In her segment, “Sharp, ‘Off The Charts’ Rise In Alcoholic Liver Disease Among Young Women,” Yuki Noguchi discusses the implications of statistics that capture the increasing rates of alcoholic liver disease among young people, especially women.
Reading the article, then listening to my voice back from April 2020, full of almost innocent-like hope, was so incredibly painful.
Flashbacks are real.
Anyway, I decided to expound on the experience of having had alcoholic liver disease. Statistics and numbers are great for envisioning the number of incidents, but they don’t paint a picture of what it’s like. My intention with this piece is to capture a sliver of how terrible ALD is. I also want to clarify that though I felt horrible, I had it fairly “easy” because I stopped drinking. My liver healed.
Carolyn, Susan’s daughter, also had alcoholic liver disease, and she passed away in January. (See, “In Memory of Carolyn.”)
The summer leading up to my decision to start my recovery process was dreadful. In August of 2019 I drank at least a fifth of alcohol a day, around 17-20 drinks, in ONE day. I was POISONING MYSELF because I hated everything about existing. I perceived having no purpose because it was summer and I wasn’t accountable to anything or anyone. It was the perfect opportunity for me to isolate myself in my then-apartment. I had no commitments except to the bottles I nursed from when I woke up, until the moment I passed out, over and over and over again. I woke up, felt sick, drank, fell asleep to forget how sick I was feeling, rinse, cycle, repeat.
Then one day, I had a doctor’s appointment.
I remember being at the doctor’s office shaking, sweating, hoping I didn’t smell like liquor from drinking the night before. I tried drinking as much water as I could stomach that morning, knowing that it felt horrible to drink, well horrible to drink water, let me clarify. I hid my hands in my pockets to hide tremors. Then I felt the tremors in my neck and my head, my brain twitched, “Am I about to have a seizure?” Every single part of my body was aching or shaking. I just wanted to go home to snuggle up under the covers with my bottle in hand. While in the waiting room, I looked down at my feet. My sandal straps were cutting into them they were so swollen. I looked up instead. My eyes hurt. I remembered they were starting to get a very slight hint of yellow, so I grabbed my glasses from my purse and put them on to distract the doctor and nurse from looking right into my eyes.
On that morning like many others, I couldn’t stop hacking. The fits were uncontrollable, and my ribs were so bruised that the few moments I could laugh in those times, I wouldn’t. I coughed up slimy green acidic bile, retching over whatever sink or toilet was near me until I could get to a drink. When I was off, I soothed my violent nausea in the mornings with whatever splashes of cheap bourbon remained in bottles I picked up off the floor around my bed or bathroom. When I gripped a bottle, I braced myself, anticipating the horrible taste and burn. It was fire down my throat, I burned while waiting for the temporary relief. The nausea stopped. The shaking subsided. Gasping, gripping the vanity in fear of falling over, I would look up in the mirror with liquor dripping out of the side of my mouth. I would look at and not recognize the woman looking back at me. I saw the unusual weight loss, random bruises, the dark circles. Cracked lips. A plump aching belly with no baby in it. I was transforming. I was imploding.
I was fearful of getting on my phone to check my lab results. I didn’t want to think that I would be like my cousin, who died after bleeding out from a simple procedure because she could no longer heal. When I got the blood results back, however, I accepted my dark fate. I got a note from the doctor saying that I had alcoholic hepatitis. If what you see in the screenshot is something you would even want to consider a note. With no explanation from my doctor as to what numbers meant what, I spent quite a bit of time doing research.
My AST/SGOT was 429, a standard range is 15-46 U/L. What did this mean? According to the U.S. Department of Veterans Affairs, “AST/SGOT is one of the two liver enzymes. When liver cells are damaged, AST leaks out into the bloodstream and the level of AST in the blood becomes elevated. AST is different from ALT because AST is found in parts of the body other than the liver–including the heart, kidneys, muscles, and brain. When cells in any of those parts of the body are damaged, AST can be elevated.” And my ALT? It was 9 times the normal range. It was 160. That normal range was supposed to be 13-69. “ALT, is one of the two liver enzymes. When liver cells are damaged, ALT leaks out into the bloodstream, and the level of ALT in the blood is elevated.” My bilirubin was 1.8 when normal ranges are 0.2-1.3, so that was another indicator of my poor liver function.
At that point, I was terrified because I understood that I had to stop, but I was afraid to ask for help without letting my secret out. I knew I needed alcohol to not feel ill but the idea of putting the bottle down terrified me. In my previous experience with getting sober in 2013, I simply stopped drinking, that shit wasn’t going to wrok this time. This time, it was different. I had been alone for what had been almost two months, and I just wanted to stay hidden in my apartment and forget this was even a problem. I wanted to disappear silently. Maybe one day I would fall asleep and not wake up, no one would notice, right?
The physical symptoms very quickly turned into psychological ones. I started to feel crippling anxiety and minor hallucinations. I noticed I would hear and see flashes of things that no one else saw. It got worse when I had to go back to work. Going back to school, I was forced to modify my drinking because I had to make it to the school building alive and barely sober. The daily withdrawal symptoms led to the worst school days. My only safe space, my classroom, riddled me with fear and panic. The sound of a notebook falling, a chair squeaking too hard, a child’s laughter, all those sounds terrorized me. They made my stomach drop each time. My coughing fits got so bad the kids thought I was having an asthma attack. I carried an asthma pump to “explain” the coughing. I knew what was going on. When your liver stops working, the fluids that should be leaving your body don’t, so they find other places to settle. In my case, it was my feet, ankles, and my lungs. It’s a miracle I didn’t get pneumonia.
It wasn’t long before the panic, anxiety, and illness brought me to my knees.
One morning in September of 2019, I couldn’t get out of bed to drive to work. I was terrified of walking out the door. I couldn’t go to work. I knew something had to give when I couldn’t go to the one place I loved the most. The only people I told that I was going to a hospital to were my principal and my sister. Neither knew I went in for my drinking. I blamed it on depression and anxiety. The rest is history, but I don’t know how I functioned when reflecting on those times.
I don’t know how I functioned so SUCCESSFULLY.
I stop sometimes and think, “What the hell?!” The only explanation I can think of is the power of the mind and its determination. A mind fueled by shame and guilt is profoundly capable of massive feats to put up appearances. I was killing myself, and yet I was showing up.
So yes, all these conversations about women and their dangerous relationships with alcohol need to happen, and I’m SO grateful that they are. I can only speak from my experience, but I will say a million times, it can’t just be me. The more we have these conversations, the more people we’ll have come forward saying, “You know what, I’ve got that problem, too.”
