Practical Advice About Detox and Getting Sober

[Jake.]

Oh good

[Sandy]

Bumping this thread for Jude

[jude999]

Thanks Sandy, Very interesting read and a couple of things I shall
implement. Jude x

[j214]

Can anyone give me advice on how to soothe these jangly nerves that I have? This is as bad as it ever has been....I can't sleep, as every time I lay down, I feel like I can't breathe...I'm afraid to go to sleep:(. I don't really want to put any more crap in my system, as I'm already taking cough medicine for my congestion....would hot chocolate have too much caffeine in it?

I feel like I'm a novice at this sobriety thing again:-?

[j214]

Oh yeah, blood sugar...I forgot about that.....hot chokkie fixed me right up!:)

[smudge]

In an earlier post I made on this thread I said I would discuss how I developed Wernicke-Korsakoff Syndrome (WKS). WKS is really a combination of two separate conditions - Wernicke's Encephalopathy (WE) and Korsakoff's Psychosis (KP). Many people developing WE go on to develop KP. Many doctors don't differentiate between the two things though and just use the combined name - WKS. I have a fairly mild case of WKS - if I had the full blown condition I wouldn't be writing this.

Paragraph added on 31st Jan 2013 : WE/KP/WKS is most likely to happen in the very early weeks of detox and sobriety. If you have escaped all the symptoms of WKS by the 4th week of sobriety (that is just an educated guess by the way, not a fixed-in-stone number) then the chances of you developing it must be quite small. If you continue to drink large quantities of alcohol then your risk obviously remains high and taking high-dose thiamine should become part of your daily routine.

So, here is my cautionary tale :

When I was still drinking

You may be under the impression that WKS only affects people drinking vast amounts of alcohol and it couldn't possibly affect you. So here are some figures about my own drinking before I gave up booze for good so you can do some comparisons

a) I always tried to have one AF day per week although I didn't always succeed. Very occasionally I managed two consecutive days.

b) I was an evening drinker. I have never drunk in the morning to "help" a hangover. I gave up drinking at lunch time when I was about 30 (and that was a long, long time ago) because I couldn't stay awake during the afternoon if I drank.

c) On a drinking day 15 - 20 units would have been fairly normal. Occasionally I could drink more than that, but it wasn't that common.

d) When I had a day with no hangover my memory worked well, I could concentrate reasonably easily, my vocabulary was good, I wasn't clumsy and I didn't stagger.

e) I always ate at least one good-sized meal a day and usually ate two meals. I probably didn't eat my 5-a-day very often though.

The early weeks of sobriety

I don't remember a huge amount about the early days. I've just been back and read some of my early posts. I remember having night sweats. I also had shaky hands. My thirst reflex (is that the right word?) didn't work. I just didn't know when I was thirsty and had to drink water using a timer to remind me. I used rehydration salts three times a day for about the first five days. I was incredibly anxious, agitated and depressed after the first few days. Day 5 was a real nightmare I never want to repeat. I had a headache that took a very long time to go away and stay away. None of the things I've listed is at all unusual for a cold-turkey detox.

Based on the conversation I had with the neurologist who diagnosed WKS these were the relevant factors after I started getting sober :

1) I staggered a lot.

2) I was very clumsy.

3) I suffered with ravenous hunger, dizziness and shakiness after the first two or three days of sobriety. In particular I craved sugary stuff to an extreme degree. And because I wasn't drinking I felt I could indulge myself with the sugary stuff - everyone deserves a treat don't they? I ate loads of sweets, biscuits, cake and ice cream. I have since discovered that sugary food requires lots of thiamine to metabolise it. The neurologist made a particular point of mentioning the sugary food in his letter to my GP (I was sent a copy).

4) I couldn't take information in and felt easily confused. I had a meeting with my local alcohol support team after about three weeks of sobriety and I took my husband with me. It's a good job I did because I don't remember anything at all about the meeting. They offered me lots of leaflets about mental-health-related subjects - wasn't I lucky?

5) My memory didn't work properly. Conversations would happen, and less than 20 minutes later I would have forgotten the conversation took place. Jogging my memory didn't bring the conversation back to me. The transfer from my short term memory to my long term memory hadn't happened so, as far as I was concerned, the conversation had never taken place.

The situation now

1) I still stagger occasionally although it happens less often than it did in the early weeks and months of sobriety. The most embarrassing thing about it is that I often do it when getting out of the car. So, if a police officer saw me stepping out of the driver's side of the car I might end up being breathalysed.

2) I'm still clumsy. I've broken more things since getting sober than I did in the previous 10 - 15 years of drinking.

3) I have been diagnosed with nystagmus - an eye movement problem.

4) I still find it very hard to concentrate. I have wondered if the eye movement problem has some effect on this because I do feel I constantly have to drag my eyes back to the page when I'm reading, and I constantly lose my place.

5) I used to have a good vocabulary but I now have constant difficulty finding the right words. This is not particularly noticeable in writing, but is noticeable when I talk to someone.

6) My memory is poor. I might remember "big" details but remember almost none of the fine detail. For instance I went on a short cruise last Spring and I remember that I did so. However, if you showed me pictures of any of the places I visited I doubt I would recognise them and be able to name them.

7) My auto-pilot no longer works. I have a hard time making my breakfast for instance. Depending on what I eat and drink I may need 3 or 4 things from the fridge. Because I constantly forget what I need I keep having to go back. I've poured boiling water over my cereal rather than in my coffee mug. I've put dry coffee over my cereal instead of sugar. And I understand that these things happen to everyone occasionally. But it happens to me far too often to be funny.

Taking thiamine

The first time a member of the medical profession told me I should be taking thiamine was when the neurologist mentioned it in his letter to my GP. So - only two and a half years after I stopped drinking - well done NHS!

I learned about the importance of thiamine for the first time from BE and then followed it up by looking for medical papers and sites I thought could be trusted about medical matters. I have no definite idea about when I started taking it but I think it may have been during the second or third month. I didn't really grasp how much I should have been taking for a very long time. So I took just one 100mg tablet per day. I also took high-dose Vitamin B Complex. At least I got that one right (eventually).

If I had my time over again what would I do differently?

For three months I would take :

3 * 100mg thiamine - break each pill in two and take 6 doses spread throughout the day.

1 * high-dose Vitamin B Complex - break this up into smaller pieces and take at intervals throughout the day.

1 * 1000mg Vitamin C - Use Ester C if you can get hold of it. It is kinder to the stomach.

Then I would probably cut down the dosages a bit but would definitely keep taking at least 100mg of thiamine and 500mg of Vitamin C for at least the next nine months.

I would also try very, very hard to keep the sugary stuff to a minimum and would eat much more decent food regularly instead.

There are some other vitamins and minerals that are very helpful to recovering alcoholics too. But I haven't really researched those to any great extent so I don't feel competent to discuss them. Other people on this thread have mentioned some of them.

So, the moral of this story is...

If you drink a lot of alcohol, or are just embarking on a non-supervised detox, do your brain and memory a favour and take plenty of thiamine!

[silkydress]

Wow Smudge, that's amazing. I think I'm a drinker like you were, red wine, a bottle in the evening, but I usually manage 2-3 days without alcohol. My bad days verge towards 20 units.

I'm not staggering and I don't have severe memory problems, but it's happened a couple times that I've completely forgotten a conversation. I was so ashamed... I am clumsy, this is recognisable, and my reflexes are slow. I've fallen off my bicycle and badly bruised my face last year.

Thanks for the good advice; I knew about vit B and make sure to take a complex.
I think i'm lucky because I've always eaten very healthily, with lots of vegetables and fruit. In fact, I often gorge on fruits and salads --and SOUPS! they are a great way to counter the dehydration and get some food in you --in an attempt to "heal" myself.

Again, thanks. x

[Whites 1992]

My stomach is always in tatters after a heavy session. I'm 3 days in now and it's still all over the place which is a normal occurrence. Figure it's my liver not coping with the session and my body just not dealing properly with food / liquid intake subsequent. Is this normal? What can help ?

[smudge]

Some suggestions :

I realise that sticking to what I'm about to suggest might be impossible at the moment because you probably feel really, really grim. But it gives you some basic principles to aim at.

1) Drink plenty of water. When I first gave up alcohol I didn't know how much water to drink because whatever part of my brain was supposed to tell me I was thirsty didn't work properly for quite a while. I had to measure mugs and glasses to find out what capacity they were and then I aimed to drink about 3 litres (just over 5 UK pints) a day in the early days. I actually used a kitchen timer to remind me to drink every hour. I reduced the amount I drank a bit after a few weeks, but in the early days it really helps to drink plenty of water. Headaches are common in the early days and water helps with those too.

2) Avoid drinking loads of caffeine. Tea and coffee count towards your liquid intake but too much caffeine is not a great idea. You could try fruit teas or herbal teas or decaf coffee perhaps?

3) Avoid sweet, fizzy drinks like coke or lemonade, even the diet versions. Sugar and/or carbonated fizz are best avoided other than as an occasional treat. If you like fizz then drink some sparkling water. If you want some flavour in the water then try no-added-sugar squash. (Definitely don't buy the stuff with added sugar!)

4) I used 3 rehydration treatments per day (spread throughout the day) for the first 5 days or so. I think it helped me to feel a bit better. I read somewhere that it isn't a good idea to take them for any longer than the 5 days I suggest, but I can't remember the reasoning behind it - you'll just have to check this for yourself.

5) Eat little and often (6 times a day is good - 3 meals plus 3 snacks) so that you don't get hungry and to maintain an even blood sugar level. Sugar cravings are extremely common in early sobriety but eating lots of sugar is bad for you because metabolising it uses up lots of thiamine (vitamin B1) which alcoholics are likely to be extremely short of anyway. (Metabolising alcohol uses up thiamine too, as does detox). If your brain runs out of thiamine you could end up with permanent memory problems (like me). So, instead of sugary stuff try and eat plenty of complex carbohydrates - porridge, non-sugary cereals, wholemeal bread, brown rice, vegetables, fruit (but don't over do it because some fruit is high in natural sugars), pulses, beans.

6) Very fatty foods made me feel sick when I was sobering up so perhaps best to be kept to a minimum. Grill, don't fry.

7) If you have no prescribed medicines for indigestion, then buy some ranitidine from a supermarket. Tesco's own brand is the cheapest I've found - 12 * 75mg ranitidine for £1. You can find it on the shelves with things like gaviscon or rennies. Don't go to the Tesco pharmacist - I think they usually charge substantially more.

Edited on 20/05/2013 : Don't rely on ranitidine to solve your indigestion problems in the long term. Cutting down on the acid in your stomach is great while your gut heals from damage caused by excessive alcohol intake, but in the long term it may reduce your absorption of minerals and vitamins. Also bear in mind that having excess stomach acid and having insufficient stomach acid feel virtually identical to the sufferer and you may actually be trying to treat the wrong problem.

8) If your indigestion is really, really bad you might like to try a fibre supplement twice daily for a couple of weeks - fybogel or something similar - I would guess that would be found on the open shelves near the ranitidine. I don't know if this is nonsense or not, but I always think they help to soak up excess stomach acid.

9) A lot of people swear by Milk Thistle. I tried it in the first week but found it made me queasy. You'll just have to try it for yourself to see how it affects you. I took Milk Thistle eventually but only after a couple of months of being sober.

10) Most important - take plenty of thiamine!

Good luck!

[silkydress]

My stomach is always in tatters after a heavy session. I'm 3 days in now and it's still all over the place which is a normal occurrence. Figure it's my liver not coping with the session and my body just not dealing properly with food / liquid intake subsequent. Is this normal? What can help ?

Well Whites, like smudge says, drink a lot of water. But personally I would take advantage of it by also nourishing myself and making a clear soup. I mean take a big pot, fry some onion and then throw some celery and tomatoes in there. Drink LITERS of it. That helps me.

Also, in agreement with smudge on the coffee. That isn't helpful at all.

I find eating bananas help. (lol --that sounds silly).

[loosebanana]

Digestive biscuits!

I was in residential 6 day detox last year and we weren't allowed anything, no caffeine or chocolates or fizzy drinks but there was an endless supply of digestives. There was decaf tea which made it bearable.

And simple meals. 3 times a day.

[DannyD]

That soup sounds a good idea - and so do the biscuits. I've finally decided to grasp the chocolate nettle and give it up for lent (starts next week). I've given up chocolate before and when I had chocolates at Easter was almost repelled by the sickly sweetness of them. It's a little like giving up alcohol mind block at the moment. I don't think I could never eat chocolate again, but surely I should be able to manage 40 days? Soup and digestives. Sounds good.

[smudge]

Soup sounds like an excellent idea! The digestives sound good too, but I prefer them with chocolate on.

[Whites 1992]

Cheers all. Some great ideas. I'll get on the vitamins as well Smudge.

[Whites 1992]

And the soup

[silkydress]

You want my champignon-noodles-lemon soup recipe?

[jaffa21]

Hi. I have been put on the waiting list for a detox and in the mean time i have been told to take Thiamin 100mg once a day and Vitamin B Compound 2 tablets 3 x a day.(GP did this) I am also trying to taper down whilst waiting. Is this enough Thiamin as everything ive read says it should be 100mg 3 x day??!! Many thanks for any advice. I have reduced the alcohol % of the wine I am drinking on an evening which has reduced my units of course night times are awful sleep and bodily shakes and horrendous scatty dreams. Day two of reduced % so expecting a rough night tonight. xx

In an earlier post I made on this thread I said I would discuss how I developed Wernicke-Korsakoff Syndrome (WKS). WKS is really a combination of two separate conditions - Wernicke's Encephalopathy (WE) and Korsakoff's Psychosis (KP). Many people developing WE go on to develop KP. Many doctors don't differentiate between the two things though and just use the combined name - WKS. I have a fairly mild case of WKS - if I had the full blown condition I wouldn't be writing this.

Paragraph added on 31st Jan 2013 : WE/KP/WKS is most likely to happen in the very early weeks of detox and sobriety. If you have escaped all the symptoms of WKS by the 4th week of sobriety (that is just an educated guess by the way, not a fixed-in-stone number) then the chances of you developing it must be quite small. If you continue to drink large quantities of alcohol then your risk obviously remains high and taking high-dose thiamine should become part of your daily routine.

So, here is my cautionary tale :

When I was still drinking

You may be under the impression that WKS only affects people drinking vast amounts of alcohol and it couldn't possibly affect you. So here are some figures about my own drinking before I gave up booze for good so you can do some comparisons

a) I always tried to have one AF day per week although I didn't always succeed. Very occasionally I managed two consecutive days.

b) I was an evening drinker. I have never drunk in the morning to "help" a hangover. I gave up drinking at lunch time when I was about 30 (and that was a long, long time ago) because I couldn't stay awake during the afternoon if I drank.

c) On a drinking day 15 - 20 units would have been fairly normal. Occasionally I could drink more than that, but it wasn't that common.

d) When I had a day with no hangover my memory worked well, I could concentrate reasonably easily, my vocabulary was good, I wasn't clumsy and I didn't stagger.

e) I always ate at least one good-sized meal a day and usually ate two meals. I probably didn't eat my 5-a-day very often though.

The early weeks of sobriety

I don't remember a huge amount about the early days. I've just been back and read some of my early posts. I remember having night sweats. I also had shaky hands. My thirst reflex (is that the right word?) didn't work. I just didn't know when I was thirsty and had to drink water using a timer to remind me. I used rehydration salts three times a day for about the first five days. I was incredibly anxious, agitated and depressed after the first few days. Day 5 was a real nightmare I never want to repeat. I had a headache that took a very long time to go away and stay away. None of the things I've listed is at all unusual for a cold-turkey detox.

Based on the conversation I had with the neurologist who diagnosed WKS these were the relevant factors after I started getting sober :

1) I staggered a lot.

2) I was very clumsy.

3) I suffered with ravenous hunger, dizziness and shakiness after the first two or three days of sobriety. In particular I craved sugary stuff to an extreme degree. And because I wasn't drinking I felt I could indulge myself with the sugary stuff - everyone deserves a treat don't they? I ate loads of sweets, biscuits, cake and ice cream. I have since discovered that sugary food requires lots of thiamine to metabolise it. The neurologist made a particular point of mentioning the sugary food in his letter to my GP (I was sent a copy).

4) I couldn't take information in and felt easily confused. I had a meeting with my local alcohol support team after about three weeks of sobriety and I took my husband with me. It's a good job I did because I don't remember anything at all about the meeting. They offered me lots of leaflets about mental-health-related subjects - wasn't I lucky?

5) My memory didn't work properly. Conversations would happen, and less than 20 minutes later I would have forgotten the conversation took place. Jogging my memory didn't bring the conversation back to me. The transfer from my short term memory to my long term memory hadn't happened so, as far as I was concerned, the conversation had never taken place.

The situation now

1) I still stagger occasionally although it happens less often than it did in the early weeks and months of sobriety. The most embarrassing thing about it is that I often do it when getting out of the car. So, if a police officer saw me stepping out of the driver's side of the car I might end up being breathalysed.

2) I'm still clumsy. I've broken more things since getting sober than I did in the previous 10 - 15 years of drinking.

3) I have been diagnosed with nystagmus - an eye movement problem.

4) I still find it very hard to concentrate. I have wondered if the eye movement problem has some effect on this because I do feel I constantly have to drag my eyes back to the page when I'm reading, and I constantly lose my place.

5) I used to have a good vocabulary but I now have constant difficulty finding the right words. This is not particularly noticeable in writing, but is noticeable when I talk to someone.

6) My memory is poor. I might remember "big" details but remember almost none of the fine detail. For instance I went on a short cruise last Spring and I remember that I did so. However, if you showed me pictures of any of the places I visited I doubt I would recognise them and be able to name them.

7) My auto-pilot no longer works. I have a hard time making my breakfast for instance. Depending on what I eat and drink I may need 3 or 4 things from the fridge. Because I constantly forget what I need I keep having to go back. I've poured boiling water over my cereal rather than in my coffee mug. I've put dry coffee over my cereal instead of sugar. And I understand that these things happen to everyone occasionally. But it happens to me far too often to be funny.

Taking thiamine

The first time a member of the medical profession told me I should be taking thiamine was when the neurologist mentioned it in his letter to my GP. So - only two and a half years after I stopped drinking - well done NHS!

I learned about the importance of thiamine for the first time from BE and then followed it up by looking for medical papers and sites I thought could be trusted about medical matters. I have no definite idea about when I started taking it but I think it may have been during the second or third month. I didn't really grasp how much I should have been taking for a very long time. So I took just one 100mg tablet per day. I also took high-dose Vitamin B Complex. At least I got that one right (eventually).

If I had my time over again what would I do differently?

For three months I would take :

3 * 100mg thiamine - break each pill in two and take 6 doses spread throughout the day.

1 * high-dose Vitamin B Complex - break this up into smaller pieces and take at intervals throughout the day.

1 * 1000mg Vitamin C - Use Ester C if you can get hold of it. It is kinder to the stomach.

Then I would probably cut down the dosages a bit but would definitely keep taking at least 100mg of thiamine and 500mg of Vitamin C for at least the next nine months.

I would also try very, very hard to keep the sugary stuff to a minimum and would eat much more decent food regularly instead.

There are some other vitamins and minerals that are very helpful to recovering alcoholics too. But I haven't really researched those to any great extent so I don't feel competent to discuss them. Other people on this thread have mentioned some of them.

So, the moral of this story is...

If you drink a lot of alcohol, or are just embarking on a non-supervised detox, do your brain and memory a favour and take plenty of thiamine!

[Topcat]

I think it's always best to stick with your Doctor's advice Jaffa. Well done on the tapering. It's not an easy thing to do and the dreams can be pretty awful. Take heart though - it does get better and better

[Jake.]

Oh I thought aswell. Nutrition.

Beetroot - It is rich in antioxidants and helps the liver rid the body of alcohol . http://www.naturalnews.com/033025_beets ... ction.html

Milk Thistle - These are suppliments available from Holland & Barrett and other health food stores. These have liver protective and regenerative properties http://en.wikipedia.org/wiki/Milk_thistle

Kudzu. - There is a thread about this on Brighteye. Kudzu is a herbal remedy which decreases the bodies tolerance to alcohol, making the effects more intense therefore prompting drinking less. http://en.wikipedia.org/wiki/Kudzu

[Jaxom]

I agree with TC on going with the doctor's advice. I didn't bother with thiamine tablets because, despite the fact that it is very important to address a thiamine deficiency and that often goes with heavy drinking, my understanding from reading bona fide synopses of medical research papers ( i.e. not just googling) is that there is a limit to the amount of thiamine which can be absorbed at one time. You can get the necessary through eating the right foods. OK for me cos I eat anything (pig-trough, trough-pig). I can't remember the exact figure but it is much less than 10 mg at one sitting/dose. So, there is no point in going for mega-doses of thiamine, or any other water-soluble vitamin. Most of the excess gets pee-ed away.

Your doc's prescription looks good to me. More than your body can use so you are getting the maximum benefit but not too much so as to cause problems. He/she would not be impressed though cos I ain't a doctor!

Dave