CHRONIC ALCOHOLISM
The coroner's office was notified by Ada County Dispatch of the death of a female in an apartment in northeast Boise. The subject was thought to be in her 50's. EMS and Boise Police officers were on scene.
Arriving on scene, the Deputy Coroner was met by police officers who stated that they had just finished interviewing the subject's son. According to the son, he came to the apartment that morning at 0930 to check on some mail that he was expecting. He formerly lived with his mother but had recently moved to his own apartment. He knocked several times but she did not answer the door. He used his key and came into the apartment, but did not see or talk with his mother as he thought she was still in bed sleeping. He stated his mother was a heavy drinker and he thought she was just drunk or sleeping. He returned to the apartment at 1630 and went into her bedroom, discovering her non-responsive - called 911 - EMS responded and found her to be DOA.
Entering the subject's bedroom, the Deputy Coroner viewed her supine on a bed covered by a blanket. Removing the blanket he saw she was wearing only a short nightgown. There was a strong urine smell - her finger tips, lips and toes were very dark. Examination of the body showed no signs of trauma or foul play.She was photographed for identification in the position found. The body was cold to the touch and early stages of decompostion were visable.
Several empty alcohol bottles were found in the bedroom next to the bed. The deputy contacted the decedent's physician for additional medical history. The doctor informed him that the decedent had a medical history of Chronic Alcoholism, Hepatic/Renal Failure, Hepatitis C and Stomach Cancer. After discussion with the deputy coroner, the doctor stated that she would sign the death certificate with cause of death being Chronic Alcoholism and manner of death natural.
Physical Effects of Alcoholism
There is no doubt as to the serious medical complications caused by alcoholism. Alcoholism is currently listed as the third leading cause of death in our society. Many alcohol related deaths go unreported, however, leading many professionals to believe that alcoholism is probably the number one killer. For example, cirrhosis of the liver (most commonly associated with alcoholism) is one of the top ten leading causes of death by itself. Often, if the cause of death is failure of a body organ or system, the role alcohol played is not considered. If a person dies of a heart attack, yet drank alcoholically for 35 years of his or her life, the death is attributed to the heart attack, not the drinking.
As an irritant, alcohol has the potential of causing serious physical harm to any and all of the body systems. Too often, though, medical and treatment professionals wait for the development of such physical symptoms to diagnose the problem of alcoholism. Unfortunately, while alcoholism is a chronic and progressive illness, the early symptoms are generally behavioral and not physical. The majority of medical problems typically appear in the late, chronic stage of the illness. Waiting for physical signs to appear accounts for the high death rate associated with this problem.
The appearance of medical complications are secondary to the primary nature of alcoholism. With proper evaluation and diagnosis of the problem, many alcoholics can avoid the more serious medical complications by becoming involved in a program of recovery.
The following illustrates some of the problems both by general symptoms that are caused in the late stages of alcoholism.
· Hand Tremor - Part of alcohol withdrawal. Can begin within hours after cessation of alcohol intake. Mild expression of withdrawal.
· Excitability, Irritability, Nervousness - This stems from the sedative effect of alcohol being removed - the body rebounds from depression of the central nervous system to stimulation. This may also be part of first stage alcohol withdrawal, resulting from the decrease of alcohol in the blood stream. Also caused by lack of sleep; alcohol can cause disturbance in REM sleep. REM sleep is necessary for the body to physically and psychologically recover each and every day.
· Jaundice - The result of liver damage. The yellow color comes from the pigment found in bile, a digestive juice made by the liver (the liver secretes 500 ml of bile/day). Bile is handled improperly and thus begins to circulate in the bloodstream, causing the skin color to change to yellow.
· Rosacea, Seborrheic Dermatitis (dry, red, itchy skin) - Caused by a nutritional deficiency, especially B vitamin, as well as poor personal hygiene.
· Parotid Swelling - Alcohol affects salivary glands which leads to an increased stickiness of saliva, causing blockage of salivary ducts and a mumps-like appearance due to swelling of parotid gland.
· Finger Clubbing - Referred to as "Drumstick" disease. Tips of fingers swell, causing a puffiness that covers the fingernails. The cause is alcohol cardiomyopathy, resulting in poor circulation to extremities.
· Rhinophyma ("Drinker’s Nose") - A painless increase in nasal sweat glands which causes an increase in the size of the lower part of the nose.