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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.

Thursday, June 21, 2012

Live cells v. dead cells...

Last week Riley had an appointment with a Veterans Administration doctor in order to set up a primary care relationship with the local VA clinic. I had originally thought it was an evaluation for his disability compensation claim, but I was wrong. This appointment was only to do with his request for VA medical services.

I’ve heard a lot of horror stories about these clinics and the medical staff. If this clinic is representative of other centers, those horror stories are without merit. I found the clinic to be very clean and well equipped. The staff was friendly and cooperative. Things felt as though they had all been trained in the art of efficiency and customer service. I was impressed.
I was also impressed with the demeanor of the doctor that had been assigned to us. He was knowledgeable and spoke to me as one human being to another. He didn’t use medical-eze which would leave me running to Wiki to find out what he had said. He was a real person who used his own personal experiences to show that he understood what we had been going through. He explained and when I left I felt we had a plan of action and I knew the consequences of all the possibilities.

While we were all talking and relating, he was examining Riley. It wasn’t a huge exam. There was no disrobing or standing and touching his toes, but rather simple things.  To a lay person it might seem that he did next to nothing of a real exam. That assumption would have been wrong.
This is what I learned –

The liver can, in fact, regenerate new cells and continue to function. However, there must be a sufficient amount of LIVE cells for regeneration. DEAD cells are just dead. They cannot regenerate. The just remain as scar tissue impeding proper function. If the liver has been constantly asked to recreate itself over and over again, it will get to a place where the regeneration cannot replace all the cells that have been killed by the intruding factor. New cells WILL regenerate, but the question is will it happen fast enough?

The only way to really determine how much of the liver is functioning is to do a biopsy. It’s a simple procedure of inserting a needle into the liver and withdrawing a sampling of the cells. Without the biopsy there is no way of telling the percentage of dead cells versus the live ones. However, the procedure generally causes heavy amounts of bleeding. Alcoholics are susceptible to having bleeding issues and are not good candidates for the biopsy. In Riley’s case the risk of him bleeding out is not worth taking the chance that a biopsy would present. So for Riley -- we don’t know and we won’t know how much of his liver has the capacity to regenerate.
The same theory works for LIVE cells and DEAD cells in the brain. However, the brain is not as forgiving as the liver. Alcohol anesthetizes many of the cells so that they do not function properly. Other brain cells are simply killed off. As the alcohol stops entering the brain, these anesthetized cells seem to wake up and start functioning again. But the dead ones are just gone forever.

It is obvious from observing Riley that he has made a remarkable improvement. However, he is now about a month from the heart attack and the condition he is in currently is about as good as he is going to get.  He will have very good days and very bad ones. But this is what it is and this is what it will be.
I’ve been trying to visit Riley at least every two days. Sometimes it’s longer. Visiting him less often allows me to see his progress more clearly. If I see him every day the subtle changes may not be as noticeable to me.  And I DO see changes. His eyes are much clearer and skin is not as yellow. He doesn’t mumble so much when he talks. He is able to follow a conversation – to a certain degree. He is also developing a desire to maintain his personal cleanliness and keep track of the schedule. He knows that does NOT want to be there. He wants to come home so that he can drink.

 S..i..g..h..

This puts me in a Catch-22 position. If he stays in the facility, he will not drink and live longer and healthier. If he comes home and can get alcohol, he will most likely die within a year but be happier about where he lives. I would like to say that this is about the “quality” of his life. But that is subjective. What would be a quality life for me would probably make him miserable.
There is the issue of having him come home endangering my health. Caretaking him has had a huge negative effect on me personally and medically. I have no desire to die. I asked Riley how he would feel if he came home and then woke up one day to find me dead on the kitchen floor. His response was that he would be worried about who would be taking care of him now. WOW!! There was no expression of regret or even that he would miss my company. His only concern was how my death would possibly upset his living arrangements.

The doctor at the clinic has noted in Riley’s file that he should be institutionalized because he is a danger to himself and others due to the fact that he will not stop drinking. Even if Riley is not displaying any outward signs of needing hospice, he is still terminally ill which will only be intensified by his return to drinking.
On my plate for today, I must request a comprehensive neurological psychiatric evaluation to determine if he is competent to make his own decisions. If he is deemed incompetent, he will not be able to make the choice of staying in a facility or coming home. If he is, in fact, competent he will be allowed to make his own bad choices. But… really… isn’t that what he’s been doing all along??

25 comments:

ADDY said...

All so familiar to me. You,meanwhile, are damned if you do and damned if you don't allow him home. It's a no-win situation. Lots of hugs and hang in there one day at a time.

Linda / Oma / Ladybug said...

After 32 years, 10 months and 19 days, I'd had enough of my husband's self-destruction. His drinking was having terrible effects on my own mental and physical health. The move was painful but I'm convinced it was my only option. Ya know what? I'm finding myself smiling again! I'm not angry, I don't drive home from work dreading going thru the door to see what hellish situation I'd walk into. Be good to yourself, he's made his decision!

BevE said...

What a horrible 'merry go round' your on! With Riley's history it seems that he should definitely be institutionalized. It's hard to believe that there is any other option here. He would be better being in a place where he could not drink. It just seems crazy to let him go back to his old life. Linda I can't imagine what you are going through-you and Riley are in my prayers.

On a personal note, my son who's 31 and has about 14 years of drinking and drug abuse under his belt says he will never stop drinking. I don't know if I can handle another 14 years or more of this - but thanks Linda for writing this blog - it helps so much.

Dixie Redfearn said...

This is just my opinion but I think entertaining the idea of letting Riley live with you and continue drinking is INSANE! Really, Linda, 2 heart attacks, a stroke and who knows what else to your physical and mental well-being is a big enough price to pay for someone who would find you dead and only wonder who would take care of him next. OMG. Are you listening to yourself? I think you have done a yeoman's job of helping your ex-husband and to do so further could kill you! Let him figure out what to do if that even comes up. You have done more than enough!

Syd said...

I think that his staying in the facility is a good idea for both of you. I think that he will be better in there and you will be happier and have much less stress. JMO. Tell Riley I owe him a letter.

Brook said...

Hi. I found your blog through the Blog Train. I am so glad you are able to help people who live with and care for an alcoholic. I do not know what that is like but I am thankful you have decided to share your life. Best wishes. :)

Linda -- Immortal Alcoholic's Wife said...

Dixie -- I'm sticking to my guns about not letting him come home. I've gotten some great advice from the VA Caregivers Rep and the nursing home staff. I'll post an update soon. I agree with you that the entire situation is INSANE. -- Linda

Louise said...

Linda, I think you have done more than enough. It seems to me that it's Riley's turn to do something for you in return, whether he likes it or not. You have given your all and it's wonderful of you. If there is the option of an adequate facility that can look after him, it seems the right choice. Riley has drunk enough in his life!

Of course I only see this from the outside, but it seems the right way to go to me. Best of luck.

Anonymous said...

From Jackie -
I'm happy to hear you will not be having Riley return home. I know it is a shock to hear Riley say to you, "His response was that he would be worried about who would be taking care of him now. WOW!! There was no expression of regret or even that he would miss my company. His only concern was how my death would possibly upset his living arrangements." But, there you have it. The simple truth of what an alcoholic really thinks about their situation. Alcoholics become very selfish even to the detriment of others. If they still have enough sense to think from one day to the next, it's going to be - where's my next drink and someone needs to take care of me. That's it. Their whole train of thought, everyday! I have a 81 year old mother who has been addicted to Rx drugs in her 40's, alcohol dependent in her 50's to present time. She functioned well enough to have a career but continues to work part time to supplement her income. I do not buy her alchohol for her when her money gets low. Her coworkers buy it for her! She has found a way to have her daily quota one way or another. She has many falls throughout the year. No broken bones so far but has two chipped front teeth. She comes down with nausea, stomach and back pain about every three months. For the first 4 days she is completely bedridden and will not go see the doctor. Ive done some research and found that her episodes are most likely be inflammation to her pancreas. During these episodes, I will need to buy her Depends, bed pads and wash up after her. It takes her 2-3 weeks to get her strength back and I spend anywhere from 6-10 hours per day working with her to eat and get her strength and balance back. I have been doing this for years. She has no assets, limited income and no retirement money or long term plans. Her retirement plan was me! I've helped her financially for over 15 years which has been difficult. I'm not wealthy. She had an automobile accident 15 years ago and it almost killed her. The ER doc told me the blood alcohol showed 3 times legal limit. This was at 7:30 in the morning! Her car was totaled and she had no means of acquiring another one. Sooooo I had to help her get back on her feet and down payment on a used vehicle. I can't let her live with me, for I would go mad! I'm trying my best to keep her independent as long as possible. I've suggested she look onto assisted living before she needs nursing home type care. She refuses and said she will die in her own place and will not go anywhere else. She told me she couldn't drink in a nursing home and will not go. She also said that as long as I take care of her when she needs it, she could remain home until her death. That may be true but I must say that after 15 years of her illnesses and several surgeries, I'm tired of cleaning up after her, doing everything for her, performing physical therapy to help her walk and get her strength back from these episodes. This kind of care is too stressful. I could tolerate it better if my mother was not so controlling, critical, selfish, lying, manipulative, obsessive and mean. During her past drunken episodes she has called me selfish, bitch, c&@t, whore, bastard, and every other thing you can think of. And many times during the presence of my children when they were young. It gets tiresome. She also loves the attention she receives during her illnesses and recovery from any surgery. I'm not cut out to be my mothers caretaker when she does reach the time when she will need nursing home type care. I'm at a loss of what to do when that time comes! By the way, she has also told me that I should do my duty and always take care of her. Plus I must keep up my health because I am suppose to be there for her, etc etc. So in the meantime the cycle starts all over again. Ain't life beautiful?

tearlessnights said...

I like the saying I heard that "we teach people how to treat us". When I see how Mr. M has treated me over the years I have had to realize that I taught him that this was all I was worth. Reading your words, it seems you are more and more aware of your value and the toll this is taking on you AND you are seeing Riley's complete self-obsession and how little he values you. You said it well when you said "wow!". Big hugs to you, Linda.

Anonymous said...

He doesn't need to come home. You've done enough for this man. Besides, coming home will only kill him sooner. You deserve a chance to live your life. Please don't take him home!

Anonymous said...

Truly immortal

jo said...

fwiw,,,all Vas all not like yours. ours is horrible, wont even do anything with mine..and tells me im a liar when i say he drinks. his chart says non drinker, non smoker. ROFL. okkkkkkk.

a little care and the body will not want to die. unless he is complete liver failure ,then nothing will help. and he wasnt and isnt.

again fwiw, my daughter took my son in law back yet again. he has no job..he endangered his kid, and she wont give up. my God, i see it in her. its AWFUL. and they never get arrested, or hurt in a wreck...and he has hep c also.

i hate this crap. and this life i got into.

Anonymous said...

for jackie....yep, aint it beautiful?

and they never die,,,which is why i was drawn to this immortal place. but they will kill us.

im a whore nearly every day , according to my husband. your not alone. i just have no answers. they are leeches. and my daughter has one now.

sins of the fathers.......

hugs.....from jo

Anonymous said...

Linda,

As I was reading this much anticipated update on Riley's condition, I thought, "wow, things CAN get better -- Riley's improving; Linda's life is improving..." I felt hopeful about the future for my AH and myself, but when I got to the line, "He wants to come home so that he can drink" I almost fell out of my chair. How often I forget that we cannot think like the alcoholic... I certainly hope you will put YOUR quality of life before Riley's, but I know all too well that's easier said than done. Hopefully the neuropsych exam will make the decision for you.

Meantime, thanks for all you are teaching me. You're a tremendous source of support and sanity.

Jan

Anonymous said...

Jackie said
For Jo . . . I'm so sorry you have a husband who is an alcoholic. I had one too. I divorced him after 8 years of mental, emotional and physical abuse. I felt like I saved my life as well as my children. I'm also sorry your daughter is in the same situation you are in. This site has been wonderful to read where there are so many others dealing with this disease. But all I read are very unhappy people helping a drunk who is killing their caregivers inch by inch. Yes, the alcoholic never seems to die. Strange phenomenon. Why is it so hard to just walk away? I wish it was that easy. I'm beginning to think it should be our goals to find our (the caregivers) way to leave the lifestyle the alcoholic is pushing on us. Why should there be so much suffering in an alcoholic family's life? The non drinker and children should NOT have such a life. The scars and problems from that can run deep. My advice I give all wives or husbands with very young children is this . . . Figure a way out NOW, before it's too late, so the children will not be effected by the years of abuse. Your alcoholic parent will cause you problems when you become an adult, like mine has. So for those who have a parent they are dealing with . . . and your their only child . . . I'm still trying to find a way to find a solution for that one. : 0 )

Gabriele Goldstone said...

I'm happy for you, Linda. Riley doesn't need you anymore. You are free. Take it and enjoy your life.

Don't go back to the way things were. Are you crazy?

jo said...

jackie, im a only child, too. i understand. i was wondering that the other day, why cant some of us walk away? even linda, so articulate and bright, is astonishing me with maybe riley would come home and saving his life and all. how could i judge? i would prob do it too. i just have no idea why im like that or so many of us are. or my daughter, who obviously learned it from me. hers wont live long, he has hep c and you might as well pour gasoline on a fire when you drink with that.

but i dont know. i dont know why we cant. maybe its karma of some kind. im glad you got out of the marriage, but you still have one.

i dont have any solution. i wish i did. all i can do is send you hugsss and caring and prayers.

well, one thing is here you never divorce. they get visitation and i was not gonna let mine have the kids without supervision. he woulda killed em. i pray my son in law doesnt but i know he drives with them in the car,and he is drunk. which is a felony, altho he will never be caught at it and then they get visitation at the prison...100's of miles away. in texas, yes. they do and the judge makes you drive it.

until there is some safety net to get away..i left mine once. it was worse hell than being here. and thats saying something!

good luck. i can not tell you how much i hate this disease, this crap and these people we deal with in our lives.

jody

catalase said...

Almost there my friend. Keep it tight.

Anonymous said...

I'm on the other side of an abusive alcoholic marriage. I now sleep like a baby. I'm repulsed by any alcoholic beverage. I can't take the smell.

Soon Linda, you will be free from the devils fluid.

Anonymous said...

I'm not sure what the comments here mean about you being free now and asking if you're crazy for considering taking him home.

If he's declared mentally competent, it will be his choice -- not yours. You'll be in the same position you were in when you first brought him into your home: take him in or leave him to go somewhere else like your daughter's house.

The one thing, though, I think the readers hope you hear in your own words are statements that ring in many of your posts. Namely, you seem to have sympathy for Riley's choice to drink and his fantasy of that lifestyle, wanting him to be as happy as possible as he lives out what you seem to suspect are a limited number of days (contrary to the title of the blog). But we all have a limited number of days left, and it is possible you could die first. What about your quality of life? Your fantasy lifestyle?

What I think we, your readers who care about you, hope you can achieve is the ability to feel the same coldness for his preferences as he does for yours. Although, in truthfulness, isn't his the same response you'd consider if Riley were in your house and you considered your own death, who would take care of him? I'm in such a similar situation to yours, I know that's what I'd worry about -- my children having to take over his care. While his response seems heartless, it is consistent with the reverse thought we all so often expect will be our reaction to our alcoholic's demise: I won't have to take care of him anymore.

Anonymous said...

After an alcoholic has gone thru 3 detoxes and continues to drink and cause such havoc in a family's life wouldn't it be nice to have a simple solution? I'm going to sound heartless here but wouldn't it be nice to have a huge empty island to drop off all the world's alcoholics and let them all have one big ole party? They can take care of each other or maybe not. But at least they can be 'with someone who understands them'. Drop a shipment of alcohol every month plus the small ration of food they will consume plus medical supplies and they are good to go. This will make them happy, for they have everything they want. It will make the family happy, the stressful, physical, emotional and financial burden is gone. . . . Only in a persons dreams!

Anonymous said...

Since the mind is not a physical organ, it cannot have a disease. A disease is something you have, behavior is something you do. People who are under the domination of drinking (both the drinker and the people around them who allow themselves to be used and abused) got there through choices they have repeatedly made. "Alcoholism" and "codependency" are behaviors......leading to disease and death. Have a great day. Stinking thinking.

Anonymous said...

You've been away a while. I hope you are okay.

Anonymous said...

hey anon, i thought i was the only one who had the island dream for all the addicts. lol.

i am a bit taken aback at lindas change of attitude, and also thought i was the only one who saw it and thought that.

my children wouldnt take over their dads care...so im not worried about that.

thanks for sharing your thoughts.

jo