8:45 am
I’m on my way to Teeda’s House. She’s been dependent on alcohol for the last four years and wants to change that. I have been working with her for about a month, helping her to get ready for life after alcohol. When I assessed her previously there was quite a lot of evidence to suggest that Teeda’s drinking was related to post-natal depression after the birth of her second child. This went undiagnosed, but she started drinking to help her cope with feeling so bad.
9.00 am
Teeda’s husband answers the door. He is at home full time and helps to care for their two children. Today Teeda is going to start what we call a ‘home detox.’
First of all I have to breathalyse her to make sure that she has a zero reading prior to the commencement of the detox.
Good - she’s clear! That’s important, because the medication we use (chlordiazepoxide) is dangerous when used with alcohol or any other depressant drugs. I then attend to Teeda’s observations, like pulse and blood pressure.
Teeda is in moderate alcohol withdrawal. I explain all the possible side effects of the medication, the dangers of mixing it with drugs or alcohol, and how store it safely.
Teeda and her husband have all sorts of questions, and I take time to listen to their concerns. When I’m sure they’re satisfied with my answers I say goodbye, reassuring them I will be in touch very soon.
10:05 am
I need to drive to Wood Green to see Wally, who is also starting his detox from alcohol today. Mmm…the traffic is pretty heavy this morning - hope I’m not delayed too much. Wally lives with his Mum, and she has agreed to look after him while he starts the process. He has taken time off work for the 10 days that the detoxification will take.
I’m not very late. Wally’s mum lets me in and offers me a cup of tea. I go through a similar process with Wally and his Mum as I did with Teeda and her husband. Then I leave them and drive back to HAGA in Tottenham.
10.50 am
Back at HAGA I have an appointment to see Adam, with one of the HAGA’s Kinesis workers. Kinesis is HAGA’s employability and education support programme. Adam is pleased to see me and I comment on how well he looks. In fact, he is very well physically. It has been 6 weeks since he started detoxification. He tells me he is still going to the abstinent group at HAGA on Fridays. Adam has not worked for 10 years. He left school at 14 and really wants to improve his reading and writing. Because Kinesis has strong links with the College of North East London (CONEL) Adam will be referred there in order to improve his education. I make an appointment to see Adam again next week, as I have done every week since his detox.
12:30 pm
Not far to travel for my next meeting – with my manager in St Ann’s Hospital. This is my opportunity to talk about any clinical issues or problems that I may have encountered during the week.
13:30 pm
Lunch! A chance to have a quiet break and check my afternoon appointments – I have two people to assess for the home detox process.
14:10 pm
My first assessment is with Helen who is drinking one and a half bottles of wine a day. She has been drinking in this way for the last 2 years. Her drinking increased when her relationship broke up. Helen has high blood pressure, which is quite common with people who drink at this level. She often feels sad and lonely but really wants to stop drinking. I need to send Helen to the hospital for a specific kind of blood test, called a Liver Function Test. The test will tell me the level of stress her liver is under due to the alcohol misuse. Although Helen is keen to start detox as soon as possible, I explain that I need to discuss this with her GP first, but if all goes well we should be able to start next week.
15:00 pm
I write up an assessment letter to Helen’s GP, requesting permission to start a detoxification.
15:30 pm
My next assessment is with Gordon. Gordon has been drinking daily for 20 years. He states that he does not want to give up drinking yet but would like to cut down, so I suggest some ways that he can do that. HAGA runs a Day Centre programme, so I recommend that too. Gordon could also attend HAGA’s Assessment Group to explore more ways to reduce his drinking. I give him a Drink Diary and make an appointment to see him in a week. I will continue to see Gordon weekly until he reaches his goal of reducing his drinking. If he can’t we’ll discuss a possible detoxification. I say goodbye and head back to my office.
16:30 pm
Ahh… a cup of tea. I give Teeda a call to see how she is doing. She’s fine, that’s good. Then I ring up Adam – he seems to be doing well too. His mum wants a word with me; she has a few worries about the medication, but I reassure her, and she hangs up happy. I spend the rest of my time at work today writing up my notes.
