Smoking could cost you an arm and a leg

unhealthy from smoking

In our subcontinent, a widely prevalent myth is that smoking or use of tobacco keeps gastric problems at bay.

Many would have observed that people, especially in rural areas, smoke the hubble-bubble (hookah) every day. If you talk to them, they will immediately start enumerating a number of benefits of the hookah.Many would have also noticed a large number of men and women smoking beedi (a local variant of the cigarette).

Why has tobacco consumption and smoking increased in recent times?

If you survey a small town, you may find that many young people have become addicted to tobacco-based products like zarda paan masala ( a betel nut and tobacco mixed product, quite prevalent in Indian subcontinent). Taking pan masala is in fact consuming tobacco.

In big cities or metros, smoking has become more or less a fashion statement. Smoking in public is considered as a public statement of modernity, an exhibition of a macho image, and is supposed to be a remedy for the so-called bad mood.

Very few people are aware of the simple fact that the basic harmful content of tobacco is called nicotine, which is present in cigarette, beedi, zarda, khaini, chaini and manipuri (tobacco-based products used in the Indian subcontinent). All these products are just different forms of the same harmful element nicotine, which is an inseparable part of tobacco.

Wrong notion
In developing countries, most people believe that use of cigarette or tobacco mainly harms the lungs only. But, unfortunately, a very small percentage of people know about the leading role tobacco plays in causing pain in leg or hand, called leg or hand angina, which is caused by nicotine.

Recognising harmful effects early
If you are a habitual smoker or a tobacco user and your hand or feet becomes excessively sensitive to cold, you should realise you are suffering from the early stage of a disease of blood pipe that carries pure blood and oxygen to the hand and leg. This tobacco-induced disease of the artery is called Buerger’s disease.

If you feel pain and a tingling sensation in the hand and foot or leg while walking, take it for granted that Buerger’s disease has completely overtaken, and oxygen supply through pure blood to your limbs has been drastically reduced. In an advanced stage of Buerger’s disease, you feel a constant and unbearable pain in your fingers and toes, especially at night; and, if not treated in time, the colour of your toes and fingers becomes blue or black.

Buerger’s disease
Buerger’s disease is a disease of small and medium sized arteries of the legs and hands. There is inflammation or swelling of the arterial wall itself and side by side there is a collection of blood clot inside the tube. This causes disturbance in blood supply to feet and hand. Many a time it has been observed people do not take complaints of Buerger’s disease very seriously. When their fingers and toes start getting black, they realize the gravity of the situation. Then it is too late and chance of amputation becomes very high.

The ulcers on feet and hands caused by Buerger’s disease never heal without correct treatment. Daily surgical cleaning and dressing of the wound is done in clinics, and a variety of antibiotics are tried, and this continues for months with no improvement, and ultimately patient is left with no other option other than losing the foot or hand.

In some cases, skin specialists for ulcer and eczema treat patients of Buerger’s disease for months. In such a situation, ulcer instead of healing gets worse and eventually results in the loss of a foot and hand. In some patients, leg pain of Buerger’s disease is either mistaken for arthritis or sciatica and therefore they are advised to consult a bone specialist.

What to do if suffering from Buerger’s disease
First of all, patients have to completely stop smoking and using tobacco products. There is no real benefit in reducing the frequency and number of cigarettes used per day. Even a single cigarette per day will keep the disease active. Therefore, complete abstinence from cigarette and tobacco is mandatory. Patients of Buerger’s disease are also advised to keep themselves far away from smokers and smoker’s zone as well. According to one study, even only simple stoppage of smoking altogether reduces the possibility of amputation of leg by 50 percent.

Where to go for treatment?
Patients of Buerger’s disease must consult a vascular or a cardiovascular surgeon, instead of a general surgeon or a bone specialist, and under his guidance an active treatment should be carried out to reduce the possibility of amputation.

Patients must go to a hospital where facility for angiography is available. They must ensure whether a full time service of a cardiovascular/vascular surgeon is available or not. These two factors play a major role in effective treatment of Buerger’s disease.

Buerger’s disease requires super specialised and modern investigations like Doppler study, echocardiogram and angiography. On the basis of the results of these investigations only, the correct management strategies can be formulated.