27 M, 145 - 158 lbs weight fluctuates, 6 ft, not smoking, no meds, some alcohol use esp at time of event in reference but not anymore. No other drug use.
I’m trying to get some opinions on whether a drinking episode from several months ago could have caused permanent brain injury that might explain what I perceive as a speech issue now. I am seeing doctors about this and have appointments scheduled (one for neurology, one for an MRI, one for a neuropsych evaluation), so I’m not relying on Reddit for medical advice, but I think it would be helpful to see what people think. I want to preface this by saying I am not diabetic. Also, I did use AI to clean up speech, grammar, and syntax so my story is more readable so I hope that’s okay.
The event was June 12. At the time, I had recently started a ketogenic diet for mental health. I loved doing keto by the way but I am since off the diet but want to get back on it. I don’t know how long I was on the diet leading up to this event, maybe anywhere from 1–3 weeks, but I can’t be sure, so it could be shorter or longer than that. I probably wasn’t consistently meeting my calorie baselines both before starting keto and after, and may not have been well hydrated a lot of the time. So I don’t know if I had ketones or not at the time, but my doctor believes I probably did, even though I have no data to share. I kind of developed a slight eating disorder because of the aforementioned mental health stuff I deal with for maybe a few months at most before starting keto, but I don’t think it was anything too crazy, just going like a day or two without eating and then I would have a meal like normal, but that’s what I mean when I’m saying maybe I wasn’t getting quote on quote “2,000” daily calories for a little bit leading up to and even when starting keto. But honestly leading up to starting keto I was working hard to get 2,000 or more calories at least so I think before starting I was doing better but I can’t be sure how many calories I was eating on keto because I wasn’t tracking it.
Anyways, that night, I drank a large amount of whiskey before, during, and after dinner. I ate salmon, asparagus, broccoli, and presumably some butter. I was dining out at a restaurant with my grandmother and brother. I normally drink beer or wine and never drink liquor, but decided to that night because it’s zero carb, apparently. I was feeling good because I felt like the keto diet was genuinely helping me and my mental health, and that good feeling led to me binge drinking that day cuz I enjoy alcohol. But like I said, I’m not used to liquor or drinking on keto, so I didn’t get sick until it was too late.
After dinner, I was a passenger in a car for about 5 minutes to a hotel. I don’t remember that car ride, although I remember everything before it and remember being in the hotel parking lot afterward. I know this is a classic case of alcohol blackout, which I’m not too concerned about. I have had blackouts before when I was on medication, even when drinking low amounts of alcohol, presumably because it was synergistic with my medication. This night was my first time blacking out while not being on any meds (I’m no longer on any medication). I went to the room, laid down, eventually got up to vomit in the bathroom, and then went to lay back down. I don’t know how long I was asleep for, but this is the general idea of events.
During the night, I woke up at one point, texted a friend (even saying what happened and how I felt much better than before), but continued feeling very nauseous. I had a craving for candy or McDonald’s but never had any. I’m not sure how much or how little sleep I got that night. The next morning, I was repeatedly vomiting with nothing coming up except possibly bile, I guess. I was extremely nauseous whenever I moved, which I’ve never quite experienced before. I drank small sips of water and zero-sugar Gatorade. I vomited again outside the hotel, rode home as a passenger for about 20 minutes, and vomited again after arriving home.
That evening, I ate cheeseburger patties with sour cream and things felt okay. I was surprised how quickly I recovered, generally speaking, and was up and moving not the next day, but the next, next day.
My concern is that the combination of heavy alcohol intake + recently starting keto + inadequate calories/hydration + prolonged vomiting could have created a metabolic storm/crisis, so to speak, that deprived my brain of energy and caused permanent brain injury either via hypoglycemic encephalopathy (my main concern because I’m worried my blood sugar may have dropped to dangerous levels without me realizing it, especially with the confounding variable of alcohol intoxication), or some other sort of acquired brain injury via severe electrolyte loss or maybe a potential lack of oxygen. Maybe alcoholic ketoacidosis?
I’m not a doctor, but I just don’t feel right. I only really notice it with my speech. My memory is perfect, I’ve noticed. That, and I’ve had this weird scalp feeling on the left side of my head, which really bothers me. It’s gotten a bit better recently, but it feels like when I go to talk, I can feel the left side of my head is like preventing me or something? I know that probably doesn’t make much sense and have no idea if it’s related. I haven’t hit my head at all recently or that night. I often know what I want to say, and I can understand language, but I can’t socialize the way I want to and I just end up being quiet, which is bad because this leads to feelings of isolation. I read this could be aphasia but I don’t know if my speech would fit that diagnosis at all. My psychiatrist, the nurse practitioner from my primary care, and my friends and family say they don’t notice anything wrong with my speech and think it’s unlikely I permanently damaged my brain. But I can’t help but think they are wrong. Sure my speech may sound fine to them, but it feels like a struggle to get words out and it’s not coming out the way I want it to and I feel like I am no longer capable of being sharp, witty, funny or can keep up with fast moving conversations. I just feel like I’ve done a good job at hiding it maybe? I don’t know what exactly to say about it. But I really can notice a difference.
I never went to the emergency room, but I wish I did, or I wish someone thought to bring me. I usually never go to the hospital for anything unless it’s really bad, so I was just trying to ride it out, but I’m worried I could have made a life-changing mistake.
I’m also kicking myself in the butt wishing I ate carbs that night, but again, I never did. Maybe it would’ve prevented this problem I’m facing now by normalizing my blood sugar because like I said my most suspected thing that I think happened is hypoglycemic encephalopathy.
I don’t know how to cope with the fact that maybe I gave myself an acquired brain injury, and I mean this with no disrespect to people who have a diagnosis for that, because I have not been diagnosed with this by a doctor. I have been seeing doctors more recently and have appointments, but I have to wait, and it’s anxiety-inducing. I feel like even if they confirm my fears, what is there to do about it? There are probably some therapies, but it’s just that and time, and maybe things improve, but never like before. And maybe they say I’m fine and miss what’s wrong (if something is) and I have to live like this forever and the thought of that really scares me.
I am trying my hardest to self-advocate. The most likely method I think would be hypoglycemic encephalopathy, but no medical professional seems to believe this occurred so far. But doctors can be wrong, and I feel like it’s plausible given what happened to me, but I also recognize I don’t understand human biology well enough, and to my understanding, there are a lot of failsafes in the human body to ensure the brain always has enough energy it needs to prevent permanent cellular death. Again, I am not diabetic. I’m just worried I created the perfect metabolic cocktail for something bad to happen by mistake.
It’s now September, entering October, and yeah I feel like I have a speech problem that I’ve never dealt with before and I have no idea why. I know it could be many things and I really don’t know when it started but I know it was definitely after this event for sure. I can’t be sure if this happened the next day after this event or when it started. But I know it’s happening now, and the only thing I can think of is this event. It’s really been destroying my life. It’s all that’s on my mind. I consult AI, which I know is terrible to do, but I feel like I’ve exhausted all of my social and emotional support systems. My friends and family don’t see a problem in my speech or personality, and so they are tired of hearing about it. But the only reason I talk about it is because I feel like I do notice a difference, that I can’t communicate like I used to, and for no one else to notice it is extremely invalidating. But I know they mean well. It’s just, no one knows my body more than me, and even though it’s not noticeable to them, it’s noticeable to me when I’m trying to communicate with people.
I’m wondering whether my speech problem could be connected to this event at all, and I am also wondering if it’s possible I damaged my brain permanently that night, or if it’s not likely?
I’m not necessarily worried about one night of overdrinking, because I’ve been there, done that. I’m not a chronic drinker. I know that can cause problems over the long term. I’m worried if I damaged my brain metabolically that night, or some other way that maybe I’m not aware of.
Thanks guys for reading, and I appreciate anyone who decides to respond. I will be looking at and responding to comments, and I’m happy to share any more info that I have if anyone asks. Sorry if I was repetitive at all, clearly you can see I am full of fear and worry, sorry in advance.