Some of my best friends drink lots of alcoholic beverages! But this is one of those less comfortable topics that needs to be talked about before you go into the hospital for surgery. In our stressful world, drinking alcoholic beverages has become very common. While it is possible drinking 1 glass of wine a day may impart some positive health benefits, drinking a whole bottle every day does not! For those patients who like to drink more than one glass of alcoholic beverage a day, I ask that you cut back a little for before your surgery. Over the years I have had MANY patients who never thought the amount of alcohol they drank was excessive, but they had alcohol withdrawal in the hospital. This is not a happy situation, and is stressful for both the patient and the staff (and the family!). Withdrawal presents with a mood change – patients go from being happy and content, to being very agitated and outright angry. Some patients will begin to feel “sick”, with flu -like symptoms. Usually the heart rate increases and some patients become confused. Over the years, I have had patients in withdrawal storm out of the hospital against medical advice.
So what should we do about this possibility? I try to pick up on patients drinking habits in the pre-op discussion, so I can advise them, but sometimes we miss this information, or the patient doesn’t mention it to us on their “New Patient intake form” filled out in the office pre-op. It seems that “More than One” alcoholic beverage ( more than 1 oz. of gin, vodka, or whiskey a day, puts some people at risk for withdrawal if they don’t get it in the hospital ). This is probably about equivalent to 3 beers a day, or two glasses of wine every day. SO, we try to get people to cut back to NO More than 1 or sometimes 2 oz a day for at least a week before surgery. We CAN serve 1 oz of alcohol in the hospital with dinner, and sometimes another drink with lunch. We greatly advise patients to drink it if their bodies are used to this. Alcohol in this instance is a medication, just like any of the others patients may take. (If you don’t take your blood pressure pill, then your pressure will go up…if you don’t drink the alcohol, you may get withdrawal symptoms. Since most of my elective orthopedic patients are actually quite healthy, we don’t think there is much medical risk in having a drink or two in the hospital. ( I often say, “orthopedic patients are broken, not sick”….). So be reasonable, and cut back a bit before surgery, but don’t stop drinking “cold-turkey”, as that will be worse!
We do not want patients to “cold-turkey” quit their alcohol consumption, as that will acellerate the withdrawal process! Instead just bring it down to one or at maximum, two drinks a day. We all should be able to handle that level of consumption with a drink in the hospital without much excitement. The best thing I can recommend if you become uncomfortable in the hospital, is to go home to your own familiar surroundings. This usually takes care of any early withdrawal symptoms.
If you have questions about this, Please ask! By the way, some of the worst scenarios I have been seen are when a family member drinks in secrecy and is embarrassed to admit it., so nobody knows about it. This patient often does get confused in the hospital, and everybody gets upset that it must be related to the pain medications we give. Withdrawal symptoms can stress the heart and lead to admission to the ICU and cardiac stress. It is no joking matter. Please just be honest with us, as this is NOT a character judgement, we just need to know so we can do everything possible to avoid problems. Follow good medical policy to maximize your good results. Thanks!
Thank you for listening!
Stuart C. Kozinn MD
Scottsdale Joint Center