Hospital detox

Ben is still in hospital. They are doing a quick and cheerful detox (not sure he’d describe it as cheerful). He’s lying in an acute medical ward, sharing a room with five other men – all of whom are fragile and elderly. He’s got one line going into his hand, is given two injections (one of which is in the stomach), and is on a round of tablets.

Hospital detox is boring. Ben is still shaking and not allowed to walk very far on his own. The drip is what keeps him tethered to his bed, otherwise he’d be roaming the corridors, looking for a place to smoke.

One of the other patients – also an alcoholic – has already broken the rules and had a cheeky cigarette in the ward toilet. He denies it. ‘So, who did?’ presses the nurse. ‘A spirit?’ I can’t stop laughing. Even Ben smiles. The culprit (as the nurse calls him) says, ‘No, no, I didn’t, no.’ He is smirking (although, to be fair, he has looked this way since he was transferred to this ward room). His face is lined, he wears a tuque and his legs are bloated.

When the other nurse arrives, the culprit is upbraided again. Nurse 2 brings a can of something and sprays it here and there, leaving a synthetic sweet vapour surfing on top of the noxious cigarette odour. The windows are promptly opened to let the fumes out.

‘You’re lucky,’ I tell Ben. ‘You’ve got some ready-made entertainment here.’ He nods. ‘At least I got a small hit, eh nurse?’ he jokes. She’d earlier told him he couldn’t go out for a cigarette because he was shaking too much, and because wheelchairs are like ‘gold dust’ at the hospital, and if anything happened to Ben, it would be on her head.

I have little sympathy for Ben’s need in this case. I can’t see why precious resources should be diverted – even temporarily – to satisfy his nicotine addiction. So, I’m with the nurse. Poor Ben looks defeated.

His request for a cigarette break was prompted by a visit from the consultant. Over the course of 4.5 hours, Ben is visited by three people: two from the local drug and alcohol liaison service (they are there to liaise with Ben’s drug and alcohol service) and the consultant. The consultant is firm but honest, dispelling any hope we might have of getting Ben straight into rehab. But before I am destroyed by this news, I realise that he knows little of Ben’s case and does not know that we have already made significant inroads on our journey towards treatment.

In my desperate state of mind, I prefer to hang on to the words of the first specialist. He seems to know a few people at Ben’s local drug and alcohol service and seems willing to endorse his request for quick admission into rehab. It’s a long-shot, but not impossible. I want to believe it is possible.

So tomorrow, I am back to work, but also, back on the phone to all these various pieces in the treatment puzzle: Ben’s key worker, his community care assessor, the two people from the local alcohol liaison service. I’m fed up of being fed a line. I’m going to keep badgering until the wall crumbles and the lines are reeled back in.

 

 

 

Accident and emergency

Ben was admitted to hospital. It wasn’t planned.

He woke up shaking, but determined to get to his regular psychology appointment at our local NHS drug and alcohol service. I stayed home from work to make sure he got there without injury. Today was also going to be the day he would finally be assessed for rehab. I was going to accompany him to that appointment, too.

While Ben was with his psychologist, he took ill; he was in acute withdrawal. They called an ambulance. His psychologist, Jane, came to get me (I was waiting outside). I found him sitting on the floor of one of the consulting rooms, his face grey, his body trembling. We ended up in A&E at a hospital an hour away from us.

There was a lot of waiting. We waited an hour before a nurse showed Ben to his own little curtained cell. About 30 minutes later, they wheeled a bed with a filthy mattress into the cell (Ben was sitting on a plastic chair until then). Another 20 minutes went by before they disinfected the mattress and bed frame (with a disposable wipe), dried it and put a sheet on it. The fitted sheet kept springing off at the top, bunching up behind Ben’s head. The bedding looked grey and dirty, even though it had been cleaned.

About 20 minutes later, an A&E doctor came in to speak to Ben and me. She asked us all the same questions the ambulance staff asked us:

  1. how are you feeling?
  2. what brought you here today?
  3. when was your last drink?
  4. is it normal for you to vomit if you haven’t had a drink?
  5. how long have you been drinking for?
  6. blah,blah,blah.

This doctor ordered several bloods, two x-rays and said she was admitting him to hospital for a couple of days. While she was taking his history, Ben vomited. A nurse, who seemed to have been beamed in from a planet far far away, took several vials of blood and put a line in. She pumped some medicine into a vein in his forearm, then attached two drips. Ben was also given four colourful capsules, with no water. The water took another 10 minutes to arrive.

Once the doctor left, we sat in silence. I read through a 4000-word document on my mini smart phone. I listened to the doctors’ and nurses’ banter. ‘Are you normally constipated?’ asked the doctor in the cell next to us. The patient had severe abdominal pains, which the consultant declared were either:

  • appendicitis, or
  • constipation.

Ben was wheeled away briefly for his x-rays, then wheeled back. He wanted to take out the line so he could go and smoke. I told a nurse he needed the toilet… and that he might need a cigarette. The nurse brought him a pulp-paper cardboard gourd to pee into. And said ‘too bad’ when Ben said he wanted a cigarette. Inside, I was cheering.

A few hours later, a consultant from the medical team, where Ben was destined, came to speak to him. She asked him questions 1-5 several times, and each time, Ben answered slightly differently, before I corrected him. It wasn’t until I was on a bus going home that I realised the consultant was testing his memory.

I stayed with Ben for nearly four hours. He still hadn’t been given a bed when I left to pick up Rosie. I think it was probably around 8pm when they finally sent him upstairs.

Our local NHS drug and alcohol service rang up Ben several times while he was in the ambulance and once in the hospital. It was more times than they have rung him about anything before.

 

Managing my anger

Today, I had my first psychology session at our local NHS drug and alcohol service. Sara, Ben’s previous key worker, had managed to do a few constructive things before she left. I’d asked her several times whether it would be possible for me to get some support from the service, and after checking with management, my request was accepted. It took about four months of waiting, but I got it in the end.

My psychologist, Elisa, is young, probably half my age. I feel vaguely ridiculous blurting out my problems to this demi-child. She has a rose ring and black lace-up army boots. She reminds me of me when I was that age (minus the nose ring). She looks like she should be pulling pints in a grunge bar, rather than sitting across from me, listening to me complain about having to clean up Ben’s vomit.

After five minutes of inchoate rambling, I finally tell her what I’ve rehearsed for so long – that my objectives in accessing this treatment are:

  1. having a safe place to unload my stress
  2. diffusing my perpetual state of rage
  3. accepting that alcoholism is a disease and not a choice (my rational mind knows this, but my heart won’t accept it).

I tell her that just before my session, Ben rang me to say that I should be open ‘about us’. He meant that I should accept partial blame for his condition – that if I didn’t recognise this, then there was no point. I tell her that I do accept partial blame – that I recognise how damaging it can be to live with someone who is hyper-critical (that’s me – hyper-critical – of myself and everyone and everything around me).

But I also say that he was drinking before he met me. That he has always been alcohol dependent, and that it is unfair to lay the blame entirely on me. I tell her a lot of other things I didn’t expect to tell her – a tale of neglect and intense loneliness (mine). And darting below all this, like a ravenous shark, my anger.

It is always there, ready to burst and consume us all. Sometimes, I think my temper will set me alight. I imagine immolating myself on the pyre of my own rage. This is the image I carry around with me every day. The thing that makes me tremble when I’m trying to get everything organised and ready in the morning. The thing that drives me up that hill again and again when I’m running (sprint up, jog down backwards, again and again and again). The thing that sends my pressure along with my volume to the top of the scale.

It is a long hour. Just 35 minutes into the session, I think I’ve already exceeded my time. By the end, I’m exhausted, but a little lighter. I make another promise to myself, to Rosie, even to Ben, that I will find a way to check my anger, find a way to  manage and channel it, regardless of its causes.

Depression

This is the root of his alcoholism: depression. Ben is clinically depressed and on Prozac. But the Prozac hasn’t had a chance to work, because of the amounts of alcohol he’s necking. He’s adding a negative to a positive and ending up with zero.

As every specialist will tell you, depression is a chemical imbalance in the brain. And alcohol is a depressant, so if you’re depressed and you drink, you’re just feeding your depression. One of the best ways to counter depression is with physical exercise. But Ben has gone from being an energetic, fit man to an idle, exhausted one.

He slouches around in the alcoholic’s costume: shapeless, stained sweater, ragged jogging trousers, ill-fitting jacket with deep pockets (deep enough to hide a can or small bottle), scuffed trainers. His feet are bone white. He is always cold.

I see them everywhere now. Shuffling about in their drunks’ uniform, some wearing dark glasses and knitted tuques.

One of them regularly begs in the pedestrian subway by my local tube station. His nose is a ravaged potato, his face red and ruined.

At my unkindest moments, I’ve told Ben he might as well join the pedestrian subway guy, because that’s where he’s sure to end up the way he’s going. He’s not far off now. He’s lucky I haven’t thrown him out, because that’s exactly where he would be, sitting on a broken bit of cardboard, nursing a tall can, holding out a dirty palm or paper cup…

This is the thing that stops me from sending him packing: the thought of walking by him one day with Rosie. What would she say? Would she recognise him? Would he her? How would we explain it to her? Would she ever forgive me?

So was it the depression or the alcoholism that came first? Hard to say. Both run in his family. His mother is depressive. She has also been alcohol dependent. What I do know is that his alcoholism is fuelling his depression. He’s coasting down into a dark and oily well. Before we know it, he’ll be there with pedestrian subway guy – in spirit (see what I did there?) if not in body.

If we’re lucky, the treatment they offer him will address his depression – unlock the root of his anxiety and help him find healthy coping mechanisms. I’m waiting for Monday, and that elusive rehab assessment. But Monday feels like a whole continent away right now. And the end of next week, a whole world.

Step 5 – Don’t be disheartened by NHS red tape

Ben has been waiting for treatment for his alcohol addiction for several months now. We have been through the mill, raising the alarm about his deteriorating condition as early as last October. Five months of chasing later, and it really was Ben’s GP’s intervention that opened the crucial door.

But my worry lately has been whether we are too late – whether Ben’s health has declined so dramatically that an urgent hospital admission will be necessary, scuppering our hopes of getting Ben into a long-term treatment programme.

Today, we made one minor (possibly major) breakthrough. Ben’s new key worker, Marc, confirmed that the appointment we had been waiting for with the community care assessor – the one which will determine whether or not Ben is a suitable candidate for residential rehab – is finally happening on Monday.

Apparently, Ben’s manager will be making this assessment. It is unclear to me why this couldn’t have been done earlier, since Marc had said that Ben needed to be assessed by someone external to our local NHS drug and alcohol service and now it transpires that someone within the service, namely a manager, is also qualified to do it. I am biting my tongue right now, saving my queries or complaints for later, since the main objective is currently within sight.

Even Ben seems to have been buoyed by this latest news and was upright when I got home with Rosie this evening. He’d managed to prepare the bathtub for her and roast some potatoes for dinner. He’d put a load of washing in the machine. And he’d taken out the rubbish. This new found, if limited, energy can only be attributed to a renewed sense of hope.

Ben’s GP has also been very good at ringing us back when we’ve left messages for him. He has been the lynch-pin in this whole process. Without his intervention, we would still be at sea.

Still, we mustn’t get ahead of ourselves. Marc was very clear with me today that things would not happen ‘over night’. Once the assessment on Monday is complete, the team’s recommendations for Ben’s treatment – namely for detox and residential rehab – need to go before a funding panel. The panel meets every Wednesday, but there is no guarantee whether that paperwork will be completed in time for it to be submitted by the coming Wednesday, in which case, we are facing yet another week’s delay.

And if the panel rejects the application, we are back to square one.

I prefer to assume that the panel will pass the application. I can’t believe that all my complaining/lobbying/beseeching will come to nought. If it comes to it, I have further avenues to pursue – starting with Ben’s GP, again. As long as he remains on our side, Ben has a good chance of finally getting the treatment he desperately needs.

Maybe withdrawal will kill him

This is what I’m thinking now. I’ve tried everything. I’ve tried speaking to Ben’s new alcohol key worker. I’ve tried ringing the GP to tell him that Ben is bedridden and hasn’t eaten anything for days. I keep telling all of them that he hasn’t got more than a few days before he collapses from organ failure or whatever else alcoholics in withdrawal are levelled by. He is acutely malnourished. He is drinking to ward off the more serious manifestations of withdrawal, but he is still throwing up anything he tries to eat – which is very little.

I made him two tablespoons of porridge and begged him to eat it. He ate some of it earlier this evening. I heard him retching outside just now (his illness has no discretion – not only does he drink by the side of the building, but he vomits out there, too – it’s only a matter of time before one of the neighbours knocks on the door).

I am unable to concentrate at work. I worry that he will go into convulsions while I’m out and I’ll return with Rosie to find his body contorted and stiff on the futon.

I don’t understand how the people at the drug and alcohol service can’t see the danger he is in. I don’t understand why they can’t simply do whatever it takes to get him into treatment urgently. I don’t understand why no one – no one –  is listening to me.