DT's...What Is It?

This is what I witnessed.

   The scene is a frenetic one in an inner-city hospital ER. It is a Saturday night and I am one of three hospital reps from my pharmaceutical company participating in a training program. We have been strapped to a third-year internal medicine resident for a week now, day and night, and it is his weekend to work the ER.

   He gently guides a prostitute by her left arm towards me, hands me her big black purse, and says "...take her into that office, go through her purse, find her pills, and look them up in that PDR on the shelf behind the desk. We have to find out what she has taken before we can do anything." In less than a second he is gone and she is standing there staring at me, pupils like big black pools of water.

   Going through a prostitute's purse is not what I expected. It holds mostly candy and pills. The pills are in various containers, all mixed up. I am going pill-by-pill through that pictorial section in the middle of the PDR and having some luck. Little red 30 mg Sudafed tablets are in abundance. They give me a direction...she is obviously into uppers.

   Suddenly, my peripheral vision picked up something just outside the door.  I sensed this convulsive jerk. When I looked up I saw an ancient wooden wheelchair with huge steel wheels going straight up backwards with a pair of legs pointing at the ceiling followed by a sickening "thump" as the woman's head hit the grey concrete floor. At the same time I heard this nurse yell "shit."

   The nurse immediately started making excuses for leaving her patient alone for only a second strapped in a wheelchair. She and everybody in the room knew that she had made a major legal gaff, but the sudden stiffening of the patient's whole body into a straight line was impossible to predict. That is one of the reasons why the DT's are so dangerous.

The medical stuff.

 D.T's. Delirium Tremens. This is a very serious condition seen often in hospital emergency rooms. When an alcoholic has been deprived of alcohol for an extended period of days after years of heavy drinking, the body reacts by stiffening and going into a kind of seizure. The symptoms do not occur immediately upon cessation of  drinking, but usually appear anywhere from two to ten days after an alcoholic stops drinking without medical supervision.

   Standard treatment for the D.T.'s in the ER is to give the patient a stiff drink!

   During the time before the seizure there is a period marked by sleeplessness, acute depression, irritability, anxiety, and mental confusion. There are horrible nightmares when the patient does manage to fall asleep. The patient often awakens covered with sweat.

    Other typical symptoms include a racing pulse, fever, and visual hallucinations that incite sheer terror (i.e., creepy-crawly things). The floor seems to rotate; the walls may seem to fall inward. There is a characteristic tremor in the hands, which eventually extends to the head and then the body. Patients are dangerous to themselves and to anybody around them (especially in a work environment) because the patient is extremely uncoordinated. There is no way to estimate the number of accidents on job sites that have been caused when workers experience this sudden lack of coordination. Imagine this happening, for example, to somebody working on the upper floors of a high-rise building.

   Finally, the D.T's can be lethal, especially when they go untreated. If you live with a family member who exhibits these symptoms upon sudden withdrawal from alcohol it is important that you get that person to medical attention. As an Al-Anon, we go to great lengths to avoid being an enabler to an alcoholic, but you need to understand that, once alcoholism reaches this point in its progression, it is as life threatening as a loaded gun in the hand of a suicidal individual.

   Call 911!

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