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.