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.

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

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

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.