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.

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