Alcohol and the medical

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Hello! I am up for third class renewal. I usually have a drink or two with dinner. Should I avoid having a drink the day (or week or month) before my medical? Thanks in advance!
 
Short term, no problemo. Long term- 80% of individuals who have daily alcohol ingestion cross over to abuse/dependency.

And you probalby should be abstinent for 24 hours. The urine dipstick can light up and that would be an issue (most docs have the stick that also shows ketones, a byproduct of alcohol metabolism).

Be careful. :)
 
I'm the OP. Thanks everyone!

Dr. Bruce, would it be wise to limit my beer to every other night or something?
 
Short term, no problemo. Long term- 80% of individuals who have daily alcohol ingestion cross over to abuse/dependency.
I wonder if that would be a statistic that applies mostly to the US. It seems quite common in other places I've been.
 
I'm the OP. Thanks everyone!

Dr. Bruce, would it be wise to limit my beer to every other night or something?
There isn't a statistic for persons using less than daily. But my sense of it would be twice a week would take you out of the vulnerablility loop (provided you're not doing the weekend binge thing like the U of I students on High Street).
 
I'm the OP. Thanks everyone!

Dr. Bruce, would it be wise to limit my beer to every other night or something?

if it means that much to you that you want to debate on how much you can get away with, then there might be more of a problem than you think.
voice of experience here
 
Short term, no problemo. Long term- 80% of individuals who have daily alcohol ingestion cross over to abuse/dependency.

And you probalby should be abstinent for 24 hours. The urine dipstick can light up and that would be an issue (most docs have the stick that also shows ketones, a byproduct of alcohol metabolism).

Be careful. :)

Hey doc,

Are there any cultural / ethnic qualifiers that you know of?

I ask because in my Italian-American family, it was customary for children to start taking a single glass of wine with dinner at age six. Actually, it was mainly water with a little wine mixed in, with the percentage of wine gradually increased every year until it became 100 percent wine on the kid's 12th birthday.

This is how every child in my extended family (including myself) was introduced to alcohol, and there's not an alcoholic among us. I'm talking about maybe 50 or 60 relatives in my generation, and not a single lush among us.

It's my personal belief (backed by nothing other than my own experience and observation) that this early introduction to alcohol use in a supervised context, with a concomitant expectation of moderation and responsibility, reduces the likelihood of alcoholism.

But again, this is nothing but a hunch on my part.

-Rich
 
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if it means that much to you that you want to debate on how much you can get away with, then there might be more of a problem than you think.
voice of experience here


I concur with that.
Stick to celebrating St Patty and go strictly with green tea the rest of the year and you'll be fine
 
I'm the OP. Thanks everyone!

Dr. Bruce, would it be wise to limit my beer to every other night or something?

I recently saw a study/paper that showed 1-3 drinks per night as "moderate" (and healthy) drinking with a disclaimer that recommended at least two alcohol free days per week.
 
I recently saw a study/paper that showed 1-3 drinks per night as "moderate" (and healthy) drinking with a disclaimer that recommended at least two alcohol free days per week.

If you didn't start drinking until you were 18, could you credit those days until you are 63?
 
Short term, no problemo. Long term- 80% of individuals who have daily alcohol ingestion cross over to abuse/dependency.

Define dependency. If dependency means you gotta have that drink, but it's still the beer you have with dinner, I myself don't see the problem. My old man drank every night of his adult life. He never missed work or had any other problems because of it.
 
Are there any cultural / ethnic qualifiers that you know of?

I ask because in my Italian-American family, it was customary for children to start taking a single glass of wine


I've often wondered if the French allowed their pilots to have a sip of wine at lunch even while on duty; it is such a deeply ingrained cultural thing there.

I recall reading how the Europeans have lower alcohol abuse rates, the theory was that it was not such a taboo thing to the youth, so they found no joy in over-indulging.
 
I recently saw a study/paper that showed 1-3 drinks per night as "moderate" (and healthy) drinking with a disclaimer that recommended at least two alcohol free days per week.

Wow...I do 1-3 drinks per month...with at least one or two alcohol free months per year!
 
The cardiologists would like you to have four or so.
There's some other specialties that will have you do less.
I had a friend working at the NIH on evaluating the "benefits of alcohol study" and she said it almost got to the point of putting it on the food pyramid.
 
The cardiologists would like you to have four or so.
There's some other specialties that will have you do less.
I had a friend working at the NIH on evaluating the "benefits of alcohol study" and she said it almost got to the point of putting it on the food pyramid.
Seems high. I have seen a recommendation of no more than 2 drinks per day and 10 per week for men and half that for women. There is some data that even that level of alcohol consumption for women significantly increases the risk of breast cancer.
 
Define dependency. If dependency means you gotta have that drink, but it's still the beer you have with dinner, I myself don't see the problem. My old man drank every night of his adult life. He never missed work or had any other problems because of it.
Professor, for a definition, see the DSM 4.

The statistic is remarkable. 80% crossing over to dependency, says your dad was in the 20%. I know that you understand the concept of "crossover".
 
Professor, for a definition, see the DSM 4.

The statistic is remarkable. 80% crossing over to dependency, says your dad was in the 20%. I know that you understand the concept of "crossover".

One man's fun guy is another man's drunk. Define to what you're crossing over. While I don't advocate dependency, I don't equate it with disease, and neither should you. A perfectly healthy person can drink a glass of wine with dinner every day of his or her life. Folks have been doing it for thousands of years.
 
And though your dad may never have missed a day at work he might have been an alcoholic. I'm not sayin, either.

Have a local helo pilot, german american ancestry, lives in the small city about 20 miles downriver where a glass of wine with supper is mandatory. But then he had the big DUI. Never missed a day at work.

Guess what the Ph.D. psychs said about him?

2 way street here, and I will not get into defining all the 12 criteria in the DSM 4 of which you must have five.
 
I'm not sure I buy the 80%. Is there some qualification on what defines the daily use and what crossing the line into dependence. You got a reference?
 
And though your dad may never have missed a day at work he might have been an alcoholic. I'm not sayin, either.

David Lee Roth once said "I used to have a drug problem, but now I have enough money". Sure, he might have been an alcoholic. But it didn't stop him from productively contributing to society, and I doubt it shortened his life by even a minute. The folks who think he had a problem are the ones with a problem. It's called intolerance.

Have a local helo pilot, german american ancestry, lives in the small city about 20 miles downriver where a glass of wine with supper is mandatory. But then he had the big DUI. Never missed a day at work.

Had a President do that, and a recent head of the FAA. Is everyone who ever got pulled over DUI an alcoholic?

Guess what the Ph.D. psychs said about him?

Yeah, cause heaven forbid they come away without a diagnosis. And we all know MD's never get it wrong ever.

2 way street here, and I will not get into defining all the 12 criteria in the DSM 4 of which you must have five.

And I doubt I need to remind you that human physiology is sufficiently nuanced to be refractory to set numerical criteria, and human behavior is far more complex than human physiology. Heck, we know all sorts of things about physiology, and still can't figure out the first thing about women.
 
I'm not sure I buy the 80%. Is there some qualification on what defines the daily use and what crossing the line into dependence. You got a reference?
It'll take a long time to find it. It was in an NIH consensus discussion about fifteen years ago.

My point, though it that I am not about the definition. I am about what FAA does about it.
steingar said:
Yeah, cause heaven forbid they come away without a diagnosis. And we all know MD's never get it wrong ever.
For Steingar, he missed the punch entirely. The Psych said he had NO problem with dependency or addiction. He's flying medevac on a regular issuance. Now try that one on for size....:)
 
I've often wondered if the French allowed their pilots to have a sip of wine at lunch even while on duty; it is such a deeply ingrained cultural thing there.

BTDT. On 'Le aircraft carrier'. Before flight ops. Everyone survived. :)
 
When I was diagnosed with DM2, I just assumed I couldn't drink any more. I would miss the wine, I thought, but it wasn't the end of the world. So I stopped having my wine with dinner, which was pretty much the only drinking I'd done for decades except for the occasional beer. I've never really cared for the hard stuff very much.

But then my doc told me of some research that suggested that a single glass of red wine with a meal actually seemed to help stabilize glucose levels. So I resumed taking my glass of wine with dinner to see what would happen. There wasn't any huge difference in my postprandial glucose levels. They went down slightly, but that also could have been because I was learning to manage my DM2 better. But I did decide to keep having my wine with dinner at that point because, if nothing else, it didn't seem to be doing any harm.

Beer, on the other hand, does cause a significant rise in my glucose levels, so my solution is not to drink beer. I always have a wide selection of beers in the fridge for guests, however. I just don't drink it.

One of my aunts is turning 102 this year, drinks about four large glasses of wine every day, and has for years. She buys Gallo by the gallon. When I asked her what her doctor thought about her wine drinking, she said that three of her old doctors didn't like it, but the one she has now says it's okay. I jokingly accused her of shopping around until she found a doctor she liked, and she said in broken English, "No, no, no. The first-a three doctors, they all a dead."

So really, who's to say at what point one becomes "dependent," DSM-4 notwithstanding? As far as I'm concerned, the main purpose of the DSM is to make it possible for anyone to be diagnosed with some condition or another so their shrink can get paid.

What I believe is that it really comes down to how drinking affects a particular person. If I drank four large glasses of wine every day, especially knowing that I have DM2, I'd say that would make me dependent. But for my 102-year-old aunt, four glasses of wine a day seems to be working out fine, despite the advice of the doctors she's outlived.

-Rich
 
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What I believe is that it really comes down to how drinking affects a particular person. If I drank four large glasses of wine every day, especially knowing that I have DM2, I'd say that would make me dependent. But for my 102-year-old aunt, four glasses of wine a day seems to be working out fine, despite the advice of the doctors she's outlived.

-Rich
That's really what it comes down to. Almost daily I receive random phone calls from my dad -- generally he doesn't even know he is calling me -- nor does he sometimes even know where he is. Sometimes he is happy but generally he is having a big breakdown. But that's what happens when you're drinking bottles of vodka a day. Only a matter of time before the alcohol kills him, or the actions he takes because of the alcohol kills him.
 
That's really what it comes down to. Almost daily I receive random phone calls from my dad -- generally he doesn't even know he is calling me -- nor does he sometimes even know where he is. Sometimes he is happy but generally he is having a big breakdown. But that's what happens when you're drinking bottles of vodka a day. Only a matter of time before the alcohol kills him, or the actions he takes because of the alcohol kills him.

My old man drank every day of his adult life. The first time any of us got such a phone call was the last, though it was the Alzheimers, not the booze, at fault.
 
Hey doc,

Are there any cultural / ethnic qualifiers that you know of?

I ask because in my Italian-American family, it was customary for children to start taking a single glass of wine with dinner at age six.

In my German-American family, from the Milwaukee area, it was routine to give the kids a small cup of beer on special occasions. In our community, it was completely normal for there to be beer served at ALL special occasions, from Cub Scout meetings to firemen's picnics.

If it were true that 80% of people who drank daily "crossed over" to alcoholism, virtually the entire adult community of West Bend, Wisconsin could be so defined.

I smell something in this statistic, and it ain't "science". :rolleyes:
 
That's really what it comes down to. Almost daily I receive random phone calls from my dad -- generally he doesn't even know he is calling me -- nor does he sometimes even know where he is. Sometimes he is happy but generally he is having a big breakdown. But that's what happens when you're drinking bottles of vodka a day. Only a matter of time before the alcohol kills him, or the actions he takes because of the alcohol kills him.

Alcoholism is a terrible scourge. My sister has been traveling the same road as your father for the last 30 years, and she's in the end stages of liver failure now.

But that's a whole different kettle of fish. Saying that 80% of people who drink daily become (or are) alcoholics is suspicious, especially in the face of recent medical evidence saying that it's beneficial to do so in moderation.

Heck, I know people who purposefully drink a glass of wine daily the way I take a multi-vitamin in the morning -- because they've been told it's "heart-healthy".
 
Heck, I know people who purposefully drink a glass of wine daily the way I take a multi-vitamin in the morning -- because they've been told it's "heart-healthy".

Alcohol lowers blood pressure, and the reservatrol found in red wine has been touted as a cure-all for everything from diabetes to cancer. MOst alcoholic beverages are rich in calories, though.

I think Bruce is reflecting the highly abstemious culture found in the US, derived from it's protestant origins. At issue is the definition of "alcoholic". That said, those truly suffering the scourges of alcoholism are indeed unfortunate.
 
If you answer "yes" to three of these, you are in danger of alcoholism. It isn't the quantity or frequency so much as it is the dependency or effect.

  1. Do you lose time from work due to drinking?​
  2. Is drinking making your homelife unhappy?​
  3. Do you drink because you are shy with other people?​
  4. Is drinking affecting your reputation?​
  5. Have you ever felt remorse after drinking?​
  6. Have you had financial difficulties as a result of drinking?​
  7. Does your drinking make you careless of your family's welfare?​
  8. Do you turn to inferior companions and environments when drinking?​
  9. Has your ambition decreased since drinking?​
  10. Do you crave a drink at a definite time daily?​
  11. Do you want a drink the next morning?​
  12. Does drinking cause you to have difficulty in sleeping?​
  13. Has your efficiency decreased since drinking?​
  14. Is drinking jeopardizing your job or business?​
  15. Do you drink to escape from worries or trouble?​
  16. Do you drink alone?​
  17. Have you ever had a loss of memory as a result of drinking?​
  18. Has your physician ever treated you for drinking?​
  19. Do you drink to build up your self-confidence?​
  20. Have you ever been to a hospital or institution on account of drinking?​
 
I guess the concern is if regular consumption could eventually lead to alcohol dependence. I don't know what the risk factors are.
 
If you answer "yes" to three of these, you are in danger of alcoholism. It isn't the quantity or frequency so much as it is the dependency or effect.

  1. Do you lose time from work due to drinking?​
  2. Is drinking making your homelife unhappy?​
  3. Do you drink because you are shy with other people?​
  4. Is drinking affecting your reputation?​
  5. Have you ever felt remorse after drinking?​
  6. Have you had financial difficulties as a result of drinking?​
  7. Does your drinking make you careless of your family's welfare?​
  8. Do you turn to inferior companions and environments when drinking?​
  9. Has your ambition decreased since drinking?​
  10. Do you crave a drink at a definite time daily?​
  11. Do you want a drink the next morning?​
  12. Does drinking cause you to have difficulty in sleeping?​
  13. Has your efficiency decreased since drinking?​
  14. Is drinking jeopardizing your job or business?​
  15. Do you drink to escape from worries or trouble?​
  16. Do you drink alone?​
  17. Have you ever had a loss of memory as a result of drinking?​
  18. Has your physician ever treated you for drinking?​
  19. Do you drink to build up your self-confidence?​
  20. Have you ever been to a hospital or institution on account of drinking?​

Ok - let's be fair here - almost ANYBODY who went to High School has at some point had #1,3,5,6, (occasionally 8), definitely 9 and 17, and 19 happen to them. Let's put some qualifiers on this list for "Adult Life" and I'm ok with it, only one of them applies to me.

Heck, half of my scars with good stories behind them started with 19 and 20, and #6 pretty much describes my first 2 years of college - beer money was primary!:D
 
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If you answer "yes" to three of these, you are in danger of alcoholism. It isn't the quantity or frequency so much as it is the dependency or effect.

  1. Do you lose time from work due to drinking?​
  2. Is drinking making your homelife unhappy?​
  3. Do you drink because you are shy with other people?​
  4. Is drinking affecting your reputation?​
  5. Have you ever felt remorse after drinking?​
  6. Have you had financial difficulties as a result of drinking?​
  7. Does your drinking make you careless of your family's welfare?​
  8. Do you turn to inferior companions and environments when drinking?​
  9. Has your ambition decreased since drinking?​
  10. Do you crave a drink at a definite time daily?​
  11. Do you want a drink the next morning?​
  12. Does drinking cause you to have difficulty in sleeping?​
  13. Has your efficiency decreased since drinking?​
  14. Is drinking jeopardizing your job or business?​
  15. Do you drink to escape from worries or trouble?​
  16. Do you drink alone?​
  17. Have you ever had a loss of memory as a result of drinking?​
  18. Has your physician ever treated you for drinking?​
  19. Do you drink to build up your self-confidence?​
  20. Have you ever been to a hospital or institution on account of drinking?​

I'd say that's an excellent list, with the possible exception of "5. Have you ever felt remorse after drinking?" That one probably applies to the majority of people who ever lived in a frat house or served in a maritime service.

-Rich
 
Some of those are telltales. Drinking alone? I don't think so. I don't see what "alone" has to do with dependency.

My test is that if I substitute "reading" for "drinking" it still indicates dependency.
 
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