8 days since detox

Ben has been alcohol-free for eight days now. He still doesn’t get to sleep until 4 or 5 in the morning, which means he is usually beached on the sofa for half the day.

But at least he doesn’t stink of drink. And I don’t have to worry about finding ‘anything’ in, on or around the toilet. He has also done a fair amount of house work since he got back – lots of laundry and cooking. He even bought a steam cleaner off of QVC – with the intention of disinfecting the putrid futon.

We’ve come around to the idea of day rehab, largely because we haven’t a choice. We visited one place down in Brixton. It’s run by people with decades of experience in the system, but they’ve only just set up, so things are a bit ad hoc. Equally, their day programme is not at regular hours – times vary from day to day. Which means that Ben wouldn’t have the kind of routine we were all hoping for. At least, that’s what it looks like.

We’re visiting another centre closer to home on Tuesday. Like the Brixton centre, it offers couples counselling. It also offers family counselling and they run a programme specifically for children – meaning that Rosie might be able to come with us when we both go in. I’m getting ahead of myself. First, we need to visit and get a feel for the place. Then Ben will make his decision.

The idea is for Ben to take the day rehab and see how he manages with it. If it doesn’t suit, he will appeal through his key worker. I did ring around to find out what happened – and by some coincidence, ended up speaking to a woman who had sat on Ben’s panel. She told me the usual – that their first port of call is always to treat a patient in the community. She also said, point blank, that residential treatment costs a lot of money and that they have a finite budget for the year. So that was that.

She did say that Ben could speak to her if he wasn’t happy with the day programme. If he had a persuasive enough reason, she would put that forward to the panel when he appealed.

For now, we’re taking it day by day. Every time Ben goes down to smoke a cigarette (at least 20 times/day), a hundred bats take wing inside my stomach. All those fears. All that anxiety.

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.

 

 

 

Step 4 – What if your key worker is unresponsive? Talk to your GP

Once Bianca retired, Ben was in free-fall. He was seeing a different key worker for post detox support – part of the after care package put in place before he went into detox – but he wasn’t being seen regularly by an alcohol nurse/key worker at the local drug and alcohol service that was following his case. This went on for two months. By then, he was back to drinking heavily. Eventually, the post detox key worker had to stop seeing him, because Ben was clearly back on the drink.

Eventually, a new key worker replaced Bianca, but he left before he even had a chance to see Ben. Some weeks later, he was replaced by Sara.

I telephoned Sara to discuss Ben’s case, before she met him. She seemed distant and uninterested, and bent on ending the conversation as soon as possible. I was telling her that Ben was drinking again, that he was heading down the same path he had been on earlier in the year and would end up back at zero if he wasn’t sent into rehab or something similar immediately. I also said that he was talking about suicide. ‘What’s his name again?’ she asked, 15 minutes into our conversation.

That set the tone for her interaction with Ben – and me. She even stopped seeing him for about a month, because he “kept saying the same things to her”. It was precisely during this time that his conditioned dramatically declined.

Whenever I spoke to her, she displayed the same disinterest. She even laughed when I told her that the only food he was eating at the moment were an apple and a few chocolate digestive biscuits. She made appointments with Ben which she didn’t turn up to. I know this to be a fact, because I was present when she made one of those appointments, and I accompanied Ben on the assigned day, only to be told that she wasn’t there. Unlike Bianca, she made no attempt to keep me abreast of developments. If I didn’t ring her, I wouldn’t hear from her.

Fed up with the lack of progress at the service, I accompanied Ben to his next GP appointment (this must have been about a month ago) and complained bitterly about what was happening.

The GP rang them up and queried Ben’s case. I don’t know what he said to them, but a few days later, Sara filled in an application form for detox for Ben, and the alcohol team had decided that detox should be followed immediately by a residential rehab programme – pending an appointment with the community care assessor. (Prior to this, all talk of rehab was firmly discouraged by them.)

Once that was done, they said, a recommendation for detox and rehab would be put before the funding panel. If they okayed it, Ben would be sent immediately into detox.

Last week, Sara left the drug and alcohol service and Ben’s case has now been transferred to a new key worker – Marc. We only found out about this after I complained to the GP again because the community care assessment appointment still had not been made despite promises that it would be made last week and the week before that.

Marc and I have spoken about Ben’s case. He appears to be concerned about Ben’s condition, and insists that they are working as fast as possible. I see him later this week. The thing is, Ben is so ill that I doubt he will make it through another week, let alone two. I feel like I’ve hit a dead end.

Still, the lesson in all this is, if your key worker isn’t responsive, request a new one (in retrospect, I don’t know why we didn’t). At the same time, keep your GP updated on any progress. Your GP is just as much an advocate as a good key worker can be.