Withdrawal scale,0-8.

Any help at all about the 0-8 alcohol withdrawal severity scale,and what it means,from 0 to 8,and health changes,as I'm confused,Thanks,what is 0 and so on.

[Zukosmile07]

Morning charloy. I've never heard of the scale. I suppose it's self explanatory, 0 being no withdrawals and 8 becoming fits and seizures. If you find out...let me know because I didn't know they had one. Cheers buddy, Dan x

[AyrshireK]

I just found this which is the explanation of how they calculate this 'Alcohol Withdrawal Assessement" ewin.nhs.uk/sites/default/f...

The small print under Procedure heading relates to what to do in patients at different scores.

Hope that helps.

Katie

[AyrshireK]

There is also the Glasgow-Modified-Alcohol-Withdrawal-Scale which is detailed here including calculation criteria and what they do with patients at various scores.

ggc-emergencycare.azurewebs...

Katie

[Hidden in reply to AyrshireK]

Hi,thanks for that,I have done a quick look through,think I'm about 7-9 ish,Honest answer,they seem to think what they say is about 18.so an untruth,thanks again.

[Hidden in reply to AyrshireK]

Hi,pretty interesting read,it's pretty similar to the CHD Pugh score derives,0 = 1 point,and so on,but as it says,sedative to be administered by trained staff,!but same outcome as not as severe as it indicates.thanks though,very wise.You! not me.how do you talk on these sites.! Think you may find my story very intriguing.thanks again,,I took advice back in 2020,still no further.well a bit.

[Ubwa in reply to Hidden]

I am a bit confused, sorry your posts are a bit all over the place…The Pugh score has nothing to do with alcohol apart from the fact if may be the cause you now have one. The link Katie found appears to be a diagnostic tool to measure and help treat acute withdrawal.

You seem to say earlier that your issue was aspirin related, now are asking about alcohol scores, what is it you are after help for? Why do you think everyone’s lying to you?

[Hidden in reply to Ubwa]

Are you ready,march 2020,I was addmitted with gi bleeds,it was suggested that I was suffering from severe withdrawal from alcohol,but hadn't consumed it the night before,I had only taken aspirin as told by my cardiologist to take if I get pain,of which I did get pain and take the aspirin,now I'm not saying I haven't drank,I had for three years,4-5 beers a night,cans,now,on arrival at a&e I had melena,and vomited blood,was given a one dose of sedative,awoke the next day and had been to endoscope and had bands placed,two.! Unaware as was under general anesthesia.the following day I felt ok,the day after he insisted I went to have a further investigation for the bleeds,of to which I refused,as I got off the bed I went dizzy and slumped back on the bed face down,just then a clinician nurse injected me in the thigh with a sedative,a I was totally aware,but after the sedative took effect I was shipped off to have the endoscope,under general anesthesia,no consent,!! Didnt want the procedure,the following day that nurse came and appolagised,after discharge I got home to read the discharge notes saying I was suffering with severe alcohol withdrawal,combative,and violent,what I'm trying to ascertain is does one dose of sedative,warrant what he says,the day of arrival,to discharge,They have lost all notes,and they say I was hallucinating that day,due to alcohol withdrawal,( Bloods inconclusive) obvious reason I had lost alot,I have since been told it was varices,Now my last endoscope clearly says GI ulcers,!! Duedeon,ok,stomach,ok,bit had suffered a severe infection in my bowel,! As for now I'm fully compensated,no issues,I understand child Pugh score,even if it's 0 you still get a point,My alcohol withdrawal tool I've now done,suggests not as bad as they suggest,taking in to account a good month for alcohol remaining in my system,my child Pugh is 5,all my bloods ok,no ascites,no portelhypertension,no HE, nothing,feel ok,so I was pointed to the fact that aspirin has had a big part in my problem,! Bleeds,which they have agreed that it had potentiated it further. The thing is I was aware what went off and been told I was hallucinating.So I was told to follow it up as someone else may not be as fortunate as myself,they are denying the injection,and that I was suffering severe withdrawal,I wasn't hallucinating,and I know I was injected,bit the trust seem fit not to act upon it.lack of there lost notes,and am apology on housekeeping.Joke,hope that clarifies,it's baffled me for two years.

[Hidden in reply to Ubwa]

I have just checked my old bloods,from October 2019,prior to colonoscopy,borderline, diagnosis,4 X low placed dysplasia, diverticulitis, FEBUARY 2020,bloods prior to endoscope investigation,GGT, 200, comments borderline,march addmitted,I am pretty sure my drinking was at the utmost low,due to the fact they was ruling out possibility of cancers.i am told that 200 GGT ,isn't major that was prior to been hospitalised with bleeds.What is regarded as high GGT.!! I hope that makes some sense.

[Ubwa in reply to Hidden]

"it was suggested that I was suffering from severe withdrawal from alcohol,but hadn't consumed it the night before"

Withdrawal can start after several hours to days , and can only start to get at its worst after 2 days. Were you drinking 4-5 can every night? You say for three years, had you never drunk before that? Do you still drink?

[Hidden in reply to Ubwa]

No ! before then quite happily married,only drank after divorce,late 2015, did drink alot then bit cut back about Easter 2016,just moderate after that,4-5 cans an evening,I got pulled into doctors late 2018 after losing weight,4 stone in 4 months ish,not intended, discovered anemia,which for worse,then jan2019,told of possible bowel cancer,so very rarely drank,shandy whilst out,day off every other day,always kept fit,that's why it's a bit strange everything they say I should have I don't,and never had an issue stopping,not had a drink now for well over two years,never bothers me,the last day in hospital before discharge I had a visit from mental health liaison,and he was gob smacked as to what he had been told,he even checked my hospital wrist band,! To see if I was the person,Violent,severe withdrawal, combative,his report said alcohol withdrawal ???,benzodiazopems,?? To be referred,local drug and alcohol service,I was with them a month,and they even said we can't help you as you don't drink.But fortunate for me I'm doing ok,I stopped all my medications on my belief,and I feel loads better,Not that I'm suggesting it I'm anyway.So I have a bit of a continuous battle for truth,like I was told,after my care that day I'm fortunate,someone else may not be,and I put my point across to the trust that not to perceive all people as worthless,as what I felt,the worst thing I don't sleep,too much energy.No idea,!! Can't answer that.

[AyrshireK in reply to Hidden]

I wonder if the behaviours they noted in hospital were perhaps more related to Hepatic Encephalopathy than alcohol withdrawal - we've had members on here who were actually arrested for drunk and disorderly in A&E when they were actually having a spell of HE which hadn't been diagnosed and had been mistaken for drunken, aggressive and breach of the peace behaviour.

Also, a lady who I met personally from here and who's husband attended same hospital as mine experienced her t-total hubby being given alcohol withdrawal drugs in hospital when he was having a bout of HE. Obviously being t-total he certainly wasn't 'under the influence of drink'.

I just wonder whether you perhaps had HE at the time rather than alcohol withdrawal. There are elements of your posts that indicate potential issues along this line.

[Hidden in reply to AyrshireK]

Hi it was mentioned,but prior to the injection I was fine,! I was anxious as the nurses who was placing the cannula went over the top,bruised both arms,and left hand,had cannula in foot,I said to them the other nurse tried and she'd had said I had got vein collapse and wasn't able to do it,but they insisted,I agree I was anxious but was totally aware,it was only after the jab that I felt lethargic,and at that point given up.its the thing where as they say no such injection took place and I was imagining it,but the following afternoon that nurse came and appolagised,so was I still dreaming.Sorry it's just I feel totally let down,thanks Katie.

[Ubwa in reply to Hidden]

Firstly I apologise if you have answered some of the blow or explained it in other posts, I did try to read them to see...

Something has damaged your liver Hidden by the sounds of it, 4-5 beers every night is not healthy, and the reason I asked about how you drank before was to ascertain if it was your norm or not. Since you didn't drink much before, and then had these issues after drinking moderately to heavily for a few years could show you just can't handle alcohol well. I have the same issue, I could handle it well in so much as I was never seriously incapacitated(although I was on a lot more than 4-5 beers a night at the end), still performed very highly at work etc, but it was doing orders of magnitude more damage to me than most people would have had done to them, in a short amount of time.

That being said, it may not have been Alcohol, but you keep going back to it which is why I mention it.

Now if you have something wrong with your liver, which all signs point to, aspirin was probably an aggravating factor in your bleed but necessarily not the root cause. Always remember, correlation does not equal causation - especially with something as complex as the human body. Your behaviour doesn't seem normal to me after having a life threatening episode, refusing treatment or more investigation as to the root cause is not normal after such an event. You don't just go in with the potential to bleed to death, get banded and then leave a day or two later. I know - I have been through it myself. The fact you went dizzy and collapsed further shows this.

The doctors were not out to harm you or cover anything up or sedate you for the lols. If they sedated you without you medically warranting it, they can be criminally prosecuted. Doctors/nurses generally become doctors/nurses because they want to help people, and are human too, not boogeymen. There is very unlikely a conspiracy by the trust to cover anything up, it would require all the people involved to be on the same page etc. Occam's razor is real.

"I just wonder whether you perhaps had HE at the time rather than alcohol withdrawal. There are elements of your posts that indicate potential issues along this line"

I agree with this. IMO from your posts(what I can pick out from them) I think:

- You have symptoms that someone with liver diseases would, bleeding, collapsed veins, mental confusion, what sounds like sleep issues, GGT levels, a child-pugh score,

- You would not be given a child-pugh score without having liver disease on the more serious side, 5 is not the end of the world though.

- You seem to have some bad confirmation bias going here that may be distorting your reality of the situation. By this, I mean you are only seeing the parts that you want to believe.

- Your liver issues or on the rare occasion something else (not sure what else can cause it tbh but I am not a doctor, nor know everything) caused you to have varices that bled. You took aspirin that may or may not have caused them to pop, but definitely would have made it more severe due to the blood thinning properties of it.

- Whether it was withdrawal ( it is not impossible with the amount you were drinking at the time), the fact you now had a lot less blood in your body or potential HE whilst in hospital, things got a bit difficult and the medical team would have done what they thought was best for you, the patient, at the time.

My advice is to put the past behind you, and with a fresh set of eyes concentrate on getting to the bottom of your issues, where you stand with them and what can be done to make them better. You will need help from the medical profession with this. If you have lost trust in your NHS trust, go to the one next door. I did.

Don't be Ahab, it didn't end well for him.