Note: I wrote this a month after my wife passed away 15 years ago.
Have you ever tried to talk rationally to a smoker about the effects of smoking? Oh boy, I think I’d rather have a discussion about the need for ethics with George Bush. Smokers will listen, nod their head, sometimes say they can or will quit someday, but they will not change.
You’ll hear such idiocy as “it’s my body and I’ll do what I want with it” and “my smoking doesn’t hurt anyone else so leave me alone”. Well, yes, it is their body, and what they are doing is killing it slowly and agonizingly over many years. As far as hurting someone else, well, here’s my story. You decide who else was hurt.
My wife, Claudia, was a smoker for her entire adult life. I watched her destroy her body for twelve and a half years, and stood by her in spite of it all. I cried many times while she was alive, trying to help her quit, listening to her promises, only to find out she was still smoking in spite of everything.
She claimed she began smoking because “her mother smoked while she was in the womb.” Somehow, in her mind, this made it acceptable to smoke. She said it was not her fault, it was a addiction and it was her mother’s responsibility. She couldn’t stop, regardless of what happened, because her body was poisoned by her mother’s habit before she was even born. What she said was not rational, but she believed it.
When we married, I was not thrilled about the smoking, but since she had so many other good qualities I decided that one flaw, one aberration, could be tolerated. After all, I had known drug users and alcoholics several times during my life. How could smoking compare to those habits? It seemed like such a minor thing at the time…if only I had known.
A few months after we were married, my dear wife called me in a panic. She was having trouble breathing, she said, and she wanted me to bring her to the doctors office. I rushed home, totally freaked out, as this sounded very serious indeed. I literally scooped her up, rushed her to the car, and drove her to the clinic as fast as I could.
The doctor took one look, said “asthma” and gave her a shot of adrenaline. Have you ever seen someone after they have received one of these shots? Her body shook violently and her heart rate went through the roof. Believe me, from my observations, this is not a shot that you would want to repeat! Her breathing cleared up within seconds.
The doctor, a kindly older lady, told Claudia she must quit smoking. Claudia nodded and said she understood; she said she would quit. Tomorrow. But tomorrow came and she forgot her promise to the doctor.
Over the next year or so, we visited that doctor on a regular basis and each time Claudia received one (and sometimes two) shots of adrenaline along with breathing treatments. Each time, I had to rush home from work, load Claudia into the car, and drive like a maniac to the doctors office. Those were very trying times, but Claudia needed me and I didn’t know what else to do.
It seemed to me that the rational to do without fail was to stop smoking. Unfortunately reason has nothing to do with smoking. On the contrary, I soon learned the folly of mentioning this to my beloved; believe me, I have discovered there is nothing worse then the reaction from telling a smoker she has to quit taking her daily doses of death. I quickly realized it would be preferable to step into a hungry cougar’s lair than even hint at giving up those slender white tubes. Even now, decades later, I still wear the emotional scars from those conversations.
As time went by, we switched doctors, purchased a machine called a nebulizer and received prescriptions for a number of asthma and other breathing related drugs and equipment.
The most significant prescription was for a drug called Prednisone. This is a steroid, and it has many medical uses, one of which is to clear up breathing issues. An asthma sufferer will typically take a small dose (20 or 30 milligrams a day) for a week, then taper off slowly for a couple of weeks. The taper down (a reduction in the dose each day) is needed because the body will react very badly if the drug is suddenly removed.
Prednisone has so many side effects that it would probably be labeled as a poison if it were not so useful. During a particularly nasty asthma attack, a doctor prescribed her for a massive dose — 60 milligrams, and Claudia became a raving lunatic for a couple of weeks. She took out all of her aggression on one of our cats, a gentle creature named Baby. That poor kitty suffered horribly during those weeks; Claudia, normally calm and serene, became so enraged one day that she tried to kick Baby, missed, kicked the wall, and broke most of the toes on one foot.
She hated that poor cat for a long time, until one day when I returned from the vet and told her Baby had asthma. Yes, believe it or not, a cat can have asthma! I guess that gave her something in common with the cat, and the two of them became constant companions.
I wondered what was causing the asthma, so Claudia and I visited several different specialists. A number of tests were performed, and it was extremely clear that cigarette smoke was the culprit. Moisture made her asthma worse, and high pollen days were very bad for her. One environmental cause was eliminated quickly: it had nothing to do with the cats or our dog.
However, over the years a pattern emerged. When Claudia got emotional, she came down with asthma. If she got upset, sad or had some event (such as a death in the family), a severe asthma attack almost always followed. Sometimes it was the next day, and sometimes it happened immediately. Thus, as the years went by, I felt more and more like I was walking on eggshells. Believe me, it’s very difficult living in this world without occasionally having something unpleasant occur.
There was one exception to this rule: anger. You see, anger causes a surge of adrenaline. Thus, if Claudia had an asthma attack and there were no medications around, I just got her angry. Usually, that pumped just enough adrenaline into her system to cause the asthma to settle down.
I remember one particular trip to the late night urgent care hospital. She was having a particularly bad asthma attack and nothing was working. So she worked her way down the stairs (and every step she had to stop to breath for a few minutes), and into the car. I drove her to the urgent care hospital and got her into a chair. The doctor looked her over, and for some reason said, “you don’t have asthma, you’re faking it”.
Holy cow! Claudia hit the roof, her face turned beat red in anger and her asthma disappeared. The doctor took one look at her face and ran from the room. He was afraid for his life, I think, and he had his nurse finish up for him. The nurse gave Claudia a breathing treatment, and I never saw that doctor again. I think he was hiding somewhere, I really do.
Eventually, our doctor ceased the Adrenalin shots, favoring a shot of a special steroid. He said it was better for the heart and safer in the short term. He cautioned that the longer term side-effects of Kenalog were, however, severe in the extreme. This drug is similar to Prednisone, except that it is gentler on the body (in the short term) and is given intramuscular, via an injection. The problem with Prednisone is it requires several days for it to have an effect, while a Kenalog injection will relax the breathing within a few minutes.
Over the next nine years, I became extremely familiar with the side effects of steroids. The most dramatic was plain for everyone to see: Claudia, who weighed less than a hundred pounds when we were married, eventually gained over two hundred additional pounds. All of this weight was water, locked into her tissues by the doses of steroids that she received regularly.
Our visits to our doctor became almost a routine, until one day Claudia could barely walk down the stairs to the car. Her legs had so much water locked into the tissues that she had trouble even moving, much less going anywhere. Needless to say, this was all new to me and I was extremely concerned. I convinced her to check into the hospital (on our doctors advice) and she spent three days getting the water drained from her system.
Three days and two nights in a semi-private room and massive doses of drugs designed to drain the water (by making her pee) and Claudia lost 21 liters of liquid. That’s literally how much water was trapped in her tissues. I remember stepping into her hospital room and seeing the dozen’s of jugs of liquid lined across the floor. Our doctor was trying to make a point: this was the result of her refusal to quit smoking.
Claudia seemed to understand. On one of my visits to the hospital to see her, I pushed her wheelchair outside so we could talk. She pulled a cigarette out of her pocket, exceedingly pleased that she had managed to smuggle it past the nurses. As she smoked, she swore she would quit. she understood that her life depended upon it and this was the last time she wanted to go into the hospital. It was kind of surreal, watching her swear she was going to stop smoking while she puffed away.
As bizarre as that seemed to me, we repeated virtually the same thing half a dozen times (six trips to the hospital to be drained of fluid), until one day Claudia went into a coma for four days. It was very serious, and the doctors could not figure out what happened. She came home and again swore, no more smoking for her.
On one of these visits, a lung specialist again explained to her that if she wanted to live, she had better stop smoking. He stressed that her condition was no longer asthma, it was chronic lung disease (COPD) a much more serious condition. This basically meant she had permanently damaged her lungs, and would live with it for the rest of her life. Again, Claudia swore she would quit immediately.
One of the more strange phenomena associated with the extreme buildup of fluid in her tissues was leaks. Yes, Claudia leaked water from her skin. Small holes opened up, especially around her ankles, and water dripped out. Her skin became brittle (another steroid side effect) and sores developed. We had to find another doctor — this time a wound care specialist. This opened a new chapter in this sad little tale — our weekly visits to the wound specialist and the twice-daily changing of dressings (bandages) on her legs.
This went on for almost a year, until I received a panicky call at work one day. Claudia had opened the refrigerator and a 2 liter bottle of soda had rolled out and hit her in the leg. I rushed home to find a huge (3 inch long) purple bruise on her left leg. We rushed to the doctors office, and the wound specialist popped the bruise open. He said he needed to do this because otherwise it might become infected. Thus the saga got much worse. This cut, three full inches long, eventually became infected with MRSA (methicillin resistant Staphylococcus aureus), a very serious disease. It’s so serious that hospital use special procedures to handle patients who have been infected with it.
I remember the look on that doctors face when he discovered she had MRSA. It was the most incredible look of panic I’ve ever seen. That was also the last time we went to that doctor. Claudia went back to our normal doctor, who prescribed a course of Vancomycin, delivered via intravenous infusion by a home nurse.
Three times her cuts became infected, and three times we had a nurse over to our house once a week to look at the wounds. Each of these events lasted several months, and required more home nursing to deliver the antibiotics. During these periods, each morning I hooked her up to an IV bottle and waited for an hour until it totally drained into her body. I repeated the ritual each morning and night, until the infection cleared up.
This became my routine for several years: change the dressings on her legs twice a day. Check the wounds to be sure they were not infected. Check her temperature and sugar levels (oh yes, another side effect of steroids — diabetes). Get her blood pressure and heart rate, and make sure she was doing fine.
I remember one visit to our regular doctor. We were each having an exam: she was getting the regular monthly checkup and I was getting my yearly physical. He looked her over and told Claudia she was looking much better. Her vital signs were better than they had been in a long time, the MRSA had cleared up, and she had managed to drain much of the water from her legs. He asked her, gently, if she was smoking, and she claimed she was not.
The doctor finished up her exam, then had the nurse help her to the waiting room until my physical was done. Once she was out of earshot, he told me, “she’s still smoking”. It was not a question. I told my doctor I wasn’t sure, but I thought she was. I asked him what I should do.
He said something that I will always remember as long as I live, “well, you cannot live your life being the cigarette police. I would suggest that you buy her a good life insurance policy.” He was not joking, that was obvious. Of course, there was not an insurance company in the world that would issue a policy to her, but his meaning was clear. Unless she quite smoking, she would die. Sooner or later, she would die.
A couple of years, another hospital visit and a four-day coma later, came the worst of the worst. Claudia was having great difficulty breathing, and she had been having trouble for a few days. We had been planning a trip to San Juan Capistrano (I thought it would cheer her up) but had to cancel — she just didn’t have the strength.
She got more and more sick, and had extreme difficulty breathing. The steroids were not helping anymore, Prednisone was not working, and even emergency adrenaline shots didn’t do the trick. Finally, I had to call 911 and get my lady into the hospital.
Thus began the worst month of my life. My best friend and beloved wife was in a coma for the better part of a month, while the doctors struggled to bring her literally back to life. It was very serious, and at several points it was questionable whether or not she would survive. She pulled out of it, barely, and lived, although weakened for years afterwards.
In one of the most bizarre things I have ever witnessed, I watched a woman who had just cheated death, just beat the odds and come out of a coma, demanding, while still in the hospital, a cigarette. The emotions that went through me as I watched her scream at me because I wouldn’t give her one were most definitely not pretty.
I was determined that she would quit smoking, whether she liked it or not. Not only was she killing herself, but the stress on me was well beyond what a normal human being should ever be asked to endure.
She fought, cried, screamed, yelled and swore at me for days, until she finally got me to agree, just because I valued my sanity, to let her smoke one cigarette a day.
Slowly she recovered her strength, although it never got back to anywhere near normal levels. I had to purchase a dozen (literally) HEPA filters to clean every speck of dust from the air. I purchased special blankets and pillowcases so she could breath, and even got an oxygen machine to use if things got bad. Claudia didn’t have the strength in her legs to stand up from the toilet, so I had to get a special commode with handles so she could pull herself up, and I also got a special bench for the shower so she could sit. I even had a nurses’ aid come over twice a week to give her a bath, since at first she didn’t have the strength to keep herself clean.
She continued to have problems with her breathing, although it seemed to be getting better, and her diabetes. Her overall health, however, seemed to be improving, and by December I actually started relaxing a little bit. It appeared that Claudia would slowly recover…
Until the middle of January, 2005, when she suddenly took a turn for the worse. Her breathing got much worse, her tissues filled back up with water, and she developed blisters on her feet. It all happened incredibly fast.
On Monday, January 31st, 2005, I was at work when I received a call from Claudia. She complained of pain in her back and she said she was having real difficulty breathing. I rushed home, tears in my eyes, to see what I could do. I tried the usual routine, but nothing worked, so I finally called 911 for the third time in our marriage. I remember watching her being carried downstairs by the paramedics, wondering how long she’d be in the hospital this time.
It never even crossed my mind that our long, sad tale was coming to an end. Claudia had cheated death twice, and had survived nine hospital visits. I clearly remember reflecting, as I got into the cab of the paramedics vehicle, that she had always said she had nine lives, and this was her tenth visit.
My beloved wife, best friend and soul mate passed away the next day, February 1st, 2005 at 10:37 am. She had a condition called sepsis, which is a blood disease, probably as a result from the blisters and cuts on her feet. According to the doctor who briefed me as she was dying, sepsis is one of the most serious things that can happen to a body.
I watched for those last thirty minutes as the doctors and nurses struggled to keep her alive. I had signed the form saying they were not to resuscitate her (that was something she had asked of me years ago — she did not want to survive as a vegetable) so as her body failed they let her go. It was very clear that there was nothing at all that could be done.
I walked into the room and looked at my beloved for the last time. Tears welled up in my eyes, and our life together flashed through my mind. Our journey together was finally over.
After she passed away, I went through our apartment and did a thorough cleaning. It was a cleansing for me, as I felt the need to get rid of all of the medical equipment and medications that we had collected over the years. I started in the back room and worked my way forward. I threw out two entire trash cans full of pill bottles (I flushed the medications), equipment (that which was not leased), machines, walkers, receipts, insurance papers, bandages, wrappings, and hundreds of other things as well.
The most infuriating discovery was the shock of finding several hundred empty packs of cigarettes stuffed in every possible location in the back room. It appeared that Claudia had been getting a little more smoke in her lungs than I had thought. Over time and with a little gentle investigating, I found out that she had been begging friends for smokes for a long time, and painfully walked down to the corner liquor store whenever she could get her hands on a few dollars.
Now when I see people smoking, I have to suppress the emotions that I feel. I feel the loss of Claudia, I feel anger at the stupidity that killed her, and I feel sorrow at her inability or unwillingness to stop her habit.
When a smoker exclaims, “it’s my body and it hurts no one else”, I have to leave the room.
Because I know, from experience, that it hurts everyone around them. Smoking is insanity.
Life goes on, and I have moved forward. I am happy at the choices I had made for myself. I don’t drink (never even tasted it), don’t smoke (never have tried it), don’t take any drugs (except those prescribed by my doctor) and live to a very high ethical standard.
I hope my words in this little article will be of use to someone. Perhaps, just perhaps, a dose of the truth might shock a smoker into quitting.