thoughts on quitting smoking

i had to quit smoking after my heart attack a few years ago and i can offer some advice…

quick background: i loved to smoke. when i quit i was hovering around a pack and a half a day. If i didn’t have a full time job keeping me inside it would have been 2 packs no prob. I was dealing with stress, depression, anxiety and uncertainty about my future at my job, life with my girlfriend and my parents dealing with serious health issues. Smoking was a way i could escape all that, in some small way, for a few minutes. I take xanax from time to time and as wonderful as that chemical is, it’s nothing like the quick, nerve calming hit of nicotine as you take your first drag…even typing this is making me really want one. (and i still live with a smoker…makes everyday its own little struggle). I toyed around constantly with the idea of quitting because i wasn’t naive to the horrible effects of a lifetime of smoking but could never bring myself to it. Hindsight being 20/20, it was going to take something major to get me to quit.

that out of the way, on we go…

First: really think about your ‘triggers’ – when do you want to smoke the most? when are the times or situations where you tend to smoke? Figuring out what those are can be very helpful in helping to curb the habit portion of the addiction. Mine were driving, sitting at the computer at home, talking on the phone, 10min breaks at work, after meals…these are the times when i was almost sure to be smoking. Kaiser sent me a Smoking Cessation Coach to my room while i was still in the hospital to talk about smoking and i was surprised down the road how just being aware of when you know you want to smoke will get your mind in a place where it can start fighting and you can go for your snack/distraction.

the chemicals will be out of your system in a few days and i can’t really speak about the uncomfortableness of that situation because i was still in the hospital and had other stuff/chemicals to occupy my mind. The real fight is going to be the next few months.

and there’s no way to sugar coat it: the first 1-3 months will suck ass but the first few weeks are critical.

You HAVE to be strong. This is why Day 1 or the day before you quit, wash anything that might smell like smoke (especially drapes, bed coverings, pillows) and toss out all your smoking accessories (ashtrays, lighters, etc). Go to the store and get a few diff kinds of hard candy and suckers. Gum too. I like candy more than gum but gum can be easier sometimes. I liked Blow Pops (or the ‘gourmet suckers’ from Save Mart), Wurthers Originals, cherry jolly ranchers. you get the idea – hard candy – not something thats going to melt away right away.

Keeping your mind off the addiction or at least distract from it for a bit is ABSOLUTELY CRUCIAL. Even after the nicotine is out of your system those receptors in your brain are going to keep screaming for the chemical. Your body has been smoking for so long it’s not even something you think about…you just light up when you’re body says ‘go’. If you can head those off before they occur, or get ahead of them a little, you can curb the craving a bit. A lot of it is habit. After those receptors stop screaming it’s all habit. The candy is something to take the place of the physical activity of the cigarette. suckers/blow pops are great for this.

Keep some all over the place. At work, in the car, in your purse…when you start to feel those first quivers of addiction grab a sucker. I liked those the best because of the stick – it keeps your mouth and hands busy and comes closest to the feeling of a smoke in your hand. The candy won’t take the place of what you really want – it’s not magic – but it WILL help. It will give you something physical to focus on and give your hands/mouth something to do. Eat as many as you need to. Don’t worry about the sugar or calories or any of that shit. the amounts of sugar you will be taking in is nothing compared to what your cig was putting in your body.*

*obviously if you have other health issues that keeps you from sugar for god sakes find sugarless!

throw yourself into any hobbies you have that didn’t involve smoking. You HAVE to keep busy. If you find yourself sitting around a lot, you will start smoking again before too long. I did a LOT of smoking when i was bored and whenever i had a free moment while i was quitting i would think about smoking. Had i not had a girlfriend who was super supportive quitting would have been way harder and the closest i came to starting again is when i destroyed our relationship a few months later. Spend time with your friends and family. Keep yourself busy. Take up gardening (wrong time of the year tho). The busier you keep your hands AND your mind the easier of a time you will have quitting – you can’t sit around and watch tv/use the computer all day and expect to successfully quit. Consider videogames tho: you have your hands and mind busy and can get lost in the story, forgetting all about having a cigarette for hours at a time. This didn’t work for me because i would smoke at the computer for the most part.

It goes without saying but avoid stressful situations as best you can and avoid those smoking triggers wherever you can. For example stay out of bars: if you like drinking, try to quit or cut waaay back: Smoking and drinking are like peanut butter and jelly. If you used to go out on breaks with other people to smoke at work; don’t. Go take a 15min walk around the block instead. Try to replace smoking with exercise or yoga. You want something that will occupy your mind as well as your body. I really cant stress this enough. When i got out of the hospital i was kept out of work for a month…yeah. that was fun. The desire to smoke was pretty strong at that point and with nothing to do having a cig was all i could think of….and you will think of smoking a LOT. I’m one of those people who NEVER remember my dreams but when i was quitting i would have and remember dreams where i was just going about my daily business but smoking. Thats it. Nothing special. Driving to work, pulling on a Marlboro.

I would try candy and other stuff before eCigs. i had one myself but ended up giving it to Anthony when i quit so i couldn’t be tempted. In the long run it will be easier to just rip that band-aid off in one quick pull then drag it out with a replacement chemical and risk going back to the real thing. Even the  zero mg nicotine refills are only addressing the chemical addiction. you are still physically and mentally hooked. Most places are banning eCigs anyway (unfairly i think) so you’re really not much better off. If you are already going to take something like Wellbutrin (i did not) try cold turkey/no eCig first and if you just cant do it, get the best eCig you can afford. Dont get a cheap one. Use this as a last resort, tho.

Pat yourself on the back each night you get in bed and didn’t smoke. If you think of a reward you can give yourself for days or milestones, do so. You will have more money due to not buying them so get yourself something you have been wanting. Or, if you are a visual person, put $5 a day in a jar so you can see your progress. At the end of the week/month buy something fun.

Each day will be slightly easier than the day before but there’s a catch and i’m going to use caps because it’s important to hear and hearing it makes it easier…

YOU ARE ALWAYS GOING TO WANT TO SMOKE*

*you may or may not always want to smoke

Quitting isn’t going to change that. At least not for a very long time. My dad said it best a bunch of years ago when he just up and quit one day – “I will always be a smoker, i just don’t smoke anymore” and it’s the truth. I still want one everyday. I still get pangs when i see someone light up (if you watch Mad Men, stop for a while). I feel those receptors in my brain burn when i smell the tang of cigarette smoke in the air. I’m always going to want to smoke. Living with a smoker still has made it harder but i decided early on a simple truth: if i don’t pick one up, i can’t put one in my mouth.

Eventually you will reach a point where you find yourself thinking “hey, i didn’t think about smoking hardly at all today!” and at that point you are well on your way, all the hard stuff is in the rear view mirror.

Also quick P.S. for when you have a few weeks under your belt: Depending on how much you smoked some of the stuff in your lungs will work its way out in the form of congestion and coughing in the morning. Ive heard it doesn’t happen to everyone but it sure did/does for me. Each morning when i wake up and brush my teeth it’s a horrible symphony of coughing and hacking. Ive read it takes about 7 years for your lungs to completely work the stuff back up the respiratory track but i’m sure everyone is different, there are no constants and there is NO undoing all the damage done.

I hope this helps. If you are quitting, Good Luck! It’s worth the struggle.

jeff

the heart attack: my thoughts, 2 years later

Two years ago tonight i had a heart attack. I was 35. I had been ignoring warning signs for weeks writing them off as chest pains brought on by being lazy and horribly out of shape. One week, the pains started while just laying in bed…still i did nothing. Bad genes, bad diet and chain smoking had come to enact their master plan.

Over at my girlfriends (at the time) for the night we were laying in bed together after dinner and a vigorous mattress workout when in the chest pains hit. This was a new sensation and i knew within a few minutes something bad was happening.

When the blood had left my face and the sweat stated to pour she put me on her mom’s blood pressure monitor. Her mom, a former nurse and a current Italian Mother saw the results. looked past me to her daughter and said “go start the car, get him to the ER. Run the red lights. Now.”

I went outside and tried to smoke what would turn out to be my last cigarette while the car was being prepared only to be able to take a few half-assed drags when the order came to get my backside in the car. The decision was made to just drive to the ER as it was literally 3 blocks away and if i was going to survive this i wasn’t going to pay $1000 a block and have to wait 10min for the privilege.

Counting the ways this is costing me money on the ride over

Had i not had Stephanie and her mom that night i might have waited too long or possibly would have waited until the episode passed. I would have then died in my sleep. (Just like my uncle who also ignored warning signs. He went to bed one night and had a massive heart attack in his sleep.)

Though her mom probably now curses my name i’m forever grateful for them for not only that night but the days and weeks that followed when they both went out of their way to make sure i had what i needed, i was looked after and was being kept on the path to healing. I miss both of them sometimes, despite what happened.

I don’t remember much of the car ride. Stephanie drove fiercely and i had the window down; i was still pale white and sweating.

My heart was beating; it never stopped. This is good. This is what kept me out of panic mode…more of a very high state of worry – Like broken bone or totaled car; this is bad, something bad is happening but i don’t think it’s going to kill me

By the time i had the car door open Steph was already at the front desk of the emergency room. The intern-driven wheelchair met me as i was coming into the ER and took me in back so fast i barely had time to register the faces of all the other patients in the waiting room watching me skip to the front of the line. At the time i felt guilty for going right in when others have been waiting for who knows how long but that was reflex. Guilt has always been a close friend of mine, always ready to help.

The pain was the feeling of every muscle in my chest and some in the back and stomach helping out for good measure, trying to constrict me from the inside. It was an ache of a strenuous workout but over-exaggerated and turned up to 11. Not painful; that threw off the ER staff at first. It was more worrisome. Unnerving. My body sending a singular signal *SOMETHINGS WRONG*.

The unfounded and undeserved belief that i was going to be just fine kept me in “This is Bad” territory as opposed to “Sheer Panic” or thoughts of not making it long enough to see my parents or brother ever again. At this point i was just focusing on external stuff. I imagined the call mom and dad was getting from Stephanie. I told her to call my boss and tell them i wasn’t going to be opening the store in the morning. I wondered who they would call to do it and i felt bad they were going to get a call in the middle of the night. I reminded myself to get a note or something i could show them when this turned out to be nothing so the opener wouldn’t be too mad.

Aspirin and nitroglycerine tabs were given to me every few minutes until the majority of the pain was gone. I was told to anticipate a nasty headache when the glycerin wore off that thankfully never materialized; but i have a natural in-born tolerance for most drugs. it’s almost a mutant power. Tho ive been told its a crappy one. X-Men ‘b’ team territory here people.

different kind of crappy mutant

It bears mentioning at this point: if you are allowed to wear what amount to pajamas at work – im jealous.
if you are allowed to wear what amount to pajamas at work and happen to be a cute girl – i will smile at you unconsciously and uncontrollably.
I’ve been known to offer nurses with glasses promises of marriage, riches and the swift dispatching of any enemies she may have.

you stopped my heart. Then restarted it.

When i was stabilized and they were convinced i wasn’t going to die on them they told me how the next few hours would play out:

It was time to take some pictures! These however would be after shooting me up with some dye they could trace thru my circulatory system to see how everything was flowing and if there were any kinks in the hoses as it were. If it came back i was clear I could go home and sleep in my own bed…or rather Stephanie’s as she would not have let me out of her sight that night. She was very protective of me as this was before i broke her heart.

That was the best case for the way things could go down.

The other way was i would be in need of an emergency angioplasty. They would have to prep me for surgery and then snake their way into my coronary arteries from an incision in my inner thigh so they can inflate a small balloon to clear the plaque that would be theoretically impeding any blood flow. That was the worst case though. That was at least a few tests and a few hours away. Steph was near, parents were aware and on their way and I was going to make it through this. Ill skate by this like i do everything else. Ill be home in a few hours. I’m teflon. Im certain it’s nothing serious.

Alone, cold and half blind from no glasses, laying on the operating table waiting for the cardiologist to arrive to preform the emergency angioplasty was the first time i felt real fear that night.

That was the first time i really thought there was a chance that this room might be the last blurry thing i ever ‘see’ after they start the gas and i drift off into nothingness. This might be it and id never know any different. I wouldn’t see the Dr’s as they try to restart my failed heart. I wouldn’t see my loved ones in the waiting room. No pinin’ for the fjords. Id just cease to be – an ex-jeffro.

As it turns out…i wasn’t far off.

i’m hardcore so mine’s barbed

The de-brief the next day went like this. They got in there and saw that my all 4 of my coronary arteries were almost 100% ‘clogged’ and how ANY blood was getting thru was a small miracle. The Dr went in and had to inflate balloons and leave behind drug-coated metal stents in 3 of my 4 arteries. They needed to do all 4 but i was told i was too weak and probably wouldn’t have survived it; that last one would have to wait until i was recovered from the first 3.

as an aside, I cant tell you how thankful i was to get this information AFTER the fact. I didn’t need THAT rattling around in my head for the 30 minutes i was waiting on the operating table the night before.

At some point (the events after the operation and into day 1 are fuzzy at best) a new form of discomfort came up that made the heart attack seem like a minor annoyance; with all the blood thinners and anti-coagulants in my system, there was the matter of the open wound on my inner thigh that had to be encouraged to close up and that involved an under-paid orderly who had to apply pressure to the area for hours. When his ‘shift’ was up, they strapped some crazy looking plastic thing onto my leg to apply the pressure of the tired dude in scrubs. I’m not sure how he managed to stand still for so long. The real torture though…the real difficultly and in my memory the worst part of the entire 3 days was the fact that i had to lie still, on my back, not being allowed to turn on my side in the SLIGHTEST or move really at all for the entire night. As a chronic tosser-and-turner it was a long, dark night. By the end i was almost in tears begging to be allowed to move in some way, to shift my weight in the slightest to either the left or right. Anything. Failing that, i said, you have to pump me full of something to knock me out because it was unbearable. They finally realized i wasn’t just uncomfortable and being a bad patient; i really needed to move. They let me shift, ever so slightly, on my side.

it. was. glorious.

it was also good for only about 10 minutes and i needed to move again. This went on for another hour or so (blurry) until i convinced the nurse to put something good and strong into my IV to make me go night night so everyone involved would have a more pleasant night. I made a convincing argument and she gave me a healthy dose of liquid Ambien and i was quickly, and thankfully carried into my specific brand of dreamless slumber. This would also be the last time Ambien would help me sleep.

Eventually the space torture device got to come off and they kept checking the wound throughout the day to make sure i was bleeding in or out; both were equally possible and equally bad.

The first thing i remember after waking up the day after is my old friend Josh, a nurse in the ER at the hospital standing at the foot of my bed looking at me like i forgot to lock the gate after bringing the trash cans in. He jokingly scolded me for being in his ‘competitors’ hospital. He was my best friend and i had not heard from him in more than a year. It was nice to see a familiar face. It was good to have my eyes open to see the morning light. At that moment, for a little while, it was good to be alive.

Then i got a ride to another hospital by a very surprised dear friend of an EMT who told me she did at least a triple take when seeing my name come across her medical pager. I didn’t get to see that face but i did see a very professional woman hide from everyone but me the fact that she was personally worried about the patient in the back of her van. I asked her if we could hit the Starbucks drive thru on the way. I didn’t get my cafe mocha. Or a laugh for that matter.

Soon after that i was able to see the rest of my friends and family. Everyone had talked to the doctor i never even saw. Stephanie and her mom had become an expert on my condition and had my rehab plans were already figured out. I had the next month off of work. The bag that contained my possessions i came to the hospital with were waiting for me but they were missing a half a pack of Marlboros and a lighter…

This was day 1 of me as a non-smoker.