Father, 36 shocked at liver condition diagnosis
Patient warns of drinking risk
HE enjoyed drinking with his friends but he had no idea the damage it was causing.
“This is the West of Scotland,” Graham Clark said. “You work hard and play hard. That’s basically the way it started.”
He had a job as an airport baggage handler and would not touch alcohol before his shifts as he knew he would be driving.
When he had time off, he said, he and his friends drank too much – mixing pints and shots. At home, like many, he poured drinks without measuring quantities.
But he did not consider any of it a “problem”. Then, five years ago. he was diagnosed with alcoholrelated liver disease, aged 36. It was, Mr Clark said, “a very big shock”.
The father-of-two, from Paisley, had felt exhausted over Christmas but put it down to flu. It was his wife who persuaded him to see his GP in January 2011 and the doctor sent him straight to hospital.
“I was embarrassed when I found out what it was,” he said. “There is such a stigma to it – as if you must be ‘an alchy’. But I am no different to anyone else I know.”
Mr Clark, who had felt too ill to drink before his diagnosis anyway, stayed off booze but his liver did not recover. He was diagnosed with a blood disorder too and was in and out of hospital. He had to leave his job, lost touch with friends and, after two years, was put on the transplant waiting list – finally receiving a new liver four months ago. “What a difference,” he said. “I have gone from being basically housebound to being out every day.”
He saw his daughter graduate from high school and will soon be seeing her off to university. “My kids are saying they have got their dad back.” Now 41, he reflects differently on his former drinking habits – noting good health should not be taken for granted.
The liver is the most complex organ in the body after the brain and, Mr Clark says, very important.
Memory problems are among the symptoms he has experienced, a side-effect caused by the build-up of toxins.
Dr Mathis Heydtmann, liver specialist at the Royal Alexandra Hospital in Paisley and co-author of a new study on the devastating impact of alcoholic liver disease in Scotland, describes patients with the condition as “the sickest in the hospital”.
Junior doctors covering the wards over night, he said, find they require the most attention. “They can be very unstable and deteriorate very rapidly.”
Since 1991, the number of patients who die with the illness in hospital has reduced, but remains high, and mortality rates have not improved in the community. Dr Heydtmann says the cost of caring for the patients is “staggering”.
He believes multiple approaches are needed to help prevent the condition and better manage those who have it. Among them is the Scottish Government’s plan to set a minimum price per unit of alcohol.
“I regularly see patients who tell me they do not know how much they drink – they drink as much as they can afford,” he said.
Professor John Dillon, a consultant liver specialist in Tayside, has seen Dr Heydtmann’s early findings, which he says reflects his own experience – there are more female patients and they are getting younger.
He added: “We are getting better at helping people to survive their first hospital admission, but we are not good at putting in treatment to focus on their alcohol use and stop them coming back. And if you keep playing Russian roulette, you eventually die.”
SCOTLAND is used to grim statistics on alcohol use and abuse, but the latest are particularly dark and depressing. According to a new study, women are developing alcoholic liver disease at an ever younger age – the median age used to be 55, it is now 53. Women are also succumbing to liver damage due to drinking earlier in life than men. The situation is so bad that girls have been taken to hospital with the problem as young as 16. And the youngest female to lose her life was just 17 years old.
There is no single reason we have ended up in this situation. Everyone knows Scotland has a dysfunctional relationship with alcohol and the culture in which it is often acceptable to drink heavily will have played its part in damaging women’s health. However, women’s relationship with alcohol has also changed in a way in which men’s has not – 30 years ago, there was stigma around women drinking too much, but by the 90s they were wearing their drinking as a badge of honour in the same way men do.
No-one would seriously suggest we should attempt to roll back that change and return to the days of stigma– why should women be judged more harshly than men for drinking? But women drinkers do face particular problems. They are generally smaller than men which means that alcohol takes a heavier toll on their bodies. Women also develop alcohol-related diseases and other consequences more quickly than men. And the culture of a glass of wine as a de-stresser after work has also developed in recent years, particularly at home where it is much harder to keep a track of what we drink. Dr Mathis Heydtmann, of the Royal Alexandra Hospital in Paisley, says he regularly sees women patients who say they do not know how much they consume.
Clearly, poverty also plays its part, although we should not make the mistake of assuming the heavy toll liver disease is taking on women is solely down to deprivation. The problem is more common in deprived areas, but the study found that patients came from all social classes. It is a reflection of how profound the problem is.
Solving it will be hard, but a good start would be minimum pricing. The proposal is still delayed by court action, but three-quarters of all drink sold in Scotland is through supermarkets and off-licences and the prices mean that a shopper can buy their weekly maximum recommended alcohol intake for as little as £2.50. That is bound to make drinking more tempting and minimum pricing could help address the problem. There are other practical measures that could help: better labelling for example, and a greater focus by the licensed trade on ensuring that smaller measures and glasses are always among the choices on offer in bars.
However, as well as the practical, there will need to be a cultural change too, along the lines we have seen with smoking. We have to stop telling each other than the way we consume alcohol is okay; women – and men – also have to start questioning the idea that a drink after work every day is fine, particularly when the latest medical evidence is linking alcohol much more closely with cancer. The latest figures on liver disease among women are deeply shocking, but they are only one part of a much bigger problem.