It just keeps coming Part 2

[Ozzie101]

This is a continuation of a previous thread: https://bpdfamily.com/message_board/index.php?topic=345753.0

You’re right, FF, there could be some other medical explanation — at least where the blackouts are concerned. He’s always hyper-vigilant about his health so it’s not hard to get him to take the possibility of a health problem seriously. He says he’s told his doctors about the blackouts and their answer was that he needs to reduce his stress. But as we went over before, I can’t be sure they (or I) are getting the full story.

Some of his problems do seem to be personality-linked. But some of the extremities I’m seeing could have another cause — at least something causing him to tip over.

[formflier]

He says he’s told his doctors about the blackouts and their answer was that he needs to reduce his stress. 

I would be curious about the "medical evidence" they are using to make that judgment. 

It's one thing for a doc to examine 1,2 an 3 and do a, b and c tests.  Based on those tests ruling out x, y and z "stress" is the most likely cause.

I really don't get the vibe that has happened.  He most likely said "hey doc, I've been having memory problems about work.  Think extra work stress could cause this."

Doc says.."Sure that could make sense, want to look into it more?"

He says "let me think about it..

He comes home and tells you doc thinks it's stress..

Knowing him...does that seem plausible to you?  How would you imagine it playing out?

Best,

FF

[Cat Familiar]

I'll go out on a limb with this hypothesis.

He knows you are a teetotaler and don't approve of his drinking. He's been gaining weight without eating much.

Do you think it's possible that he's a secret alcoholic and is drinking far more than you suspect?

Could that be why he might have blackouts?

[Ozzie101]

I really don’t know. I suppose it’s possible. I can usually tell when he’s been drinking. But maybe there’s smaller amounts being consumed on a more regular basis that doesn’t affect him as obviously

[formflier]

Or other substances?

I've wondered the same thing about unexplained weight gain...or better yet inexplicable weight gain.

The calories have to come from somewhere (barring some really odd metabolic disorders...but he's getting bloodwork that is apparently "clean")

So..we know he eats very very sparingly (perhaps even fasts most of the time). 

The meals he has are healthy and reasonable (not gorging)

He gains weight

He is a closet drinker.

Those appear to be the things we "know" (vice surmise).

Are there other things we know that I've left out?

Best,

FF

[formflier]

OK...let's accept as true you can tell when he is drinking.

How often has he "blacked out" and you've also believed he was drinking?

How often after or before a "black out" have you suspected he is drinking?

I'm looking for patterns...

Best,

FF

[I Am Redeemed]

I really don’t know. I suppose it’s possible. I can usually tell when he’s been drinking. But maybe there’s smaller amounts being consumed on a more regular basis that doesn’t affect him as obviously

It's possible he has a tolerance level that doesn't show signs until he's had too much.

[Ozzie101]

As far as I can recall, every blackout and massive blowup has involved alcohol — suspected or proven.

The blowups usually start when he’s away from home, before he gets here. But I can hear it in his tone and in his disjointed thoughts and phrases.

I made the weight-alcohol link, yes.

Interestingly, his tolerance seems to have decreased — unless he’s drinking way more than even I suspect.

But I don’t know what to do with my suspicions or knowledge. He admits it when I call him on it later, but it doesn’t stick. He’ll say he has a problem, then downplay it.

As I said, he has other problems. But I think drinking plays a big role. He uses it to self-soothe.

[GaGrl]

I had a friend who did not realize her H's alcohol problem for three years. She came home 90 minutes to two hours after he did each day. By the time she walked in the door, he was sitting in his easy chair -- well on his way. They would then have evening drinks, and he continued to get more inebriated.

It can be well hidden.

[formflier]

As far as I can recall, every blackout and massive blowup has involved alcohol — suspected or proven.
 

So..perhaps this explains my insistence that "something else" was at play.  I didn't realize that alcohol played this big a role and/or there was this big a correlation.

When the doc issued his "stress" diagnosis (or whatever he calls it), did he have this information about alcohol? (I doubt it)

Obviously alcohol plays a factor (at some level).  The only way to figure out if this is "abuse" or "dependency" or "alcoholism" (or whatever the diagnostic language is now...is to have an evaluation by an MD qualified to make that determination

For many years I was "DAPA"  Drug Alcohol Program Advisor, so I was intimately involved in sailors that had alcohol incidents (the easy stuff) to hard core alcoholics that were resistant to treatment.  

Essentially I've seen enough to know that "first impressions" (even from guys like me) are often (maybe 50 percent of the time) wrong.  Let's say I was sure a guy would be found dependent and it would turn out he wasn't and other times I thought it was slam dunk simple case of one time too many beers incident and a closet alcoholic was revealed (even though I dug and sniffed ahead of time)

So...I don't want to overly alarm you, but I do want you to have a clear understanding that it's "as least as likely as not" that your impression about his drinking is completely wrong (in either direction)

What we do no for sure...for absolutely sure is that he is hiding drinking and driving  If that continues, it's a matter of when...not if there will be an incident.  Then statistics plays another role in how severe the incident is.  The longer it continues and the more incidents...the statistics continue to get worse.

Uggg...On the one hand he seems to be open to doctors and getting better, on the other you are right to be suspicious that he gives therapists and MDs (and others) wildly inaccurate information (with additional weirdness of not knowing if he is deliberately doing it or "honestly" not remembering)

Where are things at with you communicating with doctors?  Didn't one appointment get delayed or something?

Best,

FF

[Ozzie101]

H has told me that at his last physical (late last year) he talked to his doctor about his drinking and his fear that he was starting to rely on it too much. He said his doc agreed that it sounded like it may be becoming a problem. That was when H got rid of all alcohol in the house.

That gave me the impression that (at least then) he was being honest with his doctor.

Of course, what seemed to happen then was he did his drinking away from home instead — when he did it. That’s why it’s hard for me to know for sure. At least one time he snuck some in. He told me about it the next day, ashamed, and showed me where he’d hidden it. I also searched the house next time he was out and still do, periodically.

One thing that alarmed me a couple of months ago was during one of his episodes. He zeroed in on his not being “allowed” to drink and lashed out regarding how unfair that was. How I should have to give up something too to make it fair. He ought to be able to enjoy a glass of wine and relax and he’s not allowed to.. I wrote about it here at the time.

He did have a postponed appointment with a second opinion. It’s now late this month.

[formflier]

  He said his doc agreed that it sounded like it may be becoming a problem. That was when H got rid of all alcohol in the house.
 

If this doc had referred him to a specialist for alcohol evaluation (not sure what it's called in civilian world), then that would seem to be a reasonable "doctoring" thing to do.

Of course all of this assumes accuracy of what your H relayed to the doc.

We now have several different subjects, where there are large questions about whether matter of fact issues are being accurately communicated to your H's doctor. 

Big difference in "matter of fact" and "matter of opinion".

Best,

FF

[Ozzie101]

Very true. I’ll have a talk with H (at the right time, mood-wise). He’s usually very open to my participation in stuff like that. Of course, sometimes he can get upset later if he feels like I was attacking him.

[GaGrl]

One possibility is that your H is a binge drinker. That is, he could  go a long time without alcohol -- weeks or months -- but when he does start drinking, he doesn't stop until he reaches a point of blackout.

[formflier]

Has there been a time in recent years where you thought your husband has given up alcohol for a while?

Or even perhaps reduced it by 80 to 90%?

How many years have you known him?  What variations in alcohol use have you known about in that time?

Alcohol is a drug..basically just like any other.  Over time you build up tolerance.

So...for the same amount of body mass and metabolism he can likely put away much much more alcohol than someone that rarely drinks and still appear to be "normal".

It is possible that when you are like "he's been drinking a little"...that his actual BAC is shockingly high.

Then, when a guy like that gets to the point of blacking out you often get BAC results that make you scratch your head because the medical textbooks claim that should be the alcohol poisoning range or that certain systems should cease to function. 

I say all this because once you get into closet drinking and blackouts...you are in "test pilot" territory. 

I wish you luck in communicating with your hubby.  You have a toolbox full of tools.  Wise use of them is going to be very important in the next few weeks.

Hang in there..

Best,

FF

[HappyKJ]

Oh man, I know this back and forth with alcohol all too well. The quitting, following by compromises (just one beer, needs wine to get to sleep), then turning into full-on binge drinking. At times he'll admit it's a problem and needs to stop, and when he does quit, he says how much better he feels. Other times he said he should be able to drink and why should it be a problem? And yes, he has blamed me for "standing between" him and his alcohol. Obviously the alcoholism is a symptom of his other problems but it also makes everything much worse.

[formflier]

  Obviously the alcoholism is a symptom of his other problems but it also makes everything much worse.

In some cases yes...or depending on how the medical evaluations go, alcohol is the primary issue around which all other things (dysfunctional or otherwise) circle.

There simply is no way to know other than through a full evaluation.

Best,

FF

[Ozzie101]

I’ve never seen him actually binge drink.

We’ve known each other 4 1/2 years — lived together 3 1/2. From the time I met him, he might have a glass of wine or two with dinner. Some nights nothing at all. Then he gradually did get more into a pattern of a glass or two every night. More than two and his behavior would be affected a bit so he started limiting it and paying more attention.

The last year or so (and especially since it left the house), it takes much less to affect him. Some of it depends on if he’s eating, of course. It’s been about 9 months since he stopped having it here.

Both he and I have wondered if the alcohol interacts poorly with some of his meds for depression and anxiety (confirmed by doctor and warning labels) so that could have something to do with it. But that makes it even more important that he not drink at all.

What’s odd is how much he’s like my sister. She has a lot of similar traits (anxiety, depression, eating disorder, rages). She started drinking to self-soothe and is currently at an in-patient clinic for a month to try to get better and learn how to cope. I swear, Sonetimes it feels like I married my sister’s male counterpart.
 

[I Am Redeemed]

Both he and I have wondered if the alcohol interacts poorly with some of his meds for depression and anxiety (confirmed by doctor and warning labels) so that could have something to do with it. But that makes it even more important that he not drink at all.

If he is drinking while taking meds for depression/anxiety, they are most likely interacting with the alcohol. Many antidepressants and anti-anxiety meds can enhance the effects of alcohol so that a couple of drinks may have much more potency than they would without the medications. If the doctor knows he is taking these medications and also drinking alcohol, I can't imagine that the conclusion would be excessive stress causing the memory problems. Most doctors will start with the obvious reasons: alcohol + medications that interact poorly with alcohol = likely side effects.

[Ozzie101]

I agree. He says he knows it’s a problem. It’s his go-to when he’s stressed. That doesn’t make it ok — at all.

When he’s at baseline, he’s so rational and reasonable. That’s part of what makes the episodes so disheartening.

This Saturday I went down to visit my grandmother. I came back and he was in one of his accusatory moods. Lashing out about family friends, the fact that I’m still friends with church people on Facebook, that my parents are probably still communicating with the friends in question. He never “lost it” and I don’t think he’d been drinking.

It seems like he keeps it together better when I’m around. If I’m away or of he’s away, he’s far more likely to topple over. Every major blow-up has happened when he’s been away at work or meetings or when I’ve been away from home. But I can’t be around him all the time. He has to be able to manage on his own.

I have a therapy appointment tomorrow, fortunately.