Cigarette Smoke Is More Than Skin Deep
Cigarette Smoke Is More Than Skin Deep
A pregnant woman waddles across the parking lot, balancing
her soon-to-be-born child while causally puffing on an extra long cigarette. In
an off moment my eyes wander outside. Two senior citizens are making their way
to their car. Each is supported by a crutch or two. Their movements are labored
yet both are able to balance while lighting a cigarette. Handicapped sit in
wheel chairs bound by the unresponsiveness of their extremities but unbridled
by their passion to smoke. Parents put their young children in car seats while
exhaling a silver grey cloud over them. Adolescents congregate outside of the
local theatre chatting and brandishing their tobacco weapons. Our patients
report chest pain, difficulty breathing, wounds that fail to heal, sorrowful
complexions, lines about their faces, breath that is stagnant with teeth to
match and yet are still passionate about their tobacco brands.
We know intuitively that cigarette smoking imparts
irreparable damage. Toxins that spew out of the lit end promote death not
health. Oxygen no longer bathes the nascent human cell and, worse yet, is
replaced by carbon monoxide, the very antithesis of well-being. Forget about
the cigarettes: save money! Just pucker up to your exhaust pipe. Each cigarette
causes vasoconstriction for up to 12 hours, diminishing blood flow, life
sustaining oxygen and nutrients, the very essence of what we need to mend our
wounds. These vital substances are replaced by over 40 known carcinogens and toxins
that most assuredly will be the ruin of skillful surgery; yet we question the
responsibility of asking our patients to totally suspend cigarette smoking.
The goal is to promote a salubrious lifestyle through
counseling and surgery. Why allow our patients to continue smoking? Endeavor to
assist your patients in discontinuing cigarette smoking in the perioperative
period. This window of opportunity for a breeze of clean air to fill their
lungs is 2-4 weeks before and after surgery. Rather than downsize an operation
by offering less than optimal maneuvers, surgery may be deferred or postponed
for up to six months, especially when dealing with a facelift or similar
procedure that would be potentially jeopardized. The damage that cigarette
smoking has reaped is permanent; however, we can minimize the extraordinary
risks of combining surgery and smoking by unabashedly insisting on restraint.
There can be no financial incentive high enough to risk an
unwanted surgical outcome and the accompanying disgruntled patient that must
live with this untoward conclusion. Not to mention the albatross that will
swing from your neck until the crisis is resolved to everyone's satisfaction.
Difficult as it may appear to dissuade your patients from
smoking, it is the easiest and safest path to follow. Of course, this does
require additional time to inform your patients of the harm that smoking will
cause and carries the attendant risk of losing these individuals to another
physician who has comprised standards of care. The misguided impression that
even 1 cigarette is acceptable will transfigure the most adept sleight of hand
magic into a ghastly headstone memorial.
Our power to motivate these individuals should not be
dismissed lightly. We can offer them the initial impetus through our guidance,
concern and knowledge. This not only informs them of the dangers of smoking but
also allows them to partake in the decision-making and healing process. Some of
your patients may bridle at the thought of restricting their choice but most understand
that optimal results require a healthy individual.
If our first obligation is to practice exemplary medicine
then purveying this message is of the highest priority. I look foreword to the
day that signals the end of this scourge and the beginning of a brighter and
most assuredly healthier time.
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