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.