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PaperclipPerfector  4mo ago (text post)   2213 thread views

Wellness Wednesday for July 24, 2024

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This is just my own curiosity but - doesn't that make you feel like crap the next day?

I really like drinking, and that's the main thing that holds me back apart from trying to avoid weight gain: that upset stomach/headache feeling persists all the following day for me, and I almost never go beyond 4 total drinks. For context I'm in my mid-30s and in fairly good physical condition.

Light beer or vodka shouldn’t have that much of a hangover if you hydrate.

Wine or whiskey, on the other hand….

As some anecdata from someone that drinks more than I should often enough to have some data, four of five drinks causes me no noticeable ill effect the next day provided that I cease drinking at a reasonably early hour. The negative effects either kick in at higher levels of drinking or from drinking closer to bedtime. I wear a good sports watch that tracks heart rate, stress level, heart rate variability, and sleep quality, and it confirms that basic understanding. Stress and heart rate spike in the timeframe immediately after drinking, drop back to baseline after a few hours, and the impact on sleep quality only occurs if I go to bed when stress and heart rate are still elevated.

This isn't a claim about organ or metabolic health, of course, just relaying some anecdata on short-run effects.

I wonder if your physical fitness plays a role here. Don't you run like 50 miles a week?

Yeah, on average.

I'm a decent bit younger than you, but fortunately I don't really get hungover or queasy, even after far more liquor than is good for my liver (albeit maybe like once or twice a month). I suppose age will catch up to me, but at the very least hydration makes a world of difference.

Sugary drinks gave me the worst hangovers. And I don't have sugar anymore cuz of a diabetes diagnosis. So hangovers are pretty mild.

My sleep schedule has also been real shitty lately, and bad sleep can feel about as bad as a hangover for me.

I am certain the drinking is not helping my sleeping, so it's another reason I'd like to cut back.

I am a doctor but I am not your doctor. The following is essentially a reminder of the importance of healthy life style.

I find that the medical establishment tends to be rather alarmist about alcohol (not necessarily incorrectly, but perhaps unnecessarily aggressively) but the presence of DM (2, presumably) means that curtailing drinking is a lot more important - people who would never drink six bottles of coke will down a six pack over the course of the evening and not realize it's worse for you than the soda.

Diabetes increases the risk of various things with or without obesity and we routinely advise diabetics to avoid extra "hits" to their health accordingly.

Others point out some other considerations here - the potential concern for genetic predisposition to alcoholism, the important of habits and so on.

If it's really just a slide into an unhealthier habit without addiction I'd advise just stopping altogether for a few months to prove to yourself you can. If you can't, that's evidence, what you do with that evidence is up to you. If you can stop, after a while you can try reintroducing and see if you manage it in a healthier way.

If you want help people in your life are almost always going to be better than strangers on the internet. Doesn't need to be phrased in a scary way "hey honey/bro, for health reasons I want to try and skip my after dinner drinks for a little while, can you help nag me?"

An alternate strategy may be a harm reduction approach - Friday nights only or special occasions, something like that.

Since you're dishing out common sense advice that most doctors won't give their patients...

Let's say that you were forced to drink a whole bottle of wine in one night. What would you do to mitigate the worst affects of it?

ChatGPT just tells me not to drink the bottle, lol.

Well. I am not sure I have peer reviewed data for you, but I can tell you what I know as a semi reformed party animal.

  1. A bottle of wine is not a lot of alcohol. Get swole or something if it's a problem.
  2. Don't do other stuff that increases risk of acute or chronic morbidity. Don't drive. Don't take Tylenol. Don't mix in benzos or percs or anything else. Don't be on antibiotics or have liver damage or relevant chronic disease etc etc.
  3. Don't take medication before or after unless you know what you are doing. It'd be rare for a healthy person but Tylenol after drinking could kill you. Other stuff may be more effective and safe but it'd be less responsible to guide with this. 2 and 3 above will protect you if you meant he worst of it in terms of health effects.

If you mean the morning after:

  1. A good chunk of a hangover is mineral and fluid status related. Drink Pedialyte. Maybe Liquid IV. Gatorade and just regular water will help somewhat but the drop off is pretty sharp from something that's actually correct solute wise. If you are rich you could use an IV and that'd work great. Supplement other missing shit (vitamins and minerals) in your morning meal. Eat a banana. In addition to drinking fluid after, do it before.
  2. A good chunk of a hangover is residual hyperglycemia. Go for a run. Light cardio may be the best you can do for most people.
  3. A good chunk of a hangover is nausea and other related stuff. Take a shit. Shower. Get some fluid. Lore is that fatty stuff helps, don't sure what that comes from evidence wise but might be legit. Medical people often use anti-emetics.
  4. A good chunk of a hangover is sleep deprivation. Alcohol makes you pass out. It doesn't make you sleep. These are not the same. Go home/shower/get comfortable then go back to bed. Be less tired and/or exhausted before you drink.
  5. You can also avoid sugary drinks, or sugar in your meals before. Red wine is worse than white, composition of the alcohol, impurities, tannins, all kinds of other stuff can exacerbate hangovers.

If you mean not seeming drunk:

  1. A full stomach seems to reduce total experience of alcohol and damage to the body, maybe? Someone needs to do a paper lol. It does mean you'll seemingly be drunk for potentially longer but will reduce the damage and drunkenness by slowing metabolism down.
  2. Pace yourself. A glass of wine then a glass of water then repeat. People process about a drink an hour (very roughly) go light for long and you might not even notice.
  3. DO NOT RECOMMEND: use of other substances like caffeine can reduce subjective and objective drunkenness. This is obviously highly hazardous to your health, and it reduces subjective a lot more than objective which can be problematic.

Special situation:

  1. If you are asian you might have an actual enzyme deficiency. Google this if you want to try some of the stuff people do to address that.

This brought to you by currently drunk.

I have quit for months at a time to make sure that I can. Last time I did that was a few years ago though. I've got my A1c down to 5 for the past two years, so the diabetes feels under control, but I'm just treating it like its permanent. So no more desserts, no more sugar drinks, and avoiding carb heavy meals.

Quitting sugar was way harder than quitting alcohol. Like incomparably harder. Had days where I screamed and nearly cried from the frustration of not being able to have sweet sugary snacks again. Quitting alcohol was kinda like just having a slightly less active social life, and I'm an introvert already so that was easy to fall into.

My wife will also be holding me to account on the no drinking thing, so this is just me doubling up on the accountability. She will not be drinking at all since we just discovered she is pregnant. Hopefully this one survives.

I'd never suggest this to most patients, but you are a motte poster so I have to imagine you are quite a bit more clear thinking than the average person.

Think about if the juice is worth the squeeze and use that to motivate you. Alcohol is a poison AND it's bad for you AND it has enjoyable effects AND you can enjoy it with full awareness of all this and no guilt if done sensibly and with deliberation.

Identify what an appropriate amount of consumption is for you and use the knowledge of the above to stick to it.

If you can't do that, then attempt to be honest with yourself as to why - are you normally on top of your self-regulation in this way (and is therefore alcohol different), or perhaps you are the kind of person who needs to cold turkey instead of reduce (or vice versa).

Keep an eye out for worrying patterns of use. Not necessarily likely, but very important because the risk is high. Things like: escalating pattern of use (maybe this counts, maybe not), people commenting on your use, using to cover up for bad feelings, stress, life events and so on. Basically have an honest ask with yourself about alcoholism, again not because it's likely but because it's one of the worst ways to die and you want to make sure it's not happening and you aren't lying to yourself about it.

I mentioned elsewhere but I think once a week is a good balancing point where I'm getting something enjoyable out of alcohol and not overdoing it. That is where I'd like to be where I can have a fun social outing with drinking once a week, and otherwise I'm not drinking. And if the social outing doesn't happen I don't want to feel the desire to drink anyways.

I've been at that point before. It just morphed slowly over the last two years to where I'm now at. Now that my wife isn't drinking I very quickly noticed "oh, I'm drinking just about every day".

I've seen my dad get to a worse point with his drinking so I know that's in my genes, but my dad has also lately been where I want to be where it's just a few drinks for social things once a week or every other week.

All that is reasonably reassuring, and putting aside direct health effects and addiction concerns it may be worth asking why you are starting to slide into this habit change. Down about something? Bored? Replacing another habit you used to do that is out of season right now (idk, NFL?).

May be something you can use to push yourself into picking up a new hobby or making a positive lifestyle change or sumthin.

Doesn't alcohol metabolize into sugar, and so it's also bad for diabetics? Not that I can talk as I still have sugar, I just can't quit it. But maybe thinking of alcohol in terms of "this is bad for the beetus" will help you to cut back?

It gets converted into fatty acids as far as I know.

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