Tuesday, December 31, 2013

Sober Day #63- NYE!

No alcohol for me tonight, thank you- at least not this year!  I don't know what future years will bring, but I am content with this for the here and now.

Monday, December 30, 2013

Sober Day #62: A new approach to New Year's Eve!

I was just at the grocery store, watching at least every other person load up on alcohol.  Surprisingly, I didn't feel sad, deprived or tempted.  I more felt bemused- that it is a well-entrenched cultural meme that the end of one year and beginning of the next is celebrated with alcohol, usually excess alcohol.  New Year's Eve sort of carries permission to go wild with booze.  So much so that hotels offer party/overnight packages in anticipation of people being incapable of driving home safely after said party.

I never questioned this before- it was just what 'everyone' does.  And now I am thinking about it, examining it for 'fit'.  And it doesn't fit very well.

In the grocery store, it almost seemed to me that people were functioning in a trance, carrying out cultural/social dictates of how to celebrate.  Equating (as I have done for so many years) alcohol with fun.  As in 'Alcohol is required in order to have fun'.

And I am thinking:  'hmmm, that doesn't really seem to be true, after all'.  And 'the start of a new year sounds like a great time for sober reflection'-  on the successes and challenges of the year past, and the possibilities and surprises of the upcoming year.

So, this New Year's Eve, I will be trying out a new way of having fun.  And I will awaken on the first morning of the new year feeling fabulous.  

Sunday, December 29, 2013

Sober Day #61: Powerless over alcohol? NO!!!

The well-known First Step of Alcoholics Anonymous (AA) is "admitting we are powerless over alcohol".  And the oft-quoted introduction of a new member to a group is "Hi, I'm xxxx, and I am an alcoholic".

I acknowledge that AA has been helpful for many people in coming to grips with/quitting drinking alcohol.  But for me, at least, AA delayed my facing that I was not doing well with alcohol.

First off, I am a Do-It person.  I'm powerless over the weather, or international politics, or what color is fashionable this spring-  but I am NOT powerless over alcohol.  I take full responsibility for my actions.  Nobody ever propped my mouth open and poured wine into it- except myself.  I drank because I thought I needed the respite of wine to deal with the rest of my life.  Yes, there is a genetic predisposition for many, and childhood/family-of-origin issues that make drinking more alluring- but it is ME!  I made the decision TO drink, and I can make the decision NOT TO drink.  I had absolutely no inclination toward joining any organization that told me I was NOT responsible for my own actions.

Secondly:  Ask several hundred people to define 'alcoholic'- and you will receive several hundred different answers.  The most prevalent image seems to be the homeless bum or bag-lady, drinking El Cheapo wine or whiskey, then passing out face down in the gutter in his/her vomit.  This is NOT me.  I am an accomplished professional with a great family and home.  So I reject using the label 'alcoholic'.  I have had problems with alcohol, have been a problem drinker, maybe even alcohol-dependent at one point.  But I WILL NOT call myself an alcoholic.

Third, there's all that 'turning oneself over to a higher power' stuff.  I am a deeply spiritual person, but not particularly religious, and also found that language to be a turn-off.

Like many other people, I thought my two options were to continue drinking or to join AA.  Neither appealed to me much, but AA was worse than continuing to drink.  Imagine my surprise- and delight- over the past two months to have discovered a vibrant on-line sober community.

I crossed my two personal 'red lines' for alcohol in a single day, and said, that's it, I'm done for a while.  How long that would have lasted I don't know- maybe a week or two?  But I came across Belle's 100 Day Challenge, and found that finite goal of 100 days (not stopping drinking forever, just committing to a little more than three months) to be a do-able goal.  Through Belle's blog, I have 'met' so many others on similar journeys of exploration. I take pleasure in giving encouragement to those in their first few days or weeks, and find great meaning and help in the posts of those who are many months or years into their sober journey.

At a guess, I'd say that thinking AA was the only alternative to continuing to drink probably delayed by 5+ years my deciding to make a change in my relationship with alcohol.  I think the existence of this sober online community and countless other options for help in stopping for cutting down on drinking need to be much more widely known.  That is, assuming we have a common goal of helping ourselves and anyone else we come into contact with to be the best, most fulfilled person they are capable of being!

I'm still not sure exactly what I will do after these 100 days.  I know I will never go back to a bottle or wine or more every evening!  I am becoming far too fond of excellent restful sleep, a clear head and an energetic step to go back to that drowsy, foggy, semi-grumpy place.  But neither do I think I can live with:  Never Ever Ever will a Drop of Alcohol Cross these Lips.

So I will see what I find out, what I develop-  and continue to record my experiences here, where I have sworn to myself to include nothing but my absolute truth!

Saturday, December 28, 2013

Sober Day #60! Revisiting the Power of Sleep

Yesterday I had an interesting reminder of the power of sleep!!

In my former drinking life, I was a 4-5 hour a night sleeper.  At the time, I felt like this was sufficient to 'get by' on.

In the first weeks of sobriety, I was up to 8-10 hours of sleep each night- mainly because of going to bed very early to avoid evening temptation to drink.

Over the last weeks, however, my sleep time has been shrinking again as I get more enthusiastic and drawn-in by some of my sober evening activities: Just one more square for this quilt, just one more set of glass beads, maybe another chapter of this book... and bedtime creeps later and later.

Everyone 'knows' that sleep deprivation leads to multiple dysfunctions, including slowed reaction time (physical and mental), less creativity and flexibility, and often less optimism.  On the other hand, however, most of us, while acknowledging that this is true for others, somehow think of ourselves as 'immune' to this effect.

There is a notoriously poor connection between one's subjective assessment of fatigue or sleepiness, and objective measurements of these.  (How do you objectively measure sleepiness?- one way is the Multiple Sleep Latency Test).  This means we often think we feel 'fine', are doing just 'great' after our sleep-deprived nights- whereas in reality, we are not functioning so well.

How did my life remind me of this yesterday?  By way of a game!

A few months ago, surfing around about 'successful aging' topics, I came across an online site called Luminosity.  It has a set of game-like activities purported to keep brain agility challenged.  One signs up for a nominal feel, plays different games as assigned, and sees scores comparing oneself with ones own former performance, as well as compared to age-based peers.  The website emails a daily reminder to visit and play the 5 games it has assigned to you for that day.  I find it a lot of fun.  And as a highly competitive person, I love seeing my scores in various categories improve day-by-day.  I almost always have a new Personal Best or at least a Top Five score on most of the games each day.

Yesterday, my performance was sub-par.  I didn't even hit the Top Five score for any of the games.  Hey, What's up?

Later in the day, it occurred to me.  The night before was a very short sleep night- only about 4 hours, because of getting to bed a little late, and having to get up unusually early for a must-keep commitment.

I think these games are an unusually good discriminator of reaction time and brain connection time, since they depend on quick responses requiring both mental and physical agility.  I hadn't noticed any other performance deficits for yesterday.  I wasn't depressed, unusually drawn to alcohol, having trouble driving or any other actions I usually think of as resulting from sleep deprivation.  But here was concrete evidence that apparently short sleep, even for just one night, DID impact my ability to function 'on all cylinders'.

So:  I am re-committing to getting at least 7 (and preferably 8 or more) hours of sleep each night.  I think Enough Sleep is also important in helping me meet this 100 day challenge, and figure out what I want to do after that.

Ciao!



Friday, December 27, 2013

Sober Day #59

Chilling at home- a welcome experience.  I've been enjoying working on quilts and making glass beads. This feeds my soul where it is hungry, where in the past I would have tried to feed that hunger with the distraction of wine.  This is much better.


And enjoying the company of my family, human and fur-faced:


I do see better without wine.  This is a totally new way of doing Christmas.  Now for tackling the alcohol-fest otherwise known as New Year's Eve!


Thursday, December 26, 2013

Sober Day #58- Medication help for Quitting Alcohol (long post!)

All of us who have struggled with addiction are wary of adding another medication to our intake- wary of another dependence, wary of in-authenticity, wary of adding to our woes.  But a recently-published study offers a potentially axis-altering option for making quitting a bit easier.  (The full reference is below)

This was a 12 week randomized double-blinded placebo-controlled trial  (DBPCRT).  This is the gold standard for clinical studies:

Randomized:  Participants are randomly assigned to treatment (in this case, active medication) or control (placebo, inactive medication) arms.  This avoids the potential bias of patients ending up in a group because of their own or the researchers expectations of which arm they'll do better in.

Double Blinded:  Neither the participants nor the researchers interacting with the patients are aware of which ones are getting active vs. placebo medication.  This is important because many many studies have shown that expectations (on the part of the patient or the research) can subtly influence interactions, and actually affect outcome.

Like one study of grade school kids and their teachers.  The teachers were told that tests showed certain students were expected to excel during this school year.  Analysis at the end of the year showed that these students had indeed done very well, achieving excellent grades and great evaluations from the teachers.  EXCEPT:  There was no testing.  The students were randomly chosen for the 'expected to excel group'.  Which means this group included the extra-smart and the not-so-smart, the previous-thrivers and the previously-indifferent students.  Expectations of excellence on the part of the teacher apparently helped each student to achieve his/her best.

The medication used in this study was gabapentin (trade name Neurontin), basically an anti-seizure medication.  It has, however, proved useful for lots of other problems.  Chronic cough and laryngeal sensory disorder are areas I have experience with using it, and it can work very well for these.  One really important thing about this medication in the alcohol-context is that is has no abuse potential.  Unlike the benzodiazepenes (valium, klonopin, xanax, etc) frequently used for alcohol withdrawal, and sometimes for help with anxiety in early sobriety, which have major abuse potential.  People have inadvertently replaced an alcohol addiction with a pill addiction!  Other medications like Antabuse cause physical sickness (nausea, vomiting) when alcohol is consumed while taking them.  So these options make Neurontin look like a less disagreeable or dangerous option!

This current study included 150 men and women who were alcohol-dependent, and lasted for 12 weeks.  The participants were divided into 3 groups.  One received placebo tablets, the second received a total of 900 mg of gabapentin daily, and the third received 1800 mg daily.  (The pharmacy prepared special versions of the medication so that the pills received by each of the three groups appeared identical, even though the active medication was different).

The outcomes measures tabulated by the researchers were whether complete abstinence occurred.  And if not complete abstinence,  did the patient at least have no episodes of heavy drinking.  They also looked at some secondary outcomes like changes in mood, sleep, cravings.

Here's where the results get fascinating:

Abstinence rates were 4.1% for the placebo group, 11.1% for the 900 mg a day group, and 17% for the 1800 mg a day group.  This shows a dose-dependent improvement in abstinence, that is, more of the medication was associated with higher abstinence rates.  Further statistical analysis showed that there was a very small chance of such a result occurring by chance alone, allowing presumption of a cause and effect relationship between more medication and better abstinence rates.

Occurrence of No Heavy Drinking showed a similar spread:  22.5% in the placebo group, 29.6% in the 900 mg a day group, and 44.7% in the 1800 mg per day group.

My editorializing:  that means that over 12 weeks,  over 60%, nearly two thirds, of the alcohol-dependent subjects in the 1800 mg per day group made a major change in their alcohol consumption:  17% did not drink at all, and another 44.7% did no heavy drinking.  Wow!

My Epocrates iPhone app says that the maximum dose per day of neurontin is 3600 mg, which obviously leaves more room for research about the optimal dose.

There is no Magic Bullet for quitting alcohol.  And Neurontin (Gabapentin) is not one either.  But perhaps, especially for those who have cycled through Day #1 of Abstinence again and again, getting more and more frustrated-  maybe, just maybe, this could be the little shove over the top that is needed to get to longer abstinence.

CAVEAT:  Although I am a medical doctor, I do not know you individually.  I have not sat with you, listened to your medical history, and examined you.  So this post is tantalizing information to consider, not a prescription for you to start taking Neurontin on your own.  Although impressive, this study mainly opens the door to further questions that need to be answered before this medication is recommended on a routine basis.  What is the best dose?  How long should the medication be continued?  What ancillary services best reinforce this anti-alcohol effect?  Are there particular types of people/drinking patterns for whom this works better/doesn't work?

In the US, at least, this remains a prescription-required medication.   Even if you could get some on your own, it would be A VERY BAD IDEA to experiment with this without the approval of your personal physician!!

Mason BJ, Quello S, Goodell V, Shadan F, Kyle M, Begovic A.  Gabapentin treatment for alcohol dependence:  a randomized controlled trial.  JAMA Int Med 2013.  doi: 10.1001/jamaintmed.2013.11950


Wednesday, December 25, 2013

Sober Day #57!! Enough.

Fifty-Seven days without alcohol-  a quiet little Christmas miracle all my own!  Just for today, that is enough!

Tuesday, December 24, 2013

Sober Day #56- Happy!!

Merry Christmas or whatever holiday you do or don't celebrate this time of year!!

May there be blessings on your family, and soberness in your being!

Enjoy the good things of life (which does not, for most of us, include alcohol!!)

Monday, December 23, 2013

Sober Day #55- The Myth of Controlling Others

My entire family was together last night-  Mister home from work in city 5 hours away, older daughter home from her town 8 hours away, local son and younger daughter here, as well as my mom and dad who live locally.

When the kids were little, I WAS in charge of everything-  feeding everyone, washing them, dressing them, taking them here and there (and, of course loving them- which happens naturally and fills my heart with joy!!).  And the Mister being a bit vague about time, my duties also included reminding him to get ready for X, be ready to leave for Y, etc.

There is one of my favorite e.e. cummings poems about Anyone Lived in a Pretty How Town, that included the line:  "And down they forgot as up they grew".   And I feel like that's what I've done with that Being-in-Charge, Being-Responsible-For bit.  Forgotten, really, that I no longer have to Do-It-All.

It was very apparent to me yesterday as we all gathered for older daughters 21st Birthday.

Old Internal Voice:  Gotta remind Older Daughter to be at the Restaurant on Time.
Sober Rational Voice:  She is 21 today. She manages her own life just fine 8 hours away.  She will either be at the restaurant on time, or there with be a good reason, like a flat tire, for her to be late. Trust her.

Old Internal Voice:  Gotta remind Son to be at the Restaurant on Time.
Sober Rational Voice:  He is 20 and there will be good food.  Don't worry, he will be there!!

Old Internal Voice:  Gotta go remind Mister to come in from working in the yard, change and be ready to go.
Sober Rational Voice:  He manages his life just fine 5 hours away.  I don't need to be his Minder any more.  I will get myself ready, and let him know when I will be leaving.  I can drive myself just fine, thank you, since I won't be drinking so driving home will not be a problem.  The Restaurant is nearby-  he can choose to come with me, or drive over a few minutes later on his own if that works better for him.

Final Result:  I am resigning from being everyone's Minder!!  15 year old daughter obviously still needs more of a Mom presence, and I will do that as appropriate-  AND allow her more room to grow in decision-making and responsibility.  I will take care of myself, and provide support and assistance for my beloved family as appropriate-  But I am no longer going to feel In Charge of Everything!!  (which was, of course, an illusion anyway, lol)

And not being In Charge of Everything- well, that another thing NOT contributing to guilt, anxiety and the desire to drink alcohol for relief from that pressure.  Hmmmmmm.


Sunday, December 22, 2013

Sober Day #54- Alcohol was Responsible- NOT

This morning I saw my sweatshirt on the floor in the hallway.  Oh, I thought, I must have done that last night when I was drinking.

Oops- wait, I wasn't drinking.  That is apparently just me.

Or a few days ago when 20 year old son said, Mom, I told you about this last night- Don't you remember?  Oh, yeah, um, wait, wait, sure, sure I remember now.  (Thinking:  I forgot what you said because I was too tipsy to remember).  And then- Oh, wait, I wasn't drinking.  I must just have been tired and already into relaxing/heading-for-bed mode when you told me whatever.

Or:  Morning sink full of dirty dishes again.  After the third glass of wine I lose interest in cleaning up. Shame.  No, wait, I wasn't drinking last night, I just decided I was done with To-Do's for the evening- and that's OK.

You get the idea.  There was a lot of behaviour I assumed was due to drinking, that is actually not.

This tells me 2 things (maybe more?)

#1:  Drinking was so ingrained in my image of myself that I had Automatic Excuse/Shame thoughts to put things in context the next morning.  I am OK with dumping these!

#2:  Not everything Not-Perfect I did was due to alcohol.  Some of them are just plain un-marinated me.  And accepting that is fine.

Bonus #3:  This not-drinking, this 100 days, is a time of more self-observation and self-discovery than I've seen since adolescence.

About time for me to understand my self better, yes?  And to be gentle, caring and loving about it.

More discoveries coming, I am sure!!

Saturday, December 21, 2013

Sober Day #53- The Other OFF Switch

Another wine-free Friday evening- this is getting to be a habit!  I was asleep by 9:30 and had a delicious 8+ hours of sleep.  Followed by a few hours at the gym this morning- yay!

We know that most of us who have alcohol-consumption problems have deficient OFF switches for saying NO to the 3rd, 4th, 5th, etc drink.  But I'm thinking today about that other OFF switch, that seems much more possible for us to change than the first.

This is the OFF for the To-Do List, OFF for everything must be accomplished today, OFF for If I don't do everything faster and twice as well as my (sister, friend, mother, etc) I am a failure.

It's a softening that helps turn that switch off.  A willingness to believe I am inherently a good and valuable person, regardless of exactly how much I accomplish today.  And this is really important for me!  Part of the reason I was so attracted to alcohol was how it allowed me to ignore that To Do Everything Now voice.  It put cotton plugs in my ears, so that I could no longer hear it, and thus could relax.

Imagine my astonishment in discovering now that I-  yeah, that would be me!- I hold the power to turn that Voice on and off.  At 8 PM at night, I can say- OK, that's enough for today.  Have some tea, write in your journal, read a fabulous book- then turn off the lights and enjoy your sleep.

Even at noon on a Saturday-  I can shut off the Voice if I feel stressed and in need of rest.  Even at work, I can shut off the home-family-life-related Voice, and just laser-focus on patient issues.

This is another Earth-Moving revelation for me!  Shutting off the switch that controls that annoyingly helpful voice is not some magical power integral to alcohol.  I had that power all along, but just misplaced it.

Glory Be!!!


Friday, December 20, 2013

Sober Day #52 Alcohol and Victims

I have recognized that my former worldview held a big chunk of 'Victim' in it.  As in, the world is so hard, I can't manage it on my own, it asks too much of me, I don't deserve to feel so bad, I do deserve to feel better, in any way I can.

Yesterday I saw two patients back-to-back who really crystallized this for me (all recognizable details changed):

Both were women about 30 years old, with some medical issues but nothing disabling or affecting mobility. As far as I know, neither overuses alcohol or uses drugs.

The first spent the visit telling me why she was unable to take the medication she needed (she had the medication, this wasn't a money issue), how public services really needed to find her a new apartment, and why it was impossible for her to clean her apartment to help with her allergy symptoms.  The second updated me on her medication progress, mentioned how challenging it had been to go back to school as an 'older' student, and how she was looking forward to taking her final licensing exam in January, so she could go to work in her chosen field.

I know nothing about their other-than-medical backgrounds, or their life in their families-of-origin.  There are undoubtedly complexities and profundities at work here that I know nothing about.  Nevertheless, there were deep differences in their approach to life.

I could see myself in both women.  Like the second, I'm a do-er.  I work hard at my profession, and at home with my family.  I choose goals, go for them, and achieve them.

On the other hand, there is a part of me that whined:  This is tooooo hard.  I neeeeed relief.  I caaaaan't do this.  And this is the part that said:  I deserve a (mental) vacation.  Oh, Alcohol, glug, glug, glug.  Oh, my, that is better.  What world?  What demands? Ahhhhhhh.  All the way to oblivion.

I'm very clear on which patient I more admire, and which part of me I like more.  Early sobriety has been, among other things, realizing:  Wait, existing without alcohol isn't really all that bad.  There's nothing here I can't handle.  Wow, that's not really a big boogey man, after all, it's really quite manageable.  And I AM strong, I CAN do this, Look at me!!!

Big, Crazy, Empowering Stuff!!!

Thursday, December 19, 2013

Sober Day #51- Settling into Sober (Neuroplasticity)

It's starting to all add up.  A night without wine is beginning to seem like the norm.  I think about my typical 'before' evenings-  coming home from work and immediately pouring a nice glass of cold crisp white wine.  My norm for so many years-  and yet, thinking about that now, I caught a thought flitting across my mind-  Why would I want to do that?  And I don't, really, most of the time now.

I think it has to do with laying down those new neuronal circuits, connections.  Remember the neuroscientists' maxim:  What fires together wires together?  Think of it in the context of piano practice:  The first time through a new piece, it is awkward and stumbling (for most of us, anyway, lol).  Each time through, our brains change a tiny bit, and the neurons directing each of the finger movements begin to lay down stronger and stronger connections between themselves.  Eventually, those connections are so strong that playing the piece seems automatic, like something you've known forever.  Professional pianists actually grow the part of the brain that controls finger movements to be larger than the normal person's.

So every night that I come home and do something other than pour a glass of wine, the connections between those non-alcohol-consuming activities becomes stronger.  The connection between 'coming home' and 'pour glass of wine' begin to wither, lose strength.  So now there is seldom that automatic thought:  home-wine.

When I was in medical school, they taught us that by early adulthood, the brain was set, finito, no longer capable of changes.  That this is NOT true is one of the most amazing bits of knowledge since then.  Our brains CAN change- a lot- and these changes can continue through our last breath.  This neuroplasticity- the ability of the brain to change, to be plastic- is amazing to contemplate for those of us who want to make major changes in our lives.  It IS possible, we CAN do it!!

I sometimes picture what is happening in my brain-  visualize little construction equipment paving the new roads I want to build, using little jack-hammers to remove the ones I want to change.  It is surprisingly satisfying!

Here's to each of us, building our new brains!!

Wednesday, December 18, 2013

Sober Day #50!! And a Night of Dreams

I had a busy night of dreams last night, which seems appropriate for the landmark of Sober Day #50!

I've only ever had one dream before with alcohol- then last night, 2 in one night.  In the one before, I surreptitiously drank an airplane bottle of wine, fretted over whether to admit it or not, and awoke very relieved that it had been a dream, not a real breaking of my 100-day promise to myself.

In both of my dreams last night, I was tempted by alcohol, thought through the pros and cons, and decided not to drink.

Dream #1:  I am unexpectedly in another country for a weekend without friends- I think they were late joining me and would be there in a day or two.  I was walking down a quaint street with beautiful buildings and bright colors- Sevilla?  Somewhere in Portugal?  I walked by a lovely cafeteria- bar.  It was a cold day, and it looked so bright and inviting inside.  I thought, nobody I know is anywhere around, I could have a glorious day of drinking wine, be back to normal before my friends arrived, and no one would know.  In the dream, I was aware of my exact thought process.  I stood on the cobblestones by a beautifully-painted arch, and thought:  But, I would know.  And when I talked about 100 days without alcohol, I would know it was a lie.  So I won't do it.

Dream #2:  In a small cozy restaurant-bar, by myself, waiting for a table.  I am hungry, and thinking droolingly about the steak I am going to have.  I notice the drinks station, where there are lots of interesting soft drinks, and glimmering bottles of wine.  I consider how good a glass of merlot would taste with my steak.  Then I notice a menu with pictures of items offered.  There are some mouth-watering photos of ice cream sodas in tall glasses with whipped cream on top.  I decide I will order one of these with my steak instead.  (This is a bizaare decision for the real-life me, since I eat a fairly strict low carb diet, and am not even that fond of sweets!)

I think the benefits of not-drinking are penetrating my unconscious too!

Dream #3:  Another physician walks up to me, looks closely into my eyes, and announces they show that I have a disease.  I quickly find a mirror and inspect my eyes.  My pupils have slid up, so that instead of being at the center of my iris, they are at the top and sliding upwards, with wispy strands of white showing the path they have taken.

I think this one is informing me that my vision is shifting, meaning that how I see my relationship with alcohol is changing fundamentally.

Altogether I take these three dreams as highly auspicious for sober success as I start on the second 50 days of this challenge!

Tuesday, December 17, 2013

Sober Day #49- That Pesky OFF Switch!

49 days and holding.  As in, putting one foot in front of the other, walking forward, day after day.  It seems very strange not to be drinking this time of year, but not really unpleasant most of the time.  I realize a lot of the occasions that seemed to inevitably include alcohol were mostly my personal expectations, not intrinsic characteristics of the events themselves.

One of the emails quoted on Belle's blog recently talked about alcohol making her feel like she was going to have fun soon- not that she ever got to the part about actually feeling the fun.  For me, it is the anticipation of letting go, of stress, of expectations, of duties.  Being able to go to that Fuzzy Place where I don't have to think about or listen to any of these.  And for that first glass or two of wine, it might actually feel good, rewarding, happy.

But, ahhh, that lack of a OFF switch, that inability to say, Gee, I feel good, that's enough, thank you. That is where the damage came in for me.

Where did that defective OFF switch come from?  Partly genetic, I think, and partly cultural promotion of the joys of alcohol consumption.  Is it possible to acquire an OFF switch?  Can one go from being an excessive drinker to a moderate drinker, defining moderate as the ability to have one or two drinks and feel satisfied, feel no urge to consume more alcohol?

That was my goal when I started examining my alcohol consumption-  a glass or two of wine with dinner a few nights a week.  My thoughts on that are shifting.  I am beginning to believe that getting an OFF switch, actually learning moderate behaviour, will not be possible for me.  Let me rephrase that:  I know that I CAN, with focus, drink just one or two glasses of wine in an evening, and stop there.  But it takes LOTS of energy, self-talk, will-power to make it happen.  I CANNOT see a future where I will really drink one or two glasses of wine and not care if I have another glass or not.

On the other hand, whenever I tell myself I ABSOLUTELY CANNOT ever do something, it is like a dare to me to rebel.  Redheads don't look good in red?  Oh, yeah?  Look at me in this scarlet dress!  Adult women can't squat their own body weight?  Oh yeah?  Watch this!!  You can never ever drink any alcohol again?  Oh, yeah?  Watch me head to the wine store.

I am definitely committed to doing these 100 days.  But what will I do after that?  I'm not sure.  And I don't feel compelled to make a specific commitment now-  I realize I am just barely half-way through the 100 days.  So much has changed, become apparent, been different than I expected already-  and I'm pretty sure the next 50 days will also bring more of these. But I'm just thinking...

Monday, December 16, 2013

Sober Day #48- Tomorrow is Another Day

I've always had an uneasy relationship with Time.  As in, There is Never Enough, and My To-Do List won't Ever Fit, and It Is My Enemy and Once I Start Something, I Must Ignore Everything Else to Complete This One Task.  The end result of this is that I would reach the day's end and feel very critical of myself-  I might have completed one or two, possibly three tasks.  But there were 5 zillion more on my list I hadn't even spend 5 minutes on.  And Play-Time?  Not even a background thought.

And this is changing.  The change is something I have noticed, not something I've done deliberately.
I know my research lab has been most productive when we are managing multiple studies at once.  We review them weekly, deciding to the Next Step and Who is Responsible (a la David Allen's Getting Things Done).  When we get stymied or blocked on one study, there's always another we can push ahead with.  I call this process Sheparding-  as in trying to get a whole flock of projects progressing in the right direction-  Some are always out ahead of the herd-  and if some are falling behind, we need to run back and coax them up with the rest of the flock.

What I noticed first about time was that it wasn't feeling so urgent to me.  That I could do an intensive half hour of one activity at home, then switch to another EVEN if the first wasn't completely finished.  You may laugh, but this was a revolution for me!

Once I noticed this, it occurred to me that I could use the Sheparding process at home also:  Looking at the constellation of all tasks (both chores and fun projects) as my herd (oops, stars and sheep, very mixed metaphors, sorry!), and push a bit on one, then a bit on another-  and reach the end of the day feeling satisfied rather than critical-  Thus eliminating, or at least modifying, another source adding to the heavy backpack filled with stress that led me straight to alcohol for relief.

As I was lying in bed last night, playing one last game of Candy Crush before turning off my light-  I found myself thinking back over my days, feeling pretty satisfied with the work/play ratio.  And instead of beginning to heap on the criticism for not completing more, I found that voice in the back of my head saying, with compassion and encouragement, Tomorrow is Another Day.


Two of yesterdays projects:  Wrapping Presents and Trimming the Christmas Tree:

Sunday, December 15, 2013

Sober Day #47- Bare Knuckle Tactics

One of the most educational (addiction-wise) books I've read recently is Gabor Mate's 'In the Realm of Hungry Ghosts:  Close Encounters with Addiction".  He is a Canadian addiction physician who is Buddhist-influenced.


About.com explains the Buddhist concept of hungry ghost this way:  ""Hungry ghost" is one of the six modes of existence (see Six Realms). Hungry ghosts are pitiable creatures with huge, empty stomachs. They have pinhole mouths, and their necks are so thin they cannot swallow, so they remain hungry. Beings are reborn as hungry ghosts because of their greed, envy and jealousy. Hungry ghosts are also associated with addiction, obsession and compulsion."

One needn't have a Buddhist outlook to see how this description of Always Hungry but Never Satisfied fits most of us who are struggling with alcohol.  (Hungry for alcohol, that is, not for food). 

Mate discusses the difference between a passion and an addiction:  "The difference between passion and addiction is that between a divine spark and a flame that incinerates."  Which makes it very clear-  for me, wine has been a flame that incinerates and destroys the richness that could be my life.  Even though at times I tried to convince myself that is benefited me, added enjoyment, made my life better.  

He says:  "When we flee our vulnerability, we lose our full capacity for feeling emotion."  And that is certainly what I have done with alcohol:  used its anesthetic effect to avoid feeling stressed, vulnerable, not-enough.    The challenge with this is that one can't blunt just the negative emotions-  any action that blunts them, also blunts the positive emotions-  and, as he says, we end up diminishing our capacity for feeling all emotions.  

Where do the Bare Knuckles come in?  In hand-to-hand combat with Wolfie.  If I am losing the battle, my last resort is to re-read a quote from his book (at least 10 times in a row, preferably out loud) and go to bed as soon as possible.  I have the quote written down on a card that I carry in my purse at all times.  Here it is:

"I don't NEED a drink now.  I'm only having an obsessive thought that I have such a need.  It's not a real objective need but a false belief.  I may have a feeling of urgency, but there is actually nothing urgent going on."

That kinda says it all, doesn't it?







Saturday, December 14, 2013

Sober Day #46- Suddenly a Free Weekend

No trip to visit DH this weekend after all.  Snowing here, snowing there, snowing everywhere in between.  Winter storm advisories, travel advisories:  Not auspicious for a 5 hour drive!

So 15 yo daughter Sadie and I have an open weekend at home.  I'd cancelled all usual weekend classes and engagements in anticipation of being gone.  So there is nothing on the calendar today and tomorrow, nothing we have to do.  This is what I see out the kitchen door (complete with reflected kitchen lights, lol!)



Sad:  Haven't seen sweet husband in almost 2 weeks now.  But we talk/text/skype-  a lot!!  And he will be home here for the entire week of Christmas!!

Glad:  Instead of this being the 4th of 4 weekends out of town, there is a lovely aspect to being at home.  Laundry and dishes are all caught up.  Tree decorating and present wrapping are next.  And this is what I see with a 90 degree turn from that snowy landscape.  Ahhhhh.

Conundrum:  In the not so very distant past (i.e., 46+ days ago), a totally free weekend would have been a joyous time for wine-drinking!  No concerns about driving, no having to be a certain place at a certain time-  a wine free-for-all!  And I DO feel a bit of that pull, toward that lazy, no-concerns, dreamy, floaty place.  But I could never stay there for long.  In my efforts to keep the 'tank' (of alcohol in my system) continuously 'topped up'-  I would always overshoot.  (There's that 'no more, thank you' button that is missing in my system!).  The next stage would be falling asleep, where-ever I was- bed, sofa, dining room chair).   Then waking up groggy and stiff, and starting again.

I guess that's where commitments and obligations, most of which involve driving here or there, kept me from just diving into alcohol and staying there.  But most Mondays I would think:  gosh, that sure was a short weekend!  I really didn't get to do much that I needed to/was looking forward to doing.

This weekend:  I'm focusing on:
     *the pleasure of working toward a clean tidy house
     *enjoying sweet daughter
     *enjoying some cooking-experimenting time
     *pinterest
     *Wall street journal
     *decorating house for Christmas and wrapping presents
     *a new mystery novel
     *catching up on charts and email from work (on my treadmill desk!)
     *working on quilts and glass beads
     *online yoga and pilates classes
     *frolicking with the dogs

That sure looks like enough to fill an entire weekend with nourishing and relaxing activities.

No Alcohol need apply!!

Friday, December 13, 2013

Sober Day #45- Respite and Empty Calories

Yet another calm, no alcohol evening at home.  Excellent!

15 year old daughter and I are planning to drive to the city where daddy/husband works today.  And attend his work Christmas party tonight.  BUT...

There is a winter snow advisory here in our city, and also in his city 5 hours north of here.  They already have about a foot of snow, and are expecting more snow starting this afternoon and continuing through the weekend.  I do have a new car with all-wheel drive.  I guess we'll start out, and be ready to stop for the night or turn back if the roads get treacherous.

It's funny, in thinking about this plans and possible modification, how little thought I've given to alcohol.  In the past, such a journey would have required stock-piling wine, in case we arrived really late- and arguing myself into no alcohol before the journey (at least I've always had good common sense about not drinking and driving- small favors!).  Even with husband's Christmas party this evening, it just hasn't been much on my mind.  And to me, that is really a miracle!

I know Wolfie will be back again, but it is such a gift to have this respite from dealing with him.  Now to tackle the empty calories I've been consuming to keep him at bay!!  On the other hand, I figure I was consuming about 800 - 1000 empty wine calories a day before, so that should give me some leeway!


Thursday, December 12, 2013

Sober Day #44- Relaxing Those Standards

The upcoming weekend is the 4th of 4 in a row that I am traveling out of town.  At least this weekend's trip is a lengthy drive, but not flights, as the others have been.  Which means we can be a bit more casual about exact departure time and about stuffing things in the car rather than packing them so neatly in suitcases.

Three weekends and one more to come away from home has meant, rather obviously, that I've had less time for domestic chores- dishes, laundry, cleaning, cooking.  I enjoy these duties most of the time, and enjoy having a tidy and clean home.  But with just small bits of time at home on weekday evenings, I've been falling behind.

Last evening, I was feeling overburdened.  I cancelled an evening engagement, and thought I'd catch up on a few of these things, and get some more Christmas decorating done.  This didn't feel good.  Even thinking about it made me feel tired and stressed-  those same Poor Me feelings that in the past would lead directly to a bottle of wine.

Instead, I made a different decision.  I made some comfort food, and spent the entire evening re-reading an old favorite novel.  And then I went to bed early.

This morning:  the dishes hadn't miraculously cleaned themselves.  The load of wet wash was still in the washer, and the floor remained un-vacuumed. And it was OK.  There was no lightning bolt from the heavens, condemning me as a slob or inadequate person.

The house may still be a bit of a mess when we set out tomorrow afternoon-  meaning we would come home to a less-than-tidy home Sunday evening.

And that is OK too.  I soothed myself last night.  I took care of myself the way I would care for one of my kids if they were overwhelmed.  And I feel FINE today!!

Wednesday, December 11, 2013

Sober Day #43- Sober Bedtimes

For the first couple of weeks of this challenge, time in the evenings seemed so empty.  About 4 PM, wine started calling to me.  It felt like a physical effort to resist it-  almost like there was an actual Wolf in the room with me, trying his smarmy best to have me join him in hoisting a celebratory drink.  (What celebration? Well, uh, you know, this is Wednesday and, uh, um, oh, it snowed last night...always something!).

By the time I got to 7 PM, I felt like I'd been through 20-30 rounds in a boxing ring, with an opponent who out-weighed me by about a hundred pounds.  I would tuck myself in bed by 8 PM because (a) I was exhausted and (b) at least in my sleep I wouldn't be thinking about alcohol.

Now, even though I'm only 6 weeks into abstinence, my evenings feel very different.  It didn't take long for me to find all sorts of cool, enjoyable things to fill my evenings:  Household projects, evening Pilates classes (I couldn't trust my driving to attend these while drinking), crossword puzzles, working on quilts, making glass beads, cooking, keeping up to date with professional literature, even playing Candy Crush...

Now I've swung to the other end of the pendulum-  there is sooooo much I want to do, that I have trouble tearing myself away and going to bed.  My total time in bed has been creeping downward again.

While drinking, I typically slept about 4 hours a night.  In my first few weeksof the 100-Day-Challenge, it was regularly 8, 9, even 10 hours.  Since I get up at 5:30, when I go to bed determines how much sleep I get.  I think 8 hours is ideal for me, which means being in bed by 9:30- and I've been fighting to get myself into bed by 11 PM.

My new sleep challenge:  Aim for being in bed by 9:30 most nights.  Sleep is so important for resilience and good-decision-making-  I need to remind myself that by leaving whatever fascinating thing I am doing and going to bed at my target time, I am equipping myself for better success in this sobriety project.


Tuesday, December 10, 2013

Sober Day #42: Cozy and Domestic- without Alcohol

More snow last night- it is so pretty- or, at least, it will be once it gets light!  The dogs have been out and are snuffling around as I wipe the snow off their paws and get their breakfast ready.

I have a number of major house projects underway.  The biggest is having two of the upstairs bathrooms redone.  I am bracing for workmen (work people?  Will there be any work-women?) to be in and out of the house for a few weeks.

But most of the projects are mine!  Purchased furniture to assemble, baseboards to paint, paintings and mirrors to hang; rearrange this and that, switch out this carpet for that.  This is all in anticipation of selling this house, probably 3-5 years from now.  But every time we've sold a house, we've done major fix-up projects just before selling- and said to ourselves, gee, we really should have done these before, so we could have enjoyed them ourselves.  So this is the Before!

Having these projects is very satisfying.  I am enjoying the nesting, the cocooning.  And I am specifically enjoying having sober time in the evenings to work on these things.  In the Old Days (that is, more than 6 weeks ago, giggle), I would have intentions of working on something of an evening, and probably even get a preliminary step or two done while having my first glass or two of wine- before deciding that it was really too much trouble, I'd wait til tomorrow, and just curl up with this book or magazine.

This is a Big Benefit of Evening Sobriety: Working on various projects or artwork- and Finishing!  And feeling so Satisfied!!

Wolfie has been staying away for a bit now- but I'm keeping my eye out for him.  Husband's big Christmas Party is on Friday.  With a new set of co-workers, none of whom I've met before.  In the past this would be a Major Evening for Mr. Wolfie.  I am determined that it will not be this time.

But I am not feeling sanguine.  Yes, I could skip the event- but my sweetie is really eager for me to meet the people he works with.  And since we are doing this Commuting Relationship thing these day- me working here, and him working a 5 hour drive away, in his own condo during the week- I feel that these events that reinforce our caring for each other are important.  If I said, I Just Can't Do It- he would be supportive, but disappointed.  And I'd rather not disappoint him.  So I am working on a new, enhanced set of Anti-Wolfie Armor for that evening.   (with my encouragement, he is following what I write on this blog.  It's OK, Sweetie, I can do it!!)


Monday, December 9, 2013

Sober Day #41- It's becoming a routine.


Another sober day and evening.  I spent yesterday evening on a flight so bumpy they never even got to do beverage service.  Oh, well, another temptation from those innocent-looking airline bottles of wine, eliminated, lol!  It's nice to be home, even to snow and ice.

That call of wine, even with all my recent traveling, has been getting softer and softer.  I know it happens like a post-op course, the way I explain it to patients:  It's not steadily a little better every single day!  There are good days and not-so-good days, but the general trend it toward getting well.  In the same way-  I know from reading the very helpful posts on various sober blogs-  that one can be progressing along, minimal problems with resisting wine- and suddenly, whammo, that Wolfie steps out from behind a tree, crooks his fingers, and hisses:  "Come find happiness with me".  So I am staying alert, and planning defense strategies for when that happens.

But for today, for me, all is calm.


Sunday, December 8, 2013

Sober Day #40- Disarming the Anxiety-Creators!!

I'm in Georgia- heading home today, I hope- if the ice and snow at home don't delaly/cancel flights!

I used to drink a lot at medical meetings - "everyone does"-  or so I thought, until I looked at this meeting through no-wine eyes.  When I noticed that very few people drank more than 1 or 2 drinks-  and the ones who did more often tended to be reps from the medical device, etc, companies that were exhibiting there, not the docs.  Another drinking myth/excuse shattered, lol!

I planned distractions for myself.  I love colors- so I invested in a new box of 96!!!! crayons.

And a new drawing pad to go with them.  I've entertained myself by watching for color combos and motifs that interested me, and recording them in my sketch book.

I wish there were a systematic, methodical way of hunting down and revamping all the false assumptions I/we have made:  About ourselves, alcohol, how we deal with stress, how we fit into the rest of the world.  But so far the only technique I've found to to pounce on an 'automatic' thought as it tries to disappear around the corner from consciousness.  If I can do this, I can haul it back into the light, and examine it:  Is it true?  Does it serve me?  Is it kind?  Is there a better choice?

This morning the little tail I caught and dragged back into consciousness had to do with aging. I am 61.  And there is a part of me that is apparently ashamed of this.  That feels I have to hide my age, not as far as looks (which are pretty good, glad you asked, lol!)- but as far as function.  If I am climbing stairs and someone behind me is climbing faster, I feel ashamed, defective, I should be able to keep up, to surpass.  Now that I'm thinking, I guess it has more to do with physical performance than mental function (again, pretty good, thanks!).

Is it true?  What?  That I should be able to do anything and everything anyone else of any age and training can do?  Obvious nonsense.  We all come with different physical abilities, and our training choices then further differentiate us.

Does it serve me?  Nope.  It's pretty stupid.  Who cares how fast I climb steps? Actually, the important point for me is that I am climbing them, not just always taking the elevator.  This is something to feel good about, proud of.

Is it kind?  No, it is rather mean. Why should I attack and degrade myself for anything, much less how fast I am climbing the stairs??

Is there a better way?  Sure.  Remind myself:  People come in all sizes shapes and abilities.  People have all sorts of priorities, some including fitness, and some not.  You choose to emphasize fitness- and that's great.  Compare yourself to what you do, how you are meeting your goals:  Can you go that mile a bit faster than this time last year?  Fabulous!!  Can you now do a biceps curl with a little more weight, or hold that difficult yoga pose a few seconds longer?  Good for you!  These are accomplishments that are in line with the priorities you have set for yourself, which is what matters.

What does this have to do with drinking, or rather, non-drinking?  I think it is, for me at least, the steady erosion of multiple critical trains of thought like this that add up to more and more anxiety.  And anxiety and fear of not being enough, these are prime driver of drinking.

I hope catching and defanging enough of these rascals will facilitate sobriety!!



Saturday, December 7, 2013

Sober Day #39- Alcohol Dream and What Really Matters

Last night I had my first dream- ever, as far as I can recall- that included alcohol.  In the dream, I was at day #38 of this 100 day challenge.  The dream seemed to be a bit mixed up with Thanksgiving, in that some house that my extended family was gathered in, I had to go downstairs (like to a lonely basement-type place) to prepare all the gravy.  Down there, I found an airline-sized bottle of wine.  I drank it surreptitiously while preparing the gravy.  I gave me a little buzz that I enjoyed.

I chewed to chiclets of gum (do they even have these any more?) to mask any smell on my breath.  Obviously, I did not want anyone else to know that I had had wine.  Then I went back to join the other- and felt very conflicted.  Interestingly, I did NOT feel like I wanted more wine.  But I wasn't sure how to record this on my blog.  To Lie? To admit such an untended slip?  I was in the process of pondering this when I awoke.

I was soooooo relieved to realize that had been a dream, that I had not really broken my promise to myself.  The profound intensity of this relief took me by surprise.

I kind of backed into this 100 day challenge, on a whim, without really planning to do it.  And yet, as time goes on, it is becoming more and more important to me.  And more and more illuminating to see clearly the many things I was avoiding, hiding from.  And I become more and more interested in finding out who I really am.

What a surprise!

Friday, December 6, 2013

Sober Day #38- Travel & Kindness

Another flight today.  No wine.  It was OK.

I'm sitting at a resort outside Atlanta, temp nearly 80 degrees, sunny, looking out over a beautiful lake.  And at home everything is at a standstill due to an ice storm.

Traveling alone can make me pensive.  Today I've been thinking about what I was using alcohol to avoid, to mask.  What parts of my best self do I find uncomfortable to acknowledge, to appreciate?  Using a guideline for this trip of making self-care and sobriety my top priorty (screw anything that interferes with this!) is an interesting experience.  I am appreciating myself, perhaps even cherishing and celebrating myself.  This, I think, is something those of us who turn to excess amounts of alcohol do not do well.

What, I think, just what if, I treated myself like this all the time?  With honor, tenderness and care?  (as distinct from shirking necessary duties, turning into a lazy slob, or not doing anything productive!)  I mean, just what if I believed it was true?  That I am a good, kind, honorable being with a right to exist and a duty to be true to myself?

If I'd started from that place, I don't think alcohol would ever have seemed attractive?  How do we learn to be so mean, so careless and hurtful to ourselves?

The good part, however, is that we can recognize and change this.  This is a journey we are all on, and I am so grateful for this cyber-community the celebrates and reinforces this new world-view and self-view!!!

Thursday, December 5, 2013

Sober Day #37- Time Crunches and Alcohol

Like many people, I've always had sort of an uneasy relationship with time.  I have this Endless To-Do list, and seem to have an underlying magical hope that time will expand to accommodate my needs.  When, strangely enough, this doesn't happen-  I end up frustrated and mad at myself.

And, I am an introvert.  At work, I function very well as an extrovert-  but I definitely need time alone to recharge (as opposed to DH, who draws energy from parties and social functions).  And especially 'making time'-  quilts with my sewing machine, and glass beads using my torch and kiln.  None of these items travel well.

I have been out of town for most of the past two weekends, and will be gone for the entire weekend the next two weekends.  Since I really cherish my weekends at home, my 'nesting' and 'making' time-  this is very hard for me.  Time seems to shrink, giving me barely enough time for necessary activities of daily living- and packing, and unpacking, and packing...

Usually this kind of a time stack would have me grabbing and gulping glasses and glasses of wine the I 'deserved' because of the stressful situation.  And then (serendipitously?  Coincidentally?) I read Sober Mom Write's post yesterday.  All about taking care of oneself, making life as stress-free as possible. Having only One Job:  staying sober.

And my Poor-Me-I-Need-Wine status started to crumble.  I started really thinking about what I could NOT do, what tasks and obligations I could put off, reassign to someone else (even if this meant paying them to do so) or just plain not do.  And about how I might 'treat' myself, add in some things that feed my soul even with this hectic schedule.  The specifics of these actions will obviously vary from person to person-  and my list is growing steadily.

I'm not sure whether not reading Sober Mom Write's post would have led me to give in to that calling of wine, but I do know that reading this post had a profound impact on how I am planning my support for the next weeks.

Self Care, I guess, is a major component of successful abstinence!

Wednesday, December 4, 2013

Sober Day #36- Month Two Blues

The past few days I've been having a more difficult time with alcohol-resisting.  I've even caught the thoughts going through my head "Why am I doing this stupid challenge anyway?" and "Surely just one night of drinking wine wouldn't harm me now?" and "I wouldn't even have to admit it on my blog!"

Oops.  Full stop.  Think again.

#1:  I am committed to telling the truth, the whole truth, and nothing but the truth on this blog.  So much for lying about alcohol intake!!

#2:  I am doing this challenge because alcohol was affecting much more of my life than I felt was safe or healthy.  I am doing this challenge because I made a commitment to it. And I am stubborn.  And I am competitive with myself.  And so I will complete these 100 days, even when it is uncomfortable or stressful.

#3:  In light of these truths, even one night of wine now would be harmful, and I will not do it.

Sigh. 

Tuesday, December 3, 2013

Sober Day #35- Sleep vs. The Attractiveness of Alcohol

Yesterday was the first time in a number of weeks that I felt a yearning for alcohol.  Specifically, I wanted the rosy-hued lenses supplied by about 2 glasses of wine.  I wanted that feeling of remembering all I had to do, all the commitments coming due-  and not really caring.  That feeling of being in a protected place where nothing bad could touch me, where nothing demanding really mattered.

WTF?  I said to myself.  Why now?  What's going on here?  I remain committed to doing these 100 days without alcohol, but found myself thinking longingly to Feb 2014 when the 100 days will be up-  wouldn't a nice glass of dry sherry taste good, sitting by the fire and gazing at the snowy landscape outside?  Mmmmmm.

And then I saw a possible connection.  For most of my almost-5-weeks of abstinence, I've been sleeping a lot.  Seven hours at a minimum- sometimes 9, once even 10 hours!  This is in contrast to my former staying-up-late-having-one-more-glass-of-wine, with about 4 hours as my usual time in bed.

Sunday night I stayed up late finishing a fabulous book.  It was after 1 AM when I got in bed, and I was up as usual at 5:30, meaning just a few minutes more than 4 hours of sleep.  It was the first time since starting this challenge that I got so little sleep, and the first time since starting this challenge that alcohol seemed so attractive.

I am guessing there is a connection, that insufficient sleep decreases my psychic resilience, my ability to cope gracefully with daily life.  Therefore leading to more stress (even though I didn't overtly feel more stressed than usual).  And this, in turn, leading to feeling the need for relief in the form of alcohol.

Hmmmmmmm.

Perhaps a productive approach for me would be:  When alcohol is calling to me louder than usual, look carefully for what sources of stress might be in play.  And tackle the stressor directly, rather than seeking to quiet it temporarily with alcohol.

Monday, December 2, 2013

Sober Day #34- Christmas, Autocorrect and 21st Birthday!!

Wow, I'm 1/3 of the way to finishing my initial 100-day challenge.  It's hard for me to believe I could actually do this!  Although now I feel pretty confident of being able to finish the full 100 days-  even though those 100 days encompass holiday parties, Christmas and New Year's Eve.  Phew!

The good thing about this time of year, though, is the vast number of satisfying activities that don't necessarily require alcohol.  Trimming the tree?  On my agenda for today!  Finishing the match-making of friends and family with gifts they will love?  80% done!  Enjoying wrapping the presents, beginning stuffing stockings?  Next weekend, I think.

And great news!  Older daughter, who lives about an 8 hours drive away, will be coming home later this month for a few days, and will be here to celebrate her 21st birthday with us! (She is a December 22nd baby).  I texted her that Dad would take her out for a gin and tonic, but we'd stick to flavored seltzer water at home (she knows about and supports my participation in the 100 day challenge).  But Autocorrect changed my text to "Gun and Tonic"- and she allowed as how Gin was more enticing to her than Gun, lol!!  That app is full of giggles-  yesterday it also changed 'septoplasty' to 'sextuplets'-  a veritable comedian!!

And no wine in my life these days!  It does get a little easier.  But not Easy.  

Sunday, December 1, 2013

Sober Day #33- Vitamin D deficiency and Alcohol Use Disorders

Vitamin D (the one we get from sun exposure on our skin) deficiency is wide-spread in the US, and its lack is associated with occurence and worsening of all sorts of chronic inflammatory diseases.  For example, if you plot the average vitamin D levels on a US map, levels get lower and lower as you go further north- which makes sense if you consider the sun exposure and intensity increases as you head south.  The decreasing levels as you head further north correlate with increasing ER visits for asthma. 

This study finds that lower vitamin D levels are associated with more alcohol-use problems in an Asian population.  It's not much of a stretch to guess that the same pattern occurs in the US.  The association, of course, does not prove or disprove causality.  Does low vitamin D predispose to alcohol overuse?  Or does alcohol overuse cause vitamin D deficiency?  Or is there even a direct connection between the two, or might they be totally independent variables?  

What action to take while waiting for more data to answer these questions?  I suggest that each of us should check our serum vitamin D levels, a simple blood test.  If we are indeed low, taking enough vitamin D to bring our levels at least halfway up the range of normal levels (i.e., at least 50-60 nmol/L) will have all sorts of health benefits, and might make (this is a stretch, not fact) early sobriety easier.  (More to come in future posts about other baseline blood and other testing that might be useful in early sobriety).

Abstract

BACKGROUND:

Mounting evidence suggests that deficiency of vitamin D may be associated with major health problems, including alcohol-use disorders (AUD) and major depression (MD). This study aimed to identify the vitamin D status of Nepalese inpatients with an AUD. We explored socio-demographic and alcohol-use related correlates and the relationship between vitamin D deficiency and comorbid MD.

METHODS:

A cross-sectional study was conducted on AUD inpatients (N=174) at eight alcohol/drug treatment centres around Kathmandu. Structured questionnaires were administered to assess the socio-demographic and alcohol-use parameters and to establish DSM-IV diagnoses of AUD and MD. Vitamin D deficiency was defined as a serum 25-hydroxyvitamin D (25(OH)D) concentration of <50nmol/L.

RESULTS:

The prevalence of vitamin D deficiency was 64%. Higher age, having a stable job or business, shorter time since last alcohol intake and winter serum samples were related to having lower 25(OH)D levels. Several features of AUD severity were associated with low vitamin D levels: guilt about drinking, using alcohol as eye-opener, and history of relapse after alcohol treatment (p≤0.03). Patients with a comorbid major depression, in particular secondarily depressed cases, were less likely to have vitamin D deficiency (X(2)=6.8; p=0.01).

CONCLUSIONS:

This study confirms high rates of vitamin D deficiency in alcohol treatment sample and shows a positive association between vitamin D deficiency and severity of alcohol-use disorders. Competing risk and other confounders may help explain the vitamin D status among patients with alcohol-use disorders and comorbid major depression.
Neupane SPLien LHilberg TBramness JG.  Vitamin D deficiency in alcohol-use disorders and its relationship to comorbid major depression: A cross-sectional study of inpatients in Nepal.   2013;133:480-5.


Saturday, November 30, 2013

Sober Day #32- First Holiday/Vacation without Wine

Today it is official!  Thanksgiving without wine, and a week's vacation in New Orleans without wine.  Truly a Milestone for me.

These are the things I did to help ensure my No Wine success this week:

(1)  As soon as we arrived, I stocked up on flavored seltzer water and diet soft drinks.
(2)  I permitted myself food treats this week that I usually steer clear of- my usual diet is No grain, No sugar- and this week I had some of both.
(3)  I arranged distractions of Non-Wine things I enjoy:  crossword puzzles, jigsaw puzzle, new embroidery threat, a quilt that was done except for hand-stitching the binding, a large stash of magazines and a few new books, etc
(4)  I enlisted the help of a few trusted folks- DH, one sister, my nephews- to help distract attention from me if there were questions about my not drinking.  DH was kind enough to refrain from ordering any alcohol when we ate out.
(5)  I took my kindle with me to social gatherings, and occasionally excused myself for a few minutes of Reorientation by Book.
(6)  I invented the Detail Game:  When I feel disoriented or regretful about no wine, I refocus on my surroundings.  I challenge myself to notice at least 10 details that I haven't seen before.  This turns out to be fascinating:  from cracks in the ceiling (a la Madeline in Paris?) to a carved wooden edge to the table I'd never noticed, to a column of caged oyster shells at the restaurant-  this approach seems to add a richness and grounding.

What do you do to help set yourself up for No Alcohol Success?


Friday, November 29, 2013

Sober Day #31- Eating to support Sobriety

Being a somewhat insatiably curious person, I find myself wondering about how we in early sobriety can use nutrition to support ourselves, how food and supplements might hasten our return to vibrant health.  And there is a ton of information available, as my initial google searches have identified.

On the other hand, as a scientifically-trained physician, I am highly skeptical of unattributed blanket claims.  Things like:  Eat more vegetables, Never eat xxx, always eat a lot of yyyy- grab my attention in a bad sort of way.

So I have given myself a new task:  Developing a health assessment useful for establishing a health baseline on quitting alcohol, and coming up with evidence-based recommendations for food and supplements.

Evidence-based means that I can show you (a) specific article(s) from peer-reviewed medical journals that provide good evidence to support that recommendation.  It is the opposite of the 'snatched from thin air' recommendations found proliferating on the web.

As soon as I figure out how to do it, I will make a separate page summarizing these ideas, with references back to each specific post detailing the scientific evidence for this particular recommendation.

My Thanksgiving, BTW, was alcohol-free and pretty awesome.  This was my first major holiday without alcohol, and it went pretty smoothly.  Thank goodness I have a relatively drama-free family, so I didn't have to cope with the massive drinking around me or other major crazinesses that many of our community had to face, and I am grateful for that!!

Thursday, November 28, 2013

Sober Day #30- Happy Thanksgiving!! The Visit

Last night a dear friend I hadn't seen in a while visited us in our rental house here in New Orleans.  Our typical evenings together are usually sharing wine while catching up on news.   I texted her about my 100 day challenge- expecting that she wouldn't drink when we got together.  Yet when I texted her yesterday about what she'd like to snack on, she replied:  white wine and I eat almost anything.

Well, I thought, I can handle this.  I asked DH if he would please buy a bottle of white wine, open and pour it for her, and handle pouring refills so I didn't have to handle the wine bottle at all.  And so he did.

Observation #1:  Friend is a devout Catholic.  She mentioned how another friend of hers was also doing a 100 day no-alcohol challenge- for a special novena or something (please forgive, I'm sure I have the religious terminology wrong).  And friend approached my challenge like it was no big deal, like it wouldn't be any harder for me than, say, giving up sweets for Lent.  And I actually found this very refreshing.  Since it was no big deal in her mind, it made it easier for me to say to myself:  This is no big deal, you are just choosing not to drink wine tonight.  It turned out to be very refreshing NOT to have a moral/judgmental component attached to my actions.

Observation #2:  I bought a big jigsaw puzzle for us to work on as we talked, as distraction for me.  This worked well.  And as we sat at the DR table doing the puzzle, I had the same great time I always have with her, complete with lots and lots of belly laughs.  I will admit we also had a ton of great food to nibble on, which helped me feel not-deprived (back to my usual low-carb eating after this week in New Orleans!!!).  And not-drinking was not nearly as hard as I feared it might be.

The things I keep learning about sobriety, they continue to surprise me!

Happy Thanksgiving and Many Blessing for the coming year!

Wednesday, November 27, 2013

Sober Day #29- Bone Density Improvement after Quitting Drinking!

As a, ahem, mature female, I do think about my bone density.  I want to keep it strong and normal to support a healthy active life as I age.  My weight-lifting, pilates, yoga, TRX, cardio, etc, certainly help-  but I also know chronic alcohol overuse has an adverse affect on bone density.  Therefore I was very happy to come across the following article.  What I have reprinted here is the article's abstract.  The full reference is at the bottom of the post, for anyone who wishes to review the original article in it's entirety.  It is available at www.pubmed.com as a free full text article.  I have highlighted the bits that are the most relevant!  

AIMS:

The aims of this study were to assess bone mineral density (BMD) and content (BMC), osteocalcin, serum telopeptide, PTH and vitamin D in alcoholics, and to determine if a 6-month period of abstinence leads to changes in these parameters.

METHODS:

Serum osteocalcin, insulin-like growth factor 1 (IGF-1), telopeptide (40 patients) and 1,25 dihydroxyvitamin D, were measured in 28 controls and 77 alcoholic patients, 48 of whom were evaluated again 6 months later. All patients underwent whole-body assessment of BMD by a Hologic QDR-2000 (Waltham, MA, USA) bone densitometer, at the beginning of the study and 6 months later.

RESULTS:

Patients showed higher serum telopeptide levels **(0.59 +/- 0.40 versus 0.19 +/- 0.10 nmol/100 ml, P < 0.001), lower IGF-1 [median = 49, interquartile range (IQR) = 31-121 ng/ml versus 135, IQR = 116-237 ng/ml, P < 0.001], vitamin D [26.5, IQR = 17.0-37.8 pg/ml versus 82.4 (IQR = 60.9-107.4 pg/ml, P < 0.001] and osteocalcin (2.1, IQR = 1.1-3.6 ng/ml versus 6.65, IQR = 4.9-8.8 ng/ml, P < 0.001) than those in controls. Patients also showed lower BMD values, Z- and T-scores at many levels of the skeleton and reduced total BMC. After 6 months, those who continued drinking showed a loss of bone mass, whereas those who abstained showed either no change or increase, differences being especially marked at pelvis, right arm and total BMD and BMC. Simultaneously, abstainers showed a significant increase in osteocalcin (versus a decrease among those who continued drinking). Serum telopeptide increased in both groups.

CONCLUSION:

Ethanol consumption leads to osteopenia, and decreased serum osteocalcin, which improve with abstinence, whereas those who continue drinking show a worsening of both parameters.

Full Reference: 

Tuesday, November 26, 2013

Sober Day #28- Fun in New Orleans!

I do love New Orleans.  I may have initially, long ago, decided I like the city because alcohol is so much a part of the casual culture here.  I wonder?

It is so interesting seeing New Orleans without alcohol-  without planning meals in restaurants to be sure they are in a place that serves alcohol, without mapping out where the local wine/liquor stores are, without having whole chunks of my day defined by alcohol consumed.

I actually think I may like being sober.  This surprises me, since I'd thought of a life without alcohol as a Life defined by a continuous feeling of Deprivation.  And I'm not really feeling deprived, except in a minute or two, here and there, mostly when a Habit-Thought relating to obtaining or drinking alcohol kicks in, and then I realize, Oops, I'm not doing that right now.

It is still an alien feeling, though, this feeling fully present all the time, to myself, my companions, my surroundings.  A wee bit I feel like I'm in a strange foreign country, and equally I feel like I'm home to a comfortable loving place that I'd forgotten I belonged to.

This is a sensually-rich city. The house we are renting is just off St. Charles, and I love hearing the streetcars go by!   Audobon Park is just a few blocks away, and what a lovely place that is!!  DH and I are both still liking the idea of retiring here eventually- and we're having fun driving around (it's rainy, making our usual walking-biking mode a little less attractive than usual) vetting different neighborhoods and imagining ourselves living in them.

We are now off to lunch in a French Quarter restaurant owned by the family of one of my patients-  apparently a New Orleans institution that I've somehow missed before.  I'm almost drooling in anticipation of more great food!!