Drowning In Shallow Water

Chapter 2: Surrounded and Alone

Listen Here

“Well, the funny thing is I didn’t tell him that I have the Holy Trinity.” Natalie cackled while talking to some of the twenty-somethings in the courtyard.

Off to the side of everyone chatting, I was sitting in a beat-up camping chair trying to mind my business and enjoy the sun and its warmth on my skin. Natalie’s voice carried over to my ears and I could feel them perk up. Holy Trinity? I wondered. Even though I initially wasn’t listening, her gleeful energy in between cigarette pulls caught everyone’s attention, including mine. 

Photo from Unsplash.

“You know,” she said as the smoke slowly floated up from the side of her mouth, “Hep A, B, and C!” 

Immediately my jaw dropped with a slight gasp and laugh. What? Then I had a flashback to the night before when I saw some of the “young ones,” as I like to call them, scurrying around the facility. They were trying to distract the techs from supervising so Natalie and some other kid could run off to have sex. What was another conquest for Natalie to brag about was about to become a really uncomfortable situation for that kid. Days later, he came back to us saying that he tested “positive.” Originally I thought it would be for hepatitis given Mother Teresa and her “Holy Trinity,” but it turned out to be some other STI. So maybe the joke was on Natalie? I don’t know. There were no condoms around because, of course, no one was supposed to have sex. Except they did, and clearly it was not safe. 

I remember one morning coming back to my room after brushing my teeth. As I approached, I noticed that the lights were off. Hmm, did I do that? Our doors didn’t lock, so as I leaned on the door with my arms full of toiletries, I heard heavy breathing from the other side of the room and saw shuffling under the covers. It was my roommate with a particularly creepy man who made my skin crawl. I cringed when I heard him moan then loudly whisper in her ear. He definitely was not a twenty-something. 

Do I interrupt? Do I tell a tech what’s happening? I knew the rules, but I didn’t know what was considered right and what was wrong. I was quickly learning during my stay that it wasn’t about the rules, it was about what I needed to get through those 35 days in peace. It hit me that my five weeks would quickly feel like ten if I had a conflict with anyone, so in that moment, I decided that I hadn’t seen or heard anything. 

Before they noticed that I had walked in, I stepped out and took a seat in the common area. I exhaled, putting my face in the palm of my hand to wait. It only took a few minutes for him to come out of the room. I was not surprised. 

While the techs occasionally played Whack-A-Mole trying to control the twenty-somethings, I found myself entertained in my own way thanks to another patient. No, I did not have sex with this man. I didn’t even touch him. But I still found myself distracted in his company. Our connection brought me comfort at a moment in my life when I was grieving the man I knew was permanently gone. He was no replacement, but he took me away from my pain. If I couldn’t have alcohol while in treatment, at least I could have some male attention. He was exactly what I needed for those five weeks.

I always looked forward to early evening when we could work on crossword puzzles by the tech desk. We chatted with each other and the techs, who, like Danielle, were all in recovery and helped remind us that getting better was possible.

Photo from Unsplash.

As it got close to 9 PM, I began to dread my nightly trip to the nurse’s station. As soon as I took my night meds, the clock started counting down. Slowly my eyelids got heavier and my head started to nod off, which annoyed me. It was a nice change, for once, to actually want to be awake, but those meds sapped my energy. I was finally laughing with others after not having done so in over a month, and even more surprising, I was smiling again. I didn’t want the meds to take that little bit of joy away from me early every evening. 

As we worked on the crossword one time, I looked at him and wondered, why isn’t HE sleepy? It was then that I learned from the others how to “cheek” my meds. So that night I went into the nurse’s station, took the little paper cup with my medications, emptied it into my mouth and said “ahhh” like a little kid as I stuck my tongue out so the nurse could take a look. All the while, I tasted the bitterness of the pills hidden between my gums and cheek as they started to break down. I rushed to the bathroom to spit them out before they disintegrated, wrapped them up in tissue, stuffed them into my bra, and saved them for when I wanted to go to bed. Back to the crosswords!

I rapidly fell into the daily routine. I was so wrapped up with therapy, groups, and classes that I started to forget about the world outside, the world that treatment was shielding me from. 

I was vaguely aware that it was a world that seemed to have fallen apart. Every now and then, someone would flip past a news channel while looking for another episode of Botched. I remember hearing snippets of COVID’s numbers going up as the TV abruptly switched to Naked and Afraid or some other reality show. I remember being allowed to watch TV briefly while the protests broke out around the country and just miles away from where we were. Then, as soon as gunshots rang out live on TV, it suddenly became silent. TV off. A part of me was relieved to be away from it all. Away from one unprecedented event after the other as well as the alcohol that waited patiently for me.

Every week I got thirty minutes to speak to someone from the outside on video chat. I always chose my sister, Sophie. It had hurt her so much to see me struggling that I wanted to show her how good I looked the longer I was in treatment.

“You have no idea how much at peace I feel knowing you’re safe. I’ve been taking the family support classes, and I’m learning a lot,” she’d say. The facility provided classes for both families and patients on addiction and how it is a disease and not a failure of character. 

I still felt like a failure, but I didn’t have to think about that in treatment. Instead, I could just relax, like I was at a summer camp for dysfunctional adults. I knew what was waiting for me on the other side of the fence. It was the people outside, those people and their opinions, that ran chills down my spine. 

“Mami doesn’t know where I am, right?” I asked.

Photo from Unsplash.

Each time I spoke to my sister, I asked if people had figured out where I was, fearful that my secret would be revealed. I just wanted people to think I was taking time for myself and “unplugging” after the loss. I didn’t want a soul to know that I was locked away in a treatment facility, that I was institutionalized.

The very idea of anyone knowing where I was made my heart race and my stomach sink fast, like a free fall with no end. I’d seen people get ripped apart publicly because of their secrets and I didn’t want that to be me. As I watched my sister chat on the screen about her days and what things have been like for her, my mind wandered to thoughts of how I would rather die than have others know where I was. I mean, how could I, this teacher loved by the community, be an alcoholic? How could I be such an extreme case that I couldn’t be trusted with my own life and had to be locked away? How could I be a good person but be hooked so badly? 

It. Just. Didn’t. Make. Sense. 

I didn’t tell my sister that those thoughts raced through my mind while we spoke. I didn’t tell my therapist when I looked her in her eyes across her desk. I didn’t tell anyone in my group sessions during those heavy pauses when I could have said something. I did not tell a single soul how torn I felt inside.

Even in those moments, surrounded by people just like me, I was alone.

Originally written by Jessica for Love & Literature Magazine.

Read the previous chapter, chapter 1 here.

Read the next chapter, chapter 3 here.

Drowning in Shallow Water

Chapter 1: Racing to the Bottom

Audio

“I’m fine, I’m fine,” I said, narrowly opening my eyes, trying to make sense of what was happening while hanging upside down. It was the morning of May 25, 2020, and I had just gained consciousness after wrecking my car on Bardstown Rd in Louisville, Kentucky. I vaguely remembered that my dog Cruz and I were on our way to meet a friend for a walk. Instead, I found myself suspended in the air by my seatbelt, realizing that everything was upside down and feeling the pressure of blood rushing to my head. Awake and still alive, unfortunately. 

Stock image of a flipped car. Mine was flipped in the same manner.

“Wait, my dog….” I started to mumble when I looked out, and there he was, tail still as if he was holding his breath waiting for me. Relief. 

Then the waves hit my body one after the other. Not pain, but first fear. “What is happening to me?” Next, anger. “I shouldn’t be okay…I don’t want this!” Lastly, shame. “I’m awful. How could I want to die with my dog in the car? What kind of sick person am I? I deserve to die. I’m fucking hopeless.” 

I wanted to walk away from the scene to escape the best way I knew how, racing to the bottom of a bottle of cheap bourbon. Still, first things first, these damn first responders weren’t letting me go if it wasn’t in an ambulance. I hadn’t even realized that I lacerated my elbow and had pieces of glass embedded throughout my skin like some sort of glittery decor. 

“I don’t want any Goddamn help,” I muttered under my breath as I got into the ambulance. I had to answer the same rote questions I’ve responded to many times in ambulance rides. “Wait, how do you spell your last name?” “D for David, u, e for Edward…” until getting to the hospital.

Though I was furious and incredibly resentful at going to the hospital, there was one positive: Pain pills! My favorite mind-altering drug has always been alcohol, as I never had the “oomph” in me to work as hard as people do to get illicit drugs. However, I certainly wasn’t going to reject a nice prescription, either. I could already feel the euphoria just before blacking out with burning splashes of Evan Williams. I couldn’t wait to escape my misery and get away for a day or two. 

“Here’s your prescription for Ibuprofen 800s.” 

“Excuse me, IBUPROFEN?!” I felt myself clutching my nonexistent pearls. 

“Yes, ma’am.” 

“But, I just flipped my car over. I just got out of a terrible wreck.” 

“Sorry, you aren’t experiencing enough pain for anything stronger.”

Wow. Immediately I wondered what the fuck someone would have to do to get a pain pill around here; I mean, lose a limb? Welp, there went any slight, “on the bright side,” feeling I was starting to have. My stomach started sinking again. I rolled my eyes and groaned. 

Getting home from the hospital, I knew I would have to tell my sister what happened. I had already been hospitalized several times since April 28, when I found my then-boyfriend dead from a drug overdose. Ever since, I was trapped in what felt like a never-ending bender from Hell. In less than a month, I had already gone twice to detox. I had several emergency room visits with dangerously high blood alcohol levels. So to prepare myself for this call, I got a few liquor bottles dropped off thanks to alcohol delivery and opened one of the bottles. No need to pour it in a glass, I drank it like water.

“Jess, you’re dying. You need help. Please, go somewhere. I can’t handle this. Every time the phone rings, I’m terrified,” Sophie cried. I sighed and thought to myself, Damn, I don’t want to be hurting her like this. So I picked up the phone and called a local treatment facility inquiring about their five-week program. Deep down, I was hoping they wouldn’t have a bed open. Deep down, I wanted to just keep drinking and shut down. I was already dreading the feeling of detoxing and withdrawals. The woman on the phone said, “Yes! We can take you. How about we pick you up later today?” I went to clutch my imaginary pearls again. 

“TODAY?! but I’m not packed.”

“That’s okay. Someone can drop clothes off for you.” 

I tried to deflect. “I can’t come tomorrow?” 

“Well, sweetheart, you CAN come tomorrow, but WILL you make it ’til then?” I sighed. 

“FINE. But can you come in the evening?” 

“Yes.”

Rubbing my hands together, I realized I had a few hours so that I could give myself one last hurrah before I went into this place. I couldn’t imagine five weeks without drinking. I dreaded the idea of having to feel everything, of only being unconscious to sleep. So I swallowed hard, I drank fast. I threw the Ibuprofen 800s in the trash. I vaguely remember a friend coming to get Cruz, and then everything went dark and silent. I couldn’t feel a thing. Things were exactly how I wanted them to be always and forever.

Intake picture from treatment. May 2020.

I came-to on a couch in an unfamiliar space. I looked around. There were people watching TV, others were playing games at a table, someone was writing in a notebook while reading out of what appeared to be a Bible. I could tell I needed a drink; my head was starting to throb, my hands were beginning to shake. I looked down. As I examined the dried blood on my clothes, I suddenly felt like my elbow was being stabbed. There were some rough stitches in there. The thick, black surgical thread stuck out of my elbow like a porcupine’s needles. I got up only to feel the room start spinning, and a woman, to this day I don’t remember who it was, grabbed my good arm and walked me to a room. She pointed me to a plainly dressed bed. Immediately I got in. Back to black. Relief. 

I finally woke up with a clearer head in that same bed and walked out of the room. It looked like I was in a college dorm setup of some kind. I saw people sitting in a courtyard, cigarettes and vape pens in hand surrounded by a cloud of smoke to the left of me. In front of me, standing at the desk, a young woman looked at me and smiled, “Hi Jessica! How are you, love? I’m Danielle.” Danielle was a tech, so she was introducing herself to let me know that she, alongside the other techs, supervised the area to make sure that all was in order. She was also a few years in recovery from all kinds of drugs, and she just glowed.

Medical Bracelet while in treatment in Louisville, KY where I was hospitalized May-June of 2020.

As she walked me around the facility to give me a sense of where I was, she ran down basic things like the schedule, rules, and our responsibilities. Yes, we as the patients, had chores. Some people eagerly waved “hello” as we passed them. Others looked like they had just gotten there, too, and moved about like zombies. 

“You know, my boyfriend died two years ago from a drug overdose, too.” I was immediately caught off guard. First, I wondered how she knew, then second, I felt a surge of relief. It had basically been a month since Ian died, and I had yet to hear that there was another soul on this earth who also had a boyfriend who died from a drug overdose. She sat me down and shared her story with me. There was so much I related to. I had to ask, “But, how did you live through it? How are you still here?”

In my mind, I thought this life experience was supposed to come with some sort of death sentence. That I would just bide my time until I killed myself or died of alcohol poisoning. But Danielle, here she was, joyful, glowing, and with some solid continuous sober time under her belt and proving me wrong.

“Oh, trust me, it was the worst experience of my life to date, and my heart is still broken. Eventually, you start to find your way in this world with grief. I promise you it gets better. I’m a testament to that.” 

Immediately I felt a tiny shift in me, a butterfly in my stomach. Maybe it does, in fact, get better. I mean, if Danielle did it, perhaps I can, too. She gave me a hug, which also surprised me, and went off to finish her shift. Before leaving for the day, Danielle came back to find me and handed me a sheet she pulled from the tech desk printer. The paper read:

Page from my journal where I pasted the printout. June 2020.

People think a soul mate is your perfect fit, and that’s what everyone wants. But a true soul mate is a mirror, the person who shows you everything that is holding you back, the person who brings you to your own attention so you can change your life.

A true soul mate is probably the most important person you’ll ever meet, because they tear down your walls and smack you awake. But to live with a soul mate forever? Nah. Too painful. Soul mates, they come into your life just to reveal another layer of yourself to you, and then leave.

A soul mate’s purpose is to shake you up, tear apart your ego a little bit, show you your obstacles and addictions, break your heart open so new light can get in, make you so desperate and out of control that you have to transform your life, then introduce you to your spiritual master…

― Elizabeth Gilbert, Eat, Pray, Love

I knew then that although it was going to be a long five weeks, that maybe this was exactly what I needed.

Originally written by Jessica for Love & Literature Magazine.

Read chapter 2 here.

Recovery and Rebirth from Alcohol and Teaching

Audio

Oxford defines recovery as “a return to a normal state of health, mind, or strength.” It also offers a second meaning, “the action or process of regaining possession or control of something stolen or lost.” For me, my recovery consists of moving to a functional state of good health and regaining control of myself. This has required complete abstinence from both drinking and teaching.

I’m Jessica. I was Kentucky’s State Teacher of the Year in 2019, and I’m also a recovering alcoholic. I’ve been sober since November 28th, 2020, and free from teaching since December 4th, 2020. I couldn’t tell you exactly when I lost myself. However, I can tell you my habit of avoiding feelings began when I was fat-shamed as a child. I learned to steal and hide the food I wanted to eat to avoid embarrassment. I ate like this for many years and dedicated myself to excelling as a student to feel better about being an overweight child and later a teen.

Eventually, my escapism transferred to alcohol and my career. After being called out at a happy hour for drinking too much, I decided to hide my alcohol consumption from others. “Whoa, you’re moving a little fast there, aren’t you?” I remember a fellow teacher said to me. My face was hot with shame, and from that day forward, unless I accidentally over-drank in front of others, I tried my best to not be caught drunker than the group I was with. I did well at work, so when I did slip and drink too much, no one could say I had a problem with alcohol because “look at how great Jessica is as an educator.”

Teacher of the Year Head Shot, 2019.

I hid my love for alcohol in many ways. A classic example is that I monitored how others drank at events to make sure that I matched everyone else drink for drink. If others had one glass, I had one. If they had four, I had four. I always knew something was wrong with me, but I gaslit myself. I convinced myself that there couldn’t be anything wrong with me because I went to college and then graduate school, twice. Alcoholics don’t get graduate degrees. They don’t successfully build relationships with kids and win awards for their work. There is no way that you can be named the top teacher in a state and be an alcoholic. But I was. 

I lived a painful double life where every day I suffered and every day I chose to not tell anyone and drank instead. I eventually was physically dependent on alcohol, so I felt even worse about myself. How did I cope? I threw myself into teaching. I couldn’t be a bad person if I was a good educator, right? 

My days were a non-stop Groundhog Day. I came home from whichever school I worked at and breathed a sigh of relief because I could be unbothered. I could drink without fear of judgment. Over the years, the amount of liquor I needed to escape and avoid withdrawal symptoms increased. I consumed a bit more than a fifth of liquor a day at the end of my drinking career. I ignored a diagnosis of alcoholic liver disease in 2019 and continued to drink. I allowed my health to decline as I drank more. I always had to lie as to why I felt sick. My students asked, “Why are you always going to the bathroom? Why are you always going to throw up?” I told them my stomach was just sensitive. However, no matter what, Ms. Dueñas was always doing her best.

My persona had two sides, and neither one was truly me. My teacher self took turns with my addicted self for years until April 28th of 2020, when my then-boyfriend relapsed and died from an overdose. That day between alcohol and teaching, the alcohol took over and controlled me fully until my current sobriety date.

Rehab, 2020.

For months, I barely worked as I was in and out of hospitals, staying in treatment facilities, and putting together a few weeks of fragile sobriety at a time before violently crashing. The day I left a five-week-long treatment program, I ordered alcohol delivery and faded away by myself. I wrecked my car, blew nearly a .5 blood alcohol level, and tried to purchase a gun to shoot myself with. I was hospitalized for the last time in November of 2020, which is when this recovery process truly started. 

A psychiatrist at the hospital asked to evaluate me, and upon digging into my history, he diagnosed me with bipolar 2. The Mayo Clinic defines bipolar disorder as “a mental health condition that causes extreme mood swings that include emotional highs and lows.” With bipolar 2, “you’ve had at least one major depressive episode and at least one hypomanic (somewhat energized/euphoric) episode, but you’ve never had a manic episode (which is more severe).” So, for individuals with bipolar 2, there is never a psychotic episode, for example. 

The doctor informed me of how frequently substance abuse went hand in hand with mental health conditions. He recommended that I try medication with a recovery program and therapy as part of my wellness plan. I accepted the recommendation. By then, things had gone too far. I wanted to die, but I was not dying, and my everyday existence had become unbearable. Something had to change. I needed to gain control of myself. I needed to get healthy. I needed to recover.

When I decided to accept help, I also realized that alcohol was not the only external factor controlling my life. It was not the only thing keeping me from being healthy. I allowed my teaching career to be just as much of an escape from myself as alcohol. No matter what chaos happened in my personal life, I was an excellent actor, and the classroom was my stage. I could only feel better about who I was if I helped others, but I never once helped myself. The teaching had to go as much as the alcohol needed to. I was reborn.

16 Months Sober, 2022.

Since November 2020, I’ve embarked on this lifelong journey of becoming authentically me. My medications allow me to feel enough stability to use my recovery program and therapy to address my mental and spiritual needs. I now can face past traumas that I avoided. I journal daily, pray, meditate, and lean on my support group. I don’t isolate myself. I connect with others both in person and through social media. I try new things. I care less about other people’s opinions of me, and when I do care, because I’m a human, I have ways to check myself and my fears. I don’t worry about constantly meeting others’ needs. I have identified MY needs, and I ask myself if people and situations meet them, and when they don’t, I remove myself. 

Today, my success is not measured by academic standards, standardized test results, or a score on an administrator’s observation rubric. My success is measured by the intangible, my ability to create a life I no longer need to escape. Not everyone is allowed to do so and I am incredibly grateful for my daily gifts. Happy Resurrection Day. 

She Never Thought of Herself as an Alcoholic, and Then She Was Placed on the Liver Transplant List as a 33-Year-Old Woman: Jacqueline’s Story

Jacqueline’s first words that I ever read were, “I never thought of myself as an alcoholic. I never lost a job because of it, had no DUIs, my relationships were alright. I always had other excuses for why I would end up in the emergency department. It wasn’t until last year, when I spent 46 days in the hospital and almost died, that I was diagnosed with alcoholic liver disease. A few months later, I ended up on the liver transplant list. I am now sober, but I’m living my life waiting for a miracle recovery or for my MELD score to skyrocket and get a liver transplant.” Jacqueline wrote to me when she read the NPR article about the increase of alcoholic liver disease in women.  Immediately, I had to connect with her. When we chatted, Jacqueline had recently had surgery, so she wasn’t ready at the moment to share, but it was enough to make an impact on me. I made sure to save her number. 

Today, a text notification went off, and when I went to swipe up on my screen, the miracle had happened, Jacqueline reached out. She is feeling better and is off the transplant list! Now that we finally had the opportunity to talk, the question was, how did she get here?

Jacqueline was born in a suburb of Boulder, Colorado, and spent her childhood between Colorado and a college town in Minnesota. We didn’t chat too much about her early childhood. Still, like many other people with alcohol abuse disorder, Jacqueline started drinking and smoking cigarettes in middle school. Early on, Jacqueline was successful at managing both drinking and life’s responsibilities. Through middle school and high school, she went to school, worked as a nanny and part-time in restaurants, and practiced all kinds of dance at an art academy, and of course, partied. 

Like many of the women I get the honor of speaking to, Jacqueline is a trauma survivor. Her voice shook as she recalled the experience of getting raped when she was 16. Her parents were out of town, and there were friends over for a party. The guy she had a crush on ripped peace from her that night.

In her own home. 

In her own bed.

Her friends turned their backs on her, victim-blaming her because she happened to have a crush on him. So, what about her family? Jacqueline wanted to clarify that her mother always has had the best of intentions for her. Still, Jacqueline mentioned that her mother struggled to get Jacqueline the support for her mental health needs at that turning point in her life. Trapped by the stigma of mental health problems, Jacqueline’s mother allowed her to get therapy. However, a thorough diagnosis of the effects of the trauma on Jacqueline and difficulties she had with learning were never fully addressed at that time. In turn, Jacqueline’s coping mechanisms while becoming a young woman were anything but healthy.

After high school, Jacqueline’s parents sent her to Colorado on her own to escape an abusive boyfriend in Minnesota. He constantly tried to control her, kept her in spaces against her will, and threatened to injure her. Jacqueline suffered this ordeal in secret until she confided in her sister-in-law, who alerted her parents. It was a significant change to be in a different state suddenly, but it was incredibly liberating to be on her own. She had a car, followed her own schedule, and did what she wanted. She was independent. “I finally wasn’t grounded anymore!” She exclaimed. Jacqueline provided for herself, working multiple jobs, including medical secretary, emergency room registration, teaching dance, and bartending. Despite her many positions, she managed to party, drink, and do well. 

Photo by Sam Moqadam on Unsplash

Relationships typically didn’t help make Jacqueline’s life better. She was drawn to unavailable individuals who already in relationships, married, or simply emotionally unavailable. She was a hopeless romantic that never wanted to fall in love. Once, there was a doctor she was seeing who had seen her wit and intelligence. He encouraged her to enroll in college. She did well in her first year, but suddenly things “hit a wall” for her that summer and her drinking started to take a turn for the worse. Though Jacqueline did well in school, she accepted a job she was passionate about starting. Suddenly, the position was dissolved, and she felt lost. Lost, with student debt, and alone again.

Eventually, circumstances led Jacqueline to the live music scene. She met her current partner of five and a half years when she saw him at a concert. Ever since they connected, they’ve been inseparable. They have supported each other through all of life’s challenges, including Jacqueline needing to turn her life around. 

The couple drank together, being often around musicians. They had a lot of fun, and though they sometimes had drunken arguments, they enjoyed each other, too. Despite their heavy drinking, the two were able to buy a home, keep employment. They functioned successfully, so though Jacqueline deep down inside she knew something was probably wrong, it was easy to ignore. “I wasn’t what you consider a typical alcoholic.” 

Another incident struck Jacqueline’s life that brought her drinking to another level of escalation. She was injured at work and had to take time off. She also had to fight her then employer in court to get compensated. Suddenly being trapped at home, being in pain, and being stressed about her finances, Jacqueline needed to numb herself to escape the pain of everyday living in these circumstances. Alcohol relieved her stress and her anxiety. Between her and her partner, they drank about two-thirds to three-fourths of a handle of liquor a night. They drank like this from 2018 onward.

Jacqueline eventually started noticing that she was eating less. She wasn’t thirsty anymore, either. It would be like this for days. She was getting dizzy more regularly. She was run down and just felt sick. Her dizzy spells were so powerful that she went to the emergency room repeatedly in 2019 to address “low potassium levels” or “dehydration.” I asked, “Did your family notice?” She responded, “They were in Minnesota, so they had no clue. If they ever did discover she was in urgent care or the emergency department it was just ‘dehydration,’ or a ‘migraine.’ The only one who knew was my partner (because he drank, too),” she replied. “He admits now, that he was lying to himself, but he didn’t know the full truth. A lot of the times I ended up in the ED (emergency department) and told the medical staff how much I was struggling, and he would be frustrated because I had never voiced those complaints to him.”

Meanwhile, I thought the doctors MUST have noticed something was going on with her. I asked, “I mean, didn’t they run labs on you? You had to have liver disease already, and they didn’t check your liver enzymes? They never diagnosed you with ALD?” I was shocked at the fact that no one had pointed out the simple fact to Jacqueline that alcohol was killing her. Jacqueline, I could almost envision her shaking her head, stated, “No, just nausea, dehydration, and tell me to follow up with my doctor. So I’d quit for a few weeks to seem better, but then I would start to drink again. I avoided doing blood work. I was still functioning, so I didn’t think I needed to stop. I acted like I was fine. My bills were paid, no DUI, no trouble with the law, no relationship problems at the time, my relationship with my family was fine, my relationships with friends were good, too.” “So you never thought there was something wrong?” I asked. She replied, “Well, I always knew something was wrong with me, I knew it the whole time.” I understood exactly what she meant. 

Finally, Jacqueline had her life-changing hospital visit. First, she had had an emergency room visit, and though she still felt sick after getting fluids, they released her to go home. She and her partner stopped to get groceries when suddenly everything started going black for Jacqueline. “I saw a tunnel closing in around me, I was going to faint. He grabbed me and took me right back to the hospital.” 

At the hospital, things took a turn for the worse.

“I became yellow, my MELD score was 29, my bilirubin level was 30 (normal is under 1.2). I looked like I was eight months pregnant from ascites. I was dying. I had to stay in for 46 days.” For reference, a MELD (Model for End Stage Liver Disease) score is a number that qualifies a person for a liver transplant, so the higher the number, the worse shape the person’s liver is in. The highest MELD number is 40, so Jacqueline’s liver was in bad shape. Jacqueline needed to get on the liver transplant list, but she would not qualify without abstinence given her alcohol consumption history. 

So what did that look like? Jacqueline had to take a PETH test every two weeks for six months to prove she could stay away from alcohol. Unlike a breathalyzer that only checks for a present blood-alcohol level, a PETH test can detect any alcohol consumption from up to two weeks before the exam. Jacqueline was able to stay sober and get on the list, and once she got on the list, she just had to take the PETH test once a month. 

But Jacqueline’s NOT on the transplant list now, right? She’s not. 

During our conversation, Jacqueline informed me that her numbers, though not ideal, have stabilized. Her bilirubin levels dropped from 30 to a 4, and her MELD has consistently been a 12, down from 29. Today, Jacqueline is healthy enough not to require a liver transplant. She’s back to looking normal; she happily said, “I’m not yellow anymore!” 

“So you’re safe to live a full adult life now, right?” I asked. Jacqueline is only 33 years old, just three years younger than me. Jacqueline paused, “Well, because I’m so young, the chances of me still needing a transplant when I’m older is doubled because I’m so young. So I’m really not off the hook yet.” 

Though she has stabilized, Jacqueline does have mild cirrhosis of the liver. The liver can sustain damage up until the point of cirrhosis. At that point, the scar tissue doesn’t go away, it’s irreversible. That means Jacqueline has to do a lot of work to protect her liver from any further damage. Work that she will have to do until the day she draws her last breath. 

This new life with permanent alcoholic liver disease is not an easy one for Jacqueline. For the rest of her life, Jacqueline has to be on a low sodium diet, consuming fewer than 2000 mg a day. Her liver doesn’t filter her blood properly, so fluids that a healthier person may be able to pass through urine will accumulate in her body. These fluids could press on her abdomen and potentially fill her lungs with fluid, so Jacqueline has to monitor her fluid intake and take diuretics. 

She has a stomach ulcer and varices on her esophagus. According to Mayo Clinic, “Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). This condition occurs most often in people with serious liver diseases.

The vessels can leak blood or even rupture, causing life-threatening bleeding.” 

I had to ask, “ And most importantly, you can’t drink. How do you stay away from alcohol?” Jacqueline explained that she uses cannabis for physical and emotional ailments. She takes microdoses of cannabis in candy form in the morning. It helps to keep her anxiety down and bring her appetite up. She has tried psych meds but didn’t respond well to them. “I don’t smoke the actual cannabis flowers, just the oil concentrate or eat the candies. It helps me get through. My biggest thing to not drink is focusing on how much it would hurt my partner, family, and team of doctors. They worked so hard to help get me here. It’d be a kick in the face for me just to go back out and drink. I had a relapse a year ago, and it landed me in the hospital. It was stupid, I thought I would have one, but course it wasn’t just one. It almost killed me.”

“Do you participate in any support groups?”  Jacqueline’s support is her partner, her therapist, and her garden. She explained her coping by saying, “I believe in Mother Nature. Gardening really helps me. My plants really help me. For me, drinking wasn’t so much about the physical addiction, and it was always emotional. I coped every day. It was for my anxiety, for social anxiety. Today, my garden helps me.”

“Every day is excruciatingly grueling, especially those days when nothing goes right and you just want to shut out the world. That is why I continue to surround myself with plants and my garden. They remind me that they work so hard to become their most wonderful selves. Most people only appreciate them when they bloom, but I love them from the second I plant them until I mourn them dying and use them as compost to grow the next generation.” 

(Just for some added detail, medical problems Jacqueline was treated for in during her 46 day stay because of her alcohol consumption was severe sepsis, acute respiratory failure with hypoxia, ascites, alcoholic hepatitis, liver failure, multiple hernias due to the ascites, IBS, severe diarrhea, C Diff Infection, anemia, jaundice, potassium deficiency, vitamin D deficiency. Jacqueline had a paracentesis to remove fluid from the abdominal cavity and had to have a PICC line placed to receive medications and have labs drawn as all of her IV’s started to blow out and the lab couldn’t get a proper stick.)