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Heavy drinking and health module

Further Perspectives on Alcohol

Looking after health

NOTE: Quotes are presented word for word apart from minor editing for readability and clarity. Identifying details have been removed. Square brackets show text that has been added or, where ellipses (three dots) appear, removed. For example, ‘as soon as I have that first sip, a change comes over me and that’s all that matters […] I just feel the physical buzz when I have the first drink.’

Health and well-being are key issues for men in this study because they face significant alcohol-related health issues and have concerns about their health. Most of the men interviewed for this module talk about living with a range of health conditions including cirrhosis of the liver, ascites and various other gastroenterological conditions. Some report responding to the presence of severe and chronic symptoms by reducing or stopping drinking for periods to look after their health and well-being. Various suggestions were offered about what defined good health, but most agree it involves eating regularly and having a balanced diet, drinking less, doing some exercise and seeing family and friends. For some, it also includes attending treatment regularly and following treatment regimes. Others speak about regaining pleasure in everyday activities such as cooking, eating, cleaning and running errands.

Living with a serious health condition

The men who took part in this study had experience of various alcohol-related health problems and issues such as liver cirrhosis, ascites, and other gastroenterological conditions such as stomach ulcers, bleeding and vomiting. They were often concerned about the worsening of their health conditions and the possibility of dying. The process of diagnosis and treatment was typically described as unpleasant, stressful and frightening (See Experiences of treatment).

Jakub [mid 70s, Polish, retired, drinking less] was referred by his GP to hospital, where he discovered he had stomach polyps and fatty liver disease. (Read his personal story)

I was bleeding from my stomach, you know. So I went to my GP and he sent me to [a gastroenterology clinic at the hospital] to check my stomach. They found out I have polyps in my stomach, which [is] when you drink beer too much. [There] is too much liquid in your stomach […] But my stomach expanded, [and the polyps broke] and after that, I was bleeding. So, I was told I should diet, you know, and not only what I [should eat but… ] another thing, don’t drink too much liquid […] My doctor [asked], ‘How much [do you drink]?’ I said, ‘Oh, two longnecks, not much.’ No. He told me it’s too much. Too much because [the] amount of liquid makes my stomach bigger. Two things, one because my stomach is bigger than normal, which is not good. My liver is bigger than normal. They call it ‘fatty liver’.

NOTE: Heavy drinking can sometimes lead to what Jakub calls ‘polyps’, growths, usually benign, protruding from a mucous membrane in the body such as the stomach and the colon.

Wayne [late 50s, Australian, unemployed, continuing to drink as usual] describes feeling very sick at his daughter’s wedding. Shortly afterwards he went to the Emergency Department and was diagnosed with ascites. He explains that the regular ascitic taps he has are painful and invasive. (Read his personal story)

I went to my daughter’s wedding and […] I couldn’t even eat dessert, I was that sick. So I went and put myself in the hospital the week afterwards. I admitted myself downstairs in the Emergency Department and that’s when they first came up with the diagnosis of ascites. [They said] you’ve got a swelling below your belly button, yeah, so it’s actually internal, inside your stomach – not [in your] stomach, but inside your body. So it’s caught in limbo. It’s a yellow liquid. It doesn’t smell or anything. I still don’t like the taps when they come with a needle for your side that is 12 inches long. That is kind of invasive and hurts a lot.

Steve [early 60s, Indigenous, unemployed but previously worked in nursing, drinking less] explains that drinking has damaged his liver and spleen, and on two occasions he had nearly died. (Read his personal story)

Like I said, [it’s] my liver. [Drinking has] blown my liver. It’s blown my spleen. The liver can repair itself if you don’t injure it, that’s why I’m getting back to the diet. If you eat properly and you exercise… your body’s a temple and you’ve got to treat it like one. If you treat it like rubbish, you’ll die, and I’ve been close to it. Twice in here I nearly died because of alcohol consumption.

Arjun [late 30s, Indo-Fijian, unemployed but previously worked as a chef, no drinking in last six months] attends the hospital around six times per month to monitor his health conditions. (Read his personal story)

Well, [the effect of my] heavy drinking has been spewing up blood, and obviously they found […] my oesophagus […] had a slit in it, which was [bleeding… ] And they rectified that situation, but then from there, [other situations arose]. I had to come in again because I started to have dehydration issues. Things [… of that manner], where they needed to put certain things in place, and [I’ve had] it all done now. [I need] constant monitor[ing] from the nurses here and, obviously, my specialist, I have to see her as well […] because the other aspect of it was the kidney; because of the liver, [an issue with my kidney] started to arise. So, hence I had […] a temporary dialysis, but [the] biggest concern was how to maintain the kidney. So, [I had a lot of] blood tests, [I]see the nurses and [I] keep going with that process.

Looking after health and well-being

The men interviewed for this module express a range of views about the challenges and benefits of looking after their health and well-being. Most explain that it is challenging to maintain good health when they are drinking heavily (See Perspectives on heavy drinking). This did not necessarily mean that health and well-being were not important. Rather, that drinking and associated side-effects interfered with the daily habits and routines required to maintain a balanced diet, regular sleep and exercise. Some of our participants also explain that family and friends support them in looking after their health and well-being. Work and daily obligations also help some men balance their drinking with other activities (See Relationships and work). Others look after their health and well-being through hobbies and recreational activities.

Most participants say that finding more balance between drinking and other activities allows them to eat more regularly, maintain a healthy diet, access and attend treatment (See Experiences of treatment), exercise, see family and friends and go to work.

Rudy [late 20s, Australian, employed, occupation withheld, drinking less] says that when he was told his liver function was not as good as it should be, he stopped drinking for a short time. (Read his personal story)

Yeah, my health now is good. I just remember at one stage when I was drinking a lot, I had a test on my liver and my liver wasn’t as well as it should’ve been. It wasn’t bad or anything, but [it] wasn’t as well as it should’ve been. But now […] because I’m not drinking to that extent, it’s good now, yeah […] I was just not feeling myself and I was having pains on my right side […] I had blood tests and it said that my liver wasn’t as good as it should be and maybe I should stop drinking or cut down, so I stopped it all together for a while.

Anthony [late 50s, Australian, works in hospitality, no drinking in last three months] says that over the last three months, while not drinking, he has taken more pleasure in cooking meals and eating regularly throughout the day. (Read his personal story)

Well, obviously, [good health looks like] eating, like I enjoy cooking. I’m a good cook. So yeah, I’m going to make some shepherd’s pie tonight […] Yeah, and then just to be able to get up and have a really nice breakfast and, you know, have lunch [too]. Things I take for granted [now]. [Before], I wouldn’t normally have [had] breakfast or lunch, you know. Sometimes I wouldn’t even have dinner.

Steve [early 60s, Indigenous, unemployed but previously worked in nursing, drinking less] links being healthy not only to diet but also to looking after his mental health. (Read his personal story)

Health to me is eating two meals a day […] The last time I was in [hospital, I weighed] 76 kilos. Now I weigh [… more] because they put me on a supplement, so they could boost my protein […] and help [the peripheral vascular disease] in my feet. But now […] I know how to cook for myself. I know how to cook for one person now, and I have breakfast […] I do a four kilometre walk, I know exactly where [the route] is. And then at night time, I’ve got to eat a high protein [meal]: meat, pork, beef and stuff like that [… And] you’ve got to look at your mental health too. It’s not just physical health. Physical health is wonderful, but if you are mentally screwed, it’s pointless you know. While you are mentally screwed, you’re not going to be eating properly, because you are going to be thinking about all this other crap […] You know, yesterday is history, tomorrow’s a mystery.

Michael [early 50s, Australian, works in retail, no drinking in last three months] says that looking after his dog improves his mental health. (Read his personal story)

I have one thing in my life that I do care about and that is my dog. He’s a Jack Russell and he means the world to me at the moment, and he’s basically helped me when I’ve been really dark, when … I came out of that suicide part and, yeah, just he’s basically what’s keeping me going at the moment.

Jakub [mid 70s, Polish, retired, drinking less] explains that he takes the medication his doctor prescribes for diabetes and tries to look after his diet. (Read his personal story)

Like I said, I’m on medication [for] my liver. I am on medication to, let’s say, reduce [the] chance for diabetes. Because [the] doctor didn’t say exactly if I have got diabetes or not, but sometimes my sugar level is too high, sometimes [it’s] not bad. To help my liver, I am on special medication. I don’t remember now which one. I have to use medication and, of course, [my] doctor asks me, he wants to know what did I do in the past, you know. Eat too much or drinking? And [when] I told them I was a heavy drinker, they immediately knew my liver was harmed by alcohol. So far, it’s okay, you know, but I have to now be aware and, like I said, take medication, don’t eat too much fat.

John’s [60 years of age, Australian, retired, drinking less] drinking has not changed over time, but he now takes care of his health by taking prescribed liver support tablets, vitamins, and antibiotics to support his immune system. (Read his personal story)

I’ve got liver support tablets. I’m taking plenty of, what’s it called, vitamin B, and that’s [a] constant. As well as the antibiotic to stop the ascites from coming. Because I’ve been told, now I’ve had ascites, it can come back very easily if I don’t take care of myself. If I start drinking and I start eating salt again, [continue with] my bad habits, I could die and that’s a scary feeling, you know. But what I’m on now, like [I’m] not on any heavy medication. It’s mainly my diet, the antibiotics, and the vitamins. Because the more I build my body up with that type of thing, the stronger I become, and it makes my immune system stronger. So, that helps me because I’m extremely liable to infection now. So, because inside, my immune system is way down and that’s what we’re working on.

Strategies to manage drinking

Most of the men interviewed for this module speak about the various strategies they use to manage and reduce their drinking to support their health and improve chronic health conditions. They describe setting limits, such as not drinking before or at work or at home, regularly attending treatment (See Experiences of treatment), prioritising family responsibilities, avoiding places such as bottle shops and pubs, and keeping busy.

Dylan [late 40s, Australian, unemployed but previously worked in construction, continuing to drink as usual and is on a methadone program] explains that the limited methadone dosing hours at the clinic he attends makes it hard for him to also go to work. Having so much free time makes it challenging to manage his drinking, so instead he tries to do most of the driving at home and keep busy with chores. (Read his personal story)

Well of course I drive. I try and do as much as I can, because I don’t drink and drive. So I try and do as much as I can […] in the car and that […] Yeah, [I look after the] house, like mowing the lawns, just trying to get my mind off it yeah […] But there’s only so much you can do, you know what I mean [… If I had a job] I wouldn’t be sitting at home all day, bored with nothing to do. Come home from work, tired, shower, dinner, and I might have one or two beers and go to bed.

Bryan [late 40s, Australian, unemployed but previously worked in business, no drinking in last three weeks] explains how recently he has tried to stay busy. Mowing the lawns and cleaning the house gives him a sense of achievement which motivates him not to drink. (Read his personal story)

I love alcohol, but it is hurting me at the moment in numerous ways, so I’m motivated to stop that for a while, you know. Like I said, I haven’t even been counting the days of being off the grog. I’m happy to be off the grog. Like I said, now [in the interview] I feel a bit funny. But before that, yesterday for instance, I was actually saying … I was sitting in the kitchen having a cup of tea about half past three and a smoke, and I thought, ‘I’ve got such a[lot done] … this and this and this and this and this and this and this and this done today. If I was drinking last night for instance, none of that would’ve got done. So, this is good and I’m doing something.’ And I thought, ‘Yeah, good. I’m going to stay sober for a while.’ Maybe I was thinking about having a drink, I don’t know, but for now, I’m going to stay sober for a while. I’m not having any … this is all right. I’m getting shit done.

John [60 years of age, Australian, retired, drinking less] draws on the support of his children who phone him and offer encouragement. (Read his personal story)

And my kids support me in a way, ‘How are you going, Dad?’ by telephone. Sometimes, they come around, not very often because they’re working, they’ve got their own lives, but they ring up. ‘How are you going, Dad?’ you know, and I really appreciate that because I never had it before and they’re just ringing up off their own back. ‘How are you feeling? How’s your condition going?’ you know. Just making enquiries about my general well-being, and that’s helping me.

Steve [early 60s, Indigenous, unemployed but previously worked in nursing, drinking less] explains he now sets limits about when he goes to the pub and how much he drinks. (Read his personal story)

I was coming back from the gym and I could smell onions and I bumped into someone and I said, ‘Are you having a barbecue in there or something?’ I’d never drunk in that pub. I hated it, avoided it like the plague. He said, ‘Oh mate, [we’re] having a sausage sizzle and schooners are only $3.80’ and I thought, ‘Why not?’ He said, ‘Just come in and have a beer and a sausage and we can have a chat’. That screwed me up. I went in there and I had three drinks, and I know after those three drinks, I was feeling pissy. And then I thought ‘I’ve got to get out of here’, because I could feel it […] After the gym on Saturday, I used to go to the pub from 12pm until three o’clock and then I’d leave, and I’d only have three schooners. But then of course the pub also has a lucky badge draw. So, I thought, ‘Well that’s on Thursdays, so I’ll make it on Saturdays and Thursdays and only have three each day’. That’s what I’ve been doing. Rarely have more than three.