Bob's Blog 10-5-13: What Was I Drinking...er...Thinking

[BobN]

Bob Here.

So this dialysis patient goes into a bar and orders a beer, right?

The bartender says, "That'll be eight dollars.  You know," he continues, "we don't get many dialysis patients in here."

The dialysis patient says, "And at eight dollars a beer, twelve ounces of fluid, 100 milligrams of potassium, and 50 milligrams of phosphorous, you won't get many more either."

Okay, so that's a dialysis twist on an old joke, and I admit, it kind of kills the humor.

(The original version was a kangaroo instead of a dialysis patient, and obviously didn't have anything about the nutritional contents of beer.)

But it puts me to mind of the dichotomy faced by dialysis patients with regard to drinking.

On the one hand, clearly drinking and dialysis don’t make a good mix.

I mean, the fluid alone is a complete smackdown.

I remember one time I was sitting next to a guy who had put on a lot of weight between treatments, and the nurse asked him for an explanation.

The guy said, "Gee, I don't know what could have happened, I only had a beer."

The nurse said, "Well certainly one beer wouldn't have caused this kind of gain."

"Yeah, right?  I mean, we were having nacho's with extra cheese, so I was thirsty and had to have a couple of beers."

"A couple?  What happened to 'only a beer?'"

"Well, like I said, we had extra cheese.  And the chips were really salty, so I needed to have three beers."

"Three beers??"

"Well, yeah...of course, I'm talking approximate..."

The nurse stopped writing, put down her clipboard, and stared the guy down.

"Let's forget about approximate, shall we?  EXACTLY how many beers did you have??"

"I don't know.  Hey, It's not like I was counting or anything..."

"North of ten?"

The guy hesitated.  "Might have been a pinch north of ten, yeah."

The nurse was pretty disgusted.  "Sit down," she ordered.  "We have a pinch south of a keg to take off of you today, so we better get started."

Other than the fluid issue, many types of alcoholic beverages are high in potassium, phosphorous, and sometimes sodium.  Especially if you have north of ten servings.

Not to mention the effects of drinking on blood pressure, which tends to be a problem with dialysis patients to begin with.

The conflicting part of the issue is equally perplexing.

Seriously, who deserves to take the edge off more than a dialysis patient?

Between the sticking, sitting, bleeding, cramping, nausea, vomiting, dizziness, fainting, swelling, fatigue, diet restrictions, needles, high blood pressure, low blood pressure, and various other ailments and miseries, dialysis can definitely drive you to drink, even if you're an avowed teetotaler.

In fact, other than possibly furloughed federal employees, computer operators for the new healthcare exchanges, or whoever took the Yankees in the World Series office pool, I can't think of anyone who deserves to tip a few more than dialysis patients.

I remember when I first started the Big D, the lifestyle adjustment was so drastic that I was about ready to drink up my aftershave.

But, as much as we might want to do so, we have to keep in mind that overdoing it can result in some shameful moments, and I'm not just talking about the mornings after heavy partying when you wake up with your underwear on your head.

One of my buddies in the first dialysis center I went to many moons ago admitted to regularly popping a few brewskies, but he had to ease off when his phosphorous popped up to 12.0 on his monthly lab.  (The normal high range is 5.5.)

This, of course, caused the doctor, nurse, and dietician to threaten him with everything short of hiring a hit man if he didn't clean up his act.

Then, one day, he came in looking particularly morose, and I asked him what happened.

"Big stir with the wife over the weekend," he said. 

We had just had a big ice storm in Dallas and I asked if it had anything to do with the weather.

"Well, kinda, yeah," he said.  "Went to a hockey game downtown with some friends.  We all met at my house and drove in together.  After the game, with the ice storm and all, I called to tell the wife that I didn't want to risk driving, so I was staying in a hotel downtown.  Of course, me and my buds were tipping a few.  I stayed, thought my friends were too, but they drove back and picked up their cars."

"Yeah," I said.  "What's so bad about that?"

"Their cars were at my place!  Here I was saying to my wife that we couldn't make it back home, and then my three dimwit friends drive up in front of my house."

I winced.  "Did the wife see them?"

He snorted.  "Oh yeah.  She doesn't miss anything that happens in our neighborhood.  The NSA could take a course from her on domestic spying."

There are really two schools of thought with regard to alcohol consumption while you're on dialysis.

One, and the choice I follow, is just not to do it at all.

I mean let's be honest, it's pretty hard to stop after just one frosty cold.  So, I abstain completely, as I'm sure many patients do.

Not that it was easy to give it up.  I used to think beer was the true breakfast of champions, but not any more.

The other philosophy is that limited consumption is okay, as long as it doesn't bring the blood lab police down on your butt.

Of course, everybody's definition of limited might be different.

For most, it might be a beer or two, or a glass of wine.

Others might think you're not drunk if you can lie on the floor without holding on.

I had a running "discussion" about this issue with another patient who sat next to me on occasion.

While I'm sure there are many patients who successfully subscribe to the 'light drinking is ok' philosophy, there is still danger of an episode getting unexpectedly out of control.

This other patient suddenly admitted that yes, the cost of even light drinking can spiral out of control, saying he had nearly gone broke the previous Saturday night.

"Went to the local pub with a pal of mine," he said.

"So you ended up running up a big tab there?" I asked.

"Well the tab wasn't anywhere near as much as the bail."

"Bail?"

"Yeah.  You know.  After the fight at the strip club."

"Strip club??" I asked, thinking, this is getting better.

"Yeah, and the cab ride to the zoo."

"Oh boy."

Some other guys that I've known never changed their drinking habits, even after starting dialysis.  One guy was touting the potential benefits of alcohol.

"You know alcohol wards off heart disease, Alzheimer’s, and stress?" he said to me a while back.

"Yeah," I said warily.

"Well this dialysis patient is gonna go with a healthy ticker and a smile on his face.  And, I'll always be able to find my way back to the center."

This guy's idea of a balanced diet was a beer in each hand.

So, there are pro's and cons to both approaches, but for sure dialysis patients should approach their alcohol intake with caution.

And moderation.

And, leave your debit card at home.

Thanks for reading.

[willowtreewren]

 

My husband erred on the side of "just say no." Funny, now that he has a working kidney, he has maintained that lifestyle. 

[Riki]

My brother and I went to dinner a couple of weeks ago with my dad and his girlfriend at her house.  From the moment me and Bro sat down on her deck, she was trying to get Bro to have a beer.  The first two times she asked, he said no, cuz he was driving.  The third time, she came out of the house with 3 cans in her hand, all different brands.  One of them was a light beer, so he took that, trying to not be rude.  She gave me a glass of this pink stuff (that was really good, btw) that I managed to make last the entire night.

That's pretty much how I drink alcohol.  If someone gives me a cooler, I tend to make 2 servings out of it, and usually not on the same day.  If I go out with friends for drinks, I usually only have one, and nurse it the whole night.  If I had a working kidney, I'd probably drink the same way, simply because I don't like the feeling of being drunk, or the puking that tends to come with it

[Dman73]

During the disco years I would go out with the nurses after work and to keep the fluid down I used to have a black russian w/little ice and 2 of them would make you slide off the bar stool.

[Angiepkd]

I completely gave up alcohol when I started D, and since I am not a big drinker, it hasn't bothered me.  When I learned that my brother was not going to be able to donate his kidney to me, I decided I had earned a couple of drinks.  Sitting on my machine now removing 3.5 kgs and wishing I hadn't done it.  Oh well, live and learn.  No more drinking for me!