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General Category => General Homebrew Discussion => Topic started by: weithman5 on April 26, 2011, 03:41:48 PM

Title: cirrhosis
Post by: weithman5 on April 26, 2011, 03:41:48 PM
The dear Lord has given us a wonderful combination of ingredients, and critters to make a beverage we all enjoy, but just a small pitch out there to remember to drink in moderation.  i am losing my second patient in the past 6 months to alcoholic cirrhosis. In both cases they are ladies under age 50 with kids i also take care of.  it is gut wrenching, and miserable to watch. I consider all of you to be a friend one way or another, and I would hate to see any of you suffer like this.  (and no, i dont consider it a risk of the hobby like skydiving, drag racing etc).
Title: Re: cirrhosis
Post by: ccarlson on April 26, 2011, 03:44:44 PM
I have my liver enzymes checked every year, if that's a good indicator and I think it is. They have gone up a little as I get older, but so do the charts. I guess it's a natural part of aging.
Title: Re: cirrhosis
Post by: weithman5 on April 26, 2011, 04:04:39 PM
that is usually the  first clue to there being a problem.  this last patient was fine a year ago and boom went south.  she had been a previous alcoholic and had stopped for many years then when she started drinking again things progressed rapidly.
Title: Re: cirrhosis
Post by: morticaixavier on April 26, 2011, 04:59:01 PM
I can only imagine how hard it is to be a doctor. Particularly if you actually care about your patients. and it sounds like you do. Hang in there and remember that we need people like you. I promise to be moderate in my drinking and never take tylenol in temporal proximity of alcahol (I honestly just don't take tylenol to be on the safe side anyway). My grandmother died from cirhosis after many years of destructive drinking habits. Although I suspect had she had a doctor like you she might have held on a bit longer as the doctor she had gave her high doses of tylenol for paid when she was in the hospital before they identified the liver damage.
Title: Re: cirrhosis
Post by: blatz on April 26, 2011, 05:45:50 PM
man, that is NOT good.  threads like these make me reconsider beer altogether.   :-\
Title: Re: cirrhosis
Post by: weithman5 on April 26, 2011, 06:04:49 PM
thanks for the kind words. someone told me once i shouldn't care about my patient's more than they care about themselves. that is easier said than done.  the hard part is i am a simple family practice guy and i see the kids of these people too. often times they have been classmates of my kids. ugh. watched the intervention heroin highway the otherday and a girl was on it that my son dated briefly.  hard to fathom. 

don't give up on beer.  i learned in the navy that if you don't control how much you drink, someone else will. 
Title: Re: cirrhosis
Post by: euge on April 26, 2011, 06:06:18 PM
Lately I've taken to using smaller glasses and cut my consumption in half or less. Being in the industry all sorts of scary thoughts run through my head when I consider my liver and the barrage of beer it has to deal with. The brush with gout led me to abandon the fully stocked house bar concept. :o

My understanding is that cirrhosis isn't inevitable and only occurs in a percentage of those that drink heavily. Women also appear to be more susceptible to the disease. We get quite a few patients with ascites (http://en.wikipedia.org/wiki/Ascites). Ever see that emaciated guy with a gigantic swollen abdomen? That person probably has cirrhosis and end-stage liver disease. Could be hepatitis or other ailments but most likely caused by ETOH. Usually we get them before and after a paracentesis (http://en.wikipedia.org/wiki/Paracentesis). Hopefully none of us have to experience this procedure... :( I've seen as much as 8 liters drained out of a patient.
Title: Re: cirrhosis
Post by: beersk on April 26, 2011, 06:46:18 PM
man, that is NOT good.  threads like these make me reconsider beer altogether.   :-\

I wouldn't go that far man...just be moderate about it.  There's no reason to get all paranoid and be one of those anti-alcohol kooks.  Man, I don't get those people.  It's like one drink equals alcoholic to them; fakkin' insane.
Title: Re: cirrhosis
Post by: thirsty on April 26, 2011, 06:53:02 PM

Moderation in all things

Title: Re: cirrhosis
Post by: blatz on April 26, 2011, 06:55:28 PM
man, that is NOT good.  threads like these make me reconsider beer altogether.   :-\

I wouldn't go that far man...just be moderate about it.  There's no reason to get all paranoid and be one of those anti-alcohol kooks.  Man, I don't get those people.  It's like one drink equals alcoholic to them; fakkin' insane.

nah - don't worry - I won't go all Puritanical.  Beer has been very, very good to me and that's not even taking into account actually drinking a drop.

What I said was more rhetorically introspective, in a tongue-in-cheek kind of way.  Weithman's point resonated well with me - just a friendly reminder to keep it in moderation.

Title: Re: cirrhosis
Post by: euge on April 26, 2011, 06:58:12 PM
man, that is NOT good.  threads like these make me reconsider beer altogether.   :-\

I wouldn't go that far man...just be moderate about it.  There's no reason to get all paranoid and be one of those anti-alcohol kooks.  Man, I don't get those people.  It's like one drink equals alcoholic to them; fakkin' insane.

We're fakkin insane here in America. Certain tests I've taken had questions like "do you drink and how much". Only found out later that if one answers more than 1-2 drinks a week they are considered to be alcoholic. Those tests wouldn't past muster in Europe for sure. It's our puritanical heritage and a holdover from the teetotaler movement. Bastards.
Title: Re: cirrhosis
Post by: beersk on April 26, 2011, 07:07:48 PM
man, that is NOT good.  threads like these make me reconsider beer altogether.   :-\

I wouldn't go that far man...just be moderate about it.  There's no reason to get all paranoid and be one of those anti-alcohol kooks.  Man, I don't get those people.  It's like one drink equals alcoholic to them; fakkin' insane.

We're fakkin insane here in America. Certain tests I've taken had questions like "do you drink and how much". Only found out later that if one answers more than 1-2 drinks a week they are considered to be alcoholic. Those tests wouldn't past muster in Europe for sure. It's our puritanical heritage and a holdover from the teetotaler movement. Bastards.
Oh my gad...that's insane.  Who comes up with this stuff?  Fak do they know?
Title: Re: cirrhosis
Post by: jamminbrew on April 27, 2011, 04:04:51 AM
My grandfather died of liver cancer, and he never drank a drop of alcohol in his entire life. Granted, cancer is different than cirrhosis, but it does illustrate the point that sometimes life doesn't make sense. My mom is a doctor too, so I have mucho respect for the small family practice guys.  Moderation in all things is wise.  I limit myself to 2 beers a night, no more, no less.
Title: Re: cirrhosis
Post by: richardt on April 27, 2011, 05:36:55 PM
I actually worry less about the one or two self-made homebrews I might have in an evening than I do when judging some of the entries in the beer competitions. 

I do wonder at times whether the fusels in uncontrolled (i.e., too high) temp fermenation beers and specialty, smoked, and wood-aged beers might be dangerous to my health.  Really--doesn't anyone else who is a BJCP judge ever wonder if, one day, you might be sampling or drinking a stranger's beer that, knowingly or unknowingly, is chock full of potential carcinogens, which may or may not even be detectable by aroma, appearance, taste, mouthfeel, etc.?


Title: Re: cirrhosis
Post by: weithman5 on April 27, 2011, 05:42:43 PM
makes me say hmmm ;D
Title: Re: cirrhosis
Post by: ccarlson on April 27, 2011, 05:47:25 PM
I actually worry less about the one or two self-made homebrews I might have in an evening than I do when judging some of the entries in the beer competitions. 

I do wonder at times whether the fusels in uncontrolled (i.e., too high) temp fermenation beers and specialty, smoked, and wood-aged beers might be dangerous to my health.  Really--doesn't anyone else who is a BJCP judge ever wonder if, one day, you might be sampling or drinking a stranger's beer that, knowingly or unknowingly, is chock full of potential carcinogens, which may or may not even be detectable by aroma, appearance, taste, mouthfeel, etc.?




That's a very good reason to be concerned as a judge. There could be chemicals, fusels and who knows what else in a beginner's beer or an "experienced" brewer's beer that got "unexpectedly" bad scores during the last competition.
Title: Re: cirrhosis
Post by: weithman5 on April 27, 2011, 06:00:08 PM
although these things might be present and of some concern. i doubt that the load is significant compared to the alcohol outright. i would be more concerned about someone doing something deliberate to a beer or doing something that would lead to food poisoning.  (bad infected beer etc).FWIW, i have never had a patient who had a colon cancer or something similar from eating to much burnt beef from their grill. 
Title: Re: cirrhosis
Post by: malzig on April 28, 2011, 02:06:16 AM
...something that would lead to food poisoning.  (bad infected beer etc).
Doesn't happen.  Remember, beer was what everyone drank, young and old, all day long, in the days when the water wasn't safe to drink.
Title: Re: cirrhosis
Post by: richardt on April 28, 2011, 12:48:24 PM
I agree that "infected beers" can be downright nasty, but they won't kill ya.

I was thinking more along the lines of someone doing something malicious or really stupid (e.g., "Hey, I bet I could make a gruit out of {XXXXXXXX} flowers, leaves, and/or wood/bark").  Even appropriate substances, when taken to extremes have given me pause as to the maturity and intent of the individual entering the beer/mead.  I've tasted a jalepeno pilsner--delicious and refreshing; and the pepper wasn't too overpowering.  But, I've also judged a mead made with chipolte and serrano peppers that was a weapon of mass destruction (liquid fire) and basically devitalized my tastebuds for the rest of the day.  A sip was all it took.  One could not drink an ounce or two, let alone a whole bottle of it.  Afterwards the excuse was that the entrant had not sampled the mead prior to submitting it for competition but thought my comments on the judging form were hilarious.   ???Really???  Had I travelled out of town and paid for a hotel room to judge this mead in the competition, at a minimum, I think I would have sent this clown a bill for wasting my time and getting cheap sociopathic thrills off of hurting random individuals who had the misfortune of having to judge his entry.
Title: Re: cirrhosis
Post by: Kit B on April 28, 2011, 06:13:03 PM
I agree that "infected beers" can be downright nasty, but they won't kill ya.

I was thinking more along the lines of someone doing something malicious or really stupid (e.g., "Hey, I bet I could make a gruit out of {XXXXXXXX} flowers, leaves, and/or wood/bark").  

I was just reading & reacting to a post on another forum where someone said the following:

"I made up a batch of no rinse sanitizing solution (water and vinegar and bleach). When I was done sanitizing I filled up some bottles I was planning on using later. A couple of weeks later I see in the bottom of the bottles what looks like rust flakes. Anybody else seen iron condense in their water?"

Hmmmm...What about that concoction says "No-Rinse"!?
Please, Please, PLEASE...Don't anyone try stupid crap like this!!!
Title: Re: cirrhosis
Post by: tschmidlin on April 28, 2011, 06:33:31 PM
"I made up a batch of no rinse sanitizing solution (water and vinegar and bleach). When I was done sanitizing I filled up some bottles I was planning on using later. A couple of weeks later I see in the bottom of the bottles what looks like rust flakes. Anybody else seen iron condense in their water?"

Hmmmm...What about that concoction says "No-Rinse"!?
Please, Please, PLEASE...Don't anyone try stupid crap like this!!!
In proper proportions, that is a no-rinse sanitizer solution.  I believe the proportion is 1 oz of bleach and 1 oz of vinegar in 5 gallons of water.  That is already a very dilute solution, and the amount of solution left clinging to the surface of a bottle, carboy, or keg, will be diluted even further by the product being added to it.  You don't have to use it if you don't want to, but some people do with great success.
Title: Re: cirrhosis
Post by: weithman5 on April 28, 2011, 06:43:21 PM
maybe it wasn't used as a no rinse, maybe he just forgot to empty the bottles.
Title: Re: cirrhosis
Post by: ccarlson on April 28, 2011, 06:45:41 PM
"I made up a batch of no rinse sanitizing solution (water and vinegar and bleach). When I was done sanitizing I filled up some bottles I was planning on using later. A couple of weeks later I see in the bottom of the bottles what looks like rust flakes. Anybody else seen iron condense in their water?"

Hmmmm...What about that concoction says "No-Rinse"!?
Please, Please, PLEASE...Don't anyone try stupid crap like this!!!
In proper proportions, that is a no-rinse sanitizer solution.  I believe the proportion is 1 oz of bleach and 1 oz of vinegar in 5 gallons of water.  That is already a very dilute solution, and the amount of solution left clinging to the surface of a bottle, carboy, or keg, will be diluted even further by the product being added to it.  You don't have to use it if you don't want to, but some people do with great success.

DO NOT mix full strength bleach and vinegar. Chlorine gas is released. This is very dangerous!!! It can be done, but only in a diluted solution.
Title: Re: cirrhosis
Post by: Kit B on April 28, 2011, 06:50:56 PM
In proper proportions, that is a no-rinse sanitizer solution.  I believe the proportion is 1 oz of bleach and 1 oz of vinegar in 5 gallons of water.  That is already a very dilute solution, and the amount of solution left clinging to the surface of a bottle, carboy, or keg, will be diluted even further by the product being added to it.  You don't have to use it if you don't want to, but some people do with great success.

I guess I'm just not as trusting that the user is/was aware of correct proportions.
Personally...I'll stick to Starsan.
Title: Re: cirrhosis
Post by: ccarlson on April 28, 2011, 06:53:06 PM
A lot of people have no idea what kid of deadly concoctions can be mixed up with just household chemicals. Do your research before trying this.
Title: Re: cirrhosis
Post by: tschmidlin on April 28, 2011, 07:00:49 PM
In proper proportions, that is a no-rinse sanitizer solution.  I believe the proportion is 1 oz of bleach and 1 oz of vinegar in 5 gallons of water.  That is already a very dilute solution, and the amount of solution left clinging to the surface of a bottle, carboy, or keg, will be diluted even further by the product being added to it.  You don't have to use it if you don't want to, but some people do with great success.

DO NOT mix full strength bleach and vinegar. Chlorine gas is released. This is very dangerous!!! It can be done, but only in a diluted solution.
Yes, you add the bleach or vinegar to the water, mix, then add the other.  If you are using the same measuring device, rinse in between.  Seriously!

With the 6% bleach that is common, you end up with 93ppm in the solution.  Seattle drinking water typically has about 1 ppm.  If you dump your carboy and let it drain it will have less than 1 ounce of solution left in it, probably more like a teaspoon.  Add 5 gallons of beer and the new concentration is likely to be less than 100 ppb, and only 25 ppb if there's a tsp left, that's parts per billion.  Much less than if you used straight tap water to make your beer.

I guess I'm just not as trusting that the user is/was aware of correct proportions.
Personally...I'll stick to Starsan.
Fair enough.  I use starsan too. :)
Title: Re: cirrhosis
Post by: beveragebob on April 28, 2011, 07:47:38 PM
If you consume cannabis, there are canaboid receptors on damaged cirrhotic liver tissue that actually reverses the damage and scarring. I'll poke around for the actual medical study and post it when I have more time
Title: Re: cirrhosis
Post by: denny on April 28, 2011, 07:49:17 PM
If you consume cannabis, there are canaboid receptors on damaged cirrhotic liver tissue that actually reverses the damage and scarring. I'll poke around for the actual medical study and post it when I have more time

I love you, Bob!   :-*
Title: Re: cirrhosis
Post by: tschmidlin on April 28, 2011, 07:56:02 PM
If you consume cannabis, there are canaboid receptors on damaged cirrhotic liver tissue that actually reverses the damage and scarring. I'll poke around for the actual medical study and post it when I have more time
So you're saying there is some evidence that if you drink heavily you can protect yourself by also smoking weed?  No wonder so many of the brewers around here toke . . . ;D
Title: Re: cirrhosis
Post by: Kit B on April 28, 2011, 08:00:36 PM
...Just when I thought I'd never go back to it...Geez!
Title: Re: cirrhosis
Post by: morticaixavier on April 28, 2011, 10:57:00 PM
If you consume cannabis, there are canaboid receptors on damaged cirrhotic liver tissue that actually reverses the damage and scarring. I'll poke around for the actual medical study and post it when I have more time

WOOHOOO!!!!
Title: Re: cirrhosis
Post by: Titanium Brewing on April 28, 2011, 11:53:05 PM
If you consume cannabis, there are canaboid receptors on damaged cirrhotic liver tissue that actually reverses the damage and scarring. I'll poke around for the actual medical study and post it when I have more time

WOOHOOO!!!!

Good to know I am well balanced  ;)
Title: Re: cirrhosis
Post by: beveragebob on April 29, 2011, 12:39:15 AM
Here's the link. Maybe our good Dr. here can clarify some of the more esoteric info into laymans terms.

DOH! Here's the link:

http://www.ncbi.nlm.nih.gov/pubmed/15841466
Title: Re: cirrhosis
Post by: maxieboy on April 29, 2011, 12:47:24 AM
Here's the link. Maybe our good Dr. here can clarify some of the more esoteric info into laymans terms.

I'm so stoned, I can't see a link...  8)
Title: Re: cirrhosis
Post by: abraxas on April 29, 2011, 02:53:43 AM
Polyenylphosphatidylcholine always looked promising.  I know I drink enough to put myself into a higher risk category,might be smart to look into some preventative healthcare.
Title: Re: cirrhosis
Post by: euge on April 29, 2011, 03:01:18 AM
So it introduces cell death in fibrous hepatic tissue. Hopefully the liver will then regenerate with healthy functioning tissue? Probably not if alcohol is still being consumed.

And does it have to be eaten or can cannaboids be introduced via other routes?
 8)
Title: Re: cirrhosis
Post by: weithman5 on April 29, 2011, 03:23:04 AM
It is always a little difficult for simple doc like me to follow these types of abstracts but don't get your hopes up yet. First note in the abstract it talks about endogenous levels being higher in fibrosis. To me this implies a naturally occurring respond that the body is using to try to induce apoptosis to fight off fibrosis cells. Who knows yet but another study may show they enhance fibrosis at low levels. I don't know that this cannaboid is necessarily found in a particular recreational plant. And at what levels methods would it be therapeutic. Will have to wait and see.I have had more patients with lymphoma from pot as well, but many cancer regimens have risk profiles. Here is to a glimmer of hope and to researchers brainier than i
Title: Re: cirrhosis
Post by: beveragebob on April 29, 2011, 03:26:39 AM
I remember having a discussion with a co worker that is always researching this because he has a bad liver due to alcohol and some infection he got a few years back and I seem to remember him saying intravenous of a liquid derivative was best. Apparently the half-life and absorption via the digestive tract was quite limited. Smoking is an option but, then you got the whole lung cancer risk from that. He showed me a site where you can get the pure liquid and it was like 800 for a small amount of injectable liquid. I guess you'd have to be a millionaire to go that route. Research continues.  
Title: Re: cirrhosis
Post by: amish electrician on April 29, 2011, 05:01:31 AM
Hold on everyone, put down your blunts, fattys, joints, water pipes, knife hits, vaporizers, apples, soda cans, or whatever else you are using to administer yourself the devil weed....

Translated from science nerd to normal person: the article basically says that there is a molecule that your body makes normally, called AEA that binds to your cannabinoid receptors (of course THC also binds to these).  It doesn't look like weed has this molecule in any significant amount as far as I can tell in 2 minutes of googling.

So what AEA does then according to the paper, is that in huge concentrations for a neurotransmitter (same family as serotonin or dopamine), it appears to kill fibrotic liver cells (HSCs) in a petri dish.  Stopping right here, this means that they can kill these HSCs if they give enough AEA... if you read my thing about Tylenol you'll remember toxicity is all about dose.  And what works in the lab doesn't always work in people.  I remember back years ago there would be papers almost every week talking about things that killed HIV in culture... well yeah, bleach will too, but you aren't going to give that to people.  But anyway...

The real bad news for those of you craving Funyuns and Mountain Dew is that they showed that they were unable to block cell death after blocking the cannabinoid receptors.  This means that cell death is not happening dependent on AEA binding to those cannabinoid receptors.  So, although THC also binds to those receptors, it would likely also not have any effect on the HSCs in that way.  However, if you can see the light through all that red-eye squinting, it looks like AEA works through binding to cholesterol on HSCs, but whether weed would also do this and have an effect was not studied, although it is certainly possible.  But I'd wager you'd have to do some serious work with the 7 foot bong to get enough concentration to have any effects....
Title: Re: cirrhosis
Post by: beveragebob on April 29, 2011, 07:24:08 AM
I've gleaned from other papers that if there are receptors in your body for things,  that your body actually produces them. I read that if you do a certain type of running(I forget what it's called...basically sprinting for x amount of seconds and jogging and repeating) that some of the endorphins produced in the brain are the AEA substance. Also, dark chocolate has trace amounts of the substance also.
Title: Re: cirrhosis
Post by: abraxas on April 29, 2011, 11:41:05 AM
Also don't forget about coffee:
http://www.ncbi.nlm.nih.gov/pubmed/1476147

"Cousin" Dry Hopped Coffee Stout anybody?
Title: Re: cirrhosis
Post by: kgs on April 29, 2011, 11:54:11 AM
Back to the OP, I'd like to be enjoying beer for a few more decades, and want to take it easy on my liver and also not put on the pounds (which would strain other organs, including my pocketbook).

Bottling, and bottle size, are two methods I use for moderation. Portion control is easier when I can visually count the alcohol/calories. I've had friends comment that once they started kegging, the beer somehow vanished more quickly, like that Easter candy I can't remember eating. I also bottle part of most batches, unless they are very low-gravity, in 187 ml splits. I'm a small person, and a wine glass of beer is often the right portion. (I may want more, but that doesn't mean I GET more.) I'm going to get another case or two of splits because I'm realizing I drink them first (and also because I'm putting up a barleywine I hope to use for holiday gifts).

Title: Re: cirrhosis
Post by: phillamb168 on April 29, 2011, 12:59:15 PM
I keg, but to keep a reasonable serving size I limit myself to these 25cl ikea glasses I got. One per day, unless it's a weekend or I'm barbecuing, then it's 50cl size.
Title: Re: cirrhosis
Post by: weithman5 on April 29, 2011, 01:13:31 PM

Translated from science nerd to normal person: the article basically says that there is a molecule that your body makes normally, called AEA that binds to your cannabinoid receptors (of course THC also binds to these).  It doesn't look like weed has this molecule in any significant amount as far as I can tell in 2 minutes of googling.


exactly.
Title: Re: cirrhosis
Post by: tomsawyer on April 30, 2011, 11:43:13 PM
Lately I've taken to using smaller glasses and cut my consumption in half or less.

My understanding is that cirrhosis isn't inevitable and only occurs in a percentage of those that drink heavily. Women also appear to be more susceptible to the disease.

I use a smaller glass but only so I can tryr more styles in a session.

Thats it, I'm not getting that sex change now.

Don't forget that we are all going to die,and theres a BIG genetic component.  Its eat drink and be merry for me.  Drinking beer IS moderation as far as I'm concerned.
Title: Re: cirrhosis
Post by: tom on May 01, 2011, 05:21:30 PM
you'd have to do some serious work with the 7 foot bong to get enough concentration to have any effects....
whoa dude,  a 7 foot bong won't improve my concentration