From: John De Armond
Subject: Re: Smokers, what to do
Date: Wed, 14 Nov 2001 05:16:00 -0500
> The doctor put things in a very clear perspective: "you have
> emphysema, quit smoking or die soon."
> Why didn't I quit when I knew I already had physical problems? For
> the same reason an alcoholic takes the next drink; I was as solidly
> addicted as any crackhead. It took the form of an completely
> catastrophic and unacceptable threat by my wife that woke me up, both
> to what I was doing to myself, and the collateral damage I inflicted
> on that long-suffering and good woman.
> Unfortunately, you can't rebottle spilt milk, so I'm puffing away on a
> new mistress now, my oxygen cannula. It goes with me everywhere,
> twenty-four hours a day. Sort of the screwing I get for the screwing
> up I did, but how hard can you whine about the rewards for personal
Now to the next step.
I had an old friend down for a weekend visit a couple of weeks ago.
This was his first long trip since his lung transplant about 1.5
years ago. He's in his early 50s, Vietnam vet and all-round nice
guy. He only smoked a little but unfortunately for him, he had a
genetic defect that predisposed him to Emphysema. The result? At
the age when most folks are ready to kick back and enjoy life, he
was struggling to stay alive long enough to get new lungs. When he
got his lungs he was literally days away from the respirator,
whereupon he would have been taken off the transplant list. He had
to spend all his time sitting upright in a chair because he lacked
the strength to take a breath if he lay down. Sleep was impossible
- he got short naps as exhaustion from struggling for each breath
overwhelmed the pain.
One might think that a transplant involves going to sleep, then
waking up with a new part. Not quite, but especially not in this
case. The standard surgical procedure is to administer a
combination of anesthetics and paralytics to put the patient to
sleep and paralyze him so that reflexes can't cause movement.
Unfortunately, my buddy developed an allergy to the anesthetic (not
an uncommon occurrence) and suffered a cardiac arrest. They had to
discontinue the anesthetic which, of course, meant that he woke up.
He found himself awake, totally paralyzed (couldn't even move his
eyes), with his chest wide open and a doc massaging his heart. They
heart massaged for almost an hour before they got it restarted and
could continue with the transplant. In what is probably the
understatement of the century, he said that words can't describe the
pain. Unfortunately because of the arrest, he didn't get the second
Despite the arrest and the single lung, the transplant was a
complete success. Which does not mean that he's whole again. He
just now has gotten to the point where he can walk around a little
like a normal person. He's lost 100 lbs at least. He carries
around a shaving kit that is filled with his anti-rejection drug
cocktail. Because of the suppressed immune system, even a cold can
be life-threatening. Following instructions given us by his docs,
we sterilized our place before he arrived - washed our bathroom
walls and floors with bleach, bleached the toilet tank water and
scrubbed the floors in other rooms with bleach, no carpets or rugs,
etc. We all had to make sure we had not been around anyone with a
cold for the week leading up to his visit. he has to wear a
particulate filter when out in public.
Any immune challenge, even a cold or small infection that he fights
off spurs his immune system to attack his lung. That means a stay
in the hospital while massive doses of steroids are administered to
stop the rejection and help heal the damage. Because of the heart
damage and the drugs, he continues to suffer from very high blood
pressure and blood clots. Then there's the monthly lung biopsy to
check for rejection damage. The docs have to continuously tinker
with the drug cocktail as things change. I can tell when stuff is
out of balance because he'll send me email containing what amounts
to random words. He says that his mind feels like a record with the
needle randomly skipping grooves when that happens.
If he makes it to 5 years out, he'll have beaten the odds for lung
transplantees. The survival record so far is about 12 years.
Something for all you Kewl Doodz to think about as you puff on your
From: John De Armond
Subject: Re: See pics -Smokers, what to do
Date: Wed, 14 Nov 2001 19:39:00 -0500
> Along with the excellent texts by Canoli and John are pictures of oxygen
> equipment on my site: http://www.dreaves.com/oxygentanks.htm
> .... the things used when one has emphysema.
Dot, I noticed that you included my message and editorialized that
my friend's genetic disposition to emphysema is "a doubtful fact".
I'm not in the habit of stating things as facts that I don't know to
be true and accurate. The defect is called Alpha-1 Antitrypsin
Deficiency. I would appreciate your taking the editorial out and
replacing it with the correct name of the defect.