Posts Tagged ‘heart attack’

On quitting smoking – cold turkey and silver linings

December 31, 2022

Giving up smoking suddenly, with no outside help or support, is known as going ‘cold turkey’.

More by accident rather than by design, I am quitting smoking by going “cold turkey”. I had an infarct episode just over 3 weeks ago which led to hospitalisation and the insertion of 2 stents. During my 3.5 days in hospital I had no desire to – and did not – smoke. If I had any withdrawal symptoms at that time I was not aware of them. Presumably, I had other more pressing concerns. Now I am home again and still have not smoked. Withdrawal symptoms are present in force and the urge to light up can be extremely strong – though only for short periods. I am extremely irritable and find I cannot focus for long periods. I have, so far, declined offers of nicotine plasters, nicotine replacement, some other drugs and counselling.  Of course, three weeks without a cigarette proves very little. I did though wonder why nicotine replacement was being promoted so heavily and – mainly by neglect – going cold turkey was being discouraged.

Heavy googling with multiple search terms reveals a sharp divide between those promoting going “cold turkey” and those opposed to it. But then it becomes apparent that all those opposed to going cold turkey are – not unsurprisingly – those who are promoting an alternative. They include promoters of  Nicotine Replacement Therapies (NRT), or some particular drugs, or some particular kind of counselling.

Harvard Health:  A recent study randomly assigned about 700 participants to either gradually cut back on smoking over two weeks or quit abruptly on a set quit date. Both groups were offered counseling support as well as nicotine patches and other forms of short-acting nicotine replacement. The group assigned to cold turkey was significantly more successful at quitting smoking, both at the 4-week follow-up (49% vs. 39%) and the 6-month follow-up (22% vs. 15%).

The promoters of nicotine replacement would have it that my decision to go “cold turkey” has little chance of success.

TruthinitiativeRelying on willpower alone, however, is not likely to be successful. Research over the past 25 years has shown that, out of 100 people trying to quit smoking cold turkey, only about three to five of them will succeed for longer than six months, according to Hays. In other words, while some people can quit this way, at least 95 percent of people can’t. Quitting cold turkey has such a low success rate due to the nature of addiction. Addiction undermines willpower, or the ability to control impulses through decision-making.

My googling is hardly research, but I have come to the conclusion that while quitting cold turkey does not work for all smokers, most smokers finally quit smoking this way  The simple reality seems to be that successfully going cold turkey is likely to be most successful in avoiding a return to smoking. I find I resent the claims of the promoters of NRT – though they may well be correct. “Quitting cold turkey has such a low success rate due to the nature of addiction”. I think I have to take the challenge. My rational mind tells me that if my body has done without a cigarette for 3 weeks then there can be no desperate physical need for nicotine. There is no doubt that the most insidious part of the craving is when the mind imagines the previously experienced pleasures at certain trigger points (cup of coffee, cold beer, particular meal ……). I can never, now, claim the identity of being a non-smoker, but an identity as an ex-smoker will do for me. But I think I shall need to wait for a year before I can claim to be an ex-smoker.

Going cold turkey is perhaps the silver lining to my infarct cloud.

(Note that the purpose of this post is not to give advice to anyone but to create an additional pressure on myself to help resist the urge to return to smoking).

Please don’t diss my elephant

December 21, 2022

My blog posts here are fed on to Linked In and to Twitter though I never use either of them. So my apologies for not replying to those who have responded to my previous post and sent greetings and good wishes and comments on those channels. (I stopped using Facebook over a year ago and my blog posts no longer feed in there).

Many comments have been along the lines of keeping my elephant at bay and – by lifestyle changes – denying him entrance. But this misunderstands my intended meaning. There is no need to diss the elephant. My elephant is a friendly guy. He has impeccable timing and is scrupulously fair. He is not – for me – an object of fear or resentment at all. Rather he is the familiar, friendly, Solid (with a capital S), pachyderm who can accompany me on mysterious journeys to unknown places – whenever they may occur. He is a comfort not a fear.

My elephant does not lead me to morbid thoughts but he does keep me anchored in reality. He may nor be back for a day or a month or for 25 years. (I take 25 years as a practical upper limit since I would then be older than any male relative I know of). Modern medicine does wonders for heart conditions. So my heart attack two weeks ago and the insertion of 2 stents is quite unremarkable in terms of what medical practitioners can do these days. I am struck by wonder at the skill and ingenuity involved in these procedures. However a friend of mine brought me down to earth when he described the 12 stents he has in addition to his pacemaker. My experience was not remarkable as such things go, but it was a remarkable and unforgettable experience for me. The pain was real and the fear was real and the elephant imagery I saw was real. I could see him clearly – sitting right there. I can rationalise now and speculate that I was so scared that I conjured up my friendly elephant to cope with the fear. Clearly, in my mind, an elephant is a reassuring, comforting image.

It has been two weeks and I am recovering steadily. But, most remarkably, I have not smoked in 2 weeks.

So, don’t diss my elephant. He’s a good guy. He helps me handle my fears.

My elephant came calling ….

My elephant came calling ….

December 18, 2022

“Gosh”, I said “You’re heavy”!

I thought I had eaten too much. Heartburn I thought. It had started as just a rumble, just discomfiting enough to make me squirm. I stood up, I sat down, I breathed deep, I breathed fast, I breathed slow but the pressure kept growing. From discomfiture it became severe discomfort and then the crushing pressure reached ginormous proportions. “Hello Mr. Elephant”, I said. “Why are you sitting on my chest?” I do like elephants so I did not want to be rude and scream. I did not like to mention that he was crushing the life out of me. He didn’t look like he was trying to hurt me. In fact he looked quite friendly – even avuncular.

“Gosh”, I said again. “You’re really very, very heavy”! “Am I?” he asked and seemed to float above my chest. “I just came to introduce myself,” he said. “I am your elephant after all”. And then, just like that, the pressure eased. He was no longer on my chest but inside my chest and started pushing out. “Steady on,” I said “I could easily burst. A choice between bursting or being crushed was not very nice” I said. “No, no” said my impossible elephant, “I wouldn’t do that – yet” and he eased himself out of my chest and rested – lightly – outside it again. “You do not seem so heavy now” I murmured. “Of course not” he whispered in my ear. “It isn’t quite time yet. The important thing is that we have been introduced. Now you will recognise me when I come calling”. 

“I am not in any particular hurry” he said, “but remember that I am your very own elephant. And I will be back”.

And then the ambulance came.

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