Boozeless in Vancouver

Has quitting alcohol been beneficial for my chronic illness?

It has now been two months since I last had a drink.

As I cruised past the first one-year anniversary of Project Try Everything, I finally started trying one the most obvious things on my huge list of things to try: ditching booze.

This harmonizes with a broader clean-living initiative, seeing how much it helps me to spend the summer really behaving, you know?  Tick all the healthy lifestyle boxes for a while. I think everyone with chronic illness fantasizes like this: Maybe I’ll feel better if I just crush every single bad health habit I have! And do all the good ones, too … which will takes like, what, 28 hours per day, but you can’t put a price on your health, amiright?

But my booze habit was badder than all my other bad habits put together. Last October I described booze and ultimate as my two most obvious self-destructive addictions.

“Surely if I intend to ‘try everything’ to help myself,” I wrote, “quitting alcohol must be at the top of my list,” but also: “I just honestly don’t know if I have it in me.”

After two months, I guess I do have it in me to keep the alcohol out of me for a while. I’m not thrilled, but apparently I can do it.

Why now? Partly because my liver might be in trouble.

That’s the executive summary (for all you executives).  Now for some details…

How does it feel to not drink after years of daily drinking being literally my only predictable source of relief from pain? Well, it feels kinda shitty! I’m not going to lie: I still think of it rather longingly every single late afternoon. But I’m coping. Frankly, I’m used to suffering. C’est la vie.

The medical investigation reboot has begun

One of my goals for Project Try Everything was to try doctors again, after numerous unsatisfying experiences since my troubles began in 2015. And so, on May 4, I saw a doctor for the first time during Project Try Everything, and the first time since 2021.

I did not go and say, "I’m one of those difficult cases, fix me!" Indeed, I said very little about my bigger picture. (This was not a visit with “my” doctor, mind you, just “a” doctor: Canada doesn't have enough family docs, and I haven't been able to find one for years now.  I should really try again, but until I solve that problem I have to just use walk-in clinics and get care without context.  Also, they aren't walk-in clinics anymore: overwhelmed since the pandemic, now they only do appointments. 🤦🏻‍♂️)

Mostly I just wanted referral to a rheumatologist, because my single highest medical investigation priority is to check again for signs of autoimmune disease. All past attempts have come up empty, but it’s been a while, and I spent much of the last year seeming an awful lot more like an rheumatoid arthritis patient than ever before.  There's been a slow but steady drift towards conventional inflammatory arthritis symptoms over the last few years, but they really surged last fall.

Although I have some symptoms that are “extra,” I also now have every single typical RA symptom.

So I just listed my RA-ish symptoms, and made a vague reference to feeling generally rather poorly for quite a while (understatement), and asked for a referral to a rheumatologist.

I got more than I bargained for.

So. Many. Tests!

Strangely, the doctor ordered a lot of tests, more than I’ve ever had at once, and mostly stuff I didn't even ask for. Maybe I should have told this particular doctor that I had a weird medical history.

So I did the tests, and — for the first time ever — there was a nasty little surprise in the results.

Which had nothing to do with autoimmune disease. We found no biomarkers that point that way.  But that doesn’t mean a great deal on its own. False negatives are common.  I see the rheumatologist in a month.

My lipid profile is a bit of a train wreck, but this isn’t new or surprising, and it’s probably due to familial hypercholesterolemia — a genetic predisposition to high cholesterol levels, a losing battle I’ll be waging for the rest of my life.  (Dear family: Thanks a bunch!)

Sneak preview — I have a very weird but definite success story to tell about one single symptom. A major symptom, and an embarrassing symptom, seems to have been properly defeated. That post coming soon. Watch for it!  There will be some “poop” in the title.

The somewhat more interesting liver results

My liver enzymes were a ways out of range. Too much alanine transaminase (ALT). For my lab, 0-50 is normal, and I netted 121. Sounds bad, doesn’t it?

But it’s not as bad as it sounds, because ALT can surge into the high hundreds and even the thousands if your liver is truly borked. In fact, the range is so great that physicians apparently think in terms of multiples of the upper limit of normal. Up to three times the high end of normal is a bit meh, more of a fire drill than a fire.

Also, “more study needed.“ ALT is not especially informative on its own.  “Bit of liver trouble, maybe” is about the clearest message you can get from an ALT of 120. The ALT number can get boosted by all kinds of things, including a couple that might have affected this test (a workout, and acetaminophen).

Natural trivial volatility also seems very possible.

So an ALT of 121 might mean something, and it might not.  But the most likely thing it might mean?  The steady diet of booze is irritating my liver.

The doctor called me almost immediately after the test results came in, and asked very diplomatically, in an almost musical Scottish accent: “Is it possible that you enjoy a wee bi' o' alcohol on the regular?”

A perfect description!  1-2 drinks per day for years.  And given my small body mass, it’s probably more like 2-3 drinks for someone else. Not a lot, and never more, but highly consistent.

No one's going to believe I was already on the verge of quitting

But I totally was, I pinkie swear! In fact, it was a long-planned spring and summer project to get into the most challenging phase of Project Try Everything, the “act like a health nut” phase, with at least three major goals:

1. stop drinking

2. slowly but relentlessly increase all my activity and exercise levels to new highs

3. get serious about taking it easy, take a major holiday

The liver test scores were just extra incentive! I'll have more to say about that bigger picture soon. For now…

Do I feel better after not drinking for two months?

Not really, no.

Two months seems like long enough that I would hope that I could feel a clear difference, but … I just don’t. Nothing obvious. I feel more or less the same as ever, with a modest trend towards “better.”

I probably do feel a little better these last couple months than I was all winter before that … but the winter was particularly awful, and I certainly hoped/expected that it would ease up eventually on its own. My issues have always come and gone in slow waves. This current wave of improvement does line up with the booze cessation, but it has also been slow and subtle, it was overdue in any case, and it has a half dozen other plausible explanations. 🤷🏻‍♂️

Also, some key symptoms haven't improved at all.

My liver enzymes are down, though, so at least there’s that! I re-tested a month after qitting, and my ALT improved to 87, and two new ones were normal and only slightly high — which is probably about what you'd expect to see if the original ALT score was high thanks to drinking in the first place. But it also doesn't prove anything.

In fact, the liver enzyme most strongly associated with alcohol was the normal one. That test tends to be so sensitive to the effects of alcohol specifically that it’s very hard for it not to be high if alcohol is the source of liver stress. And yet mine was normal! I put this logic to my doctor, perhaps demonstrating why doctors don’t like me, but he took it in stride: “Just so! But medicine is no’ an exact science, laddie. Until I see evidence to the contrary, I say alcohol is your culprit here.”

Fair enough, and so it goes.

Am I going to continue not drinking?

For at least a while longer, yes.  I’ve suffered to much to quit quitting now!

I think I need to give it a minimum of four months, if not six, to feel like I’ve truly given my body a chance to fully recover from years of daily light poisononings.   Recovery from almost anything is usually slower at first, and then picks up speed, so — optimistically — this is exactly when I might start to see a positive change.

Fingers crossed … but not holding my breath either.