The Biggest Loser – The Alcoholic

The definition of alcoholism is an illness marked by drinking alcoholic beverages at a level that interferes with physical health, mental health, and social, family or occupational responsibilities.

There are two categories – dependence and abuse.

People with dependence are addicts there is no nice way to say it.  If they quit they would have to go through physical withdrawal stages. 

Alcohol abusers are those that have legal problems such as drinking and driving.  They may also have binge drinking problems.

The Causes and Effects:

Alcoholism is a type of drug addiction.  There is both physical and psychological dependence with this addiction. 

Alcohol affects the central nervous system as a depressant resulting in a decrease in activity, anxiety, tension and inhibitions.  Concentration and judgment become impaired. We all know someone who has fallen while intoxicated, many times they fall and bounce right back up and laugh about it.  Then there is always the chance that a fall will cause a real injury, one that requires a trip to the ER and maybe surgery. 

Alcohol irritates the gastrointestinal tract and can cause erosions of the lining of the esophagus and stomach causing nausea and vomiting, and possible bleeding.  Vitamins are not absorbed properly which can lead to nutritional deficiencies.  Liver disease, called alcoholic hepatitis, may develop and can progress to cirrhosis.  The heart muscle may be affected.  Sexual dysfunction may also occur, causing problems with erections in men and cessation of menstruation in women.

Alcohol affects the nervous system and can result in severe nerve damage and severe memory loss.  Chronic alcohol use also increases the risk of cancer of the larynx, esophagus, liver and colon.  Add smoking cigarettes to this mix and the potential outcome worsens.

I have questions that I would love to have someone answer.  I want to know why any family member or spouse would want their partner to eventually have bleeding of the esophagus or stomach.  As I posted previously, a GI bleed was always one of my favorite patients in the hospital to admit to the floor where I worked.  It is so colorful to have a patient arrive on the floor on a gurney in a gown splattered with huge amounts of blood.  In our trauma center the ER staff did not have the time to clean the patient up, oh no, they arrived covered in blood and usually there was dried blood on their faces and chest.  Now is this something anyone wishes on someone they love?

My next question is how can a family member or spouse watch years and years of alcohol consumption and when the alcoholic has turned yellow from alcoholic hepatitis ask the doctor to “do something.”  Do something with liver failure?  Oh let me paint you that picture:

Damage to the liver due to chronic alcohol abuse can lead pathologic changes including fibrosis and the formation of regenerative nodules. These pathologic changes are termed cirrhosis, and can result in a variety of clinical manifestations.  When the liver is cirrhotic but still able to perform most basic functions, cirrhosis is referred to as “compensated”. Further loss of functioning hepatocytes can result in “decompensated” cirrhosis, manifest by coagulopathy, jaundice, and edema. Extensive fibrosis can cause portal hypertension, splenomegaly, and gastroesophageal varices.  In more severe cases, patients may develop excess fluid within the peritoneal cavity (ascites), spontaneous bacterial peritonitis, and/or encephalopathy.

That’s the medical definition – now let me give it to you from the nurse speak version.  Your belly swells up to huge proportions requiring a physician to insert a VERY BIG needle to aspirate (remove) excess fluid build up.  Your clothes of course don’t fit, you can’t roll from side to side, and if you get peritonitis (infection) you will be very ill, severely ill.  Then by the grace of all that is holy if you get encephalopathy – well here are those chances:

Subtle signs of hepatic encephalopathy are observed in nearly 70% of patients with cirrhosis.  However, when the liver cannot properly metabolize and turn poisons into harmless substances in the body, these poisons build up in the bloodstream.  One substance believed to be particularly harmful to the central nervous system is ammonia, which is produced by the body when proteins are digested.  We all know ammonia is poison, it says so on the bottle.  Our livers detoxify the ammonia produced by these proteins and the ammonia is rendered harmless.  Ammonia build up is only one substance that may accumulate in the body when the liver is not working properly.

I offer no apologies for being blunt and straight forward because these are the things that an alcoholic can end up with and let’s face it the prognosis is not good.  The only thing good that comes out of this will be the inability to get alcohol.   They won’t be drinking in the hospital.

I recently heard that one of my ex’s passed away after a lingering illness, and I have heard that it was alcoholic hepatitis even though he had quit drinking years earlier.  Alcohol is not the only thing that passes through your liver to be detoxified.  Every drug you take goes through your liver (with the exception of several that work in the gut but most people are not on those drugs.)

You only get one liver, and yes you can have a transplant but that is a life altering procedure also.  Gosh it just puzzles me to no end that families who love their addicted family member live with their heads in the sand and do nothing.  They all know better, we all know better, and yes I know everyone has a reason but what is the reason to sit back and watch someone slowly poison themselves?  In doing my research the women who did leave had guilt-guilt from leaving.  The women who stay enable their spouses to continue – it is a very mixed up world the world of alcoholic addiction.  A world where a person needs help, professional help but I also know in having attended 12-step programs that the alcoholic has to be the one to want to stop, who wants the help. 

There is always the option of doing an intervention and we have all heard about people who have done this.  It is without a doubt one of the hardest things family members can do, but they do it because their lives are spinning so out of control that they have no choice.  They make the decision to stop enabling.

Once upon a time when I was in grief counseling after losing too many people in a relatively short period of time I was discussing how I had always chosen people I thought I could fix.  I went back in my relationship history to the children’s father the one man I did not marry to fix.  The problem was he suffered from severe depression and over the period of one weekend he tried to commit suicide 4 different ways.

That will knock you on your ass, I promise.  It will also make you so co-dependent on making sure it doesn’t happen again that you become emotionally sick.  I played the co-dependent wife for years, our children became co-dependent.  Every thing we did was based on making sure their father did not get upset enough to try to kill himself again. 

Sounds like same topic I have been preaching about only now I am the spouse caught like the frog in the pan of water with the temperature slowly increasing.

However – I did finally say enough is enough.  I did finally throw up my hands and say I was not taking this any more, I was not doing this any more.  Their father gave me good reason, and we actually had to ask him to leave and after that we all had to be in counseling to move past that feeling of guilt and learn how not to be co-dependent again.

After I told this story to my grief counselor he asked me what my definition of co-dependency was and I answered “Having to make every thing so goddam perfect all the time.” 

That is what we do, those of us who enable someone, we try to make every thing so GD perfect all the time.  We fail, friends, we fail.  We are not fooling anyone, everyone around us knows that we are pretending and that means we are failing because pretense is not real.   Like only having one liver, you also only have one life to live and why continue to live it in an unreal world when you were born with rights, one of them being the right of happiness.  There is not one person out there who can tell me that being married to an alcoholic makes them the happiest person in the world.

This concludes my writing on this subject – I hope it helps someone, I have a particular person in mind (duh I think you all figured that out) and I hope one day she realizes that she deserves to be truly happy, it is her birth right.

Moving on in my continuing ongoing story, I actually feel much better having shared some of my real pain with every one here, writing is very cleansing, and it brings me to the time the phone rang on the hospital floor.  It was the ER calling telling us they were sending us up a real turkey which was slang for a patient none of us wanted to have to admit to the floor.  The elevator doors opened, the orderlies wheeled the gurney out and……………..

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The Biggest Loser-The Children
An estimated 6.6 million children under the age of 18 years live in households with at least one alcoholic parent.  Current research findings suggest that these children are at risk for a range of cognitive, emotional, and behavioral problems. In addition, genetic studies indicate that alcoholism tends to run in families and that a genetic vulnerability for alcoholism exists.

Studying children of alcoholics is a newer avenue of psychology.  After all it has only been recently that children of alcoholics (COA’S) have come forward to talk about their lives and how having an alcoholic parent has effected them.

To read all the possibilities I would advise you to go to http://allpsych.com/journal/alcoholism.html 

It is an excellent educational site but heartbreaking to read.

I will put a paragraph here from that journal paper but if you are reading this because you know a COA or you are the COA, then I think you should read the entire article because it might give you direction and answers.

Members of alcoholic’s families very often become codependent. “Codependency is an unconscious addiction to another person’s abnormal behavior” (Wekesser, 1994, p.168). Most alcoholics have periods when they stop drinking for a short while and seemingly do well, leading the codependent person to believe that the problem can be solved. Often people who don’t know the alcoholic very well don’t suspect any problem. The alcoholic’s codependent family members do everything possible to hide the problem, preserve the family’s prestige and project the image of a “perfect family”. The spouse and children may avoid making friends and bringing other people home, in order to hide problems caused by alcoholism. Codependent members often forget about their own needs and desires. They devote their lives to attempt to control or cure the drinker. Unknowingly, codependent family members often become “enablers”. An enabler is “a person who unknowingly helps the alcoholic by denying the drinking problem exists and helping the alcoholic to get out of troubles caused by his drinking” (Silverstein, 1990, p.65). The enabler will clean up the alcoholic’s vomit and make excuses to his or her boss, teacher, or friends. The enabler lies for the alcoholic, and thus enables the alcoholic to continue drinking.

I will stop here.  I actually did continue on but this post got way too long so I decided to divide it in half and post the second half later this week when I talk about the physical ravages of the addiction and ask some questions I would love to have answered.

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The 15 feet that I would have to walk across always looked like a mile because there was no way I could get into the dining room without passing by the monster in the chair.  Every time I got close to that chair, the monster’s hand would snap out and grab me right above my knee.  I HATED THAT.  I still do.  No one can touch me above my knee.  Maybe my grand father thought it was cute to terrorize me, and obviously the parental units in the room thought so too because no one ever asked him to stop.

My only memory of my grand father is of him smoking a cigarette, while watching TV, a glass of whiskey on the book shelf, and grabbing me above the knee as I went by.  Yet, years after he died I saw him again.  Lloyd Thomas Aiken, and I refer to seeing him in my writing I See Dead People.  I like to believe he dropped by to apologize to me. 

Over the years I had more exposure to the alcoholics in my family.  There was my Uncle Shorty.  Of course that was not his real name, but that is what he was called at work and it stuck.  There was my Uncle Al, who had actually been in vaudeville with the immortal stripper Gypsy Rose Lee.  He could toss back the booze and tell great stories, he was also a homesexual.  That was the politically correct term in the 1950′s.  His long time male friend was Joe Shoes.  Of course that was not his real last name, he sold shoes for a living, so that name stuck.  Both of them were fun drunks to watch as a kid, but not fun for real. I am sure.

When I went into nursing alcoholics were treated in the hospital on a regular medical floor.  They were admitted for 10 days to “dry out” and the staff got the pleasure of getting them through the DT’s and withdrawal.  Back then we put these patients on IV drips with a lot of multi vitamins because they were usually so nutritionally depleted.  To get these patients through the anxiety of withdrawal, we gave them Valium.  I think we did that to keep them from disturbing the rest of the patients on the floor as well as us.

I also saw the worst cases.  Sobriety is a great thing, but after all those years of self-medicating with alcohol, their bodies had many physical problems that had them in and out of the county hospital as if there was a revolving door.  I saw a lot of GI bleeds.  Those are a lot of fun.  Nothing prettier than seeing all that blood being thrown up all over their gowns and hospital linens.  What is even more fun is putting a nasal-gastric tube down a patient in between episodes of throwing up.  Then there were our liver cases.  If you have ever seen someone in liver failure one time, you don’t want to see it a second time.

OKAY now you have a visual sorry, I did get ahead of myself.

Yesterday I was watching Dr. Drew Pinsky being interviewed about his rehab show for celebrities.  The actual numbers of addicts in this country that he shared with the viewing audience is astounding.  1 in 8 adults are either addicted to alcohol or drugs or both.  Look around you, count up 7 other people besides yourself, got the visual? 

1 in 8 people, and 16 million people in the US are in critical need of medical intervention and treatment right now.  16 million people need help today, right now, not tomorrow.  Shocking isn’t it?

Dr. Pinsky was asked if people don’t get help because they can’t admit they need help.  His answer was that is a misconception because with all the information available about what alcohol and drugs do to a body, people know when they have a problem.  Choosing to do something, now that takes courage.

The friend whom I have had discussions with regarding someone we personally both know, shared with me that she has another friend whose husband is an alcoholic and she won’t leave him.  She has two young children, and he is the sole provider for the family.

That is why I found these next statistics so interesting.  1 in 10 women married to an alcoholic will leave him.  Only 1 in 10 and obviously many of them stay because they can’t afford to leave for financial reasons.  I won’t even go down the road of how staying destroys children.

It is just the opposite number for men married to alcoholic women, 9 in 10 leave.  Again, they have the bucks behind them to leave but it also makes me wonder what the other reasons are.  Another girl friend recently used the phrase “for better or worse” with me, and it makes me wonder if women take the vows more seriously then men.  I don’t know.  I am only quoting statistics.

Staying with an active alcoholic is something I could not do.  I am selfish.  I would not stay with someone and share him with his addiction.  I am not talking about if he got sober.  I am talking if he did not get sober.  An addiction inhabits your body and you are no longer the person I married, it is a perpetual menage a trois and I don’t do three-ways.

I dug into this topic more, about why women stay and I came across a posting on a message board written by a woman who had finally left a husband who would not choose sobriety.  She wanted to know how to move on, reach resolution and forgive herself.

The answer came from an advice columnist and recovered alcoholic and I am going to print his reply here and warning there will be blunt language!

As an alcoholic, I can tell you that’s what we do!  We do it because you don’t think we will do it.  You don’t think we are capable of it.  You don’t think we’d dare.  You think we’ll forget and move on.  You think we’re like other people but we’re not.  You think we’ve got some shame but we don’t.  We don’t stop when others stop.  We don’t slow down when others slow down.  We just speed up!  We will do anything and that’s our awesome power.

We will not be deterred by shame or pity or self-consciousness.  Whatever happens, we can take it because we have our medicine.  We’ll do anything as long as we have our medicine.  We’ll take it as far as it can go.  We’ve got the medicine to keep us going.  We’ve got the stuff that kills the conscience so we don’t have to stop halfway on account of our little conscience.  Conscience?  Nah.  Watch this.  We’ll take it where you can’t imagine anybody would want to go.  Why?  Because we can.  Because we’re drunk! Because we don’t give a fuck.  You just watch.

And just when you think it’s over? Ha!  That’s when we’re just getting started: Have another drinky-poo, we’re not even tired, we’ve been drinking all night and we’re still going, and wait till you see what’s coming next!

Not only can I channel that voice but I even, in a twisted diabolical alcoholic way, appreciate what he is up to–the awful terrible spite of it, the wounded caged-animal desperation of it, the stealthy, secretive, maniacal mad-scientist glee of its sadism and depravity.  And beneath it all the whole time I know there is that poor little abused soul, which he can trot out every now and then to win your sympathy and pity.  Ans he will do that if he can; he will put on his little “Howdy Doody Show.”

Detach.  Detach. Don’t get too close of he’ll pick your pocket.  Forgive yourself for being human.  Align yourself with other women who have been there.  If he has friends who have sobered up and can commiserate, commiserate with them.  You have to heal it.  He is not going to help.  He is going to make it harder if he can.  Don’t let him,  Heal it up.  Use everything you’ve got.

This guy is not on your side.  Pity, if you wish, those he owes things to, but do not pity this man and do not try to help him.  Take care of yourself instead.

It might not feel like it is over, but it is over for you.  It is not over for him but it is over for you.

Detach. Detach. Wait. A change is gonna come.

As I stated I give credit to this letter Cary Tennis, whose advice is found in “Since You Asked” column, Salon.com

Go there – Cary is a great writer, a good advice giver, and who would be able to answer any questions you have on alcoholism better than a recovering alcoholic?  I wish I knew him personally because I believe he would be a terrific friend.

His answer to this woman in great emotional distress is something I learned from, all that fixing I tried to do for all these years right up to yesterday has been a real waste of my time and energy. 

When we live in a sober world of course we want to take the alcoholic and make them better.  Our sober world is better (in our eyes) and it becomes our personal mission to get them to stop drinking.  Wrong, wrong, wrong.  Yesterday I had to finally admit to myself that I have someone very dear to me who likes her role in life, even though it drives her family crazy and even though her children won’t come home very often.  No one talks about the elephant in the room in that house, her husband who is drunk every night.  Alcohol inhabits his body, he is married to the bottle, not her.  I have to accept that she is where she wants to be and let it go.  I can’t fix her, she doesn’t want to be fixed.  I get it now.

Golly this got long, and I still have a breast cancer posting to do, but gaining a better understanding of alcoholism is something I needed to do also.  Note the similarity in the numbers 1 in 8 – until yesterday those numbers only meant to me how many women would get breast cancer in their life time.  Now it has a whole new meaning.

Next time I will reveal my interpretation of who- oh wait -drum roll please……and The Biggest Loser is…………….

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Albert Smith is a wonderful man, and a very dear friend.  I was living in Indiana with Larry (my present wonderful husband) and for some reason it dawned on me that I had not heard from Albert for a while.  I could not find his phone number so I called a mutual friend of ours, Tony Kirk, and Tony gave me the bad news.  It seemed Albert had suffered a heart attack and was expected home any day to continue his recovery.  I called and left a message.

Soon after our phone rang and it was Albert calling us back.  He was apologizing for not being in touch recently but it seemed Baxter had been to visit, and Albert went on to say that during that visit Baxter had one of his moments which ended up causing my dear friend Albert to have a mild heart attack.  It all began when Baxter was getting ready to fly home and could not find his keys. 

This was nothing new.  We were in Key West on vacation years back and while he did not lose his keys, he did manage to lock them inside the rental car not once but twice.  I never got upset at moments like that, Baxter would be upset enough for both of us.  In fact I usually enjoyed those moments, you know the feeling.  It is the one that you hear yourself saying (and in my case to myself) “Serves you right”.

Baxter had a great friend, Ed, who was a quadriplegic from a diving accident.  Ed had a lot of empathy for my situation, and he told me one time that Baxter was not safe outside the perimeter of his own yard.  This was a true factual statement.  The other thing Ed told me was to never carry more than a $5 bill because Baxter always managed to get someone else to pay for everything.  He was right about that too.

At home he always lost his keys.  It did not matter that I hung up a key rack, he could not remember to use it.  You had to be there to see it when he lost them because as long as I stayed out of his way there was humor in his search.  He would rant and rave, cuss like a sailor and then honest to goodness he would start to say God was punishing him by making his keys disappear.  Now mind you this is a triple degreed man–with an obvious problem.  I would say he ran 50/50 on the irrational/rational scale -someone, something or God was always out to get him.

Back to Albert and his heart attack.  He told us that Baxter raised such a fuss, & caused such a commotion that suddenly Albert had chest pain and had to be rushed to the hospital.  Albert did not let the bastard get him down, he recovered and just learned to dodge his phone calls.  If Baxter called telling him he was coming to England to visit, Albert would not return the call.  Albert is a kind man and a wise man.  He knew if he told Baxter he could not come and stay with him, Baxter would have a holy fit.  Albert did not need that in his life.

As it was Albert was feeling just terrible because while he was in the hospital Baxter searched all his belongings and found my address and telephone number.   Baxter threw a second holy fit that Albert was contacting me.  Albert was very distressed that this had happened, but I wasn’t worried, I had Larry and if Baxter wanted to show his ass (again and again) he would be going up against a man who could bring him to his knees in a nano second.

Several years passed and one day Albert picked up his telephone without looking at his caller ID and there on the other end was Baxter.  Albert said the conversation went to the war and Albert is a peace maker.  He did not approve of war and he did not approve of George W Bush.  He told me the conversation got heated and he ended up calling Baxter a “Junior George Bush” and Baxter told him to eff himself and that was the end of their relationship.  Albert got off easy.  I got a pillow over my face and had to clobber the idiot with a crystal lamp to survive.  Albert only had to hang up.

Two years ago Albert came to visit us here in Florida and we were thrilled that we ended up with custody of his friendship, something that always puts a smile on Albert’s face when we say it.  He told us the story that put the frosting on the cake for him in his friendship with Baxter.  It was about that same visit that caused him to have a heart attack and how Baxter had stolen (Albert’s words) coins from Albert.  They were worth some money, they had been discussing them, and when Baxter left from that visit, they were missing.  How obvious was that?   All I know is Baxter cannot harm anyone any longer, physically or emotionally, he passed away this past September.

When I write my stories about this time in my life it is one more example of how I always was looking for someone to fix, and what better a person to fix than a lonely, recovering alcoholic?  He had been through rehab years ago but was not attending AA any longer when I met him.

When I take a look back at relationships (before Larry) I see the pattern.  There was always someone who needed my attention and I thought my love would fix everything.  Now that I am in a balanced relationship I can really see what I was then, and who I am now.

The truth of the matter is now that I realize I was always choosing men with some type of addictive behavior and that means I was living in a world of denial and I did need to get an extreme makeover.

Normally I write my stories in a continuing style but I got a special request from a reader recently to talk more about what keeps women trapped in relationships involving alcoholics.  That is where this continuing story line will go because it is a very convoluted area, an interesting emotional lifestyle, and one that we do need to explore.  Why?  Because 1 in 8 of all adults in the US are addicted to either alcohol or drugs or both.  16 million people need immediate treatment their disease is that bad. 

I opened my eyes to the fact that I had been living in denial when I met Larry and since most of my experiences with addicts has been in the disease of alcoholism, that is where my research and writing will go.

My first memories of being around anyone with a drinking problem started when I was a very little girl and we would go to visit my mother’s parents.  Their living room was always so warm and inviting, a special place for a little girl to sit close to her grandmother and feel loved.  I would sit on the sofa that was placed right in front of the staircase to the second floor and my grandmother would doodle on my back or play with my hair.  It was just perfect, or almost perfect because there was a monster in the same room.  This monster came in the guise of a tall, slim silver haired man who would sit in his rocker/recliner next to the fireplace and if I dared to want to go color in a coloring book at my grandmother’s desk, I had to summon up every ounce of courage to walk past him to get to the desk.  I would sit patiently for a while, and then boredom would set in so I would finally get up to go to the desk.  The 15 feet that I would have to walk across always looked like a mile because there was no way I could get into the dining room without passing by the monster in the chair.  Every time I got close to that chair, the monster’s hand would snap out and …………

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