In this episode:
I discuss my experience of having alcoholic liver disease (ALD) and answer common questions. How did I know that I had it? What was the treatment? What were the signs of ALD?
Resources:
NPR – Sharp, ‘Off The Charts’ Rise In Alcoholic Liver Disease Among Young Women
Bottomless to Sober – Workshops, Writing Classes, and Coaching
Transcript:
Hey, so for today’s episode, I wanted to talk about ALD, alcoholic liver disease. I have a couple of posts on TikTok that had gone viral in the past, and it’s funny because I still get recurring messages and questions from those posts. And I thought, you know, I have a new platform, so let me go ahead and talk about it here. So first to give you context in terms of what, because one of the questions, first question I get is, well, what did your alcohol consumption look like? So I’ll tell you. From when I was 18 up until my divorce in 2017, I drank, I didn’t drink every day. I was definitely a heavy drinker when I drank. So definitely a binge drinker, but I didn’t have opportunities to drink daily because I lived with my parents or I was living with my then husband, you know, ex-husband now. And so living with other people, in those days always kept me sort of in check, right? So I only got to binge drink on occasion, but I wasn’t able to drink how I wanted to drink. I got to drink how I wanted to drink come my divorce, which was 2017. And at that point I transitioned to daily drinking. So the daily drinking went from 2017 to about 2019. And so I’ll talk a little bit about that. So when I started drinking on a daily basis was when I lived on my own, and that was about a bottle of wine a day. Bottles of wine on average are about five servings, let’s say five servings of alcohol, which is already heavy, right? So the CDC states that for women, heavy drinking is eight drinks or more in one week. So I was having five drinks in a day. So five times seven is 35. So that’s already four times the amount of what. they state is their limit. And that’s the CDC specifically outlining heavy drinking. They, you know, so we already know there’s tons of newer research that is pointing to the fact that just one drink a day is harmful, right? Like one is not necessary. With that being said, let’s talk a little bit about tolerance and dependence, right? So if you think about your central nervous system, it’s got a general set point, right? Like there’s a certain place where everything is balanced. But then if you introduce a mind-altering substance like alcohol or anything else, right, your brain is going to counter it because it wants to establish that equilibrium, that homeostasis, so to speak. So if I’m drinking the five servings of wine a night and I’ve made it a habit because I’m doing it every day, what my body is going to start doing is my body is going to, A, counter it with that same energy, But then B, my body is smart. The brain practices neuroplasticity, which means its ability to learn, right? And because it’s learned this new habit, it’s also going to prepare to receive that amount of alcohol. So it’s going to overcompensate, which means that by it overcompensating that opposite action, it’s gonna take more alcohol for me to feel the way that I felt when I drank the five glasses of wine, the one bottle. which means that over time, I had to go from the one bottle of wine to the bottle of wine plus a shot, plus the bottle of wine to a half pint. And then eventually I was like, oh, you know what? This wine is actually rather inefficient. So I’m gonna stop drinking the wine, give me the liquor. And then it was from the half pint to the pint to the fifth. By the time I was drinking a fifth of alcohol, a fifth of alcohol is about 17 units. So that’s 17 drinks in a day. And that was probably by late 2018, early 2019, that I was drinking that much. So I probably, at the time of my diagnosis of alcoholic liver disease, it had probably been about a solid nine months or so of drinking that extreme. But overall, heavy drinking for about a period of two years. So that’s one of the questions that I get often. The, and the… Yes, so the next question that I often get is, how did I know that I had alcoholic liver disease? I mean, the way that I officially knew was when I got the blood work back that told me that I had alcoholic liver disease. But what I will say is, how I knew that something was wrong, that feeling was kind of always inside of me, right? And the thing is that I always had… the ill feelings, I always had the side effects of alcohol. It’s just that over time, they were just getting worse and worse and worse. So I don’t know because obviously I wasn’t taking an enzyme test every day to tell you when, what I was feeling went from bad hangovers to actual alcoholic liver disease. But what I will do is go through kind of like what I was feeling and going through. So as my alcohol consumption stayed consistent on a daily basis, right? Things that I started to notice was I was waking up with shakes. So my hands were shaking. They were shaking to the point that if I wanted to drink a cup of coffee, I would have to grip the cup with both hands to hold it steady enough so that nothing would splash or spill as I lifted it to my mouth, right? To give you some sense of that. I was a teacher and I have this very clear memory of I was helping my co-teacher with doing measurements and I was holding a ruler out. And when I was holding that ruler out, that ruler kept shaking. And I had a student say, Ms. Duenas, why is your hand so shaky? And I mean, I covered myself immediately. And I was like, oh, I drank so much coffee. It makes me so shaky. Sorry about that. Can you come hold this for me? And that’s how I covered myself. Insane, right? But that was the reality of how bad my hands were shaking. Another symptom that I dealt with was my digestive system was messed up. So what that looked like was waking up with nausea, vomiting bile. Like I would sit there and gag over the sink and if something came out, it was like green and nasty and like it felt like acid burning. That’s what it felt like. And then I would feel this also throughout the day. So I had a really hard time eating and even the most delicious of foods, they really lost their flavor for me because I had no desire to eat them. So I was also losing weight, but I still kept the belly because when you have liver disease, you also retain fluid. So my belly was full of fluid, and then my feet and my ankles were swollen, my fingers were swollen. And I remember with my feet, if I wore sandals, it was almost like you were baking bread and there was a string tied around your foot and you could just see like the little crease of the sandal straps cutting into my feet and my ankles. That’s how swollen my feet were getting, right? And my fingers, I mean, I couldn’t wear any rings because it was just like my hands were always so swollen. My cheeks had also been swollen. If you look at old photos of me, I look like a little woodchuck a little bit because my cheeks were just so poofy all the time. So there was a lot of swelling even though there was weight loss. Another thing that was affected was my vision. I, if you look at pictures of me from about 2018 to 2019, you will see that I was wearing prescription glasses. Now I went to the doctor about two weeks ago, this is August, 2023 as I’m recording this. And I went to the doctor about two weeks ago and my eyes were checked and my vision was 2015. Normal vision is 2020. So my vision is even better than your standard good vision, right? Other, another really weird symptom that I had was coughing. I had the worst cough ever. It was like I was hacking. There had been a few times that I was sent home early from work. I was sent to urgent care. I had gotten prescribed asthma inhalers. I had done all sorts of breathing tests and doctors couldn’t find out what was wrong with me. And of course I wasn’t disclosing that I was drinking heavily. And the only thing that made my drinking feel better was drinking. alcohol. That was the only thing that would make that cough go away. And so I think I’m covered just about everything. Oh, and the other one, of course, bruising. If I bumped into anything, I would get a nasty bruise. And the other thing too, actually, I think that’s it. Yes, I had like a brain fart. So yeah, the heavy bruising, the weight loss, the swelling. the shakes, the nausea, also going to the bathroom, everything was runny, right? So like if I went number two, it was just straight up like diarrhea. There was like nothing solid ever coming out of my body. Right? And so I felt horrible. Suffice it to say, like all that is to say, I felt horrible. And I knew that I wasn’t doing well, but instead of taking that as a sign of, oh, maybe I need to go. get some help and explore what I have going on. I did my research and I found a medication that is typically used to treat alcohol withdrawal, but it has different purposes. And I got that to address my withdrawal symptoms. And what did that do? That enabled me to drink for more time how I wanted to drink, right? So when I would wake up in the morning, instead of missing work, because my withdrawal symptoms were so bad, I could take this medication and then go to work and function. And again, and I did more than just function. I excelled at work. I was, this was the year that I won the Kentucky State Teacher of the Year award. So even though I was drinking a fifth a day, I was still being a really phenomenal educator, right? It was the weirdest like split personality type of thing. And I kept that up because I had figured out how to manage those withdrawal symptoms. But again, my body… was going through so, so much. Again, like I said it earlier, right? You have a set point that you’re at, and then you introduce a mind-altering substance, your body’s going to counter that. And when your body counters that, what you are going to feel in your body is the complete opposite of everything that mind-altering substance does. So in the case of alcohol, if alcohol was relaxing, the counter to that is going to be huge waves of anxiety, right? that nauseating feeling in your stomach, the shakes. And then when you drink the alcohol, the shakes go away, hands become steady, et cetera. But again, because my body had gotten in such a habit, it needed more and more to create that sense of ease. And so it really wasn’t creating a sense of ease because again, my body would counter it so hard that all the withdrawal symptoms were incredibly, incredibly strong. So come August of 2019, I finally have my annual physical. And when I go to the doctor, my blood work comes back. And then I officially know, right, that I have alcoholic liver disease. And so there’s two enzymes that are tested when you get your liver checked. The first one is ALT, the second one is AST. Each of these essentially are enzymes that if your liver is damaged, these enzymes leak out into your bloodstream and it’s found, you know, obviously throughout your body, right? And so for example, what is normal to find in the bloodstream of ALT is anywhere from 13 to 69 units per liter of blood. In my case, I had 160 ALT as a reading. So I had 160 units per liter of this liver enzyme flowing through my body because my liver was that damaged. Then with AST, the normal range was 15 to 46 units per liter. And in my case, it was 429 units per liter. That was nine times higher than what it was supposed to be. Nine times. So that goes to show you how hurt, how injured, how sick my liver was. that these enzymes were all over my body because my liver wasn’t well. So again, if you are feeling like you are potentially at risk of having liver disease, I strongly encourage you to go check with your doctor. Their treatment, what they prescribe for you may be different than what was for me, but what worked for me, because the other question I get is, well, how did you fix it? all I had to do was stop drinking. And I say that saying, oh damn well, that all I had to do was stop drinking is a really hard, I think, thing to do, right? Like, let’s be honest, it’s not that simple to just quit drinking because we’re talking about a crippling addiction that caused the liver disease, right? It’s not that simple to just, oh, oops, and my mic just fell. It’s not that simple to just like, oh, you know, stop drinking and that’s that. because obviously the liver disease is a physical manifestation of a problem with huge psychological roots, right? Because alcohol is just a symptom of whatever else we had going on. But that is what worked for me. I didn’t have to take any additional medications. I didn’t have to do anything else. I just had to stop drinking and stay stopped. Other things to note that are really important. So when I got this diagnosis, the doctor made it pretty clear that probably within six months to the year, I could have developed cirrhosis. Now, the wild thing about cirrhosis is that once you get that diet, alcoholic hepatitis can heal, right? What I was dealing with was liver damage, but the liver is a really resilient organ. So my liver had the chance to heal. But if I had gone farther down the line, farther down that spectrum into the area of permanent scarring, which is cirrhosis, at that point, there’s no coming back from that. Now, some people with cirrhosis can live longer lives, right, if they stop drinking and stop additional liver damage, there’s ways to manage also adjusting your diet, etc. But if you have cirrhosis and you keep drinking, you are cutting, you’re counting your days essentially. And so that’s what the doctor had warned me of. So with that being said, a couple other things that I wanted to mention, right, another question that I had was, Oh shoot, what was that question? Oh, well, I don’t drink a fifth a day, so I should be good, right? That is one of the great questions that I get. And no, it doesn’t take a fifth. It takes a lot less than a fifth to cause liver damage. So first, any recent resource from 2022, 2023, in terms of alcohol consumption will tell you, especially if you’re looking at anything coming out of Europe or Canada, will let you straight up. No, just one is a problem, right? Just one is a problem. The CDC defines heavy drinking, which I’ve said it already, but to reemphasize, as eight drinks or more per week for a woman, 15 drinks or more per week for a man. So somehow biologically different if you happen to be a woman listening to this, right? You already are at a disadvantage in terms of alcohol consumption because your body handles it less well than men’s bodies do. I mean, nobody’s body handles it well, but women’s bodies… really don’t handle alcohol well, and it has harder side effects. With that being said, there was a, well, an article from NPR that I actually was a part of, the article was titled Sharp Off the Chart’s Rise in Alcoholic Liver Disease Among Young Women. And that article was showing that something drinking up to a bottle of wine a day increases a woman’s chances of liver disease severely enough to require hospitalization. And even binge drinking can put a woman at risk of liver damage to the point of hospitalization. Right? So it doesn’t, you don’t have to be to the extreme of where I was drinking a fifth a day. For you, it can be as simple as that bottle of wine a day that seems really classy and cute. That can be enough. And so that is just really, really important information for you because there is this conception that you have to be much older or drinking so heavily to get sick. And it actually does not take that much. Again, if you think about my time period of heavy drinking, my time period of heavy drinking was only two years. And I was 34 years old when I was diagnosed with alcoholic hepatitis. So I was very young, had not been drinking heavily for that long. And honestly, I probably was already having liver damage at about a year of drinking heavily because I remember feeling sick. only a year into drinking heavily. It’s not like it didn’t take that long. So in terms of what do I do with this information, right? You’re listening to this podcast. So step one is you do need to address the drinking. Now, what can that look like? Obviously I do provide coaching support. What that looks like is also encouraging you to find community. It is incredibly hard to get sober on your own and you don’t have to do it on your own and you don’t deserve to do it on your own. You deserve to feel welcome in a part of a space where you aren’t the only one in your world dealing with this, right? So I encourage people always, and my clients always to find community. But then also there’s a lot of work to be done. Is some of this work to be done with a therapist? Do we have old history that we need to work on healing? And if so, I absolutely recommend getting a therapist. Are you needing support with action plans and accountability and support and looking at different routes to recovery and get a coach? I would say schedule a session with me and see, let’s see what we can do together, right? Aside from that, do you need medically assisted treatment? There is absolutely nothing wrong with getting on medication. So all of these different things are questions to explore. It’s food for thought. And I believe that I, at this point, I’ve covered everything that I really wanted to say in terms of the alcoholic liver disease, but it can get better for many, not for everyone, right? If you go far down enough to cirrhosis, you can’t necessarily bounce back from cirrhosis, but you can still manage cirrhosis. And I think that that’s the other important thing, that if you’re listening to this and you’ve got a diagnosis of cirrhosis, I want you to understand that you have the power to make it worse or you have the power to manage it where you’re at, right? So I think that there’s still a lot of power even with that diagnosis. But if you have alcoholic hepatitis, you absolutely owe it to yourself to give yourself a shot to heal that liver. Because today my enzymes are absolutely normal. I had a physical a couple of months ago and I don’t remember the exact numbers, but my numbers were both for the ALT and the AST. They were both within the healthy range. Right? So there’s absolutely that opportunity to bounce back. um, you know that weight that I had lost, I have gained it back, right? Um, I’m healthy. I have a very healthy appetite. And so my vision is perfect. You know, I don’t scar. I go to the gym and lift heavy things and bang into heavy things all the time and I’m not bruised up like I’ve been in the fight. So there absolutely is hope in getting alcohol free, getting sober and staying away from that damn poison. It takes very little alcohol to cause a lot of damage and it’s just not worth it So if you’re needing support again reach out my website is bottomless to sober.com I have other resources that are not just coaching so check them out and Yeah, I if this was helpful to you, please share it with someone else. Thank you so much
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