The Pain Behind ‘Feeling No Pain’

Question: My father is a 71-year-old chronic alcoholic who drank heavily for many years. He is a widower who lives by himself. About two years ago he had to be hospitalized. He nearly died during detoxification. To avoid going through rehabilitation he checked out of the hospital “against medical advice” as soon as he was able to walk. He was back to drinking a month later.

He has continued drinking off and on. About a year ago he started to complain of the numbness in his hands and feet. The numbness comes and goes. He saw several doctors about this new problem. Some tried to counsel him about his drinking, but they all gave up when he told them that he drinks “just a little wine.” Recently, I read your book, “Dear Doc,” where you answer questions about alcoholism and other drug problems. After reading the chapter on medical problems I concluded that my father has nerve damage. Your description of peripheral neuropathy due to alcoholism fits his symptoms. When I gave him the book, he read it from cover to cover. Shortly thereafter he stopped drinking completely, as far as I can tell. He is also taking lots of vitamins and eating a good diet.

What are his chances of pulling this off on his own? I would like to believe him, but I’m skeptical.

Answer: Peripheral neuropathy is a sign of advanced alcoholism. It means that the nerves are damaged and dying. As the patient gets sicker, the numbness progresses to sensations of pins and needles in the soles of the feet and toes. After a while there is pain and tenderness that make the patient walk gingerly, literally as if he were walking on pins and needles. At times the condition seems to be getting better because the patient complains less. What is actually happening is that the anesthetic (pain-killing) effect of alcohol is masking the symptoms of nerve damage. The patient is “feeling no pain.” But the disease goes on. The end stage is weakness, muscle weakness, clumsiness, shuffling gait, stumbling and paralysis.

Successful treatment at this stage of alcoholism means no more alcohol intake of any kind, heavy doses of vitamins and good nutrition. This has to be done under the supervision of a physician who knows how to treat alcoholism.

Your skepticism about your father’s case is justified. Sometimes a persuasive friend, an inspirational meeting or an authoritative book will make an alcoholic stop drinking, but usually not for long. Alcoholics like your father need to undergo a change in attitude and learn how to accept help. What my book has done is strengthen your resolve by giving you information. Your father’s age, his stubbornness and the fact that he is a widower who lives by himself suggests that his chances for doing this on his own are poor.

Now is the time to show your love for your father. Get him into treatment by whatever means possible. You will need to be firm; and it may take a lot of your time. Start by taking him to open meetings of Alcoholics Anonymous. Find a good internist who understands alcoholism and take your father there--even if you have to carry him.

With proper treatment, your father’s nerve condition will improve markedly in six months and may be resolved completely in a year. But you must remember that the disease is progressive. If you don’t take him to treatment now, you’ll end up carrying him everywhere because he won’t be able to walk.

Dr. Pursch cannot answer all mail personally, but he will use questions of general interest in his column. Write to Dr. Joseph A. Pursch, Family Care Clinic, 20261 S.W. Acacia, Suite 200, Santa Ana Heights, Calif. 92707.