DEAR DR. GOTT: I was speaking with a group of friends earlier in the week and one girl mentioned a person suffered from wet brain and PAWS. All she admitted was that he is an alcoholic. Well, I thought I’d heard it all but this is a new one on me. Can you tell me what it’s all about? I was almost too embarrassed to ask her to explain.
DEAR READER: The average reader is aware of alcoholism and its devastating effects on the people that live with, care for, or are otherwise around the alcoholic person and we’ve all seen people who appear to drink too much. To some degree we understand the addiction but what we don’t pay enough attention to are the signs that make sobriety so difficult.
Symptoms include problems with memory, an inability to think clearly, difficulties with coordination, sleep disturbances, emotional changes, and sensitivity to stress and vary from person to person. The individual that has abused alcohol to the point that his or her normal brain function may be permanently impaired is a progression of alcoholism.
Wet brain, the non-scientifc term for Wernicke-Korsakoff syndrome (also known as alcoholic encephalopathy, Wernicke’s disease, and Korsakoff psychosis), is the result of a thiamine (vitamin B1) deficiency. This deficiency is most common in alcoholics, but can also affect those with malabsorption, such as following obesity surgery.
Wernicke’s disease typically occurs first and causes damage to the thalamus, hypothalamus and mammallary bodies within the brain. It is noted by confusion, a loss of muscle coordination (ataxia), double vision, eyelid drooping, abnormal eye movements (nystagmus), and leg tremors.
Korsakoff psychosis typically follows on the tail end of the Wernicke’s symptoms, causing an overlap. It results from damage to the areas of the brain that make and store memories. Symptoms include hallucinations, making up stories (confabulation), memory loss, and an inability to form new memories. On top of all this, withdrawal symptoms may also be present.
Treatment for Wernicke-Korsakoff syndrome can slow or halt progression, but often damage to memory and intellect are permanent. Hospitalization in the early stages may be required to monitor and treat symptoms. Beyond that, thiamine supplements may improve confusion, vision and ataxia. Without treatment, the condition will worsen and may become life-threatening.
It is vital to discontinue alcohol intake since doing so may prevent additional brain function loss, and nerve damage. Improving the diet can also help but isn’t a substitute for stopping drinking.
PAWS is post acute withdrawal syndrome that may result from a medical condition that caused the person to suddenly withdraw from a substance the body previously was dependent on; perhaps he or she was taken to hospital in an unconscious state and didn’t receive the constant “fix” the body was accustomed to; a surgical procedure with extended in-hospital convalescence might have occurred; or, an individual may simply choose — voluntarily or otherwise — to quit cold turkey, a difficult thing to do. It may also be seen in infants whose mothers were addicted during pregnancy. Whatever the reason, the brain alters the production of specific chemicals such as dopamine and seratonin. The substance that was abused (in this case it’s alcohol), caused the brain’s transmitters and receptors to stop “firing” the chemicals mentioned, resulting in a chemical imbalance. Over time the chemicals will flow again and symptoms will lessen or disappear altogether with proper treatment.
PAWS is thought to begin anywhere from one to two weeks into recovery and can last anywhere from three months to two years. In fact, some individuals recovering from long-term use of opiates and other stimulants often experience symptoms for up to ten years following the use of their drug of choice. PAWS will gradually improve over time.
It is important for a person with withdrawal symptoms to bring those issues under control by reducing stress, associating with people who will not criticize or accuse, and setting positive goals. Education — through Alcoholics Anonymous, Narcotics Anonymous or another reputable source, is very important. Almost all recovering patients will need information to be able to recognize what symptoms are normal and which may require additional help. Abstinence itself is insufficient if a person is attempting to rebuild damaged body tissue and maintain good health at the same time. Eating habits may need modification. A balanced daily diet should contain fruits and vegetables, whole grains and lean meats and fish or another source of protein such as legumes or soy products. Hunger produces stress, so a person with wet brain should avoid candy, soft drinks, donuts, and other high calorie/low nutrient foods. Counseling with a nutritionist may be appropriate.
Then there’s exercise that will help the body function properly. Swimming, jogging, aerobics and biking are highly recommended. The program should be coupled with relaxation, perhaps by listening to music, reading, or getting a massage.
Then comes sleep that should be regular and sufficient to allow a person to awaken refreshed and in control.
Unfortunately, this answer resulted in a long-winded explanation but I hope you can understand the picture. A person’s body has been altered and should be brought back into line. I hope you can relay this to your friend.
