John

First of all, apologies at the length of this email - but once I get
going I find that I have a lot to say. I hope some of it is of
interest, and helps understanding of WKS

I fully agree with the others that you should try to abstain from
alcohol – but I understand that it is very hard to do.
Jenny (my partner) has WKS – it has messed up her Hippocampus and
she has no Declarative Memory, although she is now showing signs of
being able to `learn'. At the bottem of this post, I have added some
information that I have extracted from elsewhere to help Jen
understand the Brain Injury that she has.

The alcohol! – I have previously refrained from mentioning the
alcohol too much on this site as it is for WKS, not alcoholics. (the
Alcoholics Anonymous & others cover the latter)

When Jen suffered from WKS, I decided to tackle the alcoholism and
the brain injury as separate illnesses.

Jen is an alcoholic. The susceptibility to alcoholism is hereditary –
Jen is aware that there were issues surrounding alcoholism within
her grandparents (her maternal grandfather was an alcoholic). A
paternal Aunt was also alcoholic and her paternal grandparents got
her praying to be saved `from the demon drink' when she was a child.
They told her that only bad/dirty people were alcoholics. When she
became an alcoholic, her self esteem as a result could not get much
lower. She thought that she was a worthless & bad person!

When Jen's life circumstances made her rely on alcohol for comfort,
and she became dependant, her shame and self esteem were at a very
low ebb – the only support that she had was her family
continually `lecturing' her that it was all self inflicted and that
she was bad!

I met Jen 3 years ago and we got together. She was inflicted by WKS
2 years ago, and I found out that she had been previously detoxed 5
times in the previous 6 years. When she was suffering from the
Wernickes over a period of 6 weeks (and needed the intravenous
Thiamine), she went to her doctor 4 times but the condition was not
picked up (the doctor just said it was her nerves!!)

The main point of this email is, however, the alcoholism! I assessed
that Jen would not make a recovery if she did not get some self-
esteem and change her attitude/feelings towards her alcoholism. We
went to approx 35 x AA meetings over a period of one month
(sometimes 2 meetings a day) and it really opened my eyes to the
difficulty that alcoholics have towards drinking. Jen now accepts
that she is not a bad person trying to be good but she is an ill
person trying to get better.

But the control/abstinence of alcohol must come from her. An
alcoholic cannot be `controlled'. The cravings that she suffers are
terrible – she is in tears many times wishing that they would go
away. A constant voice nagging her, and saying "go on, just have
one – one won't hurt" and "you have a RIGHT to go and get a drink".
She often says that if she could have anything in the world, it
would be to stop craving - and has said that she would willingly
give up a limb in exchange for her craving to stop. The illness is
the constant craving.

Really, people who do not suffer from alcoholism cannot have any
idea what the alcoholic cravings are. And Jen is not a weak person –
she has a strong will power. Within 6 months of getting WKS she gave
up smoking (after 40 years!). I encouraged her to do so as her brain
needed as much oxygen as it could get – giving up smoking as well as
alcohol is very important to help the brain deal with the WKS.

I therefore know, John, that the craving is absolutely terrible –
but the Natrexone has let Jen see life without craving – and she
loves it when she is not craving (a feeling that she has not had for
many years)

The cravings are in the background, however, and for her sense of
self worth she has had a glass of wine with her meal when we have
been out over the last couple of weeks (on the basis that I am
not 'banning' her from alcohol, which would make her more likely
to `sneak' a drink when she is on her own. (by going to the shops –
we don't keep alcohol in the house).
But – and this is important to remember, John, if you go on the
Naltrexone, when Jen has had just one glass of wine, the cravings
return with a vengeance for a couple of days.

Jen is now getting the message `if I have any alcohol, the cravings
will return! Is it worth having the drink? Is it worth it'. But it
takes time! But in the end it will be her that decides to give up
alcohol – not someone telling her what to do!

From my experience sitting in the AA meetings with Jen (which they
allowed me to do because of Jen's memory) I realised how much people
want to keep off alcohol but how difficult it is. It is easy for me
and others on this site to say, John, that you should not drink –
but we don't have the voices – the constant craving, the
bottles `talking' to us saying `go on, drink me'. I have seen the
way that the craving affects a strong person like Jenny. I just feel
relieved that I don't have any craving like that. It is difficult
for anyone who is not an alcoholic to understand.

I know, John, how much you want to give up drinking – and how
difficult it is. And from our experience, how hard it is to get any
supportive help. But if the Naltroxone takes the craving away, use
it as an opportunity to stop. Get rid of the cravings for good!

I hope that the above helps. You should keep off the alcohol, John.

When Jen first had the WKS, I received no help at all from our
Doctors or hospital in the UK – after research on the Internet, I
found out something on an Australian site. I telephoned a Consultant
in Australia for advice and they sent me a large package of
information by post (without charge). It was on the basis of that
information that I was able to argue with the Consultants dealing
with Jen and stop her from being put into a geriatric nursing home
(at 56!) which was what they wanted to do. Thank you, Australia, for
this – I will always be grateful.
In fact when I argued with one of the Consultants and asked him a
couple of awkward questions (that the Australian Consultant had
suggested should be asked), he said "she caused it to herself, and
we have to pick up the pieces – you should stop interfering, you
will cause her more harm than good!" If I had not had the help from
Australia, I would not have had the confidence to ask questions. So
once again, thank you, Australia.
Rgds & best wishes
Trevor

Of Interest - THE HIPPOCAMPUS AND MEMORY
Extract from Internet

To understand exactly how the hippocampus is involved in memory,
however, you must first know a little about memory.

There are at least three different types of memory.

• WORKING MEMORY
– The most short term is working memory. Working memory is
like the RAM of a computer. It is the type of memory that enables
you to spit back the last sentence of a conversation when someone
accuses you of not listening. Like the RAM of a computer, it is
crucial for performing some common operations in your head: adding
numbers, composing a sentence, following directions, etc. Also like
a computer, the space devoted to that operation is recycled as soon
as you turn to something else. It does not become a permanent
memory. Working memory does not require the hippocampus; it is
probably a cortical phenomenon.

• DECLARATIVE MEMORY
– The second type is what we most commonly associate
with "memory". This is long-term or declarative memory, and is
composed of all the facts, figures, and names you have ever learned.
All of your experiences and conscious memory fall into this
category. It is analogous to the hard drive of a computer. Although
no one knows exactly where this enormous database is stored, it is
clear that the hippocampus is necessary to file away new memories as
they occur.

• PROCEDURAL MEMORY
– The third type is procedural memory, and is probably the
most durable form of memory. These are actions, habits, or skills
that are learned simply by repetition. Examples include playing
tennis, playing an instrument, solving a puzzle, etc. The
hippocampus is not involved in procedural memory, but it is likely
that the cerebellum plays a role in some instances.


• Therefore, the hippocampus is critical in laying down
declarative memory, but is not necessary for working memory,
procedural memory, or memory storage. Damage to the hippocampus will
only affect the formation of new declarative memories.


The significance of the hippocampus is driven home by a famous
patient named H.M. As part of an epilepsy surgery, doctors removed
most of his medial temporal lobes. Since that surgery, in 1953, he
has formed no new memories. He can remember his childhood and
everything before the surgery, and he still has working memory and
the ability to form procedural memories. You can have a normal,
lucid conversation with him, but if you leave the room for a moment,
when you return he will not remember you or the conversation. He has
completely lost the ability to lay down declarative memory.

Experience with Jen is that she is just like the patient in the
above paragraph. She can learn - but cannot remember anything for
more than a minute or so. Her ability to learn (I use the Errorless
Learning System that I detailed in a previous email) always confused
me - how come she could learn if she could not remember? The above
has helped me to gain some understanding and I thought that it would
be helpful for other members of the group.
I would be very interested to hear the views of others on the above.
I am trying to gain some understanding of this terrible illness, for
Jen's sake.