From two packs a day to zero; is it possible?




It was William’s 72nd birthday and the day of his routine annual physical checkup. Considering his many years of dancing with most of life’s demons, he was determined to be in relatively good health – that is except for moderate COPD from 60 years of smoking sometimes two packs of cigarettes a day.

“I did find a suspicious area on your lung X-ray we need to investigate further. It may be nothing, but we need to know for sure,” his family doctor said.

He was referred to a pulmonary specialist who, using PET/CT scans, determined William indeed had lung cancer. The specialist had difficulty finding a surgeon with the skill and knowledge required to operate on such a high-risk patient.

It was not an easy row to hoe, but William survived the operation and is now on his way to full recovery. Moreover, he has been smoke-free for more than five months.

This is a true story; only the name “William” is fictitious. The surgeon’s name is Dr. Parvez Sultan, who is affiliated with Cardiothoracic Surgeons, P. C. in Birmingham. He was the guest speaker at the March meeting of the Blount County COPD support group.

Dr. Sultan explained his role as a cardiothoracic surgeon means he performs both heart and lung surgeries. He pioneered a procedure called video assisted thoracic surgery (VATS). This procedure allows the surgeon to operate through a much smaller incision, which allows faster recovery with less pain.

Before the inception of VATS, it was necessary for surgeons to make an incision almost halfway around the patient’s body to allow full visual access to the chest cavity. Using the VATS procedure requires a small incision for video access, two pencil-sized incisions for drain tubes, and a five- to six-inch incision through which the lobe is removed. Sultan said he is the only surgeon in Alabama who uses this procedure.

He said, “I see patients every day with heart, lung, or vascular disease. Unfortunately, people who smoke may get any or all of these problems.”

One group member asked, “Since smoking is probably the hardest addiction to deal with, and is what brought many of us here today, and we know great strides are being made in treatment of COPD and related illnesses, what is the medical community doing to help smokers to break the habit, or prevent others from starting it?”

“We are working on it,” Sultan said. “But one thing I have learned is that we are way behind in Alabama in teaching our kids. We have to start early (teaching them) about smoking cessation.

“My father died at an early age from smoking. If he had stopped, he would be here to watch my children grow, but instead, he robbed them of knowing their grandfather.

“As a member of the American Pulmonary Association, I and a group of other doctors take literature from the association and try to go into schools to promote smoking cessation. In many cases, we have difficulty getting permission to go into the schools. Unfortunately, the bureaucracy is still there and we have to fight because they don’t see the end product. As a group we have to do a lot more.”

One member pointed out that tobacco company advertisement is targeting our youth. “The older generation is either wiser or already hooked. They know youngsters are more gullible,” he said.

Sultan urged everyone who currently smokes or has ever been a smoker to get regular lung X-ray check-ups. “I yell everyday at insurance companies who are reluctant to pay for X-rays and CAT scans. You work hard to pay for your insurance, so why can’t you get what you pay for? I don’t understand that. I came from India to this country. I think this the greatest country in the world and everyone should have access to medical care.”

Smoking cessation aids

Quitting smoking seems so simple to those who have never been addicted to it. “Just stop doing it. What is so hard about that?” they ask.

Some physicians say it is such a hard habit to break because nicotine is, in some ways, an excellent nerve medicine. A few have even said it is a form of selfinduced mental illness. Whatever the reason, William can tell you the first few months border on mental torture.

His formula has been:

•Have a personal reason to quit. It cannot be because someone has told you to quit. It has to be your own idea and for your own benefit.

•Talk to your family doctor about prescribing cessation aids. Most people can tolerate one mg. doses of Chantix if the manufacturer’s directions are followed.

•Remove all tobacco products from your home, car, and workplace.

•Join a support group such as the Blount County COPD Support Group.

•Do not beat yourself up if you “backslide” occasionally. Dust yourself off and start over.

It is important to realize you are unlikely to quit completely the first time you try. It is common for smokers who quit and then start again to lose their self-esteem. They may think, “I am one of those who just can’t do it. I am not strong enough.” Our society of non-smokers is very quick to look at people who smoke as secondclass, ignorant weaklings. You are none of those. You are one who unknowingly made a choice that is very hard to back out of.

Your local support group meets every month to reassure its members that help is available. Group president Phyllis Downing urges everyone interested in what the group is doing to call her at (205) 274-9184.