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Discussion in 'Medical Topics' started by lbfjrmd, Jan 24, 2018.
You missed the point so far you might as well be in Africa.
It’s true. A very strange side effect of living here.
Hangin out at sea level last week I noticed my respiration rate and heart rate were both lower also. The respiration rate thing is fascinating because you every so often consciously realize you haven’t taken a breath in a while and don’t feel like you need to.
That’s about 20 minutes on the highway as I recall.
It may not take 6 weeks, I had that effect from spending 12 days up at Estes Park campground the time I hiked up Longs Peak. When I got back home to Michigan I felt like superwoman hiking in my old haunts, nothing could get me winded. Of course it only lasted a week or so, then I was back to normal. Bummer.
Yes, me, the one not claiming to be just fine at 0.15 this first time drinking. You're right. I've missed the point.
Every drunk I've ever known has the same story. And they all think they're the first.
I guess I don't see @mryan75 's logic here. If tolerance is a highly individual thing, why would it be so unbelievable that someone participating in a college drinking challenge might blow a 0.16 without having to be a habitual drinker?
And for the record, I'm definitely NOT a drinker... I have ONE beer on infrequent occasions (usually after strenuous exercise), never more than that.
Denial... a sure danger sign. You should seek help soon.
I kid, I kid. I have seen that mentality a few times though.
Oh sure, we all have - especially in this forum, from people with multiple DUIs coming on wanting to convince the FAA that they're now drinking responsibly. Such posts reek of denial, I don't have any argument against that. Kidding aside though, I am starting to wonder if we have gone so far down the Puritan rabbit hole that we now consider a person's statement that they are NOT an alcoholic as EVIDENCE that they ARE.
We now have anecdotal "data" that some naive drinkers can test at a BAC above 0.15 and still be functional, even if severely impaired.
Maybe there is strong science against this. If so, where is it? Common sense would suggest that there is a Bell curve of where the BAC corresponding to falling-down drunk lies in the absence of acquired tolerance, as with nearly everything, so I have no trouble believing that some naive drinkers might be outliers and be capable of walking and talking at 0.15 or (somewhat) higher. If this is not the case, I would like to see the science that disproves it, or at least renders it vanishingly unlikely.
That's not it at all. It's a person's statement that they are at a level of intoxication that would make any human being a staggering, slobbering mess and yet they are still "just fine" which is evidence that they have a drinking problem. Either that or they're full of crap. I'm actually more inclined to believe the latter. For the record, I have seen someone in the 0.30-range that was pretty much fine (in a hospital emergency room trying to get them admitted and dried out). She started drinking every morning right when she woke up and had been doing so for years.
There are basically 3 possibilities:
1) you aren't anywhere near 0.15 (you're full of crap)
2) you aren't even remotely "just fine" (you're full of crap), OR
3) you're a drunk.
Yes, that's what I called acquired tolerance. From steady drinking.
I don't think anyone here (except MAYBE some multiple DUI folks in denial - and I'm not sure anyone in that category did either) claimed that they were "just fine" at 0.16 - only that they were "walking and talking". Are you saying that they couldn't even be at that level of functioning without acquired tolerance? If so, what is your basis for that statement?
I'm asking for the science, not empty assertions.
Tolerance is an amazing thing at times. My personal record was that I had a patient in the ER at the old Baltimore City Hospital (now the Hopkins Bayview campus....still haven't ever found the view of the bay from there). He had a 0.42 BAC and frankly from talking to him, you'd have not realized he was impaired. Of course, the fact that he had a big hole in his shoulder where someone had knifed him also had him jazzed up.
I'm talking about posts like this. I call BS.
Why? There is no mention in that post of the BAC of any of the drinkers in that group. I don't think it's at all controversial that the ability to drink a certain amount of alcohol varies over a wide range, even when body mass is taken into account. We don't know anything about the metabolisms of those four guys.
And I wouldn't call BS, even if the poster was actually drunker than he thought (which we can't judge) - more likely a blind spot when it comes to judging one's own behavior and that of close friends.
I wasn't even contending that I wasn't drunk. I was only saying that there was no normal visible sign that my friend and I were drunk...we weren't slurring our words, we did not give the appearance of balance problems, we did not speak incoherently, we did not appear to have delayed reactions. Our two friends had all of these signs of intoxication. We didn't, as we saw on video the next day when we were sober. I also am not contending we were .15 (but more likely around .12 or so).
I'm not sure how you define "tolerance", but as to how I define it, my friend and I appeared to have tolerance, even though it was my first time drinking (and presumably all my friends' first times).
L, the science becomes firm at 0.20 which is why at 0.20 FAA automatically assigns the diagnosis of dependency. Anything less and you get “graded level of expertise” evaluations.
Drunks with breathalyzers always get ridiculous results. A drunk operating a breathalyzer is not going to use it correctly.
If you are drinking and bullshitting with friends and blow into a breathalzier you will always get a significantly over-inflated reading.
You cannot ever get an accurate reading in these drinking scenarios because you can’t get a drunk to stop drinking for 15-20 minutes so that you can get an accurate measurement.
You need a sober person, with quality equipment, that has read and understood the operating instructions. I’ve found that the values I’ve obtained by following the instructions always make sense and make the .08 limit seem very reasonable.
However anytime I’ve had the breathalyzer at a social drinking event people always want to blow into it. The bac is always high and it’s a token of pride. I always tell them the reading is ********. But nobody wants to stop drinking to find out.
Myself, I quit drinking. Can’t really handle a beer anymore..for some reason my shoulders get extremely tense and it’s the opposite of enjoyable. Kind of nice - It’s comforting knowing a DUI is never in my future.
I still bring the breathalyzer to events where I know friends are drinking. And the ridiculously high values I get (because they’re still drinking) have served well to convince folks not to drive. It’s probably prevented a dui. Maybe saved a life. Best money I’ve ever spent.
FWIW, I have never seen someone decide to drive after I make them blow into a breathalyzer and they exceed the limit. Something about having to blow and seeing the value is real enough to make even a drunk make a better decision.
I think the FAA is a bit much with some of this. But it is what it is and we all know the consequences.
I had a student once with a prior dui that I was trying to assist through the medical hurdles. All seemed well about the guy until he showed up to a lesson with his brand new truck smashed absolutely to ****. His drivers door wouldn’t even open. Got out stumbling drunk ready for his flying lesson. Told me he crashed the truck on the way to the airport. We didn’t fly that day - or ever again.
If you use a calibrated fuel cell breathalyzer (the ones costing 4 figures new), you'll see the false fresh numbers only last for a minute or two.
Until you know your rights in the state you live in - you don't say or do anything.
Hello Sir, I pulled you over because I saw you go over the yellow line back there - have you been drinking tonight?
"Officer, I respectfully refuse to answer any investigatory questions on my fifth amendment right to remain silent and request a lawyer before being questioned"
Sir, step out of the vehicle [making sure to look down so the officer does not trip you and then testify you stumbled] and step around to the front of the vehicle.
"Yes sir" step out of your car. Do as commanded.
I am now going to asking you perform certain motions and action etc etc etc [the Field Sobriety Test]
I refuse based on my fifth amendment right to remain silent. [perfectly legal]
Sir, I am placing you under arrest for suspicion of DUI . . . .
So, what have we learned here? The officer suspected you were intoxicated when he pulled you over. He is basing his arrest on everything you did before he even spoke to you - so whats the point of speaking to the officer? At this point - some officers ask if you want to blow into their field sobriety scanner to 'settle it all right here.'
Again, what should your response be? No thank you. I stand on my fifth amendment right to remain silent.
You are then cuffed, taken for processing to a police station or to the processing van right there in the area. It is at this time you must perform the test of your blood, breath or urine. 99.5% of the time you be given a breath test. And you must comply unless you are given a choice of one - then - select blood. At least you know its accurate.
In my practice, I'll be honest - under these facts its not likely you would be convicted. Assuming you do not slur your responses [and regardless the officer will testify as to the odor of alcohol on your breath - I had one client who was pulled over for DWB in a lily white neighborhood blow a 0.00 and at his trial the officer testified as to the odor of alcohol on his breath] not much in the way of suspicion of DUI. You are not required to answer questions [if you say 'only two beers' you've admitted to consuming alcohol and driving] not required in any state to perform a FST, nor are you required to consent to PAST [Preliminary Alcohol Screening Test]. So what facts does Officer Friendly have to arrest you? Driving over a yellow line. Thats it.
Police have vast authority to stop you - and I had a cop who was a friend follow me for over 5 miles and did not notice a single vehicle code violation - but there many things he could pull me over to investigate. Which is why paperwork, working lights, two license plates, all that stuff is key to avoid giving an officer probable cause. I had one cop testify once that he felt 'strainge' about a particular vehicle and found no reason to pul it over after following for 1/2 a mile - and THAT was suspicious to him. The trial judge actually let him get away with that one. The appellate court saw the wisdom of not pulling someone over because they were not breaking the law.
Anyway - learn your rights. Such as they are today.
I have a few commercial flights coming up... Which means I'll have time to kill. I'm going to endeavor to find some scholarly articles on the subject. With the number of people making assertions that 0.15 BAC while walking and talking = tolerance, period, full stop, every time...surely PubMed will have evidence to support.
I'm skeptical of that assertion myself. Not saying it's not a good guideline. A general rule, sure. I'd bet most times the statement holds true. But most times ≠ all the time.
I have no dog in the fight aside from liking to see arguments settled with facts/science. Further, I'm good friends with another example of the outliers that have been described (and refuted) in this thread.
just remember, the FAA marches to a different drummer ... theirs!
Amen to that.
Once again, a little science. Ethanol has pleasant affects on the nervous system and actually depresses blood pressure, though whether the latter is dependent on the former I do not know. It is a toxic substance and is metabolized by enzymes in the liver. Those enzymes are encoded by genes, which have different alleles within our population. There are many, many different alleles of these enzyme encoding genes in our population.
Everyone has an inborn metabolic tolerance to ethanol, based on the rate at which their enzymes detoxify the material and based on the interaction with the ethanol itself on its target tissues. The proteins involved are all encoded by genes (with lots of different alleles) and the lipids involved are (you guessed it!) made by enzymes that are encoded by genes with lots of different alleles.
There are people who carry nonfunctional alleles of the alcohol dehydrogenase gene. It is the first enzyme involved in the detoxification of ethanol, and such people have very little tolerance and are never likely to develop any. Larger people have more tolerance than smaller people, as they have more tissue for the same amount of ethanol to act on. And there are people with more of the necessary detoxification enzymes because they have stronger alleles encoding the machinery.
Human beings are not set in stone, our bodies can change over time in many ways. The ones involved in growing old mostly suck, but our bodies can adapt to low oxygen, high sunlight, high heat, and a number of other adverse environmental conditions. And our bodies can react to excess ethanol toxicity over time, by altering the targets of ethanol and by altering the production of the components of the ethanol detoxification cascade.
Personally, I think the sort of one size fits all mentality that pervades the FAA is somewhat uninformed, but it does appear to work for the majority of cases. As far as the fellow in question, I hope my fellow Airman can get his act straight and get back in the sky.
Pleased to report that the airman was granted his medical ... with the usual admonitions. Cases like these variable outcomes! At worst, it would have been HIM$ and airman would have gotten his medical ... and have lost his demand to continue to drink responsibly.
The term "administrative convenience" comes to mind. The problem with overarching bureaucracies.