How much is medically acceptable?

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rednekhippiemotrcyclfreak

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So I get a call from the preadmission nurse regarding a procedure I have scheduled next month. One of the questions is "do you use alcohol and if so how much?" My answer is of course yes and I drink about 6 to 8 beers a week. There is a perceived gasp or at least a "hmmmm" on the other end followed by a series of questions about my drinking history. One of the questions is "Have you ever worried or felt that you drink too much or you should cut back on your alchohol consumption?" Eventually I start asking questions in reply or possibly in defense and she says that the real concern is whether I might start experiencing withdrawal before I am released from the hospital.
So are there any 6 pack a week alcholics out there?
It all just seems a little overboard to me but I could be living in la la land. I don't know. Any thoughts from my drinking colleagues?
 
I had a similar thing happen to me with a physical where I did my internship.

"Have you ever smoked?"

"Yes."

"Hmmm we're going to have to do more tests. How many cigarettes do you smoke a day?"

"A day? I have probably smoked 20 in my life."

"So you've just started smoking?"

:facepalm: "No. I mean I smoke very very rarely. Like one every 3 months."

"So you're trying to quit but are having difficulties with your addiction?"

"What?"

10 beers a week is about the max of what I drink. But it's usually 2 or 3 during the week and the rest over the weekend. My SWMBO actually drinks more of my homebrew than I do...
 
This why I don't bother telling the truth in most cases, or at the very least sugar coat it.

Do I smoke? No. I do smoke cigars occasionally, but it's not worth saying yes to.

Do I drink? A couple times a week. And I'm sure if you averaged it out over a month or year that's true. Sometimes I'll have a beer a night for a week, other times I won't drink for several weeks straight.

But it seems every time you answer "yes" to such questions, it's assumed you have a "problem".
 
The answers on this thread are exactly why they asked more questions - nearly everyone lies so they assume you do as well. If many of us have 3 beers 3-5 days a week but report just one beer with dinner - they assume you're reporting lower than actual as well. I've had the same conversation because i tell how much I actually drink.

I assume a good number of people on this forum land in the clinical category of alcoholism - as have a huge portion of humans ever since we figured out how to control fermentation and made booze readily available. If you're not missing work, f**king up your life or otherwise damaging yourself with beer - then don't worry about it. :)
 
I don't really see the problem with a beer a day. It's not like I need to have it. I haven't had a beer all week then had 2 last night. I usually skip a few days now and then. IMHO if you find yourself skipping a meal and drinking a six pack instead more than a couple nights a week, then there might be a problem.
 
medical professionals and their assistants always think the worst of me. because I brew beer, I'm a raging drunk. because I have a messed up grill, I'm a meth head. because I used to smoke, I'm intentionally killing everyone around me. they see a bald, toothless, tattooed junky. I quit caring what the doctors say regarding my life & personal habits. they've already made up their minds.
 
Hahahahahaha. I used to be in HR for a chain of hospitals. Most of the time you are lucky if nurses show up to work sober...

An exaggeration... but not by much. In my experience, nurses are largely a drinkin' and smokin' bunch.
 
sonofgrok said:
Hahahahahaha. I used to be in HR for a chain of hospitals. Most of the time you are lucky if nurses show up to work sober...

An exaggeration... but not by much. In my experience, nurses are largely a drinkin' and smokin' bunch.
Click to expand...

Many of us never come to work under the influence as it is a major felony. However, most medical professionals outside of work drink a lot and a lot smoke. It helps deal with the stress. I rarely get drunk and dont smoke so i am definitely an outlier in the medical world.
 
Yeah I love to drink. I have even had some smoking history. I know that if I tell my doctor these things, or even the people i work with (doctors which are not taking care of me), I will get "the look". Screw that. I sugar coat it. I "drink occasionally, or socially" totally non-decript but true. Not that much, a couple here and there. The funny thing is that you really know the person that you should be directing the person at. You know she is drunk right now, and probably had a fifth of smirnoff for breakfast. you know she is also going to tell you she doesnt drink that much. its a stupid systemic approach that doesnt work. Just like TONS of other goverment ideas.

end rant

lol
 
rs4life said:
Many of us never come to work under the influence as it is a major felony. However, most medical professionals outside of work drink a lot and a lot smoke. It helps deal with the stress. I rarely get drunk and dont smoke so i am definitely an outlier in the medical world.
Click to expand...

Hence why I called out the coming to work drunk as an exaggeration. Although I have had to terminate people for exactly this violation. I actually have the utmost respect for medical professionals and nurses in particular. It is a **** job and you really have to have a passion for it or you wont make it. BUT many of the unhealthy people I know are doctors and nurses! ;)

Cracks me up in a somewhat sad way... its like the cardiologist I know that smokes easily a pack a day and is probably close to 100#s overweight!
 
Seriously though, I work in cardiology. Alcohol is slow poison to the heart. There are many here on HBT that can attest to heart problems and a neccesitated reduction in drinking. Not to mention liver disease.
Alcohol is brutal. Moderation is key. A glass of wine a day is recommended by half of the worlds doctors, so there are pros and cons. A glass of wine a day is 7 drinks a week. Tell your doctor that you follow their regimen and you are suddenly labeled a drunk... whoops back on the rant... lol. The questioning also is in line to help prevent you from progressing your "addiction" and therefore disease.
 
sonofgrok said:
Hence why I called out the coming to work drunk as an exaggeration. Although I have had to terminate people for exactly this violation. I actually have the utmost respect for medical professionals and nurses in particular. It is a **** job and you really have to have a passion for it or you wont make it. BUT many of the unhealthy people I know are doctors and nurses! ;)

Cracks me up in a somewhat sad way... its like the cardiologist I know that smokes easily a pack a day and is probably close to 100#s overweight!
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I can assure you this, If I had to spend 8-12hrs a day in a box full of sick people, I would be drinking heavily, same if I had to be in one full of obnoxious germy kids
 
Up to 2 drinks a day is often medically recommended for raising certain levels of "good" cholesterol. At least two of us on here have had that "prescribed," by health care professionals.

As mentioned in this thread; I Have Doubled my Alcohol Consumption , Homebrewdad and I were both given the same advice.

When It orginally happened when I began Cardiac rehab, I posted this in my heart surgery thread.

Revvy said:
This is cool....In the packet of stuff from the re-hab nurse is a rundown on my cholesterol and measures to improve it. My HDL is 36 and for men it should be above 40. Under the section of "Measures to improve it," it says-

Low saturated fat diet, excercise, weightloss, smoking cessations (I haven't smoked cigarettes in years.)

2 drinks/day
And a drink is considered
12 oz of beer
5 ounces of wine
1.5 ounces of 80 proof liquor.
Click to expand...

Anyone wanna go out for a shot and a beer with me...A DAY? ;)

Fyi my numbers are pretty good.

Cholesterol (Desirable numbers <200 ) My Number- 114
LDL (<70) Mine 57
HDL (> 40) Mine 36
Triglyceride (<150) Mine 104
Click to expand...

Most weeknights I only have one beer....some weekend days I may have several more than the recommended about, especially if there's a brewing thing going on. Some days I have nothing at all.

But if the idea of 2 drinks a day is seen as a beneficial standard, that nurse should not have been shocked by your numbers. There's 7 days in a week, and 2 drinks a day would be 14 drinks....less than what you stated you.
 
BrewGeek_Ohio said:
I don't really see the problem with a beer a day. It's not like I need to have it. I haven't had a beer all week then had 2 last night. I usually skip a few days now and then. IMHO if you find yourself skipping a meal and drinking a six pack instead more than a couple nights a week, then there might be a problem.
Click to expand...

Key words being "more than a couple"?
 
Revvy said:
Up to 2 drinks a day is often medically recommended for raising certain levels of "good" cholesterol. At least two of us on here have had that "prescribed," by health care professionals.

As mentioned in this thread; I Have Doubled my Alcohol Consumption , Homebrewdad and I were both given the same advice.

When It orginally happened when I began Cardiac rehab, I posted this in my heart surgery thread.

Most weeknights I only have one beer....some weekend days I may have several more than the recommended about, especially if there's a brewing thing going on. Some days I have nothing at all.

But if the idea of 2 drinks a day is seen as a beneficial standard, that nurse should not have been shocked by your numbers. There's 7 days in a week, and 2 drinks a day would be 14 drinks....less than what you stated you.
Click to expand...

True that EtOH raises hdl but it raises triglycerides as well.


To the topic in general (not revvy)
I do 15 or so h&ps on patients in the hospital per week and know patients lie about their habits. One patient recently said he drank about a six pack a day of heineken but was admitted for having serious withdrawals. A six pack just doesn't fit at all. But it delayed the diagnosis because we weren't sure it was withdrawal. Turns out he drank a lot more than that.

Another recent patient denied smoking marijuana, but his room reeked of bud 2-3x per day. I'm pretty sure his wife was sneaking it in.

Doctors don't really care how much you drink per se. I don't judge people. But giving an accurate number is important in clinical diagnosis. If they judge you, so what? It's totally illegal to tell anyone so it stays between the you and the practitioner.

There are two people you should never lie to-- your doctor and your lawyer. I understand feeling the need to fib (I drink 3-4 beers a night to relax, except obviously when on call), but it doesn't do any good. Either the guilt is legitimate and may indicate a problem and at least gets you thinking about it, or the medical "professional" is being a dick. There are plenty of dicks, but the former is important and worthy of consideration.
 
kroach01 said:
...I do 15 or so h&ps on patients in the hospital per week and know patients lie about their habits. One patient recently said he drank about a six pack a day of heineken but was admitted for having serious withdrawals. A six pack just doesn't fit at all. But it delayed the diagnosis because we weren't sure it was withdrawal. Turns out he drank a lot more than that...
Click to expand...

But that is the problem I see people talking about here. The person asking the question is automatically thinking well everybody is lieing to me so whatever they say must be 2-3x more. So when the honest guys comes in he is labelled as drinking 2-3x more than he actually does for no good reason other than some other drunk lied and cause holdups until we realised so we'll just treat this guy the same to speed things alone... hmmmm I wonder why he isn't responding to the treatment for alcohol withdrawel?
They should take everything said to them based all on the factors presented. If a guy comes in with a shriveled up liver, reacking of cheap whiskey and can hardly remember his own name but say he only has one beer with dinner per day - call his bluff.
 
I agree with most things kroach said, except about judging. You may be non-judgemental, but the majority of medical staff are judgemental. Severely. Its their job. You have to trust your judgement to treat patients, so you rely on it to classify all sorts of patients. Is the little girl who fell down the stairs with a broken clavicle clumsy or abused? Is the confused guy a drunk, or have alzheimers? Is that guy who has lower back pain and has a little blood in his urine actualy have kidney stones or is he drug seeking? (my sisters ex used to hit himself in the kidneys to make bloody urine, and get percocet from the ER) There is medical judgement and there is personal judgement, and both are needed, so both are used on everyone which ends up making us 1-beer-a-night drinkers alcoholics. :tank:
 
NuclearRich said:
I agree with most things kroach said, except about judging. You may be non-judgemental, but the majority of medical staff are judgemental. Severely. Its their job. You have to trust your judgement to treat patients, so you rely on it to classify all sorts of patients. Is the little girl who fell down the stairs with a broken clavicle clumsy or abused? Is the confused guy a drunk, or have alzheimers? Is that guy who has lower back pain and has a little blood in his urine actualy have kidney stones or is he drug seeking? (my sisters ex used to hit himself in the kidneys to make bloody urine, and get percocet from the ER) There is medical judgement and there is personal judgement, and both are needed, so both are used on everyone which ends up making us 1-beer-a-night drinkers alcoholics. :tank:
Click to expand...

But that is hard to do over the phone! And then blanketing all that drink a beer a night as alcoholics doesn't help. For a phone interview the only thing I can see useful is to take everything that is said at face value and note down anything to check when they actually come in. And don't sound so ****ing judgemental because if you get that from saying you drink 1 beer a night, when the next question is "do you use drugs" you are even less likely to tell the truth!
 
Anytime you mention that you drink beer they are worried about withdrawl. My Dad had a couple surgeries years back and they were worried about him. He has been drinking 3-4 beers per day for as long as I can remember. Sometimes more if he was in pain, he doesn't like to take pain pills. One of the surgeries he was in the hospital for a few weeks and nothing happened. I don't think the average beer drinker should be grouped in with the hardcore alcaholics.
 
mattd2 said:
But that is hard to do over the phone! And then blanketing all that drink a beer a night as alcoholics doesn't help. For a phone interview the only thing I can see useful is to take everything that is said at face value and note down anything to check when they actually come in. And don't sound so ****ing judgemental because if you get that from saying you drink 1 beer a night, when the next question is "do you use drugs" you are even less likely to tell the truth!
Click to expand...

I agree with you. Its crap. I am not a doctor, I dont do h&p, I am just along for the ride. I dont care what my patients do, because I'm worse than half of them. I just see it in action. I dont agree with it.

Im on your side.
 
A pattern of behavior is the hallmark of clinical alcoholism. If you drink 6 beers a week but they are all on friday night every week then you could be a clinical alcoholic. Personally I have never ran into a doc or nurse that cared about my alcohol consumption (5/week) but always get hell about my caffeine intake. Even though all my numbers are fine every time I go in.
 
NuclearRich said:
I agree with most things kroach said, except about judging. You may be non-judgemental, but the majority of medical staff are judgemental. Severely. Its their job. You have to trust your judgement to treat patients, so you rely on it to classify all sorts of patients. Is the little girl who fell down the stairs with a broken clavicle clumsy or abused? Is the confused guy a drunk, or have alzheimers? Is that guy who has lower back pain and has a little blood in his urine actualy have kidney stones or is he drug seeking? (my sisters ex used to hit himself in the kidneys to make bloody urine, and get percocet from the ER) There is medical judgement and there is personal judgement, and both are needed, so both are used on everyone which ends up making us 1-beer-a-night drinkers alcoholics. :tank:
Click to expand...

I admit this is true. Most will judge a patient. You seem to be on to the reason as to why we need to make judgements -- time is limited and we need to quickly make diagnoses. And people come in with absolutely crazy situations that they just don't want to talk about. I have seen some really, really crazy things that I would never, ever think of. Crazy sexual escapades disguised as accidents, drug problems with elaborate cover-ups.... Stories that just don't match clinical exam and lab values at all. And on and on it goes. But the theme remains the same -- to truly help the patient, they have to be honest. It is illegal for us to talk to anyone about it and the story remains with us. There's no reason to lie to the doctor. If they judge you incorrectly and look down on you they're doing it wrong or are acting on instinct.
 
mattd2 said:
But that is hard to do over the phone! And then blanketing all that drink a beer a night as alcoholics doesn't help. For a phone interview the only thing I can see useful is to take everything that is said at face value and note down anything to check when they actually come in. And don't sound so ****ing judgemental because if you get that from saying you drink 1 beer a night, when the next question is "do you use drugs" you are even less likely to tell the truth!
Click to expand...

Analyzing a patient over the phone is a very very very poor way to do medicine, first of all.
I, for one, don't judge a patient if they have 2-3 beers a night after a stressful day at work. If they come to me and don't present with complaints at all related with alcohol abuse I have no reason to be suspicious. But if someone comes in with clinical symptoms clearly indicating alcohol or benzodiazepine withdrawal yet they say only a few beers a night, it is in the patient's best interest not to believe them. Alcoholics definitely tend to deny they have a problem and will lie about it. I'm not saying everyone! People die from alcohol withdrawal, up to 20% of those experiencing Delirium Tremens, and it helps no-one to disregard symptoms that smell, look, sound, and taste exactly like alcohol withdrawal. Especially not the patient!
The reason drugs is asked after alcohol is because it is part of a systematic and structured history. We ask alcohol, smoking, and drug history. They fall into the category of "social history", hence it is useful to group these things together. I ask every single patient these questions and do not single anyone out. It is a vital part of a history and physical.
Again, there is no reason to lie to your doctor. Everything is 100% confidential.
 
I'm in the "don't lie to your medical provider" camp. They ask because it matters. Most of us on here are enthusiasts that enjoy beer...almost without exception we are on the border of having a problem...from a clinical perspective. One/two drinks per day is considered OK...but 7 beers twice a week is certainly unhealthy....and from a medical perspective the line is pretty clear: when you start exceeding 2 drinks per day the negatives outweigh the benefit. It doesn't mean you can't function, are a drain on society, or a DUI waiting to get caught....it just means you are causing issues that start to add up over time.
 
I recently started drinking once a night before bed. It relaxes me and I've been stressed lately. Prior to that it was 5/week, so not big increase.

I was sick for a few weeks and mentioned to a friend that I was on cold meds and therefore not drinking since i didn't want any conflicts and he paused and looked...I dunno, impressed. Apparently he assumed I was alcoholic and was incapable of stopping on demand.

It weird-ed me out so I asked my doctor about it during my physical, telling him I drank 6 beers a week (pints) so roughly 3 liters a week. He told me until I hit 15 beers a week I didn't classify as an alch-ie. Though I'm pretty sure he was thinking 12 oz bottles.

He exact words were 'when you hit 15 bottles a week, we'll talk. You're not an alcoholic.'
 
kroach01 said:
Analyzing a patient over the phone is a very very very poor way to do medicine, first of all.
I, for one, don't judge a patient if they have 2-3 beers a night after a stressful day at work. If they come to me and don't present with complaints at all related with alcohol abuse I have no reason to be suspicious. But if someone comes in with clinical symptoms clearly indicating alcohol or benzodiazepine withdrawal yet they say only a few beers a night, it is in the patient's best interest not to believe them. Alcoholics definitely tend to deny they have a problem and will lie about it. I'm not saying everyone! People die from alcohol withdrawal, up to 20% of those experiencing Delirium Tremens, and it helps no-one to disregard symptoms that smell, look, sound, and taste exactly like alcohol withdrawal. Especially not the patient!
The reason drugs is asked after alcohol is because it is part of a systematic and structured history. We ask alcohol, smoking, and drug history. They fall into the category of "social history", hence it is useful to group these things together. I ask every single patient these questions and do not single anyone out. It is a vital part of a history and physical.
Again, there is no reason to lie to your doctor. Everything is 100% confidential.
Click to expand...

Kroach01, and NuclearRich: sorry my post was not aimed a those that do it how it should be done. A thouragh examination of all the ques, verbal and otherwise. I agree with the way you approach the situations Kroach01, if it looks like a duck and quacks like a duck but says honest to god it is a dog - shoot it and make a nice duck curry out of it because your insticts in a situation you have been trained for and repeativly enconter are more like right and will save a lot of heartache later down the track.
I was aiming my comments at the OPs situation where over the phone he is obviously being labelled as a drunken drain on society because he admits to have a drink most nights for no other reason than their preconcieved idea that whatever the person tells me I'll double/tripple/quadruple it and get my real answer - that is (as you said) not doing their job properly and is likely to cause people to lie more on the following questions which will include drugs/unprotected sex/other stuff some people do not like to talk about openly.
 
As kroach mentioned, alcohol/bzd withdrawals are very serious (significantly more so than heroin, even), and it CAN cause death, typically due to seizures.

So with something that is literally a matter of life and death, which many patients cannot fully appreciate, it kind of makes sense to err on the side of caution. The medical staff knows what to watch out for, and alcohol withdrawals are very easily mitigated by drugs like clonazepam, diazepam, lorazepam, etc.

I'm not so sure the nurse was that out of line though. She asked some follow up questions, and the OP asked why, and she was upfront in explaining what they were screening for.

The problem with assuming that people are telling the truth is that so many (and IIRC, actually MOST) don't. Some of this is people telling their medical professionals straight-up lies, but in most cases, people tend to unconsciously minimize. We pretty much all do it at one time or another, but the degree to which we do so can vary widely. So it's incredibly difficult for a doctor or nurse to be confident in what any given patient tells them. And since assuming a non-alcoholic is dependent on alcohol has very little effect, while assuming an alcoholic is telling the truth when he says that he's not can have fatal consequences, it's really no surprise that they err on the side of the former. You may end up feeling judged, but it's a heck of a lot better than the alternative.
 
emjay said:
As kroach mentioned, alcohol/bzd withdrawals are very serious (significantly more so than heroin, even), and it CAN cause death, typically due to seizures.

So with something that is literally a matter of life and death, which many patients cannot fully appreciate, it kind of makes sense to err on the side of caution. The medical staff knows what to watch out for, and alcohol withdrawals are very easily mitigated by drugs like clonazepam, diazepam, lorazepam, etc.

I'm not so sure the nurse was that out of line though. She asked some follow up questions, and the OP asked why, and she was upfront in explaining what they were screening for.

The problem with assuming that people are telling the truth is that so many (and IIRC, actually MOST) don't. Some of this is people telling their medical professionals straight-up lies, but in most cases, people tend to unconsciously minimize. We pretty much all do it at one time or another, but the degree to which we do so can vary widely. So it's incredibly difficult for a doctor or nurse to be confident in what any given patient tells them. And since assuming a non-alcoholic is dependent on alcohol has very little effect, while assuming an alcoholic is telling the truth when he says that he's not can have fatal consequences, it's really no surprise that they err on the side of the former. You may end up feeling judged, but it's a heck of a lot better than the alternative.
Click to expand...

But the point of this thread was he was being judge by someone (not even sure it was a doctor/nurse) on the other end of a phone. They had nothing else to go by other than his answer. I agree with you that a medical professional needs to use all the information present to make their diagnosis and for the most part the actual verbal information is not the most important part, but to jump to those conclusions based of a phone call is out of line. If there was no "hmmmmmmmmmmm" it would have been a completely different story I would guess (or non at all).

I guess the flip side to all the post backing up why doctors/nurses need to not go by face value is that if you are conducting a phone interview don't sound like a judgemental prick just because you have seen others that have lied in the past. Go by all the information you have on hand, which in a phone interview is probably the answer to the question and any verbal ques such as slurring, etc. because if you don't people will get defensive and will start lieing to you
 
Doesn't anyone think that a little interrogation is the correct thing to do in this case? ESPECIALLY since she couldn't actually see the OP? Isn't that the only way she can get a handle on his actual status?

I don't lie to my doc. The new one looked a bit suspicous when he asked if I drank and how much, but I don't care. I explained I make my own beer and really enjoy the hobby. Maybe he just thinks everyone who homebrews is an alcoholic. He didn't ask any further questions so apparently he didn't think I actually had a problem.

My old doc was thrilled I drank 1-2 a night. He would actually ask my questions about my brewing once in a while.
 
i told my doctor i have 2 beers a day, he just shrugged his shoulders and said, "yeah, that's fine...", with a "what's your point" look on his face.

i was expecting to get a lecture
 
Homercidal said:
Doesn't anyone think that a little interrogation is the correct thing to do in this case? ESPECIALLY since she couldn't actually see the OP? Isn't that the only way she can get a handle on his actual status?...
Click to expand...

I think I need to clear up my stance on this. I have no issue with the questions, further questions with regards to previuos answers and in general the person trying to get as much information as possible with the means they have (phone, person to person).
My issue with the OPs experience is with her reaction to his answer that he drinks 6-8 beers a week - the gasp or "hmmmmm". A reaction like this is likely to get anyone at least a little defensive and is totally unproductive in this sort of situation where you want the person to be as open as possible.
 
Homercidal said:
Doesn't anyone think that a little interrogation is the correct thing to do in this case?
Click to expand...
Yes, as I mentioned a few posts up.

mattd2 said:
I think I need to clear up my stance on this. I have no issue with the questions, further questions with regards to previuos answers and in general the person trying to get as much information as possible with the means they have (phone, person to person).
My issue with the OPs experience is with her reaction to his answer that he drinks 6-8 beers a week - the gasp or "hmmmmm". A reaction like this is likely to get anyone at least a little defensive and is totally unproductive in this sort of situation where you want the person to be as open as possible.
Click to expand...

It's really hard to know what to think of the "gasp" or "hmmmm" bit. Even the op doesn't seem to remember exactly what it was, and a "hmmmm" is not necessarily judgmental... it could simply be her thinking of whether or not to do a follow up test. And I seriously doubt she was gasping out of shock that someone drinks about a beer a day. We weren't there, so none of us know the possible nuances of what happened. Only the op does, but even that is open to misinterpreting.

The fact that this whole thing rests on a particular interpretation of a very brief vocalization says it all, IMO. She really did everything she should have. Can it get a patient on the defensive? Absolutely. But a wounded ego is nothing compared to what can happen if she errs on the side of making sure she doesn't ruffle anybody's feathers.
 

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