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Jul 7 01 3:26 PM
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Jul 7 01 3:27 PM
Jul 9 01 4:31 PM
The clogging and clotting processes discussed above does not only affect the major arteries to the heart or the brain, but literally has effects all over the body. Peripheral circulation, arteries going to the extremities are also highly susceptible to the vasoconstrictor effects of nicotine as well as the increase of clots and clogging risks posed by smoking. Smoking is a primary cause of much of the peripheral vascular disease seen as well as a powerful aggravating factor for people who have other preexisting conditions causing circulation problems to the extremities.
One condition though stands out as being truly unique and in many ways, demonstrates the real addictive nature of nicotine better than any other cause. The condition is known as Buerger's Disease (thromboangiitis obliterans.) Buerger's Disease is a condition where there is a complete cutoff of circulation to the finger or toes, resulting in gangrene.
Once gangrene occurs the only course of action is to amputate the affected area.
The most common age bracket that this disease strikes is in people between the ages of 20 to 40, normally young to get circulation problems that result in amputations. While it is much more common in men, women are affected to. What makes Bueger's Disease unique is that it is a disease that is basically exclusive to smokers. There are almost no documented cases of this disease happening in a non-smoker. Smoking is the primary etiologic factor. This is a rare disease, but noteworthy because of this unique nature of happening only in smokers.
If a smoker gets lung cancer, the person and other people can sometimes think, "well non-smokers sometimes get lung cancer too, maybe cigarettes didn't cause it." Same thing with heart attacks or strokes, non-smokers get them too, smokers just get them much more often. But again a certain level of denial can be exhibited and there is no way to conclusively prove that cigarette did it. But Buerger's Disease, having no other known cause and basically never happening in non-smokers does not lend itself to such denials. When a doctor determines he or she is dealing with a Buerger's Disease patient, a basic ultimatum is going to be delivered-quit smoking or lose your limb-your choice! If we were dealing with simply a bad habit, how many people given such an ultimatum and knowing it is true would continue doing the particular behavior given such consequences?
While Buerger's Disease is much more common in men, I have personally had two women who were Bueger's Disease patients in my clinics. My first actual encounter with a Buerger's Disease patient was with a woman who was 38 year old when I met her, which was about 24 years ago. Three years before I met her, at the age of 35 she was diagnosed with Buerger's Disease. This is actually relatively late to first be diagnosed. Her doctor had told her she had to quit smoking, but she did not comply and within a few months she had her right leg amputated. The circulation in her left leg was also badly affected, and after the hospitalization from the amputation she did quit smoking and had no further circulatory complications for the next three years.
Then one night at a party, a friend offered her a cigarette. She figured that since she had been off cigarettes for so long, she now had control over her habit. If she liked the cigarette, she would smoke one or two a day. If she didn't like the cigarette, she just wouldn't smoke anymore.
Well, she took the cigarette. She didn't particularly like the cigarette, but the next day she was up to her old level of consumption. Four days later she lost circulation in her left leg. She knew the reason. After three years with no problem and only four days after going back to smoking her circulation was affected. Her doctor told her that if she did not quit immediately, she would probably lose her other leg.
This is when I met her. She enrolled in a smoking clinic that week and quit smoking. Almost immediately her circulation improved. The doctor took her off anti-coagulant drugs and vasodilators he had put her on a few weeks earlier to try to slow up the process even though they were highly ineffective at stopping the likelihood of gangrene and amputation. But once she quit smoking she no longer needed them. Soon, her circulation was back to normal.
Nine months later, I called to ask her to serve on a panel. At that time, she sluggishly replied, "I can't come. I have been in the hospital the last two months." When I asked what had happened, she hesitantly replied, "I had my toes amputated." She had gone back to smoking. She tried one because she just couldn't believe she would get hooked again. She was wrong. She lost circulation, had her toes removed and eventually had her leg amputated.
I have had other clinic participants with similar experiences, being told to quit smoking or lose limbs who did not quit smoking. The reason I talk about this particular woman again and again is about a year after she had the second amputation, she came back into a clinic I was conducting and told me she had quit again and was now off about 9 months. I told her I was surprised, I thought she had permanently lost control. After all, she had her leg removed, the toes from her other foot, and eventually her second leg. When I confronted her with that information she replied, "The doctor finally convinced me. He said, 'You might as well keep on smoking, I'll just take your arms off next.'" That scared her into quitting smoking. Her next comment to me was unbelievable. She looked me straight in the face, dead seriously, and said "I DIDN'T NEED A HOUSE TO FALL ON ME TO TELL ME TO QUIT SMOKING."
I had periodic contact for the next 15 years at which time she moved away. She was fine over that whole time period. Whenever I brought up that conversation, we both found ourselves amazed that she could ever have made such an irrational statement. She happened to be a very rational, bright and inspirational individual. She would get around on wooden legs, socializes, and even occasionally would sing and dance on stage. Once she had broken free of the drug's effects and the smoker's psyche, she knew she could do anything.
Frequently, I would encounter people who quit smoking on their own. When I ask how they did it, they tell me of this marvelous lady they met who told of how she used to be hooked on smoking. Hooked so bad, in fact, that she had her legs amputated from a smoking related illness. It usually turns out to be the same person. By spreading her story, she offers inspiration and hope to countless smokers to break the habit before the habit breaks them.
Her story represents the real power of the addiction. She could not deny any where along the way smoking wasn't the cause. Not only would every doctor and all the research she could do pinpoint smoking as what was causing her problem, but she had quit, was fine, relapsed and within days lost her circulation-twice! The second time she actually lost her toes and her foot and then her lower leg. There was absolutely no way she could deny the cause and yet it took another 9 months for her to quit again.
Her continued smoking and ease of relapsing shows nicotine dependency at its worst. This overpowering nature of nicotine should not be lost on anyone here. You probably don't have a condition that is obvious as to force you to make a decision almost immediately upon relapse. In many ways this is worse, for cigarettes are quietly and insidiously destroying you, sometimes with little warning, or at least ones you will acknowledge. The first symptom to many circulatory diseases caused by smoking is sudden death. You may get no second chance.
When you have a quit going, do everything in your power to make it last. Again, you don't know that you will have the desire, strength or worst of all, the opportunity to quit next time. A tragic and fatal disease may get you first. Always consider the full danger of smoking and power of the addiction and your likely choice will be to never take another puff!
Joel
Jul 9 01 4:45 PM
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I was at a meeting yesterday with a few public health professionals planning a teen smoking prevention campaign. I just had the sense that a few of the people just didn't get the full implication of the dangers of smoking. One comment made by the American Cancer representative there was that one in three cancers are caused by smoking and this seemed to surprise some of these people. While this is a staggering statistic, one out of three cancers caused by a product that is only used be one out of four people, it needs to be noted that most people who die from smoking don't even die from cancer from smoking but actually die from heart and circulatory diseases brought on my smoking. To reduce your risk of all these problems--not to mention empysema and the host of other problems caused by smoking--always remember to never take another puff!
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