Ask the Doctor: Leisure Drinking or Drinking Problem; Leg Cramps

Q: How can I know if my new beau has a drinking problem? He consumes a lot, daily, and it concerns me. My friends say not to worry.

A: It’s possible that your new relationship interest just has a lifestyle choice incompatible with yours, or he could be struggling with alcohol use disorder (AUD). The general recommended limits from the National Institute on Alcohol Abuse and Alcoholism is one standard drink per day for women and up to two for men. The definition for AUD requires personal interpretation. This sampling of screening questions helps you better understand how AUD is diagnosed. In the past year, have you:

• Had times when you ended up drinking more or longer than you intended?
• Continued to drink even though it was causing trouble with your family or friends?
• Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?
• Found that your usual number of drinks had much less effect than before?
• Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating?

AUD has been proven to be a chronic medical brain disease that is influenced by genetic and environmental factors. It’s understood that successful treatment and outcomes depend upon long-term rather than short-term management and that interventions are required. With respect to your new relationship, another consideration is to look at whether being with someone who engages in undesirable behaviors is a pattern for you. The traditional definition of codependency is controlling, nurturing, and maintaining relationships with people who are chemically dependent. The classic example is an alcoholic husband and an enabling wife. Of course, AUD and codependency are both extreme examples. As I stated in the beginning, it might simply be a relationship mismatch. Because you are uncomfortable with his behavior and desire further clarity, consider speaking with a mental health professional to sort it out.

Q: I have been enjoying brisk outdoor walks for exercise, but I sometimes get muscle cramps in my legs. What can I do about this?

A: A common cause of muscle cramps during exercise is not adequately warming up the body. For example if you are starting off at a brisk pace immediately out the door, that could be the problem. Try slowing down a bit at the beginning; then as your circulation increases, ramp it up. Give yourself a good five minutes before you accelerate to a brisker pace. Dehydration can also lead to muscle cramps. This could be especially true if you’re walking in the morning and only drank a cup of coffee. Be sure to drink at least a full eight ounces or more of water in the morning. Some older adults forgo water at night to avoid having to go to the bathroom, which can only add to morning dehydration. Drink some water, even if you don’t feel very thirsty. Another cause of leg cramps is peripheral artery disease (PAD), which is the narrowing of arteries that distribute blood flow to the legs. It’s caused by atherosclerosis (hardening of the arteries due to plaque). With PAD, cramping usually doesn’t begin until a few minutes into the activity. Most often just one leg is affected, but it can be both. The symptom tends to be fairly consistent in terms of when it occurs. For example, if cramps occur within a specific amount of time or distance, PAD could very well be the problem. If you suspect that’s the case, it’s important to see your doctor as soon as possible because that PAD-related cramping usually signals significant blockage in an artery. Nutritional deficiency can also cause muscle cramps, lack of magnesium and potassium, for example. As far as general on-the-spot cramp treatment, a gentle stretch of the muscle typically resolves it. A few slow, deep inhales and exhales done during the stretch may further calm down the spasm.

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