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Autobrewery Awareness

A comparison of cases

4/25/2016

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Ray here--
In light of the recent news regarding the DUI case involving a woman in New York and her confirmed diagnosis of Auto Brewery Syndrome, a little clarification is in order. There are two main areas I’d like to address, and as usual, I make no promises regarding the brevity (mainly the lack) of this interlude. The first area will cover the situation with ABS as it pertains to the woman in New York and the course of the legal portion of the ABS syndrome. The second area will cover the similarities and differences between her situation and mine. 
The link to the news story provided below gives a nominal amount of information about the case in New York. I encourage you to read it, and leave it up to you to decide if you would like to read the comments. (You may have to sign in on their site.) I generally preach abstinence when dealing with online news article comment sections, but I have a clearly vested interest in knowing what “Joe” and “Jane” think and/or have to say about the subject. (Generally speaking, a disconcerting number of those who comment do not appear to read more than a few sentences beyond the headlines, if at all, before commenting. Or their reading comprehension skills and retention abilities are as sharp as cotton balls. But you already knew that—pardon the digression).
​
www.king5.com/news/local-womans-stomach-acts-as-a-brewery-so-dwi-case-dismissed/150227855

Whether you read the comments or not, you will note the basic facts within the article itself:
Court records are sealed, so details such as names are omitted. A woman in upstate New York had a few drinks while having lunch with her husband over a few hours, was driving home when she had a flat tire. Being close to home, she drove on, but was pulled over by the police before arriving at her house. The officer on scene noted slurred speech and erratic behavior, and performed a breathalyzer test on the woman. She registered a Blood Alcohol Content of 0.33, and was taken to the hospital due to the seriousness of the medical implications of such a high BAC. She did not remain at the hospital for a long period of time because she was not exhibiting physical signs of extreme BAC or getting worse. She was charged with DUI, but while still exhibiting a positive BAC later, was observed for an extended period of time maintaining a BAC in the 0.30 range without ingesting alcohol, as attested to by several independent medical personnel on scene to ensure that no outside influences occurred.
Subsequently, she was tested in multiple ways to determine the cause of the rise in BAC. The results of those tests, performed by the leading experts on the syndrome and related GI conditions, confirmed that she did indeed suffer from ABS. The values shown by those tests are unique to ABS, and are not found in such a combination with any other condition. As a result, the presiding judge for the case dismissed it before the trial even began, since the evidence precluded holding a meaningless trial at all. The District Attorney filed an appeal at the beginning of the year, but has since dropped that appeal, citing the lack of merit that their appeal held.
Shifting the focus to look at my experience with ABS and the legal system, the many similarities become divergent once deep into the legal system of Lane County, Oregon. In the interest of brevity (I know, “too late!”), I’ll assume that if you are reading this, you have probably read at least some of the previous entries regarding my ABS diagnosis. If not, you’ll find all the info you need within previous postings, though certainly none of the coffee and wherewithal needed to get through it in one sitting. A short summary:
I was involved in an accident at the end of 2014, with injuries severe enough to land a multi-day stay in the hospital. A high BAC reading at the hospital several hours after the accident was the first indication of something amiss. Due to the incapacitation caused by injury, I did not get the benefit of observation for cause of the high BAC. I knew nothing of ABS at the time, and had no idea that I had it. It took several months after medication and surgery before there was an inkling that something was wrong. There were multiple occasions over the spring and summer of 2015 when I suffered from ABS “flares” or “episodes”. During three separate such events, I went to the hospital seeking to have blood drawn and monitored. All three times, I was admitted, examined, and told that I could not stay for observation because I was not showing signs of my life being immediately threatened, and beds were needed for other patients. (These visits are part of my medical record, subpoenaed and present for the court during my trial.)
On another occasion during the Fall of 2015, Sierra and I were invited to dinner at the house of friends of ours. I experienced a flare that day, and with breathalyzer in hand (it goes everywhere I go, discreetly), we told them exactly what was going on. They offered to observe, and over the course of a little more than six hours, watched as my BAC varied from between 0.14 to 0.19 while sitting at their dining room table. I ingested water and soup that they provided, and was never alone. All data recorded, of course. Predicting a flare or episode has proven nearly impossible, and completely frustrating. Having impartial observers under prime conditions is something I would have loved to have fall into my lap. Prior to treatment, it could be mere hours between episodes, or multiple weeks.
I was also tested by the same experts that handled the case of the woman in New York. I was informed that I had a positive diagnosis of Auto Brewery Syndrome, confirmed by additional testing. The values of those results are a unique combination that quantify ABS.
My trial was delayed multiple times by request of the District Attorney once ABS was diagnosed, and didn’t take place until January of 2016. A pre-trial hearing took place first, and occupied the entire day before the regular trial was to commence. The purpose of this pre-trial hearing was to present the evidence of ABS as a syndrome in total, and also as a particular with regard to my accident and medical issues. The judge confirmed that Auto Brewery Syndrome is a real medical condition for the sake of recognition by the court. She also confirmed that the doctor involved in my diagnosis (the same one in the New York case) was the leading expert on the syndrome, and that my diagnosis was valid.
We learned later that evening after the pre-trial hearing had adjourned, via e-mail, that the evidence and testimonies would not be allowed in the trial, and that such evidence and testimony would not be dealt with on the circuit court level. In essence, “take it to the Appeals and Supreme Courts, I’m not rocking the boat”. Oregon has a “strict liability” law. In a nutshell, if you are intoxicated or impaired, it doesn’t matter how you got that way. The law exists because it prevents such frivolous excuses such as “Somebody must have spiked my drink!” or, “I was at a party, and somebody blew it in my face!” etc. I understand the need for such legislation for these types of scenarios. A medical condition does not fit that scenario, however. (Unless a person with a known pre-existing medical condition does not control it when they are able, and still choose to drive.)
In New York, a judge recognized that there was no need for trial in the judicial system because it had already occurred in the medical system--the evidence was overwhelming. The court’s time was not wasted, as they chose to spend it in a more fruitful endeavor. 
This is the beauty of medical science conducted correctly: No matter how unbelievable the initial prognosis may seem, the end result bears the truth.
So, the District Attorney in New York dropped the appeal for good reason. Undoubtedly, the DA’s office looked at every angle in an attempt to discredit the diagnosis of the patient, and probably the actual science of ABS, a syndrome that has been officially recorded as early as 1938. The DA is there to win cases, above all else. When faced with a dead end, the prudent course of action is to direct efforts elsewhere. The Circuit Court system of Lane County Oregon has not yet wielded pragmatism, much less prudence, in regard to the direction of Auto Brewery Syndrome.
So, there are many similarities between the situation in New York, and the one here in Oregon. I can guarantee at least one glaring, definitive difference going forward however, regardless the outcome:
There will be nothing anonymous or sealed in the future about Auto Brewery Syndrome on this end, and you can be sure that I’ll see that through.


Thank you for reading.
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Sierra and Ray

3/24/2016

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March 5th, 2016

3/5/2016

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Still working on very important paperwork. Figuring out how to properly file taxes with outstanding restitution is not easy. This disease is affecting every single aspect of our lives.
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How it sometimes feels during a Flare

2/14/2016

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Ray here--
A week ago, I addressed several questions and comments that find my attention more than others regarding Auto Brewery Syndrome. It has been a busy week since then, including a few glorious days outside in the invigorating environs of the Douglas County landfill, replete with rain, snow, and hail, spraying skunks, and vomiting “co-workers”. I’ll expound upon those foibles a little later, but today I’d like to continue with a few common topics that crop up more often than others. As with last week’s theme, some of these are asked of me directly, while most have been brought up second hand by those who only have a partial knowledge of the goings-on of my situation. While I cannot promise that this will even approach a level of brevity acceptable by Facebook standards, (likely already surpassed two sentences in), I’ll truncate what I would actually like to write all in one sitting. In that regard, here we go:
“Even if you didn’t know that you had Auto Brewery Syndrome on the day of your accident (Dec. 30, 2014), why didn’t you pull over when you felt drunk?”
Understandably, this is probably the question that is asked the most once a person learns a bit about ABS and the role it played in the circumstances up to, at the time of, and after the accident. The answer, “I didn’t feel drunk. So I didn’t pull over”, is short and simple enough, but makes no sense without understanding the anatomy of an ABS flare.
The term “flare”, as it is applied to an appearance of positive blood alcohol content caused by ABS, was first used by the medical personnel who have been studying the syndrome. “Flare” was the word chosen because it aptly encapsulates the swift appearance and potential severity of conditions related to blood stream absorption of alcohol involuntarily fermented in the digestive system. Regular consumption of alcohol through drinking metes out the quantity of ethanol that enters the blood stream, regulated by the user. Granted, said user could affect this rate by the manner in which he or she drinks. That might mean consuming a beer every hour for several hours, knocking back several shots of whiskey over a shorter period of time, or nursing a white wine spritzer over the course of an evening spent at a social gathering. Quantity of alcohol in drinks obviously vary as well, such as watered down generic beer, 80 proof liquors, average wines and champagnes, homemade moonshine and ale, etc. But in all these cases of regular oral consumption of alcohol, the imbiber has the choice over quantity, quality, and length of time of consumption. The imbiber, in this case, knows exactly the moment that the ethanol enters their body, and very shortly thereafter, their blood stream. The ABS sufferer has no such knowledge. Nor do they have the advantage of controlling exactly how much ethanol may enter the bloodstream. Most of all, the ABS sufferer cannot know when the absorption might end.
An oral imbiber of alcoholic drinks will be acutely aware of the fact that they have consumed alcohol. They will notice the effects of alcohol much sooner than a person with an ABS flare. There is a steady rate known to the user as imbibed alcohol is consumed and processed by the body. There is also a placebo effect with traditional alcohol consumption, wherein the user is more apt to feel “drunk” or “tipsy”, because they know that they are consuming alcohol and that is the way they should feel. So any feeling aside from normal after the consumption of that alcohol is attributed to “being drunk”.
An ABS flare is vastly different than regular oral consumption of alcohol. A person has no idea when it is starting, and has no control over the quantity of ethanol being produced and absorbed. It may be very gradual, and if it were to be measured, might not rise to BAC levels that are above the legal limit. It can also rise very rapidly, outstripping the pace at which the body’s normal functions can out-process the ethanol. At lower BAC levels, a person in an ABS flare usually will not associate any feeling they have as one of being drunk, especially since they have consumed no alcohol. This is similar to undiagnosed diabetics who experience their first blood sugar fluctuations without the benefit of knowing what is truly happening from a medical standpoint. If they notice anything at all, it might be brushed off as hunger, minor fatigue, the onset of a cold, or myriad other reasons. It might possibly not even be noticed at all. The reason that diabetes isn’t the first thing that pops to mind? Well, because they aren’t diabetic. So why would that thought come up?
The most glaring difference between regular oral consumption of alcohol and an ABS flare is the potential severity, as measured by amount of ethanol entering the bloodstream over a short period of time. Because there is no regulation of ethanol production during an ABS flare, there is the potential for a rapid rise in a short amount of time. The effects of this are not the gradual “buzz” and build up that a person might feel at a social gathering as friends consume alcohol and begin to get boisterous and chummy. In the case of ABS, it can be a case of fast-forward. There is no happy, warm feeling associated with it—at least, not for me. I cannot speak directly for other ABS sufferers and their experiences, but among those that I’ve come in contact with, the overall experience appears to be similar to mine. Now, I’ve never up-ended an entire fifth of 80-proof liquor, so I can’t say that I know that feeling for certain, but that would be the best way that I could describe the experience of a severe flare to someone who does not have ABS. It is 0 to 60, so to speak, with all the fun parts removed.
On the day of my accident, the initial emergency call was dispatched around 2:45 p.m. I don’t know the exact time of the crash, but there were EMS personnel on scene fairly quickly, so the general consensus is that it occurred at roughly 2:35-2:40 p.m. I did not undergo a field sobriety test, nor was I asked to submit to a breathalyzer test or blood draw at that time. The hospital blood draws were the first measurements of my BAC after the accident, taken after 4:00p.m. The initial result of 0.29 BAC was staggering, pardon the pun. During the jury trial in January 2016, a forensic scientist who was involved in the analysis of the blood evidence and subsequent time-line extrapolation based upon the known BAC results from the hospital draws was called to testify. She explained normal ethanol absorption and out-processing for a person of my known gender, age, and weight at the time of the accident, and was able to graph the time-line for the entire day, relative to my BAC. According to the known data, I would have needed 14 to 16 regular 12-ounce beers consumed over a period of several hours before the crash to achieve the results recorded at the hospital. Or 21 to 24 ounces of 80-proof liquor over the same period. (A “fifth” contains 25 ounces.) This, of course, assumes a normal, steady rate of oral consumption in a traditional manner.
Here’s the monkey wrench:
Over those several hours of time, roughly 12:00 p.m. to 2:30 p.m., I was at McKenzie fish hatchery, working outside, with approximately 8-10 other people. Some of those people I had worked with before, some I had not. Since I was never out of view by myself at any time, we all would have had to be drinking copious amounts of alcohol, as that would be the only explanation for all those interviewed after the crash attesting to the fact that I was not drinking 14 beers or a fifth of tequila just prior to driving off station. The crash occurred approximately ten minutes later, and I was soon on a gurney with IV fluids, pain meds, and injuries that included a blow to the head severe enough to pulverize the orbital floor of my left eye socket. Did I feel out of it? Uh, yes. Did I feel that I was severely drunk? No. Why would I? I hadn’t had a drop of alcohol, so it never even crossed my mind.
The actual explanation of the high BAC measurements was a complete mystery to me, my coworkers, EMS personnel, and hospital ER triage staff. As time went on and I was diagnosed with ABS, the explanation was as plain as day. The rise of ethanol in my bloodstream occurred sometime prior to the first hospital blood draw, but was not high enough to alter my behavior or motor functions to any noticeable degree just a short time prior. Over the course 2015, I had several other ABS flares that mimicked the timing of what happened on December 30th, 2014, albeit with slight variations.
In a nutshell, my experience has been that an ABS flare doesn’t feel like being drunk until it reaches higher BAC levels, and that the experiences related by other ABS sufferers appears to be similar, though not exclusively so.
Now, as promised, the close of this installment of Facebook effrontery. I had planned on a more expansive post on this particular topic, but I hope at least one set of eyelids out there make it this far before snapping shut. We’ll pick up the thread another day, and address others as well. Currently, there is an Auto Brewery Awareness website in the works, and while it is working right now, a little minor tweaking is in order. That platform will be much more conducive to longer forays into various aspects of ABS and the ongoing learning, research, and treatment. This Facebook site will remain when the ABS website goes live, and they will work in tandem.
Tomorrow, I am scheduled to meet with personnel at an outpatient treatment center, as mandated by the court. I’m sure that it will be interesting, and will give a report when I am able to do so. Until then, thank you for reading.
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Community Service

2/8/2016

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Ray here--
So, as a condition of my community service, I’ve been fortunate enough to work at the dump. And it is exactly as glamorous as you might have imagined.
We all go there, even if indirectly. But most of our experience with the process ends with the snap of the kitchen garbage can as it swallows the tid-bits that we discard on any given day. Or, perhaps, an occasional cinch of the bag after it completes its static cling run up the sides of the under-counter can.
Out of sight, out of mind. Maybe.
The convicts of Douglas County Oregon, a group of which I am loosely associated with (much to my surprise at this juncture in my life’s timeline, even though I’m an accused misdemeanor in a sea of felonies) would like to have a word with you regarding the previous statement:
Finish.
That’s the word.
Finish.
We throw away far too much, probably because we consume too much. That’s another topic for another day. But the things that I have seen, in my short time at the terminus of what we grasp as tangible life, is astounding. It is indeed out of mind. And my community service hours, justly warranted or not, aim to put it out of sight.
I’ve covered over more useable goods in the last 32 hours (112 total owed. Living the dream.) than a regular family of four should ever need to purchase in a lifetime.
This is not champagne and caviar. It is toothpaste, and tomato sauce, and soccer balls, and lawn chairs, and camper shells, and garden hoses, and goats, and barrels of apples, and caviar (so, I lied. Send me to jail.), and sunglasses, and floor mats, and iPods (yep. No shit.), and couches, and pickles, and Frisbees.
The soccer balls, Frisbees, and iPods flew the farthest, by the way. Unfortunately, I have no photographic evidence of this.
I don’t know who threw them, because I was hard at work, and I’m a newly adjusted model citizen, finally worthy of walking down the streets of your genteel town.
/sarcasm.
Thank you for reading
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Answers to some basic questions

2/6/2016

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Ray here--
Over the last week or so, the story of my accident, diagnosis, trial and outcome has been mentioned or featured in a few newspapers and television newscasts. The benefit of that is that the story brings the subject of Auto Brewery Syndrome to eyes and ears that have never seen or heard of ABS. One of the pitfalls is that those people who are just now being exposed to the syndrome are limited in knowledge by the brevity of those reports. Because my case is unique--in that Oregon law prevents an outcome that permits the medical evidence of my diagnosis at the circuit court level--those reports are abruptly truncated in scope, unbeknownst to the new viewer or reader.
Now, anyone with a modicum of internet savvy knows that one of the steadfast rules for viewing or reading news reports on the web, if one wishes to retain a smidgen of hope for the human race, is this:
Never, ever read the comments. 
Never. 
Ever.
I’m a rule breaker. I’ve perused the reports, and I’ve read some of the comments. I’m a skeptic by nature, and some would probably say that I’m a bit of a cynic as well. So I’m jaded enough to avoid puncture by the misspelled barbs set forth by the average internet troll. Don’t worry about my fragile sensibilities, because in the case of the cyber world, they do not exist. As it is, my aim was not to count the number of incorrectly used homonyms per comment, but to get an idea as to what the most common misconceptions about ABS are for those newly exposed to the syndrome. Several things came up repeatedly, and I hope to address those today. As always, I profess the desire to keep this from rattling on and on, but I make no absolute promises. Common questions and/or concerns, in no particular order:
“Why was he driving when he knew he had this condition?”
The short and simple answer: I had no idea ABS even existed, much less that I had it. Most of the news reports I read stated the correct timeline, and detailed the process of discovery and diagnosis, months after the accident in December of 2014. I can only assume that reading comprehension, or acute lack thereof, leads many people to the question above. For those who read a shortened blurb about my case, the query is certainly understandable. Had I known that I had the syndrome, I most certainly would not have been driving that day. Or any other day. As a result of the circuit court trial judgment, my drivers license was suspended for one year, beginning January 15, 2016. That had no drastic effect upon my driving life, however, because I had voluntarily stopped driving in the early Summer of 2015. I had not yet been officially diagnosed with ABS at that time, but it was clear that I could not get behind the wheel and guarantee that my blood alcohol level would not become positive sometime down the road, even if it registered 0.00 when I first put the key in the ignition.
“He couldn’t have ABS. He wouldn’t be able to pass the required physical to get a Commercial Drivers License.”
Any of you reading this that have a CDL are chuckling to yourselves right now, and for good reason. For those of you that do not have a CDL, I’ll explain. In order to obtain and keep a CDL the driver must pass a Department Of Transportation physical. There is one national standard, regardless of the type of CDL, or the state in which the license is issued. The medical card that a driver receives when passing this physical must be renewed every two years, if in good health. If there are health issues that require more frequent check-ups, the frequency may be as often as every few months to a year. The physical itself includes a urine sample, vision test, hearing test, blood pressure check, health questionnaire, hernia test, basic balance and reflexes, as well as ear, nose, and throat checks, and probably one or two other things that I’ve forgotten, because they are so benign as to be easily forgotten. There is no blood test. No stool, no saliva, no EKG, etc. The urine sample is a drug and alcohol screening. None of these tests have Auto Brewery Syndrome in mind when given. The only way ABS could be caught would be if a subject was going through a flare at the exact moment that they were present at the doctor’s office for the urinalysis. And in that case, the subject would not be presumed to have ABS, but only to have consumed alcohol in a traditional manner, and therefore not given a medical card at all. In essence, a CDL physical, as currently conducted, would have as great a chance at diagnosing the Hanta Virus, Crohns Disease, or Tourette’s Syndrome as diagnosing ABS. A driver would have to self-report ABS, which would be difficult to do if the driver has never even heard of the syndrome, and surely has no idea that he or she suffers from it.
“I heard about a case in New York a few months ago that was dismissed by a judge. Now everyone is going to claim they have it, and get away with drinking and driving.”
Most of these remarks fall under the reading comprehension scenario mentioned above. In one regard, these comments have some merit. I would not doubt that a few desperate people may try to claim that they have Auto Brewery Syndrome in an effort to extricate themselves from an unwanted situation. I would also not doubt that their pursuit of that angle would be extremely brief. The multi-faceted testing performed over and over would show the falsehood of the claim before it even partially got off the ground. People may lie, but the numbers and the science never do, especially when they are repeated and then corroborated by other testing. And this is before the price tag to have this process undertaken and completed even enters the equation. Currently, that number lies in the tens of thousands. I don’t care what your deductible is. You don’t want to begin to be involved in something that expensive and time consuming if you know from the get-go that what you are claiming is false. The truth will come out, you’ll see no refund, and the legal hole you started in will become a gaping maw of your own doing.
There are a few other comments and questions that I would like to address, but as I write this, it is just past midnight. I have an alarm that will be ringing at 5 a.m. so that I may get to my Saturday community service on time. I will get to the rest as time allows. As always, feel free to ask questions, comment, drool on your keyboards, or what-have-you.
Thank you for reading
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Anatomy of my Diagnosis

2/1/2016

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Ray here--
In this posting, I would like to address how I was diagnosed with Auto Brewery Syndrome, and why ABS is not a “Get Out Of Jail Free” card.
During a scheduled phone appointment with Dr. Anup Kanodia in mid-September of 2015, I was told that I had been positively diagnosed with Auto Brewery Syndrome. This diagnosis was not a result of a phone conversation, a single medical examination, or a one-time blood or urine test. This was the culmination of multiple factors, spread out over a period of time that ranged as far back as the Fall of 2013, and up to the day of that particular conversation. Because this is a posting on the “Too Long; Didn’t Read” realm of Facebook, I will attempt to keep it as brief as possible without omitting pertinent information. Since the original court case is in the infant stages of an appeal, there are a few things that will have to wait to see the light of day, but this particular topic does not suffer for that.
So in a cyber nutshell, the following factors (in no particular order) were all ingredients in the unwanted ABS pie that I have been served:
Blood tests. These were drawn in May, June, July, August, and September 2015. They were drawn at Evergreen Clinic in Roseburg, OR, Mercy Medical Hospital in Roseburg, OR, Eugene Gastroenterology in Eugene, OR, and Kanodia M.D. Practice in Columbus, OH. These blood draws and subsequent lab testing were done on multiple occasions for each clinic, over this period of time. These were compared with other blood draws and testing performed at Sacred Heart Medical Center in Springfield, OR, Evergreen Clinic, and Dr. Sathianathan Family Practice in Roseburg, OR in October 2013; December 2014; March, April, and May 2015. Some of these were single sample draws. Others were 3 to 5 vial samples. In addition to the clinics listed above, some were sent to accredited third party labs for testing.
Urine tests. These were conducted in May, June, July, August and September 2015. They were conducted at the same clinics listed above. They were compared with other urine samples, also taken at the list of clinics above in October and November 2013; June, September, November, and December 2014; March and April 2015. As with the blood tests, some of these urine tests were more than a one-time sample. Some were an all day collection. Some were multiple day collections. Some went to third party labs for separate testing.
Saliva tests. These were conducted in August in 2015. These tests were sent to third party labs for testing.
Stool sample tests. These were conducted in July and August 2015. Eugene Gastroenterology and third party labs via Kanodia M.D. conducted the analysis of these tests.
Blood Alcohol Testing. This was conducted using three separate BAC breathalyzer devices approved by the U.S. Department of Transportation, used by law enforcement (including Oregon State Police) across the United States during field sobriety tests. These tests were conducted from February 2015 through mid September 2015. The total number of tests during that time frame, as recorded on the breathalyzer devices is 477.
Colonoscopy testing. Not a fun one, by any means. Conducted July 2015 by Eugene Gastroenterology, Eugene, OR.
Endoscopy testing. Again, not something that I would recommend as a killer for one’s idle time. Conducted July 2015 by Eugene Endoscopy, Eugene, OR.
Food, Drink, and Medication Intake Logs. All encompassing. Every single thing ingested by me, recorded by quantity, date, and time of day. Recorded from May 2015 to September 2015.
EKG testing. Conducted at Evergreen Clinic June 2015. This was compared to EKG testing conducted at Evergreen Clinic in October 2013.
The culmination of these together, overlapping large amounts of time, were necessary to diagnose what was going on with me. The entirety of the data is necessary to rule out anything that may result in false positives. The results must be repeatable and consistent. A one-time test, using only one of the methods above, is not reliable science. Together, they eliminate many scenarios, and positively point to the true diagnosis.
I was seen by eight different doctors and countless registered nurses, phlebotomists, and physician’s assistants. My testing results, and their observations raised so many questions, I was passed around like a medical anomaly. Turns out, I am. One of my stool samples grew mold. I was told that that had never been seen before. Multiple lab results showed that I had over 400% overgrowth of Candida yeast in my system. Another showed that I had virtually no normal stomach enzymes. While some people take Pepcid AC or Rolaids for relief, I was prescribed pills that actually kick started new acid. Another lab result showed zero presence of pro-biotic “good yeast”. The list goes on and on.
So far, I’ve brought you up to September 2015, because that is when I received news of the diagnosis. As any scientist worth their salt will tell you, the testing could not stop there. As I write this, it is February 1st, 2016. Between mid September 2015 up to this day, I have been re-tested in all the above areas, multiple times, with the exception of the colonoscopy/endoscopy and the EKG. I am currently undergoing urine testing, and will visit yet another lab for blood testing in two days. The intake log is still ongoing, and the Breathalyzer reads a total number of 772 tests taken. This is further confirmation of the multiple tests already taken, but most importantly, it is to track progress as I have undergone treatment to control ABS. So far, the results are encouraging. Candida yeast levels are much lower, and several other indicators are much better. My last ABS flare resulting in a positive BAC reading was January 4th, 2016.
This has been a long, extremely expensive process. Tens of thousands of dollars. As you might imagine, typical health insurance does not cover many of the procedures, and if they do, certainly not multiple times in one year. Not to mention multiple times in one month, for many months on end. The cumulative results show that I have Auto Brewery Syndrome. These results cannot be fabricated. Much as any person can claim to have cancer, or diabetes, or epilepsy, or multiple sclerosis, etc., the proof is in the testing. You have it or you don’t. Any Jane or John Doe could try to claim to suffer from ABS, but they will have to go through the same process that I did, and it will not get any cheaper to do as time goes on. Being observed in the midst of an ABS flare at a hospital or clinic as the sole means of diagnosis is not enough, as that would be a one-time occurrence. It must be repeatable.
This brings me to another topic, which I will only touch on briefly, as I have already yammered on for far too long. Positive BAC with Auto Brewery Syndrome is not a constant, consistent thing. The woman in New York who was in the news a month or so ago had a constant reading in the 0.20 range for many days on end. That appears to be the exception among ABS sufferers. Most, including me, have “flares” wherein the BAC will spike from 0.00 to positive levels in no seemingly discernible pattern. We do not walk around in a drunken state, though there are physical symptoms that can appear before and after a flare. Before my diagnosis and treatment program, I had flares more often, particularly from March through October 2015, but I have gone anywhere from 5 or 6 days to over a month with no positive BAC. I will go further into the topic of purposely inducing ABS flares as a means of observation with my next posting.
For now, I will close this and apologize to those of you who have chipped your front teeth by hitting the keyboard with your face as you fell asleep while navigating this deluge of words. Apologies for any typos. I don’t use spell check, it is getting late, and I must be up early in the morning to head off to knock out more of my community service hours.
Thank you for reading.
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The Beginning

1/22/2016

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​At approximately 3:00 p.m. on December 30, 2014, I was involved in a single vehicle accident while driving a loaded tanker truck, hauling fish for the Oregon Department of Fish and Wildlife.  After leaving the McKenzie fish hatchery east of Eugene, Oregon, I was startled by deer emerging from trees on the side of the road, just at the beginning of a long sweeping curve.  I was momentarily distracted and the vehicle drifted just far enough to place the outside tires onto the soft shoulder, and despite my efforts to regain control, I crashed after side-swiping trees and tipping over onto the driver’s side of the vehicle.  I remained conscious, but had to be extricated from the vehicle, and was taken by ambulance to a nearby hospital.

Upon arrival at the emergency room of the hospital, I was put through triage and testing, which determined that I had a fractured rib, fractured arm, dislocated shoulder/rotator cuff injury, blown out orbital eye socket floor, multiple facial and head lacerations requiring stitches in five places, a concussion, and a “scalping” laceration that required stapling of part of the scalp back onto the top of my head/skull.  As a matter of standard operating procedure, as I was getting IV fluids and IV medications, blood was also drawn for testing.  This is done in any incident involving property damage and/or injury.  The attending physician informed me shortly thereafter that the blood had been tested and registered a Blood Alcohol Content of 0.29.  As I had consumed no alcohol prior to the accident, and had in fact been at work all day, this was understandably surprising to me.  The doctor found the result to be incredulous as well, and insisted that it should be retested, if it were okay with me.  I consented to a retest.  The ensuing result then showed a BAC of 0.26.  At that point, it was clear to me that something was wrong somewhere along the lines of the testing, resulting in these varying false positives. This all occurred while I was receiving treatment for the previously mentioned injuries, so my focus was largely upon that.

A trooper from the Oregon State Police arrived at the hospital to get a statement from me, and asked for permission to conduct a third blood draw, to be analyzed at a separate lab that was independent of the hospital.  Realizing that this would be the way to clear up the false readings from the hospital, I naturally consented.  I remained at the hospital for that evening and the next, and was discharged the morning of January 1st, 2016.

I spent the next few weeks recuperating at home, with ice packs and multiple medications, so I wasn’t in a frame of mind that most would consider “with it”.  I had many appointments scheduled for surgery, and was awaiting the OSP lab test results. Those results came in, and I was informed that they showed a BAC of 0.17.  It was it this point that the circus really began.

I received citations for Driving Under the Influence of Intoxicants (DUII) and Criminal Mischief, both misdemeanors. I had surgery to replace the floor of my blown out orbital socket in late January of 2015, resulting in more medications and recuperation. I was definitely in and out of what would be considered a medication-clouded state of mind until well into late February.

The court system in Lane County Oregon, I soon learned, did not operate in a speedy manner.  Because I did not consume alcohol leading up to the accident, I chose to go to trial.  That process was stretched out and the trial postponed repeatedly at the request of the Lane County District Attorney, presumably to prepare for court.  By Spring of 2015, I was no longer on pain medications, and beginning physical therapy, but something was amiss with the way I felt.  I had intermittent periods where I was extremely lethargic, irritable, and often times forgetful.  I thought it to be lingering effect of head injury. My wife Sierra saw all of this first hand and thought that it was almost as if I were drunk or otherwise debilitated. A friend of hers remarked that she had heard of a syndrome in which the stomach could actually create its own ethanol, with specific yeasts as the causative start. Of course, I thought that this was absurd.  I still had no answer for the false positives on the blood draws from the day of the accident, but I was certain that it wasn’t a true positive, from a veritable brewery in my own gut. Sierra wasn’t so sure. She obtained a Department of Transportation approved breathalyzer, and the next time she noticed that I appeared “off”, she brought it to me and I blew into it.

I registered a BAC of 0.12. To say that I was in shock would definitely be understating my mind frame in that moment. In order to keep this long story from growing too much longer, I will tell you that I had subsequent readings anywhere from 0.02 to 0.14 at various times over the next several weeks.  This was not continuous, but would happen in “flares”. Most of the time, I was perfectly normal. At no time had I consumed alcohol. We decided to look into what Sierra’s friend had suggested earlier:  Auto Brewery Syndrome (ABS), also known as gut-fermentation syndrome. (In an effort to condense this into something manageable for anyone who wishes to read this, there are links provided at the end here that explain ABS in total detail).  I went to several doctors, each one scratching their heads, and referring me to another doctor.  I got the full endoscopy and colonoscopy treatment. I was poked and prodded in myriad ways, and we did our own research to discover that quite a bit of research had been done on the subject, and that there were leading experts in the field, one in particular who specialized in gastro-intestinal diseases, with ABS at the forefront.

I eventually went to Columbus, Ohio to meet with Dr. Anup Kanodia, to see if anybody could figure out what exactly was (or wasn’t) going on with me. Again, for brevity, the gist is that I was tested in many different ways, over many weeks, with different labs.  In September 2015, I was positively diagnosed as having Auto Brewery Syndrome, and by extrapolating data and previous test results, it was determined that I suffered from it since at least early 2014, and probably late 2013.  All the while from Spring of 2015, I had been recording all flares, BAC readings, food intake, medication intake, etc. I began receiving treatment to combat the rare digestive system ailments that lead to ABS. All of this occurred while I was suspended from my position at ODFW, and the incredibly high expenses that all of this incurred were paid out of pocket by Sierra and I.

In the meantime, there was still an impending trial and legal charges to face. After yet more delays, I was able to finally go to court for trial in January of 2016. Again, to keep this as brief as possible: In a pre-trial ruling, the presiding judge stated that ABS could not be used for my defense against the charges. She cited previous case law that covered what is known as “strict liability” in the State of Oregon.  The previous case cited involved a man who received a DUI after friends of his spiked what he believed was non-alcoholic beverages throughout the evening. The ruling was that it didn’t matter that the man had no idea that he was ingesting alcohol. The fact that he did ingest alcohol, and then drove a motor vehicle was enough for a verdict of guilty.

The presiding judge and even the prosecuting DA acknowledged the validity of ABS, my official diagnosis of having the syndrome, and the pre-trial testimony of Dr. Kanodia was accepted as valid and legal.  But I could not breathe a word of the syndrome in my defense, as the case law that the judge cited had been determined previously through the court of appeals, and that I would have to go the same route.  It would not be settled in the Circuit Court, which is where my trial was taking place.  What this meant is that I now had no way of properly defending myself at my own trial.  As the judge had ordered, ABS was not used, and all medical evidence of such--including Dr. Kanodia’s testimony--never saw the light of day during my trial.  Naturally, I was found guilty.  I do not blame the jurors, as they had no idea any medical condition existed.

The crux of the appeal is simple: I had a confirmed medical condition at the time of the accident, of which I was unaware.  I had not consumed alcohol. When a diabetic discovers that they have that disease, it can happen anywhere.  Sometimes it is diagnosed in a doctor’s office.  Sometimes they discover it at home. Sometimes, it can even happen when they are behind the wheel of a vehicle, and have an episode for the first time.  A previously diagnosed diabetic who gets behind the wheel after neglecting his or her own proper medical care can be charged with DUI, and many have. Driving under the influence is not limited to drugs and alcohol. An undiagnosed diabetic who gets behind the wheel and has an episode for the first time does not receive a DUI.  It doesn’t happen, because they had an unknown medical condition.  ABS falls into this scenario.  Had I chosen to drive after being diagnosed with ABS, and then had a flare, I would be guilty of DUI. On December 30, 2014, that was not the case.

In the meantime, I have several misdemeanor convictions to deal with pending appeal. The whole thing may very likely be overturned, but until that happens, I have to follow the law like anybody else.  What that means for me:
-One year suspension of drivers license.
-Two years probation.
-Alcohol counseling.
-112 hours community service.
-Nearly $10,000 in fines and court fees.
-$375,000.00 in restitution for the fish tanker and clean up costs.

A very interesting part falls under the terms of the two years probation. I am not allowed in an establishment that has the primary purpose of selling alcohol. Not a problem. I haven’t had anything to drink since before the accident in 2014. I still have occasional ABS flares, but they are shorter and fewer. Treatment is getting me there.

I am also not allowed to consume any alcohol during the probation period, and must submit to breathalyzer tests if asked to do so by law enforcement at any time.  This creates a unique problem for a person who suffers from ABS.  I cannot control the timing of a flare.  Over the last year, I have had several flares at home where my BAC crept in the range of 0.30 and higher.  Sierra took me to the ER on several occasions because we were afraid that those flares would be life threatening. It is one thing if a person willingly ingests alcohol and achieves a high BAC, because the simple cessation of drinking at that time will prevent that person’s BAC from skyrocketing to even higher, possibly deadly levels.  An ABS sufferer does not have that option.  I was monitored until the level evened out and/or began to subside. That was before the conviction was handed down.  Now, if I go into the ER and it is documented that I have ANY level of BAC, I am in violation of the terms of my probation.  In essence, Lane County Circuit Court has potentially given me a death sentence, and not a misdemeanor.

There is much, much more to this than I could possibly cover here. This is simply a rough outline of the last year for Sierra and I.  Due to the pending legal case at the time, we could not discuss this. Only a few people have known about this as the events unfolded.  My own family has been unaware, as investigators for the prosecution would have hounded them otherwise. In the meantime, I’ve had to remain mum, knowing that most everyone believed that I actually chose to go to work, drink, drive and crash. Even if the appeal is successful, my reputation is ruined.

I have certainly learned the true character of people around me.  Many co-workers and acquaintances simply disappeared from my life (though certainly not all of them). I very much appreciate those who stuck by Sierra and I, even though they have known nothing about this until now. You are truly good people.

Anyway, Sierra and I are slogging through to the next steps, even though we are likely headed for financial ruin. The easy thing for me to have done was simply plead guilty after I had received my citations back in January 2015.  I would already have my drivers license back, and would have completed all community service and counseling.  But I simply could not stomach pleading to something that I did not do.  And while ABS is rare, it does exist, and there are other people fighting through their own hell as they try to navigate this mess. Pleading guilty in order to take the easy route would have been a disservice to everyone else who ever has the misfortune to experience the stigma of ABS. I will be whatever advocate I can be, regardless the outcome of all this.

To that end, please feel free to share this with others. Everything I have put here today is public record now that the circuit court trial is over. There are many, many details not included here because it would be prudent to wait until the appeal process has been completed. But I would like this to be known, because I know that there are others out there who have gone undiagnosed.  I want them to know that they are not crazy, as I thought I was earlier last year.

Below, some links with much more information.  Feel free to ask me anything. E-mail, PM, whatever. I will answer the best I can.

Thank you for listening.

​--Ray
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