Total amount raised: £2130.00 ... including Gift Aid: £2501.26

Friday, 26 December 2014

Laziness

Walton PureGym 7.30am, Boxing Day
I am a big fan of laziness. I champion it. I think time spent in idle contemplation, relaxing, reading, drinking and socialising is time well spent. It has to be balanced by work and productivity - I think you should earn your leisure time to make it more meaningful - but it seems too many of us have bought into the myth of hard graft making us all winners. For most of us, our labour is making someone else a winner. And that winner is usually a prick.

In the light of the last 12 months, I might have to reassess the above sentiment. It could well have been the booze talking. This year I was sending work emails on Christmas Eve and in the gym by 6.30am on Boxing Day, where for a full hour I was joined by no one. Which surprised me. I thought there'd be a few. When there isn't one other person doing what you're doing you start to wonder if what you're doing might be a little bit weird.

Thing is, much as it's nice to spend time clearing up after and sorting out arguments between the kids, I rather enjoyed being productive on Christmas Eve, and I rather enjoyed going to the gym this morning. Christmas Day itself was... well... calorific?

I've enjoyed working hard this year. Possibly far too much. But it has brought its rewards, and I'm enjoying those too.

I guess it's all about balance.


Wednesday, 24 December 2014

One week to go

So then we started this hip-hop outfit...
It's been an interesting year. I'll admit, not drinking has given me the capacity to work harder.

Or at least, I think it has. It might just be that I've had more work.

I've certainly had less fun, but I've become more determined and learned a lot.

I've got a sober Christmas to go, two days work at ITN and then we're off to my brother-in-law Dave's, for NYE.

Rather than post the traditional "Wahey!" video of me having my first drink in a year at midnight, I am tempted to collude with Dave and the other houseguests to recreate the scene below. For lolz.

But I have a feeling they'll all be too pissed.

This project has a sponsorship element. If you have been holding off donating to see whether or not I make it all the way, believe me, I've got this far - Christmas won't trip me up. If you can see your way to bunging the four worthy causes I'm supporting a few quid, I would be most grateful.

Have a wonderful Christmas.

Sunday, 30 November 2014

Home straight sighted

I've already chosen my first drink when this is all over. Some very nice people sent me a Christmas hamper the other day.

It contained three bottles of booze, including a bottle of Fortnum and Mason champagne. I felt it would be appropriate to put the champagne aside for midnight on New Year's Eve.


The last drink I had as the pre-bong Big Ben bells rang out on NYE 2013 eleven months ago was champagne so it seems like a neat ending to the project.

I suspect thereafter the pattern will follow a similar one to the last few New Years Eves - watching the fireworks on the telly, switching back to Jools Holland straight afterwards and falling asleep on the sofa at 1am before dragging ourselves to bed ready for the 6am onslaught.

As the home straight approaches I have been planning a bit of a cheeky January. There are some old friends I haven't seen for a while, and I'd like to fix a night out to say thank you to those who have kindly put some money in the kitty.

In the meantime, I have work to attend to. A couple of sponsors have asked questions:

1) Could I write something on the metabolism of alcohol in relation to other energy sources?
2) Have I finished Dr Marjot's second book Addiction: A kind of loving?
3) Having left thousands of avid blog readers on tenterhooks with This is Hardcore Pt 1, could I write up This is Hardcore Pt 2, so everyone knows what happened in the second experiment?

To which the answers are:

1) Yes I'd love to, it fascinates me, but I need to get research time which I currently don't have.
2) No, but I'd love to. I spent a bit of time with it recently and finally understood a key part of the reunion/attachment theory, which I'd also love to write up, if I had the time.
3) See answer 1).

I will try to get something on one of the three subjects together before the end of the month, but, y'know... work... Christmas...

One thing I will be writing about over the course of the next 31 days is sponsorship. I'm not a good hustler, and the world is full of people constantly asking other people for charitable donations.

But the joy of seeing the money come in, the response from the charities (heart-meltingly grateful and charming with it) and realising what a very generous bunch of people I am lucky enough to know has made me determined to try to prise a few more quid out of those around me.

To be honest, the charitable donation element to this project has served its purpose. Having bound myself in to several early sponsorship commitments, a dual sense of pride and parsimony (I committed to refunding double any donation out of my own pocket if I did have a drink this year) stopped me from falling off the wagon.

There was one moment in late March where I know I would have cracked if the prospect of a very public humiliation hadn't stopped me. Whilst cussed determination might have got me through the last eleven months, it was entirely fuelled by your generosity.

If you would care to join the merry throng of freewheeling debit card dilettantes, this is how to get on it. If you would rather wait until 1 Jan 2015, then my double donation cashback offer becomes redundant and you lose any possibility of ever seeing your donation again. But you will actually know I have done what I set out to do. Either way, I am keeping the fundraising page open for a few weeks into 2015 to hassle people some more.

Finally if you think this is all massively over-indulgent, faintly pathetic and have absolutely no intention of making a donation - I can't say I blame you. I haven't really done much. Your eyeballs on this blog are reward enough.

Tuesday, 25 November 2014

It’s a bit like being a vegetarian

Carrot on Steel - Nick Wallis (2014)
Being sober in a drinking world is like being a vegetarian. I don’t know why it’s taken me eleven months to realise this. 

The moral high ground, the generally feeling healthier, the creeping certainty other people are having more fun than you…

I respect vegetarians and vegetarianism.* I aspire to eat less meat. I could probably go quite happily without it.

Vegans are proper hardcore. I once tried a vegan diet and lasted two weeks. It’s a lifestyle which requires great bundles of morality and fibre.

Being teetotal is much the same. All these drunk people ruining the world, ruining themselves and me. Me. Me being a little bit special. Not just a better person, but also able to remind people of The Path I Have Chosen every time we go for a drink or a meal.

Richard Herring stopped being a vegetarian once he realised he probably liked slightly annoying people with his moral superiority more than he enjoyed not eating meat.**

I would hate Britain to become the sort of society where having a few sherberts after work is no longer considered okay. Where career, family and vegetariansim/environmentalism/charity/church/over-consumption of material goods become life’s be-all and end-all.

I’d like to think there is a place for hedonism, rueful recovery and the occasional opportunity to put aside our worries and celebrate being alive. So long as most of the time we’re all eating carrots.

***************

* Though my friend Natt (a comedian and journalist currently pulling up trees at usvsth3m) points out vegetarians must not like animals as they clearly want to see far less of them around. Natt only eats animals who have lived well. If the restaurant doesn’t know the provenance of its meat, he’ll take  a vegetarian option.

** The person Richard told this to (Sara Pascoe, in another excellent RHLSTP) eloquently argued he should have remained vegetarian notwithstanding - if you believe in the idea of vegetarianism voting with your wallet makes a real difference.

Monday, 17 November 2014

Alcohol Awareness Week


I am making a start to alcohol awareness week wired up on coffee.

I am also reading on the front page of today's Times that more and more professional women are presenting with liver problems due to excessive drinking.

Better stop committing crimes whilst drinking
I am reading on twitter this morning (via Jeremy Hopkins) about a report which points out alcohol's role in protecting against heart disease only works for 15% of the population and a Guardian piece about older drinkers becoming more of a problem as younger people foreswear booze.

I am not even going looking for this stuff. It's everywhere. I consume the daily drip of news articles on alcohol (whilst bearing in mind most journalism on science is misleading and most medical studies have gaping flaws) and I look at our behaviour and I wonder. I really wonder.

Search the hashtag #alcoholawarenessweek and you get a barrage of frightening stats, advice and very well-meaning people desperately trying to stop you opening that extra beer or bottle of wine this weekend.

It is perhaps denialist and irresponsible to suggest an apparent level of hysteria. Health professionals and the emergency services see what alcohol is doing to too many people, daily.

Unless the reason WHY is Because You Enjoy It
If I've learned one thing this year it is that everyone who drinks is playing with fire. Alcohol is a seductive drug - once in our system it will make our brains demand more until we are well beyond safe limits. It then embeds itself in our neural pathways to ensure going back to unsafe limits becomes habitual. Even tiny amounts can permanently alter our behaviour, so that even when it is not coursing round our bodies, it directs us back towards a reunion. The more you drink and the more you have drunk, the more likely and often this happens until:

a) you stop drinking
b) you die

Is it a risk worth taking? Well that's the million dollar question. When I think about the happiest times of my life, alcohol has been involved. Would they still be the happiest times of my life without alcohol? No. They wouldn't have happened.

Important, richer and more fulfilling experiences like watching your child being born and getting married don't make you happy in the way alcohol can - these are far more profound episodes that make you a better person and give you a deeper understanding of life. Booze is irrelevant to that.

Still seems like a good deal
Alcohol is a useful short cut, a quick release and, handled properly, a way of shrugging off the stresses and responsibilities life throws at you. I contend (once it has left your system and only once it has left your system) it can put you in a better frame of mind to deal with those stresses and responsibilities when they return. Others vehemently disagree.

This year has taught me many things about my relationship with alcohol and the nature of the drug itself. I haven't been afforded any particular insight into my own spiritual well being. There is no clarity. But it has allowed me to stop and see what a teetotal life entails: hard work, fewer smiles, with death lurking at the end of it. I would certainly be a wiser and better person, but I'm not sure I would be happy.

It's premature to come to any firm conclusions right now.  It's what I take forward into next year, when I start drinking again, which will really measure how useful this exercise has been. Until then, happy Alcohol Awareness Week. Mine's a latte.

The Joys of Drinking

Saturday, 8 November 2014

Target reached!

Wahey!
Thanks to an extraordinarily generous donation to each of the four charities this blog is supporting (see picture above) I have now reached and exceeded my fundraising target of £1000.

I am very grateful to Kirstie and the Spence Family Trust who have donated the £400 those cheques represent. Writing one cheque is a physically and emotionally exhausting process nowadays, writing four is dedication above and beyond the call of duty.

I am, of course, most grateful to everyone who has put some money this blog's way. From Stephen the Crawley Town fan who chucked in a fiver the moment my Virgin Giving page went live to the stranger in Dubai who read an article in the Times of India written about alcohol by a man called Nick, managed to confuse him with me, but donated anyway in memory of his alcoholic father. Every time I get an email notification of a donation of any size it puts me in a proper happy mood. Which is helpful when you are not drinking.

I have a choice now. My totaliser stands at £1305. I could try doubling my target to £2000 and then spend the next couple of months hassling you to give me money. But why risk failure?

That said, I am sure the four causes I am supporting would appreciate it if you did have any spare cash, target or no - so please don't let my inherent lack of ambition stop you from clicking on the Virgin Money Giving button on the right hand side of this page.

Thank you - thank you for reading, thank you for donating and thank you for all the kind words you've said about this blog. Next post - how to get brain damage from drinking! Yay!

.

Tuesday, 4 November 2014

This is Hardcore pt 1


Here's another tale from Dr David Marjot's book, The Diseases of Alcohol. Don't try this at home.

In 1955 ten male prisoners were asked to take part in a scientific experiment. All were, allegedly, willing volunteers.

The aim of the experiment was to see if delirium tremens and/or 'rum' fits were caused by alcohol withdrawal.

The prisoners were sane and physically fit.

They started off being given a 133ml daily dose of alcohol every two hours across the course of the day. 133ml is the equivalent of an 18% vol bottle of port, or 13.5 units a day.

Each day the dose was increased.

The prisoners were soon being given between 367ml and 465ml of alcohol a day.

367ml is roughly equivalent to a 70cl bottle of 40% vodka and a 75cl bottle of 12% wine. A day.

465ml is roughly equivalent to a 70cl bottles of 40% vodka, a 75cl bottle of 18% port washed down with two cans of Kronenbourg. A day.

In all cases, both metabolic and behavioural tolerance occurred, brain activity slowed, and the men displayed symptoms such as tremor, nausea, vomiting, hyper-reflexia, anxiety and depression.

At one stage, one of the prisoners had to cut back on his alcohol intake because of nausea and vomiting. He developed hallucinations as his blood alcohol declined, but these disappeared once he got back on the programme. Dedication.

After 36 days of being given increasing doses of pure alcohol, the volunteers had their supply abruptly cut off.

Six patients rapidly became tremulous, hyper-reflexic, sweated profusely, could not sleep and lost weight. Two of the six had convulsions. Five of the six developed hallucinations and three of the six were disorientated. The other four showed only mild tremors, weakness and nausea.

It is not noted whether any or all of the men suffered lasting medical problems.

The experiment's basic conclusion was that it is possible to suffer from the symptoms of alcohol withdrawal whilst very drunk. Useful stuff.

It wouldn't happen nowadays, of course.

But it did happen again. A decade later, in the sixties. This time the experiment was expanded.

TO BE CONTINUED





Sunday, 2 November 2014

Calories in alcohol

Drug takers in a drug den on my news telly last night
The BBC's Dominic Hughes ventured into a boozer on Friday on the back of a report which suggested, nay demanded, calorie information be made obvious on each alcohol purchase.


As part of the ten piece, Mr Hughes (above, left) asked drinkers to rank the above items in calorific order. If you can't see the choices in the picture, they are:

a) a pint of lager
b) a large (250ml) glass of red wine
c) a doughnut
d) a pint of Guinness.

Here's your answer:



Basically, five pints of lager = four doughnuts = 900 calories.

I don't want to be too glib, because one of the ways I learned to lose weight was by realising how many calories there were in everything, and then not eating as much.

Last year I lost a stone without drastically modifying my alcohol consumption. I still drank as much as I wanted, but there were times when I stopped myself from having a ("just one") pint because the effect it would have on me calorifically outweighed the effect it would have on me psychoactively.

However, in the general scheme of things 900 calories is a small price to pay for a cracking night out. I would rather forgo a posh dinner and stick to the five pints if it meant sneaking in under my calorie goal. Certainly my awareness of the calories in alcohol stopped me compounding the problem going home via the kebab van.

This year is different. I have not had a drop of alcohol. Yet I have not lost any weight.

For the last 22 years alcohol, and the carbs in its delivery system, were a regular part of my diet. You would have thought the weight would have been falling off me in 2014. Sadly not.

Have I been compensating for my lack of alcohol by eating more rubbish? Probably.

On balance, the more information you have about anything, the more likely you are to make a better decision. This kind of stuff:



is, therefore, fine by me. It won't work, it's not the answer, but it's a small nudge in the right direction.

*******************

All pics: BBC News

Thursday, 30 October 2014

The physiological effects of alcohol

I have always been more concerned by the psychological power of alcohol than its physiological effects.

That was until I read about its physiological effects.

What follows is by no means a comprehensive list. It was taken, with kind permission, from Dr David Marjot's excellent book The Diseases of Alcohol. Much of it is copied (by hand) word for word.

I have tried to explain some of the medical language, and in doing so (or in the transcription), may have made some mistakes. Any mistakes, therefore, are my responsibility.

So, this is what booze does to you:

Nervous system disorders

Eyes - in moderation alcohol may protect against macular degeneration. In excess it may hasten its development. Alcohol increases the risk of cataracts.

Cerebellar atrophy (brain cell wasting) - a common companion of Korsakoff's psychosis (a disease for proper alcoholics). Moderate doses of alcohol (one bottle of wine daily over a long period) can lead to the loss of Purkinje cells (quite important bits of your brain) in the cerebellum.

Purkinje cell at the top

There is also a possible link between cerebral atrophy and (alcoholic) dementia. Alcohol, particularly in heavy drinkers does cause loss of brain substance - both white and grey matter. These changes can be partly reversed by abstinence.

Other brain disorders due to alcohol - Marchiafava-Bigami degeneration, myelosis of the corpus callosum and Central Pontine myelosis.

Nutritional disorders

Thiamine deficiency: Myopathy, encephalopathy (eg Wernike-Korsakoff disease, cerebellar atrophy and peripheral neuritis)
Folate deficiency: Raised mean corpuscular volume of red blood cells (MCV)
Niacin deficiency: Classic pellagra with pigmented dermatitis, diarrohea and dementia (all rare)
Vitamin D and calcium deficiency: Osteoporosis and osteomalacia (heavy drinkers only)
Protein deficiency: usually due to poor intake

Disordered digestion due to direct effects of alcohol on gut mobility, damage to the lining of the bowel, or pancreatic and liver disorders.

Malabsorption of nutrients associated with disorders of the liver and pancreas, nutritional deficiencies and gut bacterial activity.

High utilisation and poor retention of vital nutrients.

Metabolic changes

Hypoglycaemia (low blood sugar) - usually occurs after an alcohol binge or in children during one, a mechanism being the inhibition of gluconeogenesis.

Hyperglycaemia (high blood sugar) - alcohol can cause a rise in blood sugar due to activation of the sympathetic-medullary system with adequate glycogen stores in the liver. If the islet cells in the pancreas are damaged or lost due to alcoholic pancreatic damage, then insulin-dependent diabetes can occur.

Hyperlipidaemia (too many fat-soluble molecules in the blood) - can occur in heavy drinkers that may be also associated with other alcohol disorders such as pancreatic malfunction, renal disease, diabetes and liver insufficiency. There is a disturbed LDL/HDL ratio.

Hyeruricaemia (too much uric acid in the blood) - changes in the alcoholic liver (in particular the reddox shift) can lead to an excessive production of uric acid with high blood levels and associated gout. Most gout, though, does not come from heavy drinking.

Stroke - heavy drinking causes hypertension and arterial disease. This increases the risk of strokes and coronary artery disease.

Fits - Grand mal fits (jerking and muscle seizures) can happen during withdrawal/early abstinence, but withdrawal symptoms can also be seen while a patient is still drinking heavily. Tremors due to alcohol withdrawal can become clonic movements and pass into fit.

Peripheral Nervous System Disorders

Peripheral neuropathy - primarily an axonal sensorimotor wallerian degeneration. This is only associated with a long period of heavy drinking, and women may be more susceptible than men. The distal lower limbs are affected, in worse cases the proximal leg and distal arms. Symptoms include weakness and muscle wasting, particlarly of the small muscles in the foot. Foot drop may occur.

Sensory loss - touch, sensation (heat and cold) and pain. Gait may be affected with a wide base when walking. Tendon reflexes are diminished or absent. Burning pain, particularly in the feet, may be common.

Alcoholic autonomic neuropath - diarrhoea, constipation, bowel incontinence, bladder incontinence/retention, loss of sweating, peripheral vaso-dilation or vaso-contraction with heat or cold intolerance. Irregular heartbeat or even failure. Loss of control over blood vessels with postural hypotension and faints.

Pressure neuropathy - can occur if a patient becomes unconscious or comatose after a bout of heavy drinking. Prolonged pressure over many hours can lead to severe damage to a peripheral nerve.

Chronic or atrophic myopathy - muscle wastage. Not entirely clear how alcohol does this, but it is by far the most common skeletal muscle disorder in those dependent on alcohol. Cured by abstinence.

Gastro-intestinal system

Parotid Gland enlargement - common sign in heavy drinkers. The swelling is likely to be a direct effect of regular alcohol consumption and subsides with abstinence.

Mouth and pharynx disorders - Pre-cancerous changes such as leukoplakia and cancers themselves can be observed. Swallowing may be affected by alcohol-associated neuropathies (nerve diseases/problems) and encephalopathies (brain diseases).

Pancreatitis - quite common complication of heavy drinkers. Pancreatitis is most likely a chronic disease with exacerbations (ie acute pancreatitis). Acinar cells metabolise alcohol. This in turn may cause pancreatic stellate cells to produce fibrosis, changes very similar to those seen in cirrhosis of the liver.

Malabsorption syndromes - a number of changes can occur to the small bowel due to heavy drinking. Impaired pancreatic function often associated with hepatic dysfunction (liver failure) can lead to malabsorption. In some cases motility is affected by neuropathy. Alcohol (or it's metabolite acetaldehyde) has a direct toxic effect on small intestine cells causing villous atrophy and smooth muscle myopathy. It also causes a reduced synthesis of proteins.

Liver disorders

Alcoholic Liver Disease (ALD) - a major cause of morbidity and mortality in heavy drinkers which is in no way confined to alcoholics. Women develop cirrhosis at half the accumulated lifetime alcohol intake of men.

As little as 25 ml of alcohol (approx one 175ml glass of 12% wine) a day in women and 75ml (three 500ml cans of Kronenbourg) a day in men over several years can bring ALD on.

In men, 75ml a day over a period of weeks can bring fatty changes to the liver, 100ml (four cans of Kronenbourg) a day can cause Acute Alcohol Hepatitis (AAH) and 200ml (eight cans of Kronenbourg or just over two bottles of 12% wine) a day over around ten years can lead to cirrhosis.

When alcohol reaches the liver three enzymes are involved in its initial breakdown; alcohol dehydrogenase - responsible for 80% of the metabolism, cytochrome P-450 2E1 (CYP2E1) and catalose for the rest.

The metabolite is acetaldehyde that is broken down to acetate by mitochondrial aldehyde dehydrogenase. Hydrogen is produced that converts nicotinamide-adenine dinuclucleotide (NAD) to its reduced form NADH. This has the effect of increasing the redox potential in the liver. Fatty acids are replaced as  active energy-producing metabolites

The three types of Alcoholic Liver Disease:

Fatty liver or steatosis: probably the most common liver consequence of drinking too much. There is an accumulation of fat in large vesicles such that the nucleus is displaced to one side. Small vesicles can also occur that are more evenly distributed. This latter represents mitochondrial damage. The liver is enlarged and the cut surface is yellow. Abstinence will cause the condition to reverse.

Acute Alcoholic Hepatits: The source of inflammatory damage in ALD is probably acetaldehyde. It changes stellate cells lining the blood sinusoids to fibroblasts that are active products of collagen. This fills in the sinusoids with obstruction to the blood flow and associated metabolism. Kupffner cells respond by an inflammatory cytokine cascade, bringing about the release of tumor necrosis factor alpha (TNF alpha). Toxins including gut bacterial toxins are not broken down with the production of inflammatory cytokines and active leucocytes that further cause inflammation. This starts up a cycle of inflammation and scarring. The typical pictures is of macrovesicular fat, neutrophil, infiltration, Mallory bodies and liver cell necrosis.

AAH will often resolve through abstinence, if irreversible liver failure hasn't happened. AAH with liver failure may still respond to cortico-steroids.

Cirrhosis of the liver: These are features of fatty liver and acute inflammation but the picture is dominated by widespread fibrosis which destroys the liver architecture. Initially there are small island of regenerating liver cells (micro-nodular cirrhosis) and later with larger nodules (macro-nodular cirrhosis). The liver shirnks into a jaundiced scarred organ with surface marked by the nodules - the hobnail liver. The clinical picutre of ALD can be one or more of the following elements:

 - symptomatic hepatomegaly
 - acute hepatits with fever, upper right quadrant pain, liver tenderness, jaundice, prolonged INR, raised liver enzymes, hypoglycaemia, raised sedimentation rate.
- acute liver failure with acute encephalopathy.
- chronic liver failure.
- spider naevi, Dupuytrens' contractures, feminization in the make
- portal hypertension, oesophageal varices, GI bleeding, ascites, portal-systemic encephalopathy, hepato-renal syndrome.

The development of hepato-cellular cancer does make the prognosis grave.

Only around 15% of heavy drinkers develop ALD.  Abstinence will bring about a stabilisation in the majority of patients. If the cirrhosis is too severe, the disease will remain progressive, but at a slower rate. Transplant remains an option if liver failure persists.

Blood disorders

The effects of alcohol on the haemopoietic system are complex. There is a positive correlation between acetaldehyde modified haemoglobin, values for carbohydrate deficient transferring (CDT), raised gamma-glutamyl transferase, aspartate aminotransferase and haematological abnormalities in alcoholism. There is also evidence for folate deficiency in some patients.

Anaemia

Macrocytosis of alcoholism: The mean corpuscular volume of red cells is a frequent finding in heavy drinkers. Most patients are not anaemic so it could be related to folate deficiency, but it could equally be a direct toxic effect of the alcohol itself.

Blood loss: This may be direct, such as the result of damage in the gastro-intestinal tract such as bleeding oesophageal varices. Alcohol also lowers platelet counts, particularly if the spleen is enlarged.

Haemolytic anaemia and sidero-blastic anaemia.

Leucopenia (low white blood cells): The suppressive effect of alcohol on bone marrow leads to poorly functioning white blood cells and in some case to leucopenia. This has a marked effect of resistance to infection, typically in the lung.

Macrophage (groovy white blood cells) disorders: There is evidence that the initial cirrhotic effect of alcohol is on the liver macrophages with initial local inflammatory responses not only to harmed liver cells but to damage to the macrophages themselves. A similar mechanism could be at work in the lungs with impaired defences against infection.

Thrombocytopaenia: Alcohol suppresses the production of platelets by the bone marrow. The bone marrow shows a general loss of cellularity, megaloblastosis, vacuolation of developing red cells and sideroblasts. The peripheral blood picture reflects these changes.

Kidney disorders

Alcohol can be associated with a number of renal conditions:

Acute tubular dysfunction
Acute tubular necrosis after binge drinking
IgA nephropathy with glomerulonephritis
Hepato-renal syndrome
Inhibition of anti-diuretic hormone ADH
Hyponatraemia (low sodium in the blood) - secondary to high fluid intake
Hypokalaemia (low potassium in the blood) - due to poor retention of potassium
Hypophosphataemia (low phosphate in the blood) - due to poor renal absorption
Hypocalcaemia (low serum calcium in the blood) associated with loss in the urine, poor albumin binding, lack of vitamin D, muscle breakdown and magneisum deficiency.

Heart and blood vessels

Hypertension (high blood pressure) - even in non-alcoholic patients there is a connection between alcohol and high blood pressure. The effect of alcohol may be greater than that of salt intake. Low alcohol intake (less than a third of a bottle of 12% wine a day), has no effect on hypertension.

Arrhythmias - particularly atrial fibrillation can be associated with a bout of heavy drinking. This can occur in healthy subjects causing sudden death, particularly during exercise. The mechanisms are obscure but may be related to dys-regulation of cardiac rhythm by changes in adrenergic stimulation, or poor vagal control of heart rhythm.

Cardiomyopathy (heart muscle disease)

Alcoholic cardiomyopathy - not clear whether alcohol and/or acetaldehyde are the toxic agents. While there are increases in cardiac enzymes on biopsy it is not clear if these are an adaptive response or evidence of damage. Some patients show antibodies to acetaldehyde-protein adducts. Treatment is to reduce alcohol intake.

Thiamine deficiency cardiomyopathy - in some drinkers (not all alcohol dependent) thiamine deficiency can occur with the development of the syndromes of heart failure with oedema or wet beri-beri and peripheral neuritis or dry beri-beri. Both may occur at the same time. Thiamine deficiency may arise as a result of high utilization (as part of the hypermetabolic state induced by very heavy drinking), low intake of thiamine and poor retention of that little taken in.

Coronary heart disease

Alcohol in small doses may reduce the risk of coronary artery disease, possibly due to an increase in high density lipoproteins HDL associated with coagulation and fibronolysis. Alcohol reduces the chances of coronary artery clots and if clots occur there is a slightly more rapid fibrinolysis with attenuation of the clot.

The effect on coronary artery disease means that stable, moderate, regular drinkers not taking more than 30ml of alcohol (ie one pint of Stella or a third of a bottle of 12% wine) a day do show overall reduced mortality compared with non-drinkers. In practice this only benefits the middle-aged.

It seems from this study the best possible thing you can do with your life and alcohol is not drink until the age of 45 and then have one drink a day until you reach your sixties, then other things like cancer come into play and you are better off stopping.

Whoop. Tee. Doo.

Blood disorders

The effects of alcohol on the haemopoietic system are complex. How complex? There is positive correlation between acetaldehyde modified haemoglobin, values for carbohydrate deficient trasferring (CDT), raised gamma-glutamyl transferase, aspartate aminotransferase and haematological abnormalities in alcoholism. That complex.

There is also evidence for folate deficiency and an effect on developing blood cells with possible effects on haemapoietic growth factors.

Macrocytosis of alcoholism - the mean corpuscular volume of red cells is a frequent finding in heavy drinkers. This may be related to folate deficiency in some cases but a direct toxic effect of alcohol seems a simpler explanation.

Blood loss - this may be direct, such as the result of damage in the gastro-intestinal tract (ie bleeding oesophageal varices). Those with liver disease may suffer from low levels of vitamin-K dependent coagulation factors. Alcohol also lowers platelet counts particularly if the spleen is enlarged.

Haemolytic anaemia - there is Zieves syndrome in which there is a haemolytic anaemia, jaundice, hyperlipoporteinaemia associated with cirrhosis of the liver.

Sidero-blastic anaemia - can occur in poorly-nourished alcoholic patients. High iron with low folate readings. Responds to abstinence.

Leucopenia - the suppressive effect of alcohol on bone marrow leads to poorly functioning white blood cells and in some cases to leucopenia.

Macrophage disorders - there is evidence that the initial cirrhotic effect of alcohol on the liver macrophages with initial local inflammatory responses not only to harmed liver cells but to damage to the macrophages themselves. A similar mechanism could be at work in the lungs with impaired defences against infection.

Thrombocytopaenia - alcohol suppresses the production of platelets by the bone marrow. The bone marrow also shows a general loss of cellularity, megablastoisis, vacuolation of developing red cells and sideroblasts. The peripheral blood picture reflects these changes.

Dem bones

Chronic excessive alcohol use leads to increased nitrogen excretion associated with loss of lean tissue mass (becoming therefore, an effective, but incredibly unsafe way to lose weight). In animal studies alcohol caused loss of bone protein.

Osteoperosis - alcoholism is a risk factor for osteoperosis. If you abstain or take more than two drinks a day you are at higher risk of hip fracture. Bone density falls as alcohol intake rises.

Osteonecrosis - secondary to trauma but still a problem with alcoholics. Associated with osteonecrosis: vascular damage, cell death and defective repair.

Immunity and infectious disorders

Alcohol has many effects on the immune system. It inhibits the activity of the cellular non-specific response to infection. Among the cells affected are neutrophils, macrophages and natural killer cells. also involved are soluble mediators such as complement, cytokines, leukotrienes and prostaglandins.

One of the functions of the natural killer cells is to seek out and destroy the body's own damaged cells such as cancer cells. This may be one of the mechanism whereby alcohol 'causes' cancer

Alcohol affects the function of T-cells and B lymphocytes in transforming B lymphocytes into plasma cells and producing immunoglobulin antibodies.

There may be a an excess of antibody IgA that is associated with autoimmunity. This antibody can become deposited in tissues including the kidney. It can be associated with inflammatory liver disease and give rise to the hepato-renal syndrome.

Most humoral responses involve B lymphocytes, CD4 T lymphcytes and antigen presenting cells. If any of theses cells are affected then the immune response if reduced; as with B lymphocytes and alcohol. This refueced response is critical in the body's reaction to tuberculosis and pneumonia.

CD4 T and CD8 T lymphocytes are essential for cell medicated immune responses, particularly for viruses. The function of these cells is impaired by alcohol. The most significant co-factor in the progress of hepatitis C infections is alcohol.

The primary effects of alcohol are to create a functional immunodeficiency but also autoimmunity.

Endocrine disorders

The endocrine system is a collection of glands which secrete hormones into the bloodstream in order to target distant organs - pineal gland, pituitary gland, pancreas, ovaries, testes, hypothalamus stc

Corticotropin-releasing factor (CRF) is released in the brain in those central systems involved critical to the development of addiction, apparently in response to the stress of withdrawal. NPY is used to ;calm' these systems. Central effects doimpinge on the hypothalamus and on to the control of the hypothalamic-pituary adrenonocortial system.

Pseudo-Cushings Syndrome is the result of stimulation to the pituitary by CRF with the release of adrenocorticotropic hormone (ACTH) and the output of cortisol via the adrenal cortex. This can lead to the Cushing's picture of typical facies, abdomnial striae, proximal muscle wasting, bruising, hypertension and osteoperosis. You have to be drinking a lot for this (more than a 70cl bottle of 40% spirits a day) and it soon goes if you (can) stop.

Alcohol can produce hypoglycaemia if liver stores of gylcogen are low and/or glucose mobilisation is inhibited while alcohol is metabolised. The onset is 6 to 36 hours after a proper bender. In addiction sometimes insulin secretion is increased by alcohol. This effect is a serious risk if children, particularly small children, take an overdose of alcohol and must always be considered when children are seen to be intoxicated.

Those with insulin-dependent diabetes who are taking insulin may be at risk of hypoglycaemia if they drink at all heavily. Chronic heavy drinking can be associated with hyerglaycaemia as this type of drinking can reduce the responses to insulin; both exogenous and endogenous. This is particularly seen with impaired liver function whether or not showing frank alcohol liver disease.

Reproduction

Alcohol may inhibit the metabolism of Vitamin A, which is essential to sperm development.

The Hypothalamic-Pituitary-Gonadal Axis (good name for an indie band) is a system which involves feedback from the target organs, the gonads. The hypothalamus releases via the portal system the luteinising hormone release hormone (LHRH) that on reaching the pituitary gland sends the gonadotropin hormone's luteinising hormone (LH) and follicle stimulating hormone (FSH). LH is linked to the production of androgens. FSH is responsible for the maturation of sperm and the development of the ovarian follicle. In men, drinking alcohol leads to a fall in androgens with diminished sexual function. In women, mistimed and absent ovulation occurs with changes to the menstrual cycle.

Alcohol is toxic to Leydig cells and can be associated with testosterone deficiency. There is a reduction, but abstinence will pick it all up again.

Prolactin is secreted by the pituitary gland. It supports lactation and breast feeding. Its production is inhibited by dopaminergic neurones. Alcohol can increase the output of prolactin. This may lead to impotence in men and fertility problems in women.

Fertility is generally greatly affected by alcohol, through miscarriage, aneuploidy, structural congenital abnormalities, disordered foetal growth, perinatal death etc.

Alcohol is a teratogenic agent - it can cause foetal damage. Binge drinking in critical moments of the foetal nervous system can cause foetal damage. The rate at which the mother can metabolise alcohol may be a key factor. Whilst the greatest risk is during the first trimester, damage can occur throughout pregnancy.

Inter-uterine exposure to alcohol can lead to:

Death - miscarriage, stillborn babies, prematurity early mortality
Physical malformity - heart defects, spina bifida, cleft palate
Pre-natal growth deficiency
Central nervous defects from structural changes (eg foetal alcohol syndrome) to behavioural disorders (eg Alcohol-related Neurodevelopmental Disorders - ARND).

But the occasional unit of alcohol during pregnancy is unlikely to do any harm.

Growth and development

Calcium is stored in the bones and to some extent in the teeth. It is a key electrolyte in brain function. Calcium flux is regulated by the parathyroid hormone (PTH), vitamin D derivatives and calcitonin from the thyroid. Alcohol may by its action on the kidneys lead to a loss of calcium. Heavy drinking may lead to a shortage of vitamin D. Reproductive hormones may be low in drinkers with loss of calcium. Osteoperosis can occur in heavy drinkers.

Alcohol may lead to a diminution of growth hormone with impaired immunity and muscle weakness in the adult and problems at puberty in the adolescent.

A high alcohol intake can lead to a reduction in thyroid-stimulating hormone (TSH). The thyroid responds to TSH by putting out two hormones, theroxine-3 and thyroxine-4.

The following paragraph is taken from You and Your Hormones: "Too little production of thyroxine by the thyroid gland is known as hypothyroidism.  Hypothyroidism in adults causes a decreased metabolic rate.  This results in symptoms which include fatigue, intolerance of cold temperatures, low heart rate, weight gain, reduced appetite, poor memory, depression, stiffness of the muscles and infertility."

Cancers

Alcohol is broken down in the liver into acetaldehyde, and acetaldehyde itself is toxic. Acetaldehyde modifies proteins and acetaldehyde-protein complex is a one of a number of possible cancer mechanisms.

Others are:

Direct damage by acetaldehyde
Genetic variation in aldehyde dehydrogenase ADH
Free radicals
DNA adducts
Changes in hormone metabolism
Altered response to commensal bacteria

Cancer of the aero-digestive system (ie mouth, tongue, pharynx, larynx and oesophagus) is exponentially likely if you drink and smoke.
Alcohol is a cause of liver cancer.
Alcohol is also one factor in a complex interaction of gut bacteria, tobacco, diet and genetic variation when it comes to colon and rectum cancer. Half of all colorectal cancers could be prevented by drinking in moderation, not smoking, exercising and eating a balanced diet.
Only a small proportion of breast cancers are due to alcohol, but the risk rises in linear fashion with dose. Binge drinking increases the risk. It's possible that alcohol initiates changes in oestrogen metabolism via a damaged liver.

Overdose

More than 0.3% blood ethanol concentration in grams per litre will kill you.

-------------

Happy drinking!

Wednesday, 15 October 2014

Scaremongering?

From an ITV news website report today:

"The South East of England has the most "high risk" drinkers in England, with more than 1.6 million consuming dangerous levels of alcohol on a daily basis, fresh data has revealed."

OMG!


"Research from the charity Alcohol Concern showed there at least 1.6 million "high or increasing risk" drinkers living in the wealthiest corner of England."

There are 8.7m people in the South East of England, so that means 18% of people in the South East of England, nearly a fifth, are "at risk"!

"High risk drinking is defined as people who have more than six to eight units of alcohol each day, while increasing risk is more than two to four units a day."

Hang on a minute. What? 

Does this mean high risk drinking is 6 to 8 units a day or more than 8 units a day? And are increasing risk drinkers drinking 2 to 4 units a day or more than 4 units a day?

According to the report if you are part of the "increasing risk" group of drinkers, you are drinking at dangerous levels. Yet "increasing risk" is defined as "more than two to four units a day". Is that 3? or 5?

Drinking "more than two units" and you are "at risk"? At risk of what? There are 2.2 units in this bottle of Doombar

4.3% vol, 500ml bottle.
According to the drinkaware website (which is funded by the drinks industry), drinking one of these a day marks you out as a lower risk drinker.
As it says on the drinkaware website: "No level of drinking is considered risk free". Well this is perfectly true. But as we know, breathing air also carries a risk, so no level of not drinking is risk free either.
So what is the real risk to our health of a bottle of Doom Bar a day?
According to the Alcohol Concern website (which is not funded by the drinks industry), a bottle of Doom Bar a day is actually well within "sensible drinking limits" for both men and women.
Yet according to today's report, people who drink a bottle of Doom Bar might be statistically part of the 1.6m "high or increasing risk" drinkers in the South East of England. 

Certainly anyone who drinks two bottles of Doom Bar a day is at "increasing risk". Really?

Now you're in trouble.
The South East of England has the highest population of any part of Britain. So it's unsurprising it has the highest number of people drinking at "increasing or high" risk levels. It has the largest number of people.
The South East also has the highest life expectancy for men. This must be in spite of our alcohol consumption. The South East also has the second highest life expectancy for women in the country (by 0.1 of a year from the South West, that well known bunch of teetotallers). 
I am not in any way disputing the statistics, and I don't have a problem with the way they are reported. I would just suggest our public health messages around alcohol are close to meaningless.

Tuesday, 14 October 2014

GUEST BLOGGER: The Downsides of Giving Up

Nick writes: I had a very unusual response to yesterday's blog post about trying to find out if I had liver damage as a result of my drinking. A number of people contacted me privately with their stories. 

Last night I asked one of my correspondents if she would write something for publication on this blog. When I woke up, this was waiting in my inbox (my correspondent wishes to remain anonymous, which is her prerogative):

"Nick's blog grabbed my attention. Without seeing or therefore having the chance to understand a set of blood test readings - Nick decided to quit drinking! A lot of people decide to take a day, a week, or a month off alcohol. Right now Stoptober is giving inspiration to many.

But of those who decide to quit (with or without a bit of worry about a blood test) and those that make it for a day, a week or a month, never mind a year - the period Nick set himself - is anyone's guess. We don't hear about those who sigh and open the next bottle or order another drink at the bar and give up giving up immediately. Not until they need a lot of help.

Like quitting cigs or any behaviour we can't control, we're suddenly in the realm of addiction and all the self-delusion that follows.

The first time I tried seriously to stop smoking I remember wanting to throw a chair out of the window of my second-floor flat ('I Love the Sound of Breaking Glass' was in the charts). My frustration as I realised that I could not stop even when I really wanted to was a terrible loss of confidence in myself. 

That was a long time ago. I did quit smoking cigarettes. It was the proudest achievement of my life when I managed it.

I remember saying so in a group for alcohol addiction. Other women there had babies they said they lived for and would do anything for. Their children were the proudest achievements of their lives, mine was that I had stopped smoking cigarettes. For twenty-five years. During that time I was made redundant and both my parents died.

My alcohol addiction group was a day programme. I attended faithfully for 12 weeks. I spoke in groups, I cooked soup, stirred porridge, meditated and only baulked at drumming.

And I started smoking again.

I remained abstinent from alcohol but the pull - probably about sixty per cent of those at the centre (including the staff) smoked - meant I felt pressured to join in.  I ended three months there clear of alcohol but re-addicted to smoking.

So, thanks alcohol rehab. 

I know I started smoking, no-one forced me."

Thank you, Anonymous Correspondent, for getting in touch and writing this. You might think you are weak, but you kicked drinking and there's no way I'm going to do that permanently. And if you kicked smoking once, you can do it again. Read Allen Carr's book. That really put me off.

If anyone else would like to write something about alcohol on this blog, preferably identifying yourself (but anonymously is fine), please get in touch with me on twitter or facebook.

Thanks.


Monday, 13 October 2014

Nick is not ill


As I mentioned in March, I went to the doctor. I wanted to see if 25 years of drinking had had any effect on my health.

Now, admittedly, I haven't drunk every day of those 25 years. But I have drunk more than the recommended weekly limit many times.

There's a Wonder Stuff song called The Size of a Cow which repeats the refrain "You know that I've been drunk a thousand times...."

I remember working out, with my bass-playing friend Aidan, what age we would have to be before we had been drunk a thousand times. I reckon I probably made it by the age of 25, certainly by 30.

In recent years, the Friday and Saturday night binge drinking has eased off, replaced by more regular, habitual drinking. Two pints here, three bottles of beer there, most of a bottle of wine on a Saturday night at home etc. That's not to say that if a drinking buddy came over I couldn't put away a lot more, but those nights are few and far too painful to do very often.

Knowing that any alcohol is unhealthy, you would have thought that over the years I might have done myself some damage, which is why I went to the doctor in March.

Blood test No 1

They took some blood. It came back with a slightly high bilirubin score. I wasn't told what that score was. The document in the link above says 17 is normal. A high bilirubin score can suggest liver damage. I didn't get to discuss the result with a doctor, I was just told over the phone I had a high bilirubin score and had to go for another test three months later.

Blood test No 2

I went for another test and the following week I got an email back telling me I had a low white blood cell count, which was probably due to a virus, but could I go back for another blood test the following  month. No mention of the bilirubin.

Blood test No 3

So back I went. This time my white blood cell count was higher, but still below normal. So could I go back for another blood test, this time in two months?

Blood test No 4

Eight days ago I did my most recent blood test, on 3 October 2014.

Time to go see the doctor and discuss the results.

As the set up at our medical centre means you rarely get to see the same GP twice in a row, I explained my initial request for a blood test and subsequent return visits to a slightly bemused Eastern European lady who I had never met before.

She looked at my results. Yes, my bilirubin score was initially 28. She thought 20 or 21 was about normal. By the second blood test it was 23. The other three tests of liver function:

GGT - Gamma Glutamyl Transferase
ALT - Alanine Aminotransferase
MCT - Mean Cell Volume

were all fine on both occasions. The doctor said if I had any alcohol-inflicted liver damage she would expect to see high levels in all three of the above measures before any increase in bilirubin levels. All three were normal. She was unconcerned. She said she wouldn't get even slightly worried unless a bilirubin score was consistently above 30 to 40, and that my varying levels hovering above normal could just be a genetic trait.

We had a chat about alcohol and safe limits and it was clear she wasn't going to endorse my drinking habits. I wasn't expecting her to.

We both agreed alcohol is not good for you. She told me she sees people younger than me coming to her with cirrhosis and that alcohol abuse is a real problem. I don't doubt it.

But... I would estimate I have drunk more than the recommended daily limit of 3 to 4 units of alcohol on at least a fifth of the 10,000 days that have passed since I first started drinking. On some of those 2,000 days my unit consumption was significantly higher than the recommended daily limit. Days when (and I feel curiously ashamed to admit this) I was drunk, your honour.

The long term effect this has had on my liver? Nil. Nothing. It is as perfectly healthy as if I were teetotal and had been all my life. Think about that for a moment.

Now, I haven't had any of my other organs tested. My adult drinking might have already set in motion a series of problems quietly gestating in my body.

Pancreatic cancer is linked to heavy drinking, as is throat cancer and brain damage. I am currently putting together a list of the conditions linked to excessive alcohol consumption, and believe me it ain't pretty.

But when I read the literature, and compare it to my own behaviour, I am starting to think maybe I just don't drink anywhere near enough. The liver is the one that tends to start throwing up red flags if your alcohol consumption is becoming problematic, and mine is just chipper, thanks.

What to make of this? Well here's an idea - the reason public health messages about alcohol are failing to hit home is because they are not relevant to the majority of the population.

Watch men in pubs on a Friday night. Many are drinking three to four units an hour. Telling them the limit is 3 to 4 units a day is like telling a journalist it's not a good idea to go round asking too many questions.

That's not to say the addictive nature of alcohol can't wear down your defences, take a hold of you and, over time, push you into a high level of consumption that causes problems. It's a powerful, seductive, liberally-available, socially-sanctioned drug.

But come on... tell me my real safe limit and I'll stick to it. Tell me I'm in danger after a couple of pints and I just will not believe you.

Oh and in case you were wondering, my white blood cell count is back to normal, too. So that's nice.


Wednesday, 1 October 2014

Stoptober


It's the first of October. There are three charity things happening this month which have all appropriated an otherwise innocent chunk of autumn.

The first is Stoptober, an NHS attempt to make us give up smoking.
The second is Go Sober for October, a MacMillan Cancer Nurses initiative which speaks for itself.
The third is Octobeardfest, which comes from the Prostate Project, and is "inspired" by Movember.

All are worthy causes. All can be achieved (for men, anyway) with minimal effort.

As I don't smoke, haven't had a drink since December, and will be filming a TV series throughout this month, I can't take part in any of the above October-related fun.

But that doesn't mean you can't. So join me in feeling better about yourself and raising money for good causes by doing nothing in October.

It's easy.

Right now I am not really thinking about not drinking at all, which is a deliberate ploy. Partly because there's no point and partly because the urge to have a drink simply does not exist any longer, almost to the extent that I am feeling a little daunted about starting again. This will change in December as I start hassling people for sponsorship and planning some exploratory visits to pubs with friends in January.

So making it three-quarters of the way through the year has been unremarkable save for one unexpected exception. The dawning realisation that I am going to watch an entire season of Strictly Come Dancing sober.

After Saturday night, that might be more of a struggle than I anticipated.

.

Sunday, 28 September 2014

Is this hypocrisy?

I pose it as a question, because there are many subtle cultural forces at play, but on the front page of the Daily Telegraph today, there was this:


At the top: "Free pint of ale".

At the bottom: "Why Stephen Fry is wrong to boast about cocaine"

In the first instance the Telegraph is encouraging us to take psychoactive drugs.

In the second instance the Telegraph castigates someone for taking psychoactive drugs.

Libby Purves' distaste at Stephen Fry's drug use is twofold.

1) it's a criminal offence 
2) he enjoyed it.

Cocaine is more addictive than alcohol. It's a dangerous drug. 

Alcohol is addictive, and in terms of health risks, probably (depending on frequency/size of dose and susceptibility) as damaging as cocaine. 

So the distinction is what? Legal?

Well, yes, we absolutely shouldn't do things which are illegal. But laws should exist for good reason.

The laws which make certain psychoactive drugs illegal should either be applied to alcohol on the same grounds, or we should be looking at ways of making popular psychoactive drugs "safely" and legally consumable. 

Trying to have it both ways patently isn't working, from the health and social costs of making alcohol liberally available, to the health and social costs of criminalising alternative poisons.

So why give away a powerful, dangerous, psychoactive drug purely for the pleasure it brings, and then (pausing only to notify us of George Clooney and Amal Alamuddin's travel arrangements) condemn someone for taking a different powerful, dangerous, psychoactive drug purely for the pleasure it brings? 

It doesn't make sense. 

.

Thursday, 28 August 2014

I have not had an alcoholic drink for 8 months


Bavaria Wit Beer 0.0%
“All the calories, none of the fun!”
I’m kinda over it now. If my attempt to stay dry were a mid-Atlantic row, this is the bit where I would be struggling with various existential crises. 
I’ve done the hard part. I’ve got past half way. I’m already thinking about what’s going to happen when I get to the end, but first I’ve just got to get through… this.

And what is this, exactly? What am I trying to prove? What am I not trying to prove? Do I care? Does it matter?

All these questions I will answer in another blog post, because right now I want to talk about the joys of alcohol-free beer. 
Nick Wallis
Photo: A. Wallis
I do not wish to denigrate the service alcohol-free beer provides. When I was on holiday in France, it was nice to be able to return to our villa after a hot day, open the fridge and pop the lid on an ice-cold alcohol-free beer. 

If it were real beer the first would be followed by the second in pretty short order, then perhaps a third or a fourth. But it wasn't and so it didn't. That is what is missing from alcohol-free beer. It's not very moreish.

In fact, I bought twelve "Bavaria" alcohol-free wit (wheat) beers (pictured above) on the second day of our one week holiday. By the end of the week I had three left. I gave them to my brother-in-law who was driving his lot to England whilst we flew. I saw him the other day and he returned two of the three bottles to me unopened. He didn't really like Bavaria Wit 0.0%, and as he is not Not Drinking for a year, didn't see the point.

I don't think I'll be buying any more alcohol-free beer, just as I won't be having a go at any more alcohol-free wines. Back to the water, and the diet coke, and the endless rowing, rowing, rowing...

Monday, 18 August 2014

Completely random kindness

Recently, an article about the dangers of alcohol appeared The Independent and was syndicated to the Times of India.

It was written by Dr Nick Knight, a man I have never met.

An gentleman called Jasmit Chadha in Dubai read this article in the Times of India, and was so taken by its content, he felt moved to find out more about its author.

Jasmit Chadha. What a nice man.
I'm guessing he chose to Google “Nick” and “alcohol", because he ended up on this blog. Putting two and two together and getting at least seven, Jasmit not only decided to send me a complimentary tweet, but also made a donation to the charities I am supporting, saying 

I read ur article on Times of India and it was brilliant! then i stumbled upon the interview. P.S: My dad was a chronic alcoholic. This is for Him :)

Whilst thanking Jasmit for his donation, I politely pointed out that I was not the author of the piece that inspired him to make the donation.

I am pleased to report he was happy to make the donation anyway. 

If you are a random stranger who has landed on this blog by accident and feel moved to part with your money, particularly if you think I am someone completely different - please click here. I promise you your money will go to four very fine causes.