Monday, October 10, 2011

Smoking is a Lifestyle

Nursing Pajamas



I remember growing up watching television and thinking how cool the actors were who smoked. From James Dean to Dean Martin, I thought the coolness they endeared was personified by the cigarette hanging out of their mouth. I can still picture the poster of James Dean leaning against the hot rod, smoking his cigarette.



Nursing Pajamas

A lot of that still goes on today, I imagine. The youth see prominent role models drinking alcohol or smoking a cigarette and think the same things I thought when I was their age. They begin to experiment with these items, casually at first, then with purpose second. I suppose they begin to believe that they too are now becoming like their heroes. They are living out what they see and enjoying it immensely.

The lifestyle of someone who is young, living on the edge and rebelling against what they know is not in their best interest. But hey, they're young. They have their whole life ahead of them. So if you ask them about their lifestyle as a young adult, they'll likely respond with an affirmation, "life is good". Now lets speed up the clock a little bit and see what their lifestyle looks like in 40 years. Now they are in their sixties and have smoked for 30 or 40 years.

A new study examined the effects of middle aged smoking on long term risk of impaired activities of daily living (ADL). Lets first define ADL - these are things we do everyday, like bathing, brushing our teeth, urinating/having a bowel movement in the toilet, combing your hair, etc. Most of us think we'll be doing that without any problems well into 80's. Then we hope to have a cute, young nurse change our Depends. The study looked at 2,200 people in 1980, then again in 1999. They found that smokers had a much higher risk for impairment of ADLs. This means it was harder for them to do the simple things of just existing. The odds ratio (risk) was even higher for those who smoked greater than 20 cigarettes per day.

That's the problem with smoking. When you're young and invincible, smoking only creates silent changes in your body. But the repeated affect of smoking every day for years on end, transform these previously unknown physiological changes into a stark ubiquitous reality. Breathing becomes labored, chest pains are present, infections simply come in waves, and you get on a first name basis with your emergency room charge nurse. Sure, some people are physiologically wired to be less affected by smoking, but as a general rule of statistics and experience, smoking does not improve your lifestyle as you age.

Imagine for a moment that you are 62 years old. You wake up at 4:00 am to take a breathing treatment. You go back to bed where you can only sleep with 2-3 pillows stacked up, otherwise you can't breathe. You turn up the oxygen concentrator located by your bed because you're a little more short of breath than usual. Eventually you doze off, only to awaken 3 hours later feeling very anxious. You use your inhaler which you keep in your bedside drawer. You reach over to your walker and move toward the bathroom. Half way there, you sit back down to catch your breath. A few minutes later, you get back up and use the facilities. You return to your bed where you take another puff from your inhaler. You decide that you'll just keep your pajamas on because you don't feel like getting dressed today. Now you go into the kitchen to get your coffee. When you arrive ten minutes later, you pour a cup and start to feel a little bit better. You call your spouse over and ask them to get your nebulizer and meds from the kitchen counter.

It's too difficult to go back to the bathroom to brush your teeth and shower, so you move over to the easy chair and sit down. You ask your spouse to move the oxygen tubing so it doesn't get caught under the easy chair when you recline. Next, you read the newspaper, comb your hair and think about what you'll do today. After talking it over, you call your grandkids up (if they're in town) and ask them to come over for a visit. It is simply too hard for you to make it over to their place. Plus, they haven't made the front door wheelchair accessible yet. But they did get an oxygen tank delivered to their house, so they'll be ready for you when the ramp gets built.

Now, it's time for another breathing treatment, except you need a new box of facial tissue, because you used up the last box in the morning. The decision is made to get a second tissue box to save time tomorrow, when you'll be finished with this one. The rest of your day is spent reading, watching t.v., doing crossword puzzles or whatever other activity you've decided to "enjoy" during your retirement.

Lets skip to nighttime. Since you've still got your pajamas on, all you have to do is brush your teeth, take your pills and inhale on your last breathing treatment. Finally, you collapse in bed after a stressful and physically challenging day. While you lay their on your 3 pillows trying to get comfortable, you think about how you idolized James Dean. It's then you wish you could go back to that 24 year old kid and tell him that smoking was not worth it.

Smoking is a Lifestyle
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