PUFF PUFF. The struggle is real.
Smoking.
It negatively affects every aspect of one’s health.
It pretty much keeps us in business.
I am one of those doctors that constantly pesters patients to quit.
Every visit, every email, every chance I get.
Does it make any difference? Maybe. Hopefully.
A few patients have quit and gotten healthier.
BUT ~ many haven’t …
For those few who can’t seem to shake the bad habit, they know I will never stop asking. Never.
Often our conversations are light hearted, but pithy.
Here are a few of my recent interactions with patients.
Patient #1
60y M with HTN LIPIDs and PVD
member for 9 years ( at initial visit, said he’d see us once and drop out )
DOC: Hi. Did you finally come in for your check up?
PT: No. My wife told me to come in and pick up my meds.
DOC: Do you want to at least get those labs done today?
PT: No just picking up meds.
DOC: You feeling ok?
PT: Yeah. Sometimes my legs hurt.
DOC: Have you stopped smoking?
PT: Dr. Amy, smoking is keeping me alive.
It’s all those meds that are going to kill me .
DOC: Tell you wife I said hello and that I “suggested” you STOP SMOKING.
PT: Rolls his eyes. Waves good bye w a smirk while holding a pack of smokes.
Patient #2
53y F with COPD, GERD and neck pain
member for 8 years
PT: Dr Amy, I tested + for covid this past weekend. Was seen at UCC while out of town.
Its horrible. The cough will not stop. It’s painful.
DOC: Yes, we have seen a lot of this: respiratory infection w a cough that seems to be quite bothersome and lingers 2-3+ weeks.
PT: Oh dear Lord. I would rather have the flu again. I haven’t smoked since last Wed because I can’t inhale.
DOC: Did you really just say that to your doctor?
YOU SHOULDN’T SMOKE AT ALL.
That is exactly WHY it is worse, my friend.
PT: I know. I am a slow learner.
Patient #3
50y M with CAD s/p MI, HTN, LIIPDS And RA member for 9 years
PT: Dr Walsh, I need refill of my Rx.
DOC: Sure, but just letting you know we switched brands.
It’s a bit more expensive, but I think this one is better for you.
PT: I’ll do whatever you recommend.
DOC: Hey, I recommend you STOP SMOKING !
PT: D—-! You got me.
Patient #4.
67y M w severe COPD & multiple exacerbations
No conversation.
I just gave him a Rx with instructions.
I hope all of these patients quit.
Chances are they wont.
But I’ll keep trying.
Thank you for sharing.
I had a patient in the ER with chest pain and worried about a heart attack. She said she can’t quit so I gave her my best story.
I took care of a gentleman from ages 60-75. By the time I met him he had several strokes and heart attacks with CABG, stents and carotid endarterectomy as well as multiple revascularization procedures on both legs. He was a 2 pack a day smoker since joining the military as a teenager. I would frequently bring up the topic but not spend too much time on it. One day he came in and proudly told me that he had quit smoking and it was easy. After falling off my chair, I asked the reason is was easy. He said the Orthopedic vascular surgeon told him that he would cut his leg off the next time he asked for revascularization due to pain.
He quit smoking. Two months later he had an amputation and died 3 months later. He is a great story that when one comes up with the right reason, it can be done. I think he left a great story and legacy for his children and grandchildren that grandpa did something no one thought he could do! He also gave me a great story to share. I would like to think my kind badgering helped but will never know.