Will I get my wish on the second post-operative day?

What do I do when I arrive home after seeing patients all day? I have a pre-dinner drink with my wife. This week I’ll wish I could still do it. But on March 22 I’m scheduled for a hip replacement at The Toronto Western Hospital. So today, a column dealing with alcohol is appropriate. And will my surgeon recall Sir William Osler’s wise remark?

A report in the Journal of the American Medical Association claims alcohol causes cancer. The prestigious Nurses Health Study followed 106,000 women for more than 25 years. This revealed that women who routinely consume three to six drinks a week are 15% more likely to develop breast cancer than non-drinkers, regardless of the type of alcohol. For women having six to nine drinks a week the risk is 20% and jumps to 50% for those who partake of more than nineteen drinks a week.

But how accurate is this immense study? The first thing to remember is that there are three kinds of lies, “Lies, damn lies and statistics”!

For instance, at first glance a 15% increased risk of cancer for women drinking three to six drinks a week appears to be a fair-sized danger. But at age 50 the average woman has a 2.4% chance (1 in 42) of developing breast cancer in the next 10 years. An increase of 15% increases the risk to 2.8 percent (1 in 37). Stated another way, among 1,000 women, age 50, light drinking may cause an extra 3 or 4 cases of breast cancer during the next 10 years.

While any increase in deaths from cancer cannot be taken lightly, you have to consider the other side of the coin. Later in life far more women will die of heart attacks than breast cancer. And several studies show that both women and men who drink moderately live longer than teetotalers or those who drink excessively. I say amen to that.

But does the consumption of alcohol also increase the risk of malignancy in men? Reports from the National Institute of Health (NIH) in the U.S. show that alcohol increases the risk of oral, stomach, colon, pancreas, liver and prostate cancer.

What women and men decide about alcohol when faced with these facts is a personal decision. And if you’ve never touched alcohol, don’t start now.

But hell will freeze over before I stop having my pre-dinner drink. I’ve believed for years that alcohol in moderation is the best medicine ever devised for mankind. Consider the tens of millions who, over the centuries, have died from drinking water!

Consider also the thousands who every year die from prescription drugs. This doesn’t happen to moderate drinkers. So I’ve always believed there is a place for the relaxing effects of an alcoholic drink in medical practice.

Years ago I shocked nurses when I wrote a post-operative order that allowed surgical patients, who normally enjoyed a pre-dinner scotch- and- soda, to have one, but only if they wanted one, on the evening of the second post-operative day. This practice had a huge effect on their psyches and convinced patients they were not going to die.

Besides, the benefit is not just psychological. Alcohol increases the good cholesterol and relaxes blood vessels. It also keeps platelets, tiny particles in the blood associated with the clotting process, slippery so they’re less likely to form a blood clot in the legs. This is a disastrous complication if the clot travels to the lungs causing death.

Enjoy your drink, always in moderation, whether thinking about cancer or other problems. There are many more serious risks than having a cocktail before dinner, including popping pills that may be useless.

I imagine hell will freeze over before I get my drink on March 24. But maybe my surgeon will recall Sir William Osler’s remark that, “Alcohol is for the elderly what milk is for the young.” And he knows I’m a long way past being 16!

See the web site www.docgiff.com. For comments and information — @docgiff.com

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