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Friday, July 12, 2013

On Alcohol and Transverse Myelitis: A personal reflection

Let me begin by saying that in my late teens and early 20s, I was a rugby playing medical student. After a match on a Saturday it was customary to drink copious amounts of beer, and still play a mean game of darts. Since then (or at least since I got married and had children), I have been a very modest alcohol drinker. For many years, I used to come home from a heavy days work, and have a glass of gin and tonic before dinner - but it was only ever one glass. At various times in the past (particularly living in South Australia close to vineyards) I fancied myself as a bit of a wine connoisseur - but it was the taste I went for, rather than the volume.
Then 3.5 years ago, I got Transverse Myelitis. If you want to read about the full catastrophe, and my reactions to hospital systems and staff, you can at Taking Charge: a journey of recovery
But that is not why I am writing at this point. I have made a moderate recovery, having been initially totally paralysed from T7 down. I walk (occasionally uncertainly), I continue to work (despite the daily chest pain, and the ongoing uncertainties of bowel and bladder function). I can manage each day, whatever I am doing (although I get immensely fatigued by work, and by driving the car). One thing that bugs me, and that I continue to have to work on, is my walking. I used to be able to do a fairly regular 5-800 metres (and then collapse). I have done the occasional 1.2Km (and then collapsed in a sweaty heap). Now I can only manage about 2-300 metres as a LONG walk before I get fatigued and begin to get a bit of foot drop in my right leg.
What I wanted to talk about is the feeling in my legs - or rather the odd feelings in my legs - like I am wearing thick rather scratchy woollen socks up over the knees. My legs appear not to have very good circulation, and most of the time they feel cold, even tucked up under the duna in bed. We are all different, and I have heard all sorts of stories. I have lost quite a lot of sensation in both legs - in patches. I can feel heat and cold, and sharp and dull. My physiotherapist says I have quite poor proprioception - the sense of where my feet are in space, or what they are doing at any moment. I now have a set of specific exercises to improve this. A massage has certain areas where it is really quite painful - in the lower calves, over the join between metatarsals and toes, and round the end of some toes. I enjoy massage despite that, and have a belief that 'pain is good' (well, mostly).
But what has intrigued me recently is that when I have a glass of wine in the evening, my legs seem to be slightly more odd in the morning, more difficult to get going. The woolly sensation is slightly more noticeable, the proprioception is worse, by balance is just not quite as good, and a couple of times I have had a foot drop later in the day, but earlier than I usually might. The day after, I seem to be back on track. Exercise on the indoor bike seems to help this recovery, as if increased circulation makes a difference.
I can find nothing useful about this online, and there is certainly nothing I can find in any scientific reports or booklets I have read. 
Certainly, in chronic long term alcoholism, there is a peripheral neuropathy described. But I do not fit that... There is a peripheral neuropathy described in severe long term diabetes, but I don't have that. Of course we know that serious alcoholism can terminally damage the liver, heart and brain. I also remember a sermon at my church when I was a choirboy (?? about 12 or 13), when a vicar held up a glass of alcohol and dropped a live worm into it, telling us all of the terminal evil of drink. The worm lasted a wriggly minute. (I guess you never forget those early lessons. LOL).
The upshot to all this, is that I am slightly wary of alcohol. I think wine (with its aromatic amines) may be slightly worse than a glass of beer, but don't really know. I am careful. Not a wowser, but certainly a bit boringly abstemious...
I would love to hear from anyone who has a story to tell, or can put me wise as to why alcohol may have an adverse effect in transverse myelitis. And of course your experience may be totally different....


  1. Alcohol is a CNS depressant and TM is a disease of the CNS. When you have a system that is already struggling for health, with all you are doing to try to help your CNS heal, it would seem counterproductive to depress it with alcohol.

  2. Tony, I agree with you. Its just that with TM, I think you keep doing as much as possible in your life that is normal until the disease tells you to stop it. My TM has told me to stop it; I don't need to add to the struggle to recover health. But the signs have all been quite subtle - which is why I raised the issue. :-)