Smoking and Circulation

While most people equate smoking deaths to cancer and lung disease, in fact many more people will die from circulatory conditions from smoking than die from cancer or other lung diseases. Also, in general, they will die at much younger ages from these problems. We would have many more lung cancers than we do if smokers could live long enough to get them. When many people with fatal heart attacks or strokes are autopsied, there are often precancerous lesions found that indicate that if these people had a few more years to live they would have eventually succumbed to these smoking induced diseases.

As for heart and other circulatory diseases, the two chemicals in cigarettes that stand out as the biggest problems are nicotine and carbon monoxide. Nicotine, besides being addictive, has very powerful effects on arteries throughout the body. Nicotine is a stimulant, speeding up the heart by about 20 beats per minute with every cigarette, it raises blood pressure, is a vasoconstrictor – which means it makes arteries all over the body become smaller making it harder for the heart to pump through the constricted arteries – and it causes the body to release its stores of fat and cholesterol into the blood.

The heart has to work harder to overcome all of these effects. To work harder the heart, like every other muscle in the body, needs extra amounts of oxygen for the additional workload. The oxygen has to be transported through the blood. But carbon monoxide from tobacco smoke literally poisons the oxygen carrying capacity of the blood. So this results in the heart having to work harder to get more blood to itself to work harder, because it’s working harder. This is a circle. A vicious and deadly circle when it comes down to it.

Cigarette smoking increases risks of blood clots significantly. If the blood clots in an artery and blood can no longer get through, the tissue that is supposed to be supplied with blood has lost the source of its oxygen and nutrients and dies in minutes. But clots are not the only way these arteries can be blocked. Another way is by clogs.
The clogging and clotting effects of nicotine and carbon monoxide are the primary reasons why smokers are at such a higher risk of this condition. But this clogging/clotting effect is not limited to just major organs like the heart or brain. These chemicals affect arteries throughout the entire body. These affects may not be as deadly as cutting off circulation to the heart or brain, but in a real way they can show the true potential of the grip of the nicotine addiction.

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.
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 dependency. 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.”

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 addiction before the addiction breaks them.

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.

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.

Once you have a quit smoking, do everything in your power to make it last. 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!

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