When Doctors Can Hear, but Can’t Help

article-1286369-07BA6D6D000005DC-830_468x347Last week, I read a troubling article that fell under the column title “Hard Cases” in the New York Times. Read on and you’ll understand why.

The author, New York Times writer Abigail Zuger, M.D., wrote about a patient’s wife who called her to express concern about her husband drinking. Dr. Zuger was surprised to learn about her patient Tom’s drinking, and yet without Tom’s admission of a problem, there was nothing Dr. Zuger could do or say.

Dr. Zuger goes on to write about the difficulties doctors have detecting drinking problems that are not extreme, and that many patients try to save face. “A new analysis from the Centers for Disease Control and Prevention estimates that of the 38 million problem drinkers in the country, only one in six have come clean to a  health professional,” she writes.

The phone call from Tom’s wife made the situation clear to Dr. Zuger, yet she was forced to reply, “I’m so sorry. I can’t talk to you about that.”

There are moral and ethical standards whereby an adult patient’s health issues are his business alone. And of course, there is the law and the HIPAA (Health Insurance Portability and Accountability Act) which govern patient privacy.

Dr. Zuger did tell her patient, Tom, that his wife called, but didn’t say what she’d called about. She asked Tom if it would be okay for his wife to come to his next appointment, to which he replied, “Absolutely not.”

The story ended there. The doctor never met Tom’s wife or spoke with her again. But she listened and never forgot.

To read Dr. Zuger’s article, “What Patients Don’t Tell Their Doctors,” click here.

 

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The Law of Equivalent Drinking

by UnknownRonna Benjamin

Mike and I watched the swirling snows of Nemo that Friday afternoon, curled up on the couch in front of a roaring fire. Carole King radio played on Pandora over the stereo. We each had a glass of tequila splashed with Cointreau, in which floated a few wedges of three-week-old lime. Ahhh, the benefits of an empty nest! It was a fine afternoon for a storm.

We relaxed as we soaked up the warmth of the fire and the liquor.  And then…I couldn’t breathe.  I began to blow my nose.  My throat was on fire, and I began to sneeze. I wanted to amputate my head.

Not knowing where to turn to ease my misery, I grabbed my laptop so I could let the world know how miserable I was, and my spirits were lifted when I saw an email from my daughter in Abu Dhabi.  The subject of her email was: “Check out this article…you guys are right…duh.”

I perked right up.  Screw the cold!  My kid thought we were “right”!  And she was reading the LA Times!

I immediately clicked through to the link in her email.  It was to an article that had appeared on February 6, 2013 in the LA Times Health section,  The article was about incompatible drinking and divorce, and sure enough, it confirmed we were right.

The LA Times article focused on a Norwegian study of 19,977 married couples (which, of course, begged the question, “couldn’t they have gotten 23 more?”) that proved that spouses who consumed roughly the same amount of alcohol (“compatible” drinkers) were less likely to divorce than pairs where one partner was a heavy drinker and the other was not. (Interestingly, the study indicated it was worse if the woman was the drinker and the man was not.)

I asked Mike to freshen our drinks in celebration, because we were so very ahead of the (LA) times; we have been talking about this “compatible drinking” theory with family and friends for decades.  Many moons ago, without spending a dime on research (unless you factor in the cost of the alcohol) my brilliant husband came up with the Law of Equivalent Drinking, or as we call it, LED (not to be confused with Light Emitting Diode).  We could have saved them a lot of money if they had just asked us.

LED, or the Law of Equivalent Drinking, as Mike explained it one night over a round of martinis with friends, provides that everyone–married or not- gets along best with people who drink roughly the same amount. Having legal backgrounds, we called it a law and not a theory.  Besides, TED would be taken soon enough–though ironically, this indeed has proved to be an Idea Worth Spreading.   We toasted to shedding the light on LED the night of Mike’s epiphany, and have done so with friends many times since.

The fact is, we tend to gravitate toward, and get along best with, people who drink like we do–and we know others do too. Mike enjoys the company of men who can appreciate a fine scotch.  We like to share a bottle of wine with dinner.  We like to see the excitement in our friends’ faces when we bring over an oversized glass container of fruit-infused vodka.  We like to start our Saturday night out with a martini.  It’s ok if it’s dirty, but if you pass altogether, it changes the mood.

Like any law, LED has its exceptions.  I have a few wonderful girlfriends that are truly special to me- even though they order a diet coke instead of a glass of wine at dinner.  I get that some people do not like to drink.  I get that some people cannot have a drink and of course I respect that.   But on the whole, I’m just sayin’….we spend an awful lot of time with people who drink like we do.

Mike may not bring me a box of chocolates this Valentine’s Day (though if he does, it should be dark chocolate with sea salt.)  He probably won’t bring me a dozen roses either.  But I do know for sure that we will share a toast over a nice bottle of Cabernet this Valentine’s Day. And there is no doubt in my mind, that because of LED, we will finish that bottle.

*This essay was originally published on 

Ronna Benjamin is the Managing Editor of BetterAfter50.com. About the time Ronna  turned 50, she had an epiphany.  After 28 years of practicing law, she realized she didn’t want to be a real estate attorney, and jumped into the world of writing.  She never looked back.  Ronna writes humorously about the things BA50’s are concerned about:  adult children, aging parents, illness, anxiety and insomnia, to name a few.  She is a native Bostonian and loves to spend time with her wonderful husband and three adult children.  She also loves to cook, sail, ski, run and bike.

 

 

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Marriage Leads to Women Drinking More and Men Drinking Less

couple_champagneDoes your husband drink less than before you walked down the aisle? Do you consume more? According to a recent study, married women drink more alcohol than divorced or recently-widowed women–apparently because they live with husbands who simply consume more.

On the flip side, the study revealed that married men consumed the least alcohol–compared to single, divorced and widowed men–due to their wives’ lower levels of drinking. Men were also more likely to turn to drinking after a divorce than women.

After reading the study’s findings, I had to stop and think about what it was like for my husband and me before we got married, a whopping 23 years ago. When I think back, it does seem feasible that we were drinking wine more frequently–I’m happy with a glass or two, he prefers to polish off the bottle–after we said “I do.” I’m sure he pounded many more beers when out with buddies than he did at home with me, and while I had my share of happy hours with friends, they were not a daily event.

While research has been done on the drinking habits of single and married people, the study, conducted by sociologists from University of Cincinnati, Pennsylvania State University, Rutgers University and the University of Texas at Austin, is the first to look at alcohol use among the never-married, the divorced and the widowed, says an article on LiveScience.com.

The researchers reviewed survey data from the Wisconsin Longitudinal Study to explore trends in the relationship between marriage and alcohol. They also analyzed data from two in-depth interview studies, the Marital Quality Over the Life Course Project, conducted between 2003-2006, and the Relationships and Health Habits Over the Life Course Study, conducted between 2007-2010.

“Stable marriage curbs men’s drinking yet is associated with a slightly higher level of alcohol use among women,” the authors wrote. “Our qualitative findings suggest that being married to a man who is more likely to drink creates a new social environment that may promote drinking among women,” lead researcher Corinne Reczek, an assistant professor of sociology at the University of Cincinnati, told LiveScience.

So in the marriage category, we can see how a woman may be influenced by her guy’s greater consumption level and he by his wife’s avoidance of a beer belly. But when it comes to divorce, it’s different coping mechanisms that seem to cause men to consume more booze than women on average. “Some research suggests that men are more likely to cope with stressors in ‘externalizing’ ways (i.e., alcohol use), while women are more likely to cope in ‘internalizing’ ways (e.g., depression),” Reczek wrote.

I hope not to find myself in the never-married category, but I imagine there can be some complicated outcomes that arise from the intersecting influences of relationships and alcohol. “Men who fail to converge with their wives’ drinking habits in marriage may set a trajectory towards divorce and continued heavy drinking,” wrote the study authors, “while men who converge with their wives’ lesser drinking habits may set trajectories towards lower overall consumption and sustained marriage.” So it seems that men would be smart to take their wife’s lead on the lighter boozing front–apparently one step in the direction of a successful marriage.

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What It’s Like To Care for an End-Stage Alcoholic

By Linda Jane Riley

Linda Jane Riley is the creator of the blog, “The Immortal Alcoholic,” about what it’s like being a non-alcoholic person married to an end-stage alcoholic. In her own words: “I’m an ordinary woman of a seasoned age who is faced with a difficult challenge–and I will not allow that challenge to destroy the happiness in my life or anyone else’s life.” She is the author of The WorkbookforCaretakers OfEnd-Stage Alcoholics.

Following is an excerpt from her blog, in which she addresses the frustrations of readers of her blog who wonder why she chooses to take care of her husband Riley, despite the enormous daily struggles.  

I welcome everyone’s comments even if they may be a bit hostile or negative. Each of us has a right to an opinion and a right to voice that opinion. In fact, one commenter says I’m a “sick f***” and that I would drive a person to drink if they weren’t already an alcoholic. So this post is dedicated to all those who think end-stage caretaking is a form of amusing entertainment for sadistic Nurse Nancy’s and bitter spouses.

Why don’t I just… put Riley in a long-term care treatment facility?

No matter how sick a person is, if he is not declared incompetent, that person cannot be forced into any alcohol treatment facility. Even then, most of those types of facilities would not accept an individual that has been forced in a facility through an incompetency hearing. Recovery just doesn’t work that way.

As for a regular nursing, physical rehab or long-term facilities – they will not allow the consumption of alcoholic beverages on their grounds. They offer no detox care, so they are not equipped to handle an end-stage alcoholic. Most end-stage alcoholics have been through the detox and rehab process many times, with the end result being a return to drinking. Because of that statistic, it is extremely difficult to find even a rehab center that will take on a multi-relapse end-stage alcoholic. The reasons for that are that they want to invest their time in people who really desire sobriety and also to eliminate a risk of injury on their premises. After the last detox episode (when Riley had a stroke) there was no rehab facililty of ANY type that would accept Riley as a patient within a hundred miles of our local area. He was too big of a risk for a potentially fatal fall.

Why don’t I just… have him declared incompetent?

That’s not as easy as it sounds. Riley is incompetent to handle his own finances or any other legal matters. But, he is aware what a competency hearing is all about. He knows what he is supposed to do to pay bills and buy groceries, etc. He has no ability to follow through on those tasks–and that is hard to prove. He often will appear to others as being perfectly capable of managing his own affairs. Outward appearances are deceiving, and he has the ability to “pull the wool over the eyes” of medical professionals who are not truly trained in alcoholism.

Being an end-stage alcoholic is degrading enough all by itself. Having your spouse, parent, partner or whoever declare that you are incapable of the simplest things–like choosing what you want to eat for dinner–is beyond degrading. It’s not my job to make him feel any worse about himself. He does that on his own.

I have full power of attorney, which gives me the ability to act on his behalf over everything that is relevant. It’s all I need for now. I’m fortunate because Riley doesn’t usually cause me problems that would require court intervention. The only issue we don’t seem to be able to resolve is his desire to drive drunk.

Why don’t I just… let him drive?

OK. Well… now… that’s just a stupid question. Drunks should NEVER be allowed behind the wheel of a 4000 pound potential lethal battering ram. Anyone who has to ask that question is not someone I would want on the road when I’m running my errands.

Why don’t I just… pack him up and send him on his way?

I took on this task as a means of preventing my daughter or grandson from becoming Riley’s caretaker. If I sent him on his way, he would find his way into their homes and thereby create insanity in their lives. I am his legal spouse. He is my responsibility. Many years ago I took a vow that said something about “sickness and health.” This is the sickness part and I will stand by that vow.

If a family member were sick of some other disease – Leukemia, Alzheimer’s, Stroke, etc – I would not pack them up and send them on their way. I would do the best I could to provide a safe haven. Riley has suffered a stroke as a result of abusing alcohol; he can’t remember simple things like how to get a message off the answering machine or to remove a pan from a hot burner. If he lived on his own, how soon would it be before he burned down his house? I don’t know, but I’m not willing to take that risk.

He’s not my prisoner. He’s my sick husband who would not survive in the real world.

Why don’t I just… pick him up when he falls?

I’m an old lady who is not even five feet tall and I don’t have a lot of physical strength. Riley isn’t a huge guy, but when he falls he is like dead weight. He has no muscle mass and cannot (or will not) assist in any effort to get himself upright. Even my daughter has failed at attempts to pick him up after a fall. But, because he won’t “push” or “pull”, even she has stopped trying to come to his aid.

I could call 911 and the paramedics would race to my door and get him back into his chair. The problem is Riley falls multiple times during the day and I truly believe the EMT’s might have people who are in urgent need of assistance. Someday, I’m going to need them to come running – quickly – so I don’t want to be the little girl who cried wolf.

Why don’t I just… make him use a walker or wheelchair?

Using a cane, wheelchair or walker, in Riley’s opinion, is an indication that he is old or not physically fit. In Riley’s mind, he is perfectly fit and is young. He mocks the seniors at the local senior center and laughs at the frailties of the aged. He wants no part of anything that would make him appear to be more “seasoned” than he wants to be.

In order to use any devices that would aid in his mobility, he would need some upper body or arm strength. Riley has no muscle strength from which to draw.

Why don’t I just… make him wear a diaper?

See the above answer. Same thing applies here. Diapers are for babies and old people.

Why don’t I just… stop buying him booze?

Taking away Riley’s alcohol would throw him into a self-induced detox, which could be fatal. Detoxing without medical supervision is extremely dangerous and it becomes more dangerous each time it happens.

By the count of the centers listed in the workbook that I keep on Riley, he’s been through five – FIVE – medically supervised detox experiences. Each one was worse than the last in terms of the actual process, causing seizures and strokes. None of the detox sessions ever led to long-term sobriety. After the last hospital stay, I promised Riley I would never push him into detox again. I do, however, encourage him and ask him if he wants to go. But, I don’t insist and I don’t push.

Why don’t I just… take him to AA or get him some help?

For Riley, AA is just a social activity. He would go all the time if they would just stop harping on the drinking thing. Because they don’t stop, he won’t go. He knows there is help there. He was very active in AA for many years, but now he just wants nothing to do with the “brainwashing” of any 12 Step program.

You can lead a horse to water, but you can’t make him drink. It’s the same way with alcoholics and counseling. While I think it would be one of the best ways for an alcoholic to recover, it requires pure, unbridled honesty. Most active alcoholics are incapable of being completely honest. Many drink to cover their true feelings. I think it’s unrealistic to expect a counselor to take on the impossible of task of getting a drunk to tell how he/she really feels.

Why don’t I just… stop laughing at him?

To read the rest of Linda’s post, click here.

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Booze and Marriage Go Together Like a Horse and Carriage

45823-Royalty-Free-RF-Clipart-Illustration-Of-A-Romantic-Bride-And-Groom-Toasting-With-Champagne-On-Their-Honeymoonby RhoRho

I’ve always said that I don’t trust people who don’t drink (yes, even out loud), so it’s only fitting that I’m married to someone who shares my affection for the booze.  We’re married with children, a dog, a mortgage and a ton of bills, and we do what most parents we know do to take the edge off at the end of the day: we drink. We don’t take any prescription or street drugs, we don’t smoke cigarettes or gamble away the family’s money on slot machines. We drink.

Sometimes my husband, who typically drinks quite responsibly, can get off his game. A few times a year, he gets around an old buddy, starts mixing it all up like a kid in a candy store, and gets good and shit-faced. He starts with vodka and Red Bulls, then goes to beer, then maybe some of my wine. He loses any shred of common sense. But me, I’m too fuzzy myself in those situations to notice, and sometimes, he doesn’t even appear to be all that drunk. But the next morning, he awakens, throws his arm across his forehead, lifts one knee up toward the ceiling, and coughs a little bit. This is when I know. The Hangover.

Now, normal people like me awaken, acknowledge the Hangover, moan a little bit, and get on with it. We have kids to feed, duties to perform, coffee to make. Not my husband. He is famous for the all-day hangover, and when he “pulls one,” as I have come to call it, he is either in the bed or hugging the toilet until about seven o’clock at night, when he suddenly pops up, takes a hot bath, and starts cleaning the house or something crazy like that.  He may not drink for a week or two after a really bad one, and I get lonely for my drinking buddy. If I do suffer from overindulging, I am out of commission (meaning wine) for one, two days, tops. What if I pulled an all-dayer, I ask?

When I see the first sign – the arm flinging over the forehead, I get furious. And I don’t mean furious on the inside, I mean steaming mad and threatening him with his life.  It’s not like, at the time, he has much control over his body, but my point is that, by God, he should’ve used his head last night and stuck to Michelob Ultra. I can’t be the booze police and have my own fun too! He has to be in fresh air to even try to recover, so on the last one, he got his ass up and out of the bed and into the yard, where he chopped wood in the rain… as he puked. What must the neighbors have thought? “That bitch runs a tight ship,” that’s what they thought.

At this point, yes, the booze is our stress relief, but when we think about the thousands of dollars that could be sitting cozily in the bank, we do question ourselves. And those dozens of hours lost on all those Saturdays, while the kids are asking, “Mommy what’s wrong with Daddy?” are irreplaceable, and he lost them to something as ridiculous as bingeing like a frat boy.

I do get nervous before a night out, and start threatening him before he even thinks about mixing. He doesn’t want The Hangover any more than I do. And me, I want a husband I can take places. But to his credit, it has dwindled down to only a few times a year.

We don’t really see ourselves ever giving it up totally, and we question what we would do if there were ever an ultimatum. Spouse or alcohol? Could the former even cope with the other if not for the latter? Make sense? So for now, we’re trying to be responsible drinkers, take taxis so the DHS doesn’t come get our kids, and enjoy it rather than depend on it. We’re trying, I said. Our own little Days of Wine and Roses.

RhoRho is a mother of two, wife, freelance writer, blogger, kid taxi service, budget traveler and wine enthusiast, among other things. She has been freelance writing here and there for several years, with writing for a magazine like National Geographic Traveler being one of her many ultimate goals. Rhonda lives with her husband, two kids, a Welsh Corgie and a Dwarf bunny, and travels whenever possible. Her blogs are: Momwhodrinksandcusses and Wine4poorishfolk

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