Houston, we've got a problem.

Tonight I went to my first Cadeucus meeting since I left rehab. Cadeucus gave me a format to tell the story I want to tell, so I'm excited to begin writing. There's a bit of backstory, but all will be revealed. The important thing about this blog is that it will allow me to tell the truth about things that people may want to understand, and that it will allow a forum for others in my situation, whether more or less, to discuss their experiences. Anonymously. Openly. With rigorous honesty. (Hat tip to P.)

I'm going to write about what I know. If you're reading this, and you've figured out who I am (you probably know me in the context of anonymity) be assured that I will neither violate your anonymity nor will I allow your stories to identify you. Your privacy is of paramount importance to me. I may tell your story, but I'll change the names, cities, drugs, and specialties.

So, I guess I will begin in the middle, as it took me a while to sit down and write after returning home. I was really glad I went to Cadeucus tonight, and I realized, as I told Suzy Q. about my brief relapse, that I have a problem. 

My entire medical career hinges upon abstinence. However, I am "not an alcoholic." My drug of choice (DOC) is any opiate. Preferably a pill, not injectable, but otherwise, any opiate. Any port in a storm . .  But given that I knew the possibility of being drug tested was real, I still had three glasses of wine after being told by the PHP that I would not be subject to a PETH test. The PETH test is an assay for phosphotidylethanol, a pathologic metabolite of alcohol that is used as a biomarker of heavy alcohol consumption. When you metabolize down the PETH pathway, the metabolite ends up in the membrane of a portion of your RBCs. The problem should be obvious, then - at that point, your metabolite must undergo degradation - or, in other words, you have to wait out the appropriate amount of time for destruction and erythrogenesis. 120 day life cycle. Hmmm. AND PETH is detectable at a limit of detection of 22 nm per liter. The half-life is a robust 4 days in whole blood, and the dried blood spot test offered by USDTL is stable for analysis to the same extent.

While performing initial calculations (after realizing that I would end up having the PETH test) I used studies based upon results obtained from HPLC analysis of PETH in blood. Well, the standard is now LCMS, and why would the PHP use anything else? It is exponentially more sensitive than the previous assay. 

My boyfriend is a genius chemist, and he calculated the likely result of my drinking escapade. Yep, he called to tell me I needed to donate blood, cut an artery and get a transfusion. That seemed pretty hard core, but I was unable to think of a way to adulterate the sample, which was eventually collected yesterday. This was after I donated 10% of my blood (HCT 39 to 33) AND after 12 days had passed. 

So, back to Cadeucus. Suzy Q. was kind enough to mention after the meeting that she had initially relapsed but it was not discovered (her DOC was an anxiolytic). She encouraged me to call her if I wanted to drink again, and like some of the other docs in attendance, her "problem" is not alcohol. Except that it is now one of our problems.

While in rehab, I feigned my "awakening," my St. Paul on the Road to Damascus experience: Yes, I can see how alcohol could BECOME a problem.

I wasn't sure if I believed it. I mean, yes, it could become a problem. To some extent, it was becoming a problem, although I don't drink to blackout or to get drunk. Now, however, I think it may be more of a problem than I realized, as I allowed myself to risk months of hard work and tens of thousands of dollars for three glasses of wine. I guess I am powerless over alcohol.

In the morning, I am going to a meeting and begin to search in haste for a temporary sponsor.