Double vision

[bungeejumper]

Going on from the booze discussion, but in a different direction, so a different thread. I've had to see a couple of specialists at my local hospital recently, and my initial consultation ran me straight into a wall that I didn't even know was there.

We're getting along fine with the consultation. Weight fine, BP fine, everything fine. And then the consultant asks me (as they do....) how much I drink?

Well, I say, I generally buy a couple of bottles of red wine a week, and probably half a bottle of rough red that goes into cooking. She almost drops her biro. Then fixes me with a shocked and ferocious glare.

"Two bottles of wine a week? How many people share that with you?" "Err, nobody," I say, feeling suddenly a bit flustered. "The wife doesn't drink." And she's off straight away with the full-strength lecture about how I'm on the road to liver failure and I really must do something about bringing my life under control, and blah blah blah. Going a bit over the top, wasn't she?

Anyway, I didn't really think very much more about it until I saw the piece on the news last week about how the quantity of booze that people really buy in the UK outstrips the amount they claim to drink by about 100%. And then suddenly the penny dropped. This doctor (and probably many more?) simply doubles the amount that you tell her, and proceeds from there, and concludes that I'm getting through 24 glasses a week, and then up goes the balloon and suddenly I'm a menace to society.

Now that's not an honest way to respond when a patient really is telling the truth, is it? It's basically calling him a liar. More to the point, all that it's really likely to achieve is that eventually I'll resort to telling her half the amount that I really drink, so that she can double it in her head and then she'll have the right number. And so will every other patient. And all the health statisticians in the country will still be working with the wrong figures. Honestly, you can't win.

BJ

[Lootman]

then the consultant asks me (as they do....) how much I drink?

Well, I say, I generally buy a couple of bottles of red wine a week, and probably half a bottle of rough red that goes into cooking. She almost drops her biro. Then fixes me with a shocked and ferocious glare.

Even if you double that, it's only 4 bottles a week, or 5 if you include that used in cooking. So that is just three to four glasses of wine a day.

I wonder what your doctor would say about our household. My wife and I get through about 20 bottles of wine a week. I tell my doctor about half of that, as it happens.

[vrdiver]

It's a funny old world. For quite a few years I would answer the question "how much do you drink" with an answer that was well over the recommended limits. My doctor wouldn't comment, other than at the summary stage to mention I should cut down a bit...

One time I was challenged was when I'd filled out a pre-questionnaire with the historically true answer, before starting to record a diet diary, during which I happened to be on "dry January". The only question was why the numbers were so different!

I understand the embarrassment of "fessing up" about drinking that some people may have, but there seems little point in going to a doctor and not telling them the truth.

VRD

[vrdiver]

It turns out Hugh's 'slow and steady' consumption meant he was drinking as much, if not more than the 'binge' drinker.

There was an experiment run by twin brothers who were (are) doctors: one drank the recommended maximum amount of alcohol evenly throughout the week, whilst the other saved his units and drank them all in one night.

Whilst the "binge" brother suffered more the day after, when they looked at their blood chemistry it seemed the liver was impacted the same in both cases: whilst not a statistically significant study, they pointed out that long-term damage appears to be a function of consumption, not peak consumption.

VRD

[didds]

Good points BJ, that echo many of my own.

I've long been of the opinion that medical professionals do the doubling up thing, though they deny it when I preface such answers with that "theory". Yeah, right.

Its also clear to me that the medical staff I encounter really don't understand what drinking "is". I don;t mean the effects of alcohol, but "what" drinking is.

Last autumn I was asked the question, and I responded maybe 40 units a week. They all but spluttered and asked me how on earth I drank that much - they clearly thought I must be on bottles of sp[iriuts a day. I explained its really quite easy... most beer I drink in the excellent pubs I frequent is between 4 and 5%, often in the higher end. Two pints a day of that is 5-6 units. 7 days a week, there's your 40-ish. On two pints a day (albeit stronger beer yes). They asked me about spirits - I said no, high days and holidays (which equates to a very occasional G&T in the summer, and whiskey on Burns night basically!). They asked if we had spirits in the house - I said yes - quite a lot (usually inherited from Burns night leftovers!). I/we just don't touch it as a norm. then wine - I answered we buy a case of wine at Xmas and that normally lasts us until at least easter, as an indicator of wine consumption (we've still got 4 bottles left over as it happens this year).

I am not doubting at all the terrible effects of alcohol on society and individuals and am not belittling the medical issues surrounding it. But its clear to me that its become such a demon withing the medical profession that there is seemingly no real comprehension of what "drinking" is. Clearly I was down as a hidden alcoholic but none of my answers fitted the mental template these professionals had, and how anybody can get to 40 units a week without a recycling box stuffed full of alcohol bottles.

Then there is the units guidance... 14 units a week. In the UK. Both men and women. Meanwhile elsewhere... Ireland 21.2, Denmark 21, New Zealand 19 and Spain 35!. I asked how it could be that the Spanish levels are over twice that of the UK - were Spaniards more physiologically inclined to cope with alcohol by some genetic thing? No answer. So again without decrying the concerns of alcohol effects etc etc etc etc - its just a line in the sand frankly, a finger in the air. 35 is "OK" for Spanish doctors. So why 14 here? Or if its really 14 after all, then don't Spanish doctors care? They can't both be right...

Its all a bit of a buggers muddle frankly.

As it is I was "advised" to cut my drinking. So I now drink soda water in the pub, though I do miss the taste of some of the excellent beer otherwise available. I can see whoever that when I am next asked the question and I say 5 units a week - they won't believe me anyway. Or will double it to 10 whatever!

Didds

[Lootman]

I was "advised" to cut my drinking. So I now drink soda water in the pub, though I do miss the taste of some of the excellent beer otherwise available.

It is interesting to me that you are, as am I, cynical of these limits, but then you took their advice anyway.

I can see cutting down if you are manifesting symptoms, such as poor liver function tests. Or if drink is causing other problems. But if you are fit, healthy and are not using drink as a crutch, then why cut out beer in the pub? I think I'd rather not go to the pub than drink soda water.

Then again, perhaps that makes me an alcoholic, so I will keep lying to my doctor and he will carry on disbelieving me.

[dionaeamuscipula]

Many years ago, I was posted overseas and had to have a medical before going, presumably for insurance purposes. In those days I was reasonably fit and weighed about the right amount for my height and build. I had not long previously given up smoking, and until about a year before I had cycled everywhere and my 11 mile journey to work took about 35 minutes.

However my workmates and I had lunch in the pub every lunchtime, sinking a couple of pints along the way, as one did (or some, at least) in those days in the early 80s. We would quite often have a quick one on the way home too, and then the weekends and evenings often revolved around the pub as well, or a glass of wine with my housemates.

The doctor doing the medical did all the tests, and then started on the lifestyle questions. He was pleased that I had given up smoking, then asked how much I drank. This was the first time an actual doctor had asked me, and the company was paying quite a sum to have me put through the tests, so I quickly added it up. 3 pints a day, plus a glass of wine, then a few more pints at the weekend. "About 60 units a week" I said. The doctor looked up sharply, looked me up and down, and consulted his notes. "I'll just put down 35 " he said.

DM

[dionaeamuscipula]

Its also clear to me that the medical staff I encounter really don't understand what drinking "is". I don;t mean the effects of alcohol, but "what" drinking is.

I went to a university that had a medical school, although this was many years ago, as I have just said. I can only assume that if the medics out of that school didn't really understand alcohol units it was because they were too wrecked to go to the appropriate lecture.

DM

[bungeejumper]

Maybe I'll head off to Amsterdam and sample some of their fayre.

Ah yes, I imagine you'll want to be heading for a [snigger] "coffee" shop, then?

Which reminds me. I'm long overdue for a quick puff of weed. I've got the bonfire ready, all it needs now is a northerly wind and a match.

BJ

[johnhemming]

It is quite difficult to work out what quantities of alcohol affect people in what ways. Government guidance is almost useless. There is a similar problem when it comes to childhood obesity. I tried to find out how they define when a child is obese, but it was really difficult to get any of the actual measurements.

I do think they tend to exaggerate problems in order to get people to change behaviour. The problem is that I, for example, tend not to be believe what the government are saying unless there is good peer reviewed research that can be used to justify it.

Another example of the government misleading people is the issue of children taking holidays during term time in primarily school. The statistical evidence that is properly produces shows that (in primary school) the old system of allowing this to happen at the discretion of the head in special circumstances did no harm to children's education. In order to justify the change in policy the government (and I assume it is the civil servants here) have produced research that is completely opaque - which still when looked at carefully does not substantiate the arguments for government policy.

Whichever way I used to drink a lot. I have reduced it dramatically more recently because I wish to improve my circadian cycle and the consequential sleep patterns. I am more healthy as a result. However, units are useless as a mechanism for working out the health impact.

One issue which I think should be taken into account is how the body processes alcohol. The same amount of alcohol taken as wine or spirits puts a lot more pressure on the liver than in beer or cider simply because the alcohol concentration of urine is higher than the blood it comes from (that is really because of the other things in blood other than serum (red blood cells, clotting agents). Hence much more beer alcohol leaves the body through the kidneys as a proportion of input than whisky. I am unaware of any research on this that has compared alcohol concentrations and the impact on health. I have a theoretical project to do some practical research on this at some stage.

This is why also I would recommend a pint or two of water after a lot of spirits to reduce the impact on the liver. I am, however, of course not a medic.

[UncleEbenezer]

Many of us have two different booze intakes: drinking at home, and drinking out. Your two bottles at home should be in the ballpark of the three-units-a-day recommended limit[1], but if you also drink out at all regularly it could look quite a lot more.

I wonder if many people would tell the quack about home consumption and omit drinking out (or vice versa) in all innocence, just not thinking about it?

FWIW, I drink less wine than you, but make it up with beer on other days, and very occasionally something stronger. Cheers!

(and why's there no smilie for a drink?)

[1] OK, I have an idea that's no longer current, but YKWIM.

[didds]

It is interesting to me that you are, as am I, cynical of these limits, but then you took their advice anyway.

I can see cutting down if you are manifesting symptoms, such as poor liver function tests. Or if drink is causing other problems. But if you are fit, healthy and are not using drink as a crutch, then why cut out beer in the pub? I think I'd rather not go to the pub than drink soda water.

Then again, perhaps that makes me an alcoholic, so I will keep lying to my doctor and he will carry on disbelieving me.

LOL.

I am on a pretty strict diet to control my diabetes so it all fits - beer just has too many carbs basically. Its not so much the "cut your drinking" aspect really, I'm just very underwhelmed by the lack of joined up thinking across the board.

maybe the real limit IS 5 a week. So Spaniards are basic borderline alcoholics with raging diabetes and cholestrol issues but nobody actually cares!

didds

[kiloran]

then the consultant asks me (as they do....) how much I drink?

Well, I say, I generally buy a couple of bottles of red wine a week, and probably half a bottle of rough red that goes into cooking. She almost drops her biro. Then fixes me with a shocked and ferocious glare.

Even if you double that, it's only 4 bottles a week, or 5 if you include that used in cooking. So that is just three to four glasses of wine a day.

"Only" 4 bottles a week equates to around 36 units. That's uncomfortably high for me.

I wonder what your doctor would say about our household. My wife and I get through about 20 bottles of wine a week. I tell my doctor about half of that, as it happens.

20 bottles a week between 2? Yikes!! I'd be a useless gibbering wreck on that (my wife already thinks that )

--kiloran

[AleisterCrowley]

Pah! I only drink Fri/Sat nights (and holidays) and probably bust the limit by 9pm Friday.
I suspect the committee who set the limit looked at lots of cases and picked the lowest, so it's the safe level for a frail 9 stone elderly man with poor liver function.
Probably an attempt to scare people into cutting down - they think 'crikey I'm consuming DOUBLE the limit' but may actually be drinking at a safe level.
Anyway, yesterday I was at Reading Beer Festival, in a massive tent full of people ignoring their doctors- great fun!!

[Lootman]

"Only" 4 bottles a week equates to around 36 units. That's uncomfortably high for me.

Is it? So a bottle is 9 units? So a glass is 2 units? Thought it was 1.

Depends on the strength though. Wines vary mostly between 10% and 15% ABV.

I wonder what your doctor would say about our household. My wife and I get through about 20 bottles of wine a week. I tell my doctor about half of that, as it happens.

20 bottles a week between 2? Yikes!! I'd be a useless gibbering wreck on that (my wife already thinks that )

We are never drunk. It is a steady drip feed during the day. A couple of glasses with lunch. Maybe one in the afternoon (I don't drink tea). A couple more with dinner, another while watching a film and then a nightcap.

So consumption is at about the same rate as the body processes it.

[AleisterCrowley]

Nobody will miss me, I have no dependents. Not even a cat.

[bungeejumper]

Is it? So a bottle is 9 units? So a glass is 2 units? Thought it was 1.

Used to be, back in the days when wine was 8% alcohol. I think 1.6 units per glass /10 per bottle is closer to the mark now that ABV is widely 14%.

We are never drunk. It is a steady drip feed during the day. A couple of glasses with lunch. Maybe one in the afternoon (I don't drink tea). A couple more with dinner, another while watching a film and then a nightcap.

I sympathise about the tea business. I don't drink tea either, and my one half pint of coffee at breakfast time is often the only hot drink of the day. Which means that keeping hydrated during the day is an issue that requires conscious thought. I am slowly learning to keep a bottle of flavoured sparkling water by my desk. (I can get quite short-tempered when I'm thirsty but don't know it. Something that my wife watches out for on long car journeys.)

I may, of course, be avoiding liver failure at the risk of turning into Donald Trump. But what the heck, my health is astonishingly excellent, making me the healthiest individual ever seen on the Lemon Fool board. I am fortunate to have been blessed with great genes. And I have all my own hair. Not much of it, I grant you, but it's all mine.

BJ

[kiloran]

"Only" 4 bottles a week equates to around 36 units. That's uncomfortably high for me.

Is it? So a bottle is 9 units? So a glass is 2 units? Thought it was 1.

Depends on the strength though. Wines vary mostly between 10% and 15% ABV.

A unit of alcohol is 1cl, so a 75cl bottle at 13% is 75 x 0.13 = 9.75 units.

--kiloran

[didds]

http://www.cleavebooks.co.uk/scol/ccalcoh3.htm

Obviously it depends on the ABV of the wine etc..

1 x 75cl bottle

13% 9.75 units
13.5% 10.1 units
14% 10.5 units

etc
didds

[didds]

I may, of course, be avoiding liver failure at the risk of turning into Donald Trump. But what the heck, my health is astonishingly excellent, making me the healthiest individual ever seen on the Lemon Fool board. I am fortunate to have been blessed with great genes. And I have all my own hair. Not much of it, I grant you, but it's all mine.

BJ

must be the water over your way!

didds