdrawal symptoms. It is a controlled substance and is addictive in certain circumstances.

My reader is right – in my opinion – it’s NEVER a good idea to do a home detox. Of course, it depends on the amount of daily consumption, how long the drinking has been going on, how many times the alcoholic has detoxed before, and the physical condition. There are a lot of variables. I wonder if the doctor has asked these questions. And I wonder who gave the answers – the non-alcoholic or the alcoholic. The alcoholic will lie and the doctor will not get a clear picture of the situation. The non-alcoholic is the most reliable source for information.

Having been though many detox experiences with Riley, I can tell you that emotionally it’s harder on the bystanders than it is on the alcoholic. Whatever happens, the alcoholic will most likely not remember any of it. The non-alcoholic must come to terms with the things they hear and the abuse they receive while trying to make the alcoholic as comfortable as possible. I heard over and over again how Riley hated his children; was never sexually satisfied with me and regrets marrying me; thought both his and my parents were selfish; and the list goes on. It really doesn’t matter if he means them or not. The words are out there and no matter how much we tell ourselves that it was not the person we loved saying those things, the words hurt. Rationalizing that it was the alcohol doesn’t ease the sting. AND the alcoholic WILL NOT remember it.

Delirium Tremens (DTs) will start about 3-5days after removal of the alcohol. Riley had drugs that kept him calm or sedated during this time. But when he was awake, he imagined spiders and scorpions crawling over his bed covers. He thought aliens and spies were watching him and that the IV bags were filling him with truth serum. He had no idea where he was, who he was, who his visitors were, what year it was. It was painful to observe. I’ve learned, after several episodes, that Riley’s detox is best for me if I am not present until after this period has passed. I did not create the situation. I am not responsible for the results. I will protect myself from the abuse that may ensue by trusting the medical personnel to do what is best for him. I use this time to recharge my own batteries. And, he will remember NONE of it.

When Riley detoxed, he had IV bags and monitors. He had a nurse check on him constantly. A nurse changed his diaper and gave him sponge baths. A lab tech took his blood and urine for testing daily. Every vital part of his bodily functions were monitored. Who will do this if the detox is in a home environment? Is this to be the role the wife/husband plays? If so, how unfair is it to put them in that position? To me – it would be the ultimate slap in the face.

A detox can change direction in a second. What seems to be going along just fine, with all the proper dispelling of the alcoholic toxins, can suddenly turn into a heart attack or a stroke. What if the alcoholic slips into a coma? What if he comes through the whole ordeal just fine and the family discovers he’s been in a black out for years and has no memory of a child being born or the death of a parent that took place during those lost years.

So, to answer my reader’s question – I would not ever have Riley detox in my house without around the clock, 24/7, nurses and daily lab tech visits besides having the doctor make a house call everyday. I am not qualified for the task. Although I am a caretaker, I am not a nurse. I am a wife.

This reader is in the UK and I welcome any of my UK readers to comment with suggestions or alternatives for her. In the US, we have a plethora of centers that provide medically supervised detox. However, Riley is so advanced and has had so many near-fatal detox episodes, he can only detox in the intensive care unit of a real hospital – if I could find one that would be willing to accept the risk – which is unlikely.

In my opinion, this reader must find that strong vocal presence and direct her concerns to the doctor. Speak up. Insist that you not be put into the position of being the nurse. Don’t worry about appearing to be a bitch – if you believe your alcoholic needs hospitalization – be a bitch until you get what you need. So what if not being able to be his nurse makes you appear wimpy. Is there really any reason for you to be strong enough for the task?

You are not to blame for the alcoholism. You didn’t cause it. You are not responsible for the results. Why should you put yourself in that position if there are other options? What about what you need to aid in your own recovery? While he’s detoxing, why shouldn’t you be allowed to take care of yourself and yourself alone? Who knows when the opportunity will present itself again?

There truly is no place like home. But for detox there is no place like the hospital.


Syd said...

I agree with you. Detoxing is serious business. Alcohol withdrawal can kill a person while drug withdrawal usually does not. At the hospital detox here, no visitors are allowed during the first few days so that the hospital staff have a chance to get their job done. I realize that my wife was a functioning alcoholic who did not go through detox. She "white knuckled" her way through but we were lucky. Great post, Linda.

Anonymous said...

Thank you so much Linda for all of your advice.

In the UK im told that rehab and detox are no longer available on the national health becuse the success rate is so low and the cost so high. I am not insured to have him put into rehab. My alcoholic doesnt want to live, his mind is completly tomented with demons from the past. I always thought i could help him and give him a new and happy life but i was wrong. He said he will detox for me but i know he doesnt care or want to do it for himself.

My sister has offered to come and stay with me throughout the process which is wonderful. We have more counselling and check ups to get though before it starts and i will voice my feelings and definatly the words of the people who really are in the know. Non alcohoic carers across the globe! Thank you so much. Wendy

Anonymous said...

This is Wendy again. Just thought i would add. How end stage is end stage in peoples opinions? Dave has long since finishned working, has nerve damage he cannot feel his feet, secondary infections all over his body due to a low immune system. Has a very very high chlorestoral level, it is 9 which is the main thing that worries me about detox, my step father had a heart attack when his chlorestoral was 7.9! Dave has at least a dozen seizures per day, his body shakes and flails, his eyes roll back then he just flops and passes out. He is constantly tired and napping, i buy his alcohol now, he just hasnt got the energy to get to the shop. So how end stage is end stage? Every day i check if he is still breathing yet sometimes i think could this really go on forever? My daughters are 16 and 11, he is not their father and i think they have seen enough!

Anonymous said...

This is Wendy again. Just thought i would add. How end stage is end stage in peoples opinions? Dave has long since finishned working, has nerve damage he cannot feel his feet, secondary infections all over his body due to a low immune system. Has a very very high chlorestoral level, it is 9 which is the main thing that worries me about detox, my step father had a heart attack when his chlorestoral was 7.9! Dave has at least a dozen seizures per day, his body shakes and flails, his eyes roll back then he just flops and passes out. He is constantly tired and napping, i buy his alcohol now, he just hasnt got the energy to get to the shop. So how end stage is end stage? Every day i check if he is still breathing yet sometimes i think could this really go on forever? My daughters are 16 and 11, he is not their father and i think they have seen enough!

ADDY said...

My doctor refused point blank to detox Greg at home and said she would not take responsibity if anything went wrong (which it inevitably would). Of course, the disadvantage to this was that Greg would not go to detox or rehab as he did not want to stop drinking. But I do agree that trying to do it at home is not a good idea.

Eli said...

Wendy, I think that it would be completely worth investigating to talk with someone directly at the National Health Center. Like Linda said, "Be a bitch." If you go to the NHC armed with information, they may listen.

That said, if Dave only wants to detox for you, and not himself; it will be a waste of UK's money plus time, effort and health on your part. Additionally, witnessing the detoxing process isn't anything that your daughters should be a part of. Please, if you decide to do the detox at home, ask a friend or family member if the girls can stay with them during the ordeal.

Hire a nurse to stay with your husband so that you can remove yourself as well. If that's not possible, consider contacting your local chapter of Alcoholic's Anonymous. There might be sober alcoholic(s) who would be willing to be with your husband so you don't have to. It's worth a shot.

Terrific post, Linda. Thank you!

Linda (The Immortal Alcoholic's Wife) said...

Wendy -- I follow 2 blogs from the UK. You might find them helpful. On the left side of the post you will find a list of blogs I follow. Alcoholic Daze and HyperCryptical (I think that's how to spell it) are both UK blogs. It might benefit to go there and see what they have written. I also have many UK followers -- so keep reading.

Linda (The Immortal Alcoholic's Wife) said...

Wendy -- You must also ask yourself -- who is the detox for? Is it for you or for him? How many times have you been down this road? What do you hope will happen and how realistic is it that you will get what you want?

They are hard questions and only you know the answers. You have a tough decision ahead of you. Please know that my readers are supportive and understanding. You can also e-mail me privately if you wish. Oh-- don't forget about Facebook for The Immortal Alcoholic -- fast responses from very open followers!

Linda said...

Eli -- Excellent comments and suggestions. I agree with you 200%.

Eli said...

Wendy, I'm not quite sure where you live in the UK, but I have a listing of AA-Intergroup phone numbers outside of the US. The GSO's (General Service Org., I believe) phone number is 44-1904-644026. There are several, specific cities listed as well if you'd like for me to look yours up for you.

jo said...

my first question, since his health is so bad, is why on earth would he detox? and know,,if he begins to drink again AFTER one, it will do far more damage almost instantly. the constant level of alcohol seems to be protective physically. stopping and starting is far more damaging physically.

re lindas question to drs...i apologize in advance that this is a sore spot with me. i have intense anger at the drs around here who dont give a $hit..and tossed us out on our butts. my opinions would be skewed badly on this subject. i would LOVE to hear from any dr who actually would see a end stage, or even a first stage alcoholic! they seem to have this holier-than-thou attitude to addicts. they dont seem to understand when they so nicely treat a cancer patient, and toss us out..its no diff!

good luck to the poster in UK.

i put a link somewhere that addressed the 4 stages of alcoholism. if you cant find it, i can search it again. try searching stages of alcoholism. its how i found it.

all alcoholics go thru these stages. certain things mark each stage, and 3rd and 4th stage are a bit interchangable until they decompensate physically.

i would never tell anyone what to do...but i would caution yall to rethink a detox. if they dont quit drinking...its actually the worse thing one can do.

linda, its funny that you posted what all riley said during his detox. this is what i hear almost every day when mine is drinking. !!! after awhile, i just am used to it and nod a lot...agreeing that i am the monster he says i am. it destroys your soul...im telling ya.

love to you all today....

jo said...

@ syd...

drug withdrawal can indeed kill someone. i had a friend who died from it. its very dangerous...VERY.

Colleen said...

Just a brief comment to Jo re doctors.... You have to find a dr in recovery. They are out there, they just don't advertise:).. try contacting a local rehab for a referral..
And just another general comment to all... I think it is dangerous to ask for or give medical advise over he internet... too many variables in each individual situation which we know nothing about.
Sharing experience is one thing...giving advise is slippery territory.

Linda (The Immortal Alcoholic's Wife) said...

Colleen -- I try very hard not to "give advice." I try to share my experiences and give my opinion. I'm not a medical professional or a counselor, I'm just a survivor. If I've given advice it was not intended to be professional counseling. I'm very sorry if it appears otherwise.

Have Myelin? said...

I remember when Nicole went through Detox on her own (I didn't know it) and she was sweating it out good - she had the DT's (this is knowledge is hindsight) and she was asking me the symptoms for MS... showing me her shaking hands. That was some time before her death.

I think that the first time she tried to tell me something was up but it was too subtle of a hint.

Detoxing is quite serious.

Karen E. said...

people ask why do we supply vodka to an end stage alcoholic... IF she sleeps straight 10 hrs she wakes up shaking so bad she can hardly hold the cup.... I have been told while she was involuntarily detox (due to broken shoulder/arm bone practically protruding..so she HAD to go to hospital..not her choice) anyway..twice IN A HOSPital ICU setting Dr's told me that she probably would not make it thru the DT's...she made it and it was torture to watch!!!..there will be no detox in this house...if she drinks herself to the end, so be it..its her choice.

jo said...

@ karen, i like what you said.

re advice...like linda, i try to give and make it plain i give my views on my experiences. nothing more. my opinions , when asked for by another. but then again, we have learned a ton in this journey, far more than many so called medical professionals have. everything i know is from either medical fact and articles or first hand experience.

@colleen, we live in a small town. we dont have the money to drive out of town only to be turned away yet again. apparently, the drs here are extremely perfect and no doubt believe it, also. 2 gastros...and 2 pcp's wont take him again. i am not messing with them any more, cause i see the point in that he wont do anything they say. it is more for my benefit, than his, to have him seen once a yr or so.
he goes to the Va, which is worse than a bad animal vet. they think he is fine and i am lying. ! seriously, i was told i was lying. HA. his chart says no smoking, no drinking. when i went to correct them,,they said your lying. its on the chart, its correct. O M G. but what do i know? only been married to him 35 yrs now.

i have resigned myself to the ER when needed, hoping i wont smack someone at it, and still being angry at drs who think they are so much better than us and that i dont matter as a spouse or a human being.

i would love to hear a dr defend the profession who turned us away. altho i doubt i would comment,,lol. linda would ban me once i did!

i find being told your spouse has less than 8 yrs to live, ushered out the door with a "see ya in the ER" just appalling in the year 2011. reeks of old time myth and hypocrisy.

anyways. hugs guys!

Anonymous said...

Hello Linda, and readers,

On the topic of detox, I wonder if you or anyone reading can tell me if it's at all safe for someone with a lesser drinking problem to detox at home. I'll be honest -- I'm the one who needs to stop drinking. My mother is an end-stager as advanced as Reily, and I drink at bed time to make myself fall asleep. I can't continue doing this -- I fear I will end up exactly like her.

Can anyone tell me if it is safe for me to try stopping, right now, tonight?

Bless you all,

Linda (The Immortal Alcoholic's Wife) said...

Mary -- PLEASE, PLEASE, PLEASE, call your local chapter of AA and tell them you need help -- today -- tonight. Let them help you to decide what to do. If you don't feel comfortable calling them -- call a rehab center and ask for help.

I beg you to not follow in your mother's footsteps. There's still time. Do yourself the ultimate favor and choose life.

If anyone else can help -- please send her a message via this comment page!


Karen E. said...

MARY..Call someone..let someone know you need help..This is no way to live your life. Drinking only at evening hour evey nite will lead to a serious addiction like your mother. I speak from experience. My 70 yr old mother grew up with alcoholic parents..beating one another. My mother was a fabulous loving mother to me and my sis as children. I do not remember alcohol ever in our household. My parents divorced when my mom was like late 30's...she handled it by partying..drinking and lost control. She is an end stage alcoholic..spends her days in bed, vomiting. She has no idea if its day or night. I am all she has..my sis, her brother, friends left long ago..GET HELP TODAY>>TONIGHT!

Eli said...

Mary. Please follow Linda's suggestion. It is very unsafe for you to detox at home. If you don't want to contact anyone at AA, go directly to the ER. (Take a cab or ask a friend to drive you there if you've been drinking.) There are SO many things that can go wrong. I say this as a fellow, albeit, sober-recovering alcoholic. If you live near me, I will come and take you. If you want to talk with me, directly, please let me know. I SO totally understand the exact situation that you're in. Admitting your problem out loud is a huge step in the right direction. :-)

Mary, I am a a friend of Linda's Facebook page (The Immortal Alcholic.) You can message me there are well. Godspeed!

Eli said...

I thought it would be a nice thing to provide Mary with the Serenity Prayer. (Fellow blogees, I'm not trying to preach anything specific. Just sharing something that's worked for me.)

"God, grant me the serenity to accept the things I cannot change; The courage to change the things I can, and the wisdom to know the difference."

jo said...

mary, i so applaud you wanting to stop drinking. you can not do it alone, my friend. you will need objective help...in the form of rehab, drs, free AA meetings, any of these. not family...we are not objective enough.

detoxing from ANY addiction is so dangerous. i lost friends from it. please seek help. your worth it.

jo said...

linda, i am so excited at the turn this has taken. i want every addict out there to know how i (and im sure the others here) support your choice to LIVE. thats what it is. you want to LIVE. what courage your showing. go for it! i admire every recovered addict, including my own daughter.

you can do this! yes, you can. daily, sometimes minute by minute. do not be ashamed or afraid to ask for help from anyone. even a ER!

but alcohol and drugs are poison. they become addictive to your body as well as mind. its a disease. please respect its power. its danger.

there are also AA online meetings. and Al anon. better than nothing, dont be ashamed that you will need help from others tho. others who know, who understand, who have been there.

hang in there guys.