Arithmetic for Beer Drinkers: The Average Beer is 4.8% Alcohol. What if you drink strong beer, wine, etc? By J.D. (Joffre) Meyer

I am writing this beer consumption article because it seems easy to underestimate the actual number of beers that you have consumed. In other words, do you favor alcoholic beverages that go beyond the 4.8% average? Maybe you’re a fiscal conservative, who wants a cheap buzz? Usually, I walk a block to Speedy’s at the NE corner of E. Front ST & S. Beckham AV in Midtown (Hospital District) Tyler, Texas. Speedy’s is also a gas station. This article focuses on drinks in my neighborhood.

My Choices at Speedy’s
Let’s start with my favorite strong, very cheap beer: Milwaukee’s Best Ice ($1.79). This quart comes in a fat can–blue and black with white letters, together with red and gold trim. Milwaukee’s Best Ice is 6.9% alcohol, meaning you really drank 46 ounces–closer to 4 beers than a quart.

How about a Bud Light-a-Rita ($2.69)? They come in a variety of exciting flavors—such as mango, lime, lemon, grape, strawberry, cranberry, apple, watermelon, peach, etc. The 24 ounce slender can is 8% alcohol, meaning you just slammed a 40-ouncer!

The Gold 4Loco ($2.69) tips the scales at 14%, the second strongest beverage you can buy at a take-out store in Damp Tyler, Texas. A 23.5 ounce can is more like 68.54 ounces of standard beer. I like mixing it with low-fat milk, horchata powder (Mexican rice milk powder with cinnamon), and water. I call it a Damp Eggnog! If it’s half-&-half, I’m still drinking a 40-ouncer.

The Schlitz Gold Bull ($1.89) arrives in a 24 ounce can that is 8.5% alcohol—roughly 1 ¾ times stronger than regular beer. So you really drank 42.5 oz of conventional beer. It’s stronger than the original Schlitz Malt Liquor. The original Schlitz with the brown label was my favorite regular beer; unfortunately, it seems to be rare, unless you leave town for a liquor store.

Once I got adventuresome and bought a Bud Light Platinum ($2.69)–a 25 oz. beer in a silver can. Don’t let that word, “Light,” fool you. It’s really 6% alcohol, or 1 ¼ beers. So 25 ounces is really the equivalent of 31 ¼ ounces.

Most Ice beers range from 5.5% alcohol (Bud Ice) to 5.9% (Keystone Ice). I’ll let you do the arithmetic this time; just divide the beer in question by 4.8 & multiply by the ounces per can. You’ll get less than a 1/4 extra beer per 12 oz. serving in both cases.

My Picks at Family Dollar
Steel Reserve ($2.35) combines size–42 oz–with strength: 8.1%. This big, plastic bottle condenses a staggering 70 7/8 oz of conventional beer—nearly a 6-pack! A new blue disk on the label tells you if your beer is cold enough, based on how blue the cold sensor gets. I buy Steel Reserve at the Family Dollar on the NW corner of E. Front ST & S. Beckham AV–across the street from Speedy’s.

Let’s say I’m wheezing. I’m going to buy red wine because there are no bubbles like beer; plus, you get glutathione, a natural anti-inflammatory for those eggshell lungs. Liberty Creek Sweet Red ($6.49) is 8% alcohol in a 1.5 liter bottle. So that’s like drinking 83 1/3 ounces of standard beer.

My Choice at CVS Pharmacy
I go to CVS Pharmacy for asthma & COPD medicine: Advair, Combivent inhaler, & Dalisresp pills–as well as CoQ10, Red Wheat Rice, macular degeneration capsules, & Montelukast-an allergy pill at the corner of S. Broadway AV. & 5th ST in the Bergfeld Shopping Center—home of the 2nd Tyler Transit hub. I buy a bottle of Grape & Vine Sweet Red ($3.60), a 12% alcohol wine in a ¾ liter bottle. Once again, I avoid carbonation in beer and acquire glutathione. That’s like an even 2 ½ beers per drink, so it’s really like having 1 ½ liters of regular beer.

Miscellaneous
Wild Irish Rose is Tyler’s strongest takeout drink at 17% alcohol! Among other stores, you can find it at D&N in North Tyler near W. Gentry & Palace–next door to Neighborhood Services. Who could forget MD 20-20, aka. “Mad Dog 20-20?” This 13% alcohol, 3/4 liter wine comes in a wide variety of flavors, even Dragon Fruit & Habanero Lime-a-Rita. Alas, we can’t buy it around here either.

Conclusion
In conclusion, a beer needs to be over 6.5% to be particularly strong. So with standard Ice beers, you can have the full flavor without a severe alcohol level. Beware when your beverage is in the 8% alcohol level and over. Enjoy the flavor! Seek variety and save money.

“Asthma-COPD Overlap Syndrome (ACOS),” Footnotes & a Commentary from a Patient (6th Edition), by J.D. Meyer

 

“Asthma-COPD Overlap Syndrome (ACOS): A diagnostic challenge,” was a Top 100 WebxMD article for 2015. http://onlinelibrary.wiley.com/doi/10.1111/resp.12653/full It caught my attention because I’ve had this condition for ten years; however, I never heard the two described as a unit in this manner! Three symptoms stood out on my first reading: increased sputum, more dyspnea (breathlessness), but better response to inhaled corticosteroids. At once, I told all my local health connections about ACOS. This article was written by three doctors in the Far East: Vietnam, Korea, and Japan. “Tho, N. V., Park, H. Y. and Nakano, Y. (2015), Asthma–COPD overlap syndrome (ACOS): A diagnostic challenge. Respirology. doi: 10.1111/resp.12653.”

Furthermore, a Google search for ACOS yielded nothing unless I entered the complete term. So the breakthroughs didn’t happen around here—adding to this disabled Developmental English/Writing—ESOL teacher’s sense of urgency!

Definition of Terms

I printed this article and started highlighting and making notes. Fortunately for me, many of these technical terms corresponded to familiar brand names for my many ACOS drugs. Symbicort is a Long-Acting Beta2-Agonist (LABA) and an Inhaled Corticosteroid (ICS). A LABA is a long-term brochodilator while an ICS decreases inflammation. Rinse your mouth with water after each use, and don’t swallow the water; spit it out. I was switched back to Advair (another LABA +ICS drug), which has bee my usual inhaled corticosteroid. Both drugs are used for asthma &COPD. A Muscarinic Antagonist is also a bronchodilator, such as tiotropium (Spiriva) and aclidinium.

Spiriva, an inhaled capsule, is used for COPD, including emphysema and chronic bronchitis. Later, I was switched to Montelukast, the pill version of this drug.

There is only one PDE4 inhibitor—Daliresp (roflumilast), and it works against excess bronchitis and phlegm. Daliresp decreases the number of exacerbations in severe COPD, and it’s not a bronchodilator. Daliresp decreases lung inflammation and prevents COPD flare-ups. Don’t use Symbicort, Spiriva, or Daliresp for an acute attack.

For an acute attack, use your “inhaler,” such as ProAir and Proventil; they’re examples of Short-Acting Beta2-Agonists (SABA); both are albuterol. Proair will open the airways and prevent a bronchospasm. You could go for your nebulizer for an acute attack, especially a bad attack. Our albuterol vials for the nebulizer could be called an”extra-strength” SABA. Iprat-Albut (Albuterol & Ipratropium) are two bronchodilators for the COPD patients’ nebulizer. For two decades, I was on pure Albuterol for my nebulizer. Now my inhaler is Combivent–a stronger ipratropium-albuterol inhaler.

Atopic is an allergic reaction, often hereditary. Atopy is a feature of ACOS and associated with a higher prevalence of chronic cough and sputum production, according to Tho, Park, and Nakano. Eosinophilic airway inflammation means there’s a higher than average number of white blood cells. It can be detected in mucus if it’s tissue eosinophilia. Tho, Park, and Nakano note that ACOS patients have higher sputum eosinophil counts than those with COPD alone, but sputum count profiles may change over time. Blood eosinophilia is over 500 in a microliter of blood. I found these definitions at Medicine Net and the Mayo Clinic websites too.  Much of the drug definitions came from the pharmacy’s medicine sheets themselves.

Economic Burden & Disability

Tho, Park, & Nakano note that the percentage of ACOS patients visiting the ER or admitted to hospitals is significantly higher than COPD alone in South Korea. A United States Medicaid population reports that ACOS patients have a higher rate of utilizing any service versus asthma or COPD alone. Moreover, the average annual medical cost for an ACOS patient in the US is $14, 914–much higher than asthma, $2307 or COPD,  $4879. ACOS is common in the elderly. It features more dyspnea (breathlessness), wheezing, and more frequent exacerbations. The respiratory quality of life and amount of physical activity for those with COPD alone.

Addendum to Tho, Park, & Nakano

Using my peak flow meter to check my forced exhale volume (FEV) always has been one of my strong points in managing my ACOS. I check my peak flow meter before I go for a walk, and if I’m under my usual low moderate level of impairment, I head for the albuterol nebulizer. Check my article https://www.newscastic.com/news/forced-exhale-volume-fev-lung-disease-your-peak-flow-meter-1155949/ The “whole story” includes a link to an About.com article on Pulmonary Function tests, by Deborah Leader, RN, COPD Expert.

Returning to the Tho, Park, and Nakano article, we see that a staggering 49% of smokers develop chronic bronchitis and 24% get emphysema or COPD. “Smoker’s cough” is worst upon arising. Dyspnea increases as the disease worsens. Quit smoking or else!

Guaifenesin (Mucinex) has been one of my favorite OTC medicines for years because it’s an expectorant. You can find a cheaper generic version in the dollar store too. Warn the doctor if you smoke, or have asthma or emphysema. It thins the mucus, so it’s less sticky and easier to cough up, according to www.drugs.com/mucinex.html  Take guaifenesin when you have a cold, bronchitis, flu, or allergies–whatever got your chest full of phlegm. Still drink plenty of fluids. www.webmd.com/drugs/2/drug-63818/mucinex-oral/details I’ve been told by my doctor to take a larger than average dose of guaifenesin during an ACOS attack.

I also take an over-the-counter allergy pill, for I’m allergic to Bermuda and Johnson grass. My choice is non-drowsy Loratadine Tablets, an antihistamine that’s another find at Family Dollar. Loratadine is a generic form of Claritin.

Beware of drinks with carbon dioxide (CO2) also, such as beer and soda. http://respiratorytherapycave.blogspot.com/2008/06/asthmacopders-should-avoid-pop-beer.html The ability to exhale carbon dioxide is vastly impaired for the bad lung crowd. “The normal human body breathes to eliminate CO2, producing 200 cc./minute. However, one can of soda has up to 1000 cc. of dissolved CO2. Most is absorbed by into the blood stream by the intestines.” This can lead to more dyspnea (breathlessness) in those with lung disease. Furthermore, beer can cause dehydration too–another cause of dyspnea. Maybe gas pills help; time will tell.

On the other hand, if you like alcoholic drinks and wish to be more careful, then try red wine. First of all, you won’t have to worry about bubbles. Red wine increases antioxidant status and decreases oxidative stress in circulation, mainly because of glutathione (GSH). The “French Paradox” is explained by their love of red wine lessening coronary heart disease despite a fatty diet. https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-6-27

In closing, there’s a rich amount of literature on asthma, bronchitis, and COPD. Learn to manage your illness before you continue to deteriorate, and get a pulmonologist if you don’t have one already.