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Medical Forum / Diseases and Disorders / Arthritis / October 2006

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OTP: alcohol question for my work in progress

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Diane - 16 Oct 2006 00:03 GMT
I'm having trouble finding the info I need for the book I'm working on.
in 1992, a young woman suffering from post partum depression begins to
self medicate by drinking. she gets pregnant again and when she gives
birth, the baby has problems related to her drinking and is taken from
her and put in a foster home. this is her wake-up call and she goes
into rehab. the question i have is what rehab would have been like for
her in 1992? if she was not a heavy drinker, but still a 'regular'
drinker, what would detox be like for her? i know now they have less
agonizing, medicated detox but did they back then? if anyone can help
me with this info, i'd greatly appreciate it.  feel free to email me
privately if you'd prefer.

thanks,

diane
www.dianechamberlain.com
http://blog.dianechamberlain.com
Cooly - 16 Oct 2006 02:16 GMT
    Around that time is when the insurance coverages stopped paying for the
extensive treatments programs which usually included 30 days in-patient
treatment. It would be likely that your young woman would have done an
out-patient treatment unless finances were not a concern. In 1992 I
helped a friend through this type of program, no family members were
available and I had been through it with my father a couple of times.
The treatment was offered by a local non-profit group which offered
programs for alcohol and drug abuse.  As I recall there were twice
weekly meetings in group and the treatment followed the 12 step approach
of AA.
    It was difficult dealing with the alcoholism while still carrying on
with daily life. But she succeeded and hasn't had a drink in over 14
years, and we've been happily married for 10 of those.
Cooly

> I'm having trouble finding the info I need for the book I'm working on.
> in 1992, a young woman suffering from post partum depression begins to
[quoted text clipped - 13 lines]
> www.dianechamberlain.com 
> http://blog.dianechamberlain.com
Diane - 16 Oct 2006 03:12 GMT
oh cooly that is a sweet story! congratulations to you and your wife.

duh. i hadn't even thought of the insurance/money issue. i need my
character to be in residential treatment program for at least two
months, so i think i'll have to give her money. though she's not a
moneyed type of gal.

thanks,

diane
RoseB - 16 Oct 2006 03:20 GMT
i think i'll have to give her money. though she's not a
>moneyed type of gal.
>
>thanks,
>
>diane

What about an anonymous benefactor?

(Just kidding) LOL
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Adelle - 16 Oct 2006 03:50 GMT
> oh cooly that is a sweet story! congratulations to you and your wife.
>
> duh. i hadn't even thought of the insurance/money issue. i need my
> character to be in residential treatment program for at least two
> months, so i think i'll have to give her money. though she's not a
> moneyed type of gal.

I think Medicaid paid for a 24 to 72 hour drying out inpatient. After that,
the social worker at the inpatient facility tried to get you into another
program. If you had good insurance (certain HMO's, and higher tier benefit
plans) you still got the 30 days inpatient and an additional 90 day
outpatient treatment (up to twice in a one year period). Always ticked me
off that if I abused substances, I could get more treatment than for my
depression, which was limited to ten visits/year at the regular copays. More
visits were charged at a higher copay.  I've hear certain HMO's, like
Kaiser, were stingier with benefits that ones here in Massachusetts (at the
time - Harvard Community Health Plan, Tufts, Fallon).

So either your character has good insurance, is the dependant of someone
with good insurance, or is completely at the other end of the economic scale
and is getting into programs for the indigent.

There were a few non-profit programs (Boston had one) which were designed
specifically for new moms trying to get clean and sober and maintain or
re-establish parental rights (and aimed at getting people off welfare). I
had a client in one. They taught life skills (personal responsibility, time
and money management, etc.), parenting skills,  required everyone to help in
the house (it was a residential setting); had AA meetings available multiple
times a day (some in house, most out in the community) and daily therapy
sessions (mix of group and individual).

They accepted Medicaid and Medicaid paid for the program, but I forget for
how long. After that time, you were allowed to stay if you were progressing.
You needed to be recommended for the program by a social worker, parole
officer, court officer from family court or some such. And it was limited to
about 12-15 women.

Adelle
Nann Bell - 16 Oct 2006 05:43 GMT
>> oh cooly that is a sweet story! congratulations to you and your wife.
>>
>> duh. i hadn't even thought of the insurance/money issue. i need my
>> character to be in residential treatment program for at least two
>> months, so i think i'll have to give her money. though she's not a
>> moneyed type of gal.

does it have to be a fancy inpatient treatment program?  There was/still is
one in Gainesville that did things on a sliding scale - it was publicly
funded but I'm not sure how it works now with recent reductions in social
services.  Anyway, an old friend of mine went through their residental
program many years ago (28 or so) and then worked as a counselor with them
for many years after getting sober.  She might be able to go into such a
program.

It wasn't and probably still isn't unusual for heavy drinkers to go through
several days on librium while detoxing.  I'm not sure if your character would
have been that heavily addicted yet.  IIRC, my friend went off alcohol cold
turkey when he did so after 14 years of drinking.  If you need any more info
than you can collect here, I can see if the email addy we have for him is
still good and ask him some - his work as a counselor gave him wide exposure.

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

DeeTee and Bob Taggart - 16 Oct 2006 04:56 GMT
Awesome, Cooly!

DeeTee

> Around that time is when the insurance coverages stopped paying for the
> extensive treatments programs which usually included 30 days in-patient
[quoted text clipped - 26 lines]
>> diane
>> www.dianechamberlain.com http://blog.dianechamberlain.com
debbie m - 16 Oct 2006 15:22 GMT
oh, cooly - what a beautiful story.  I'm glad you've had a good
marriage.  What a support you were.  That's the definition of love.

debbie m.

> Around that time is when the insurance coverages stopped paying for the
> extensive treatments programs which usually included 30 days in-patient
[quoted text clipped - 28 lines]
> > www.dianechamberlain.com 
> > http://blog.dianechamberlain.com
d'huit - 16 Oct 2006 15:38 GMT
Around that time is when the insurance coverages stopped paying for the
extensive treatments programs which usually included 30 days in-patient
treatment. It would be likely that your young woman would have done an
out-patient treatment unless finances were not a concern. In 1992 I
helped a friend through this type of program, no family members were
available and I had been through it with my father a couple of times.
The treatment was offered by a local non-profit group which offered
programs for alcohol and drug abuse.  As I recall there were twice
weekly meetings in group and the treatment followed the 12 step approach
of AA.
It was difficult dealing with the alcoholism while still carrying on
with daily life. But she succeeded and hasn't had a drink in over 14
years, and we've been happily married for 10 of those.
Cooly

now, that's the sweetest biographical story i've read in a lonnnnng time!
cooly, you're special and she knows it.  and now, we know it, too.  thank
you for sharing this with us.  it is wonderfully uplifting.

kate

Diane wrote:
> I'm having trouble finding the info I need for the book I'm working on.
> in 1992, a young woman suffering from post partum depression begins to
[quoted text clipped - 13 lines]
> www.dianechamberlain.com
> http://blog.dianechamberlain.com
Cooly - 16 Oct 2006 17:17 GMT
Thanks, and I mean that, to all of you. My wife is the special person in
this story though. She had lived with bad back pain for several years
and had extensive surgery with a rod implanted in her lower spine. After
the surgery she realized that she had been using alcohol to manage at
least some of the pain. She knew my family history and didn't want
alcohol to be part of our relationship. She has been supportive to me
through my adventure with RA and you all know how important that is. I
am a lucky man.
Cooly

> Around that time is when the insurance coverages stopped paying for the
> extensive treatments programs which usually included 30 days in-patient
[quoted text clipped - 35 lines]
>> www.dianechamberlain.com
>> http://blog.dianechamberlain.com
Diane - 16 Oct 2006 17:35 GMT
She has been supportive to me
> through my adventure with RA and you all know how important that is. I
> am a lucky man.
> Cooly

i think some of the best partnerships occur when both people understand
what it's like to go through adversity. you can really be there for one
another.

you've all given me some great ideas! i think i'll have her
hospitalized while she gets off alcohol and onto an antidepressant,
then perhaps move into one of those residential programs for mom's
adelle mentioned. i figured out how her hospitalization can be paid
for, too. :)

thanks, all

diane
Diane - 16 Oct 2006 17:35 GMT
She has been supportive to me
> through my adventure with RA and you all know how important that is. I
> am a lucky man.
> Cooly

i think some of the best partnerships occur when both people understand
what it's like to go through adversity. you can really be there for one
another.

you've all given me some great ideas! i think i'll have her
hospitalized while she gets off alcohol and onto an antidepressant,
then perhaps move into one of those residential programs for mom's
adelle mentioned. i figured out how her hospitalization can be paid
for, too. :)

thanks, all

diane
ladylove77 - 16 Oct 2006 19:31 GMT
Cooly, congratulations to both of you.
Gwen

> Around that time is when the insurance coverages stopped paying for the
> extensive treatments programs which usually included 30 days in-patient
[quoted text clipped - 26 lines]
>> diane
>> www.dianechamberlain.com http://blog.dianechamberlain.com
Duckie - 17 Oct 2006 02:45 GMT
My ignorance talking here but I thought a pregnant woman would have to
be consuming more than 2 drinks a day to cause fetal alcohol syndrome.
Probably not but that would make it more than a casual drinker I think.
Duckie

> I'm having trouble finding the info I need for the book I'm working on.
> in 1992, a young woman suffering from post partum depression begins to
[quoted text clipped - 13 lines]
> www.dianechamberlain.com 
> http://blog.dianechamberlain.com
Joan Carter - 17 Oct 2006 04:57 GMT
>My ignorance talking here but I thought a pregnant woman would have to
>be consuming more than 2 drinks a day to cause fetal alcohol syndrome.
>Probably not but that would make it more than a casual drinker I think.

It can be caused by even small amounts. Better not to drink any alcohol while
pregnant.
---
Joan
RoseB - 17 Oct 2006 05:59 GMT
>It can be caused by even small amounts. Better not to drink any alcohol while
>pregnant.
>---
>Joan

Well I did an internet search, and many sites seem to indicate two
drinks. I have done worksops on FASD many times though, and the best
advice is no alcohol at all. The amount that can cause damage is
variable, and is dependent on body size and alcohol tolerance,
therefore for some people it is generally believed that even a small
amount can cause damage.

I have taught many children on the fetal alcohol spectrum, and it is
heartbreaking really. There is no understanding of cause and effect.
Learning does not stay in the memory, so that new tasks have to be
retaught over and over again. There is no perception of danger so
children on the spectrum often engage in high risk behavior. Some also
derive stimulation from sensory experiences such as spinning (tire
swings are popular) or may poke at their eyes for the sensory effects.
There is new research that says that the pain threshold of FASD
children is altered, and they may not perceive heat and cold the same
way as other children. You may see children out without coats in
winter who end up with frostbite because of this altered perception.
The converse would also be true and they may not experience heat the
same way.

In my situation I frequently teach children whose parents also have
FASD. That is a difficult situation as the parents may not understand
the ramifications of their choices, and require a great deal of
support.

More info than you want to know, I  am sure. But this is a topic near
and dear to my heart since I deal with the results of FASD. I would
estimate that in a typical class, I could have as many as 5 students
on the spectrum. Many are undiagnosed, and if they are FAE, do not
have the facial anomolies that make diagnosis easier.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Duckie - 18 Oct 2006 21:24 GMT
Thanks Rose. Also interesting that there is a different spectrum where
the facial anomalies are actually missing.
My daughter has never to my knowledge had either type in her classroom
but this year in a class of 31 kindergartners, she has 5 with autism and
one of those who has a full time aid just to himself. Something is
definitely going on with this 'disease'.
Duckie

> Well I did an internet search, and many sites seem to indicate two
> drinks. I have done worksops on FASD many times though, and the best
[quoted text clipped - 31 lines]
>
>      Please remove "Ima" to reply.
Duckie - 18 Oct 2006 21:16 GMT
> It can be caused by even small amounts.

Thanks for that info Joan.

Better not to drink any alcohol while
> pregnant.

No kidding...
The perk for being pregnant is that eating is a good thing. lol
Duckie
Nann Bell - 20 Oct 2006 13:20 GMT
> My ignorance talking here but I thought a pregnant woman would have to
> be consuming more than 2 drinks a day to cause fetal alcohol syndrome.
> Probably not but that would make it more than a casual drinker I think.
> Duckie

yeah, what they say has varied from time to time.  When most of my cohorts
were pregnant the word was that one glass of wine/day was ok.  now they say
avoid ALL alcohol if at all possible.  For most pregnancies a bit of alcohol
could be fine, but there are some that just a couple of drinks during that
first trimester can be all it takes to cause fetal alcohol syndrome.  So now
the advice is no alcohol.  The birth complications are severe enough that it
is best to err on the side of caution.

interestingly enough, my developmental psych book says FAS wasn't identified
until 1973.  Big changes there in the last 30 years.

Reminds me of my mom who has always said she's glad she didn't know of the
potential complications of some of the meds she was on for chronic conditions
during her pregnancies.  She would have felt guilty about taking them, but
couldn't have functioned without them.  Of course, today they have more
options medically for getting you through the critical months.

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

Diane - 21 Oct 2006 02:24 GMT
Rose, I really enjoyed, though that's not the right word, your post.
one of the main characters in the book I'm writing is a 15 year old boy
with FAE (fetal alcohol effects, which means he doesn't have the facial
deformities of fetal alcohol syndrome). Your description fits him
perfectly. I've learned so much, especially from talking with Jodee
Kulp who has an FAE adopted daughter and has written a number of books.
Jodee would say no alcohol, even if you're trying to conceive. You
don't know what part of the baby is being developed at the moment the
alcohol crosses the placenta and it's just not worth it. I've also read
that fetal alcohol is a primary cause of mental retardation. however, a
person with fetal alcohol can have a high IQ as well, but still have
the memory and neurological problems. my character, whom i love, is a
physically beautiful boy with a normal IQ but very concrete thinking,
poor memory and in desperate need of rules, which need to be constantly
repeated. (an example of concrete thinking jodee gave me was about her
daughter who saw the sign in the airport that said you can't carry
lighters on board, so she stuck hers in her sock. needless to say, this
created major problems that made them miss their plane!)

anyhow, it's easy for me to be self-righteous about this since i'm a
tee-totaler, but i just don't see why a woman would drink while
pregnant now that we know the potential danger.

diane
RoseB - 21 Oct 2006 02:35 GMT
i just don't see why a woman would drink while
>pregnant now that we know the potential danger.
>
>diane

Thanks, Diane,
I know what you mean about finding it difficult to understand why a
woman would choose to drink especially given that the information is
out there. Even in bar washrooms there are posters warning against
drinking during pregnancy.
We taught children of a doctor's daughter and she drank throughout the
pregnancy knowing full well the risks involved.
Our Resource teacher attended an FASD workshop with a mother who was
herself FAE, and had three children with FASD. She got up, spoke about
how she was an alcoholic in her early teens and regretted drinking
through her pregnancy. Within days though, she was back on the streets
in her old lifestyle patterns and once again became pregnant. I
believe that social services took that child immediately. Her others
are in foster care.
Insofar as teaching, we know which children are affected, or certainly
have suspicions, but in a small town it is difficult to get a
diagnosis because to diagnose FASD reflects a lifestyle choice. Unless
a mother has changed her lifestyle she may be unwilling to pursue a
diagnosis that impacts on poor choices that she has made.
Unfortunately without such a diagnosis, there is no support in the
school system. :(
Kudos to your friend for taking on the responsibility of raising a
child with FAE. It is a difficult challenge.
    Rose   @}>->--
    Being educated means that rather than fearing the unknown, one seeks to understand it. RB

    Please remove "Ima" to reply.
Nann Bell - 22 Oct 2006 15:27 GMT
> anyhow, it's easy for me to be self-righteous about this since i'm a
> tee-totaler, but i just don't see why a woman would drink while
> pregnant now that we know the potential danger.

LOL, though I know this is a very serious subject ultimately.  I'm just
remembering the one time in our marriage that I was late and really wasn't
sure I wasn't pregnant.  We'd just returned from Italy so our bodies were all
messed up by jet lag and, of course, we'd had a lovely time in beautiful
contry ;-)

We went out to dinner at home and I decided not to have wine, just in case.  
Until then, Mike was fairly calm about the possibility I might be pregnant,
but me avoiding the wine just freaked him out!  I was much amused by the way
that really brought it home to him, though we'd been discussing this for
several days.  We had to stop on the way home and buy a test kit - which was
negative.

Of course, some women still don't hear the word about completely avoiding
alcohol, especially if they weren't intending to get pregnant.  There is such
a sadly large segment of the population that just isn't privy to enough of
these basic health decisions.

Signature

Nann
remove the Gator cheer to email me
Simply the thing I am shall make me live --- William Shakespeare

Gary Z - 24 Oct 2006 14:01 GMT
>  my character, whom i love, is a
> physically beautiful boy with a normal IQ but very concrete thinking,
[quoted text clipped - 5 lines]
>
> diane

Sounds like ADHD to me.....Could be my son your speaking of, though his
mother was a non-drinker.
GaryZ
 
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