Dougly Bruce* was buried yesterday. He died of cirrhosis of the liver, and kidney failure associated with a life of alcohol abuse. He was 67 years old. "He was 67 and when I saw him, he looked 87," recalled Nadine Thomas* who had known Bruce all her life and went to see him regularly during his month-long hospital stay.

"He was always slender, but when I saw his tummy he look like he was about to give birth. His legs were four to six times their normal size and when I asked the doctor why, he said Bruce was retaining fluids." Bruce's liver and kidney had shut down completely. A few days later he died.

Drink of choice

Thomas notes that sometimes Bruce would have his drink of choice, white rum, straight or just with ice cubes. "He would sit in that bar for hours and consume several quarts of the poison with each visit."

Thomas is now very careful of what she drinks. Three of her uncles were alcoholics and have also died from cirrhosis of the liver. They never admitted it but she knew the signs.

"My youngest uncle was the first alcoholic I saw up close," she recalls. "He was so dependent on rum, he had a drink every morning in his coffee and the last thing he had before his head hit the pillow at night." She noted that it's part of our culture to ignore the 'seriousness' of alcoholism.

"The tendency in Jamaica is to see them drinking and say they are 'drunkards'. But if they are not rowdy and pass out, then we don't think they have a problem." Then there is also the instance where a man is held in high esteem if he can 'hold him liquor'. "My uncle was more than a social drinker. He drank all the time."

The dangers of alcohol

Remember the commercial with the character Boysie, who, in explaining why he ate a whole bun, said, "one likkle piece lead to anodda likkle piece ... and it dun"?

As hilarious as that is, imagine if that's how an alcoholic sees it. One little drink won't hurt, but then it leads to another little drink and another and ... you get the point. Before you know it, you're stoned.

Hangovers aside, there are far worse things that can occur from drinking too much. (Note: A 'drink' is four to five ounces of wine, 10 ounces of wine cooler, 12 ounces of beer or about two ounces of distilled liquor like vodka, scotch or rum.)

Signs of alcoholism

How do you spot that someone might be becoming an alcoholic?

✗ Neglect of other activities. Important social, occupational, or recreational activities are given up or reduced because of alcohol use.

✗ A long period of time is spent in alcohol-related activities.

✗ They exhibit a need for increasing amounts of alcohol in order to feel its effects.

Alcohol and the liver

One of the liver's jobs is to get rid of toxic substances (like alcohol) from the body. If there is too much alcohol, the liver can't get rid of it all and this causes a chemical imbalance. Cirrhosis is one possible result of heavy drinking. It is a condition in which the liver slowly deteriorates and malfunctions. Scar tissue replaces healthy liver tissue, partially blocking the flow of blood through the liver.

Signs that your liver is being damaged by alcohol:

Fluid Collection

One sign of possible alcoholic liver disease is the collection of fluids in the intestinal cavity. This is called ascites. It is associated with liver cirrhosis, which is when liver tissue is replaced with scar tissue. Extra fluids that would normally be processed by the liver begin to overflow and collect near the intestines. Fluid may also collect in the legs. This condition is called edema.

Jaundice

Jaundice is a yellowing of the skin, especially around the eyes. It happens when old, red blood cells are not properly filtered out of the body. Those blood cells have a by-product called bilirubin that the liver normally breaks down. Bilirubin is responsible for the yellowing. With a malfunctioning liver, bilirubin will remain in the system and not pass through the biliary tract into the intestine.

Bruising and bleeding

When the liver slows or stops producing the proteins needed for blood clotting, a person will bruise or bleed easily.

The dangers of excessive consumption of alcohol might be common knowledge but it is a disease that should be treated. If you suspect that a loved one might be an alcoholic, don't ignore it, get help.

You can contact Rise Life Management Services (formerly Addiction Alert) 57 East Street Kingston. Tel: 967-3777-8.

Names changed to protect identity.

Sources: www.alcohol.org.nz/, http://alcoholism.about.com, www.healthchecksystems.com, www.ehow.com and http://digestive.niddk.nih.gov

Alcoholism is a disease that can affect anyone.