Saturday, June 28, 2014


   When I see patients, who are either smokers, or alcoholic or are obese, I try to tell them the health hazards of all of these. Everyone knows that smoking is bad for the lungs. But not many people are aware of the facts that  the chance of  cancer of every organ is higher in smokers than in nonsmokers. Be it a cancer of lung , throat, breast , prostate or esophagus or stomach and many others.The smoking also increases the chance of stroke , heart attach , and many circulation issues and need for amputation due to gangrene.But in spite of all the information that I give , people still smoke . This is due to number of reasons . Smoking is highly addictive and also many patients 'enjoy' it. Many patients do try to quit and are successful. But at times it is too late. The story that I am going to tell you is one such , but not what you may be thinking of.
     I saw this patient who was 55 years old and was seen by me for shortness of the breath. He was a smoker and also used to drink significant amount of the alcohol. He was also obese. He had history suggestive of sleep apnea. So I did the breathing. I did show that he had some damage to the lung related to smoking and so I put him on medicines for the CO PD. I also told him to quit smoking.The chest X-ray was OK . I also told him to reduce or quit drinking too much alcohol. We also ordered a sleep study It showed that he had severe sleep apnea and so he was put on a CPAP, pressurize mask to help sleep apnea and improve oxygenation.He was also told him to do exercise and loose weight.
      I saw him on follow up. He continued to smoke , continued to drink and had not lost any weight.He had tried to use the CPAP but did not like it.So was not using it . I gave him my 'serman'. Told him to quit smoking, and drinking.and told him the advantages of using the CPAP.I saw him several times and the story did not change . Then one of these days he missed his appointment and then rescheduled it . So when I saw him , it was almost 6 months , since my last visit. I was pleasantly surprised.He looked better. He had lost 40 lbs. quit smoking and drinking and was 'reborn'christen .I was very happy . I asked him as to what had happened that he turned his life around.He told me that he had started going to church and had met a lady and now planning to get married to her . He had retired and was planning to move to cost.
   I saw him one more time after that. He was moving out of town and wanted to get records ,so he can take them to new doctors . He had further lost some weight , about 25 lbs and was feeling better . I told him that he may need new sleep study if he continues to loose weight.
   I met his wife , I had seen her with his previous follow up. But now they were married.I gave him copies of some of his tests and told him that if he needed something else he or his new doctor can call our office and we will fax them to him .
    I got a call from a physician that I had not known or heard before . He was working in a hospital 50 miles from my office and he had some questions about this patient. He was hospitalized there in Intensive Care Unit.As I asked some questions ,I came to know more. He owned a boat , a small one that he took for fishing.When he went out once , he lost his balance and fell down , and broke his neck and dot paralysed neck bellow . So he was admitted to ICU and was on respirator . Had not much chance of recovering from the paralysis and get off the respirator.I told him as much as could , but I was left with very bad taste in mouth . Here was Guy , who had after several years of abusing his body with smoking , drinking and eating,(yes eating too much is as bad as any other wicc) , had improved and was following my advice ,and now was at the end of life or at least good life.So unfortunately as it turned out it was too little or too late.

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