Thursday, 21 September 2017

Who knows about cirrhosis?

I've been an alcoholic all my life.  Long periods of recovery interspersed with shorter relapses of mayhem.  I know I'm an alcoholic, and a few other things too.  I didn't think I was in denial, but secretly and unknowingly I had denial.  I thought I was indestructible and immune to liver damage and could physically get away with the odd bout of drinking.  When people warned me of the physical effects of my drinking I would glaze over and continue to intellectualise about the subject.  I knew the psychological, emotional and material consequences but I never thought I would get cirrhosis.  Yet no alcoholic can ever drink safely.

It took just two relapses last year for the scans to start showing a fatty liver.  This is liver damage.  Although not permanent it should have been a serious warning.  Then I had a fierce bender for 30 days of two bottles a day, minimum.  I was back in hospital and this time the body wasn't coping at all.  It went into shock, needles went into the arm and oxygen applied.  Bleeding started inside me.  There was 'turbulent hepatopetal flow' in my liver with reflux.  Over a litre of blood flows through the liver every minute, so if its not going the right way it's bad news.  In short it was about to pop.  Blood pressure had to be dropped.  All the time I was being very sick and hallucinating.  Nasty but I got through these four days.  Then I got my discharge note.

I had been looking forward to this.  So many alcoholics can't cope with the agony of detox they self-discharge and go out drinking again.  To get the discharge note means you've completed the course and get lots of information on your physical health.  I've had plenty of them and they usually say happy things about how health is restored.  Not this time.  There staring at me were the horrible words: "Early cirrhotic change".  The doctors said I'd done it now.  I wasn't indestructible at all.

I was devastated.  The scales dropped from my eyes. That I could permanently damage myself from one of my very private little 30 day benders.  I was inconsolable as I paced around waiting for my taxi from the hospital.  I had been through so much unimaginable pain, and all I get is this.

I cried a bit.  I went to my GP, he confirmed everything.  All the experts were saying the same thing.  You're screwed.  You will now always have a damaged liver and that means you will always be slightly unwell.

Well, we know about experts don't we?   Few in number.  Theoretical.  Personal agendas.  Peer reviewed journal articles count a lot.  The alternative is a more democratic crowd wisdom, which works when the group is large and diverse, drawing on local information.

I went to an AA meeting, the epitome of a wise crowd.  This organisation has been going for 80 yrs, involves millions of members around the world.  All the good recovery stays in the rooms and the bad ideas exit with those who relapse.  Each meeting distils this experience-based wisdom further.  At my meeting there were 30 people.  They had heard plenty on the subject of cirrhosis.  Maybe five or six had it.  This was a far more optimistic land than the doctors surgery.  There were stories of rejuvenated livers with mild cirrhosis (which may not have been cirrhosis at all).  Like a dying man clinging to a raft, I felt this wonderful feeling it would be alright.

Now let's be totally clear.  The situation is very serious for me, I'm not indestructible anymore and I can never drink again.  That point was made over and over in the meeting.  But I trust this crowd optimism as much as the pessimism of the expert doctors, who will probably suggest an alcoholic tries some "controlled drinking" that may lead them to their death.  Many think there are pharmaceutical solutions for alcoholism.  There aren't.

Now I am public about my alcoholism and also my liver disease.  It's good for me to hold no secrets and be very open and honest.  For me this is a proper surrender.  I'm also seeking no sympathy for the dire consequences of my own actions.  If one alcoholic suddenly twigs the destructive capabilities of alcohol from this piece, then it will all be worth it.  I will be tested again in six months and keep you posted.