How to Get Sick and Stay Sick

Future

PROLOGUE

This book describes how bad habits contribute to ill health. The habits the author refers to that so negatively impact patients, but are responsible for the great majority of the world’s deaths, include the following:

Alcohol abuse

Tobacco abuse

Obesity

Poor dietary habits

Excessive stress

Exercise, on the other hand, is a habit that can help negate or delay the negative consequences of the first five if practiced continuously and faithfully. All these first five "habits’’ inevitably lead to significant illness and mortality. This book is written for those who desire good health. It will detail the vast number of negative health consequences that will befall anyone who practices one or more of these habits. How can I be so sure? Because I’ve seen innumerable patients at both ends of the spectrum: at the start when basically well, and at the end when prematurely and seriously ill—or at their early death. This book describes how bad habits contribute to ill health. The habits the author refers to that so negatively impact patients, but are responsible for the great majority of the world’s deaths, include the following:

Alcohol abuse

Tobacco abuse

Obesity

Poor dietary habits

Excessive stress

Exercise, on the other hand, is a habit that can help negate or delay the negative consequences of the first five if practiced continuously and faithfully. All these first five "habits’’ inevitably lead to significant illness and mortality.

Through the different parts of this book, the reader may find some repetition of certain physiological principles. Consider it extra credit as you study and learn.

PART 1: ALCOHOL ABUSE

Oh many a peer of England brews

Livelier liquor than the Muse,

And malt does more than Milton can

To justify God’s ways to man.

Ale, mam, ale’s the stuff to drink

For fellows whom it hurts to think.

Alfred Edward Housman

1859-1936

ALCOHOL ABUSE

This is the alcohol found in alcoholic beverages (ethyl alcohol). C is carbon, H is hydrogen, O is oxygen and the hyphens are the chemical bonds between them. Drinking pure alcohol risks life. Alcohol in its pure state is deadly and drinking it, or a high concentration of it, can kill. That should tell a prospective drinker something, but it apparently does not as they continue drinking while the occasional report still comes in about the college student who died after chugalugging because blood alcohol level rose past the danger zone—and the alcohol imbibed was usually the high concentration variety of the commercial products available.

Getting ill and staying ill is possible with any alcoholic drink after prolonged use, but will happen quicker when an alcoholic beverage with a high concentration of alcohol is the preferred drink. For instance:

1. Beer has an alcohol concentration between 4 and 6 percent

2. Wine has an alcohol concentration of 7 to 15 percent

3. Champaign has an alcohol concentration of 8 to 14 percent

4. Whiskey, vodka, rum and gin have a concentration of 40 to 95 percent

From the above, it should be evident that the frequent use of whiskey, vodka, rum, or gin will bring on illness more rapidly, and its continued use will perpetuate the pathological process, keep the imbiber sick, and bring on an earlier demise. That is a guarantee. An alcoholic, by definition, is a man or woman who must drink; they cannot stop, and the reason is because they are addicted. An addiction (by the Merriam-Webster dictionary) is defined as a compulsive physiological need for and use of a habit forming substance characterized by tolerance and by well-defined physiological symptoms upon withdrawal; broadly: persistent compulsive physiological need for and use of a habit-forming substance known by the user to be physically, psychologically, or socially harmful.

Nobody knows what illnesses an alcoholic may or may not get. There is no way to control this, but alcohol can affect the entire body and target every organ. Socially and psychologically, it can target and accentuate the worst of a person's negative traits, making it very difficult to live with an alcoholic. In the world of an alcoholic, often everything revolves around him or her, or where or how he or she is going to obtain the next drink. A few drinks per day can offer some health benefits, particularly in the realm of cardiology. One or two drinks per day (red wine in France for instance) has demonstrated an improvement in cardiac risk factors and cardiac disease. Anyone who drinks more than this may meet his moment of truth in physical withdrawal symptoms including sweating, tremors, nausea and vomiting, or even blackouts (forgetfulness of recent events). By this time, the now confirmed alcoholic may well be drinking four or five or more drinks per day, and will be well on the way to getting ill. Family members or friends may try to intervene, hoping to reverse what they see as danger signals and a spiraling downward path. The true alcoholic will usually ignore those family members or friends, but some do buckle under the pressure, especially when the pressure emanates from a spouse; they manage to stop. Clearly, the desire to get sick did not overcome the fear of losing their spouse. But for many, the addiction is so pervasive that nothing can come between the drinker and his drink. He or she refuses to allow the thought of a possible destructive path to deter alcohol use; there is no room for any thought other than the next drink.

However, for the alcoholic, there may be a bump on the road to getting sick; an unexpected bump—early death. It is well established that chronic alcohol use results in a higher rate of death from injury or violence than a non-drinker. For instance, half of all automobile fatalities involve the use of alcohol. Studies demonstrate that as few as two drinks can impair driving ability and four or more drinks increases risk 11 times. In the persistent drinker, alcohol is incriminated in more than half of all fatal auto accidents, 25 percent of all suicides, and over 50 percent of all murders. Domestic violence is common amongst alcoholics manifesting itself as verbal and physical abuse involving spouses and children who may suffer long-lasting coping effects. But the drinker does not worry about such possibilities because they believe they happen to other people. So the road to a chronic alcohol induced disease progresses unhampered—and there are many. In fact researchers have linked alcohol consumption to more than sixty diseases. For the purpose of this book the author will concentrate on the list below:

Psychological Impact

Liver disease

Heart disease

Cancer

Gastrointestinal tract

Pancreatic disease

Effects on Diabetic disease

Brain and nervous system disease

Osteoporosis

Immune system

Eye disease

Birth defects

All of this list can be affected to some degree adding up to a fatal event or events from one or more on the list—or an increasing chance of the fatal accidental type event as these disease processes advance. An alcoholic lives ten years less than a nonalcoholic.

Discussion now ensues regarding the psychological effects of chronic alcoholism and the physiological and pathological effects of alcohol misuse and abuse regarding the above list.

PSYCHOLOGICAL IMPACT

The great majority of the world’s adult population drinks alcoholic beverages. There are very few teetotalers (non-drinkers) out there. Most drink in moderation, know when to stop and are not alcoholic. Some, however, cross the line, start drinking in excess and begin to manifest the inevitable psychological strain on relationships and adverse medical effects of excessive alcohol consumption. When one considers that too much alcohol taken abruptly may kill, it should be no surprise that the chronic use of alcohol over months and years could lead to the same outcome, but in a slow, lingering way. The question for an alcohol drinker is when does the drinking cross the line from moderate occasional use to a significant health destroying problem? If drinking becomes a way to avoid feeling bad, to cope with depression, to forget worries, the line may have been crossed into chronic alcoholism. There are greater risks for this eventuality if there are genetic factors, if there is a family history of alcoholism, if there are close associations with alcoholics, if there is a history of mental illness such as depression, anxiety, bipolar disorder; and the use of alcohol has been found to moderate the symptoms (self-medication). In other words, if drinking is causing problems, there is a drinking problem. The criteria to determine if alcoholism has reared its ugly head include:

Drinking alcohol in spite of involvement in dangerous physical conditions such as driving a vehicle, operating potentially dangerous equipment, and engaging in sports

Using alcohol to relieve stress

Using alcohol in conjunction with prescription drugs

Avoiding commitments because of recent drinking affecting coordination and clear thinking

Driving an automobile while under the influence of alcohol

Continued drinking in spite of arguments with family or friends

A physical dependence on alcohol to function

And a compulsion to drink

Any one of these situations can thrust the problem drinker into a full-blown alcoholic state, or together they can all gang up on the drinker and slowly move toward chronic alcoholism. The requirement to need more and more alcohol to receive the same buzz is a sure sign that alcoholism has evolved. A further sign is the requirement to drink in order to offset developing withdrawal symptoms including:

Trembling (the shakes)

Sweating

Insomnia

Headache

Nausea and vomiting

Depression (crying)

Marked fatigue

Irritability

Medical crisis including seizures, hallucinations, confusion, disorientation, and fever

These last symptoms can lead to an acute medical emergency, delirium tremens, a condition that years ago carried with it a 50 percent mortality rate, but now has been reduced to 10 percent.

In time, alcohol becomes so entrenched that it literally becomes the foundation upon which all decisions are made—or rationalized into the following disordered thoughts:

Drinking only affects me, no one else, and I can stop it whenever I want

I have a good job, so I can’t be an alcoholic

I don’t drink any hard liquor, so I’m not an alcoholic

Only drug addicts are addicted, alcohol can be controlled

Only people who drink everyday are alcoholics—I don’t

Of course, this is pure rationalization and denial so as not to have to deal with the problem. In time, continuing with this disordered thinking will wreak havoc with family, friends, career, finances, and plunge its victim into isolation and poverty.

This completes the brief section of the book dealing with the purely personal, emotional, and psychological aspects of alcoholism. The following sections will discuss the pure medical implications (physiological and pathological)—and there is hardly any part of the human anatomy that is spared alcohol’s pernicious long-term effects.

LIVER DISEASE

To understand the impact a failing liver will have on the body, let’s first discuss the anatomy and functions of the liver, a vital organ that once it is irreparably damaged is incompatible with life.

The liver rests under the right diaphragm, the large muscular sheet separating the chest from the abdominal cavity. It is attached and fixed in this location by portions of the peritoneum acting as ligaments. The peritoneum is a membrane that covers most intra-abdominal organs including the liver. The liver consists of four lobes (sections), and like any other organ is made up of cells. Each cell produces a substance known as bile which drains into ducts within the liver (bile ducts) that increase in size and form larger bile ducts known as hepatic ducts that carry bile into the gallbladder for storage and into the duodenum (first portion of the small intestine) where it serves to digest ingested fats.

Like any other organ the liver receives blood, but in the case of the liver it receives blood from two sources:

1. In the first source, the blood has passed through the stomach, intestines, spleen and pancreas and then leaves these organs and heads directly to the liver through the portal vein so that the liver can do its necessary work on this blood before passing it on to the rest of the body via the small hepatic veins that coalesce to become the main returning vein (vena cava) that delivers blood to the right side of the heart. From there the blood passes to the lungs where it picks up oxygen for delivery through the arteries to the rest of the body cells.

2. The liver also receives its own supply of blood that provides sugar (glucose) and oxygen for use as energy by the liver cells.

There are two main liver cells:

1. Hepatocytes are the liver cells mentioned previously that manufacture bile. They also perform other functions including digestion, metabolism, and storage.

2. Kupffer cells are cells known as macrophages whose function is to break down worn out red blood cells.

The