I know several pack a day plus smokers who state that their doctors say their lungs are fine and show no significant damage. These people have all been smoking for over 20 years.
I wonder how this could possibly be! One person told me that his doctor said that his lungs are “pink.” Another was cleared for a heart transplant!
Doesn’t long term heavy smoking cause definite damage to lungs that would clearly be visible upon examination?
My Grandfather smoked 3-4 packs of unfiltered Camels or Lucky Strikes a day since he was 12. He keeled over at 87. Whether that was smoking related or not is unknown, but statistically he was already on borrowed time and had no other health related problems. How much longer would he have lived, or even wanted to live had he not smoked? I’ll bet the pleasure a good smoke brought him was worth the months or handful of years it cost him.
My wife’s friend Sharon is 52 and smoked about 2 packs a week. She has emphysema and some lung disease I don’t remember how to spell. She’s on mobile oxygen and won’t make it to 55 without a heart/lung transplant according to her doctors.
My Grandmother never exercised a day in her life, I don’t recall her ever weighing less than 300 pounds, she drank like a fish and smoked, and she cooked everything in lard. She lived to her mid 80’s, with no health problems up until about a week before she died.
I quit smoking cigarettes about 18 years ago and cigars almost 3 years ago. While I consider them both an unnecessary risk to take, I still miss them both every single day. Especially when I’ve got a few drinks in me. What makes it hard is my observations of people like my grandparents and my wife’s friend. It seems to me that genetics and luck are factors in the risks people take with their lives.
If the lungs of the healthiest regular smoker were taken out and examined under a microscope, evidence of damage from the smoking would be found.
It’s just that it’s not always so damaging for all individuals that it would be found on less exacting examinations. Nor is it so damaging in every individual that it causes significant illness or dysfunction before the person dies of something else.
Having said that, the evidence is still clear that regular smoking will cause damage on some level, and will shorten the typical smoker’s life.
It is also possible for an armadillo to cross a six-land highway safely, but I wouldn’t put any money on it.
What kind of exam would show lung damage? Or, to ask another way, how damaged would lungs have to be before the fact becomes obvious to a doctor. I’m pretty old and I’ve never had a doctor probe my lungs in any way that would tell them if I’m “pink” or not. Maybe smokers get special tests? I’ve had a few chest xrays but I don’t think they would show minor damage.
Thanks for the replies so far.
My concern is that these friends of mine have had their unhealthy lifestyles minimized by a seeming lack of evidence of damage according to their doctors.The doctor examined the one friend with a camera in the lungs and allegedly reported no damage of significance.
I believe my friends are in denial of course. Each of them have that cough that heavy smokers have. They wheeze to a degree and one friend had to have a heart transplant. They all have that look that heavy smokers have - kind of tired and unhealthy. They get winded easily even as one of them works hard at a physical job every day. They blame their known health problems on things other than cigarettes and each has stories of the 88 yr old that drank and smoked until the day they died with a smug smile on their face.
People that drink and smoke with abandon and live a long time certainly have existed but they are OBVIOUSLY the exceptions. And what of their seriously diminished quality of life? I guess that only counts if thing like walking a few miles or breathing clearly matter to the individual…
Does tar not stick to SOME peoples cilia? Is it possible for SOME people to not show visible (by camera) evidence of damage after 20 plus years of sucking thick sticky smoke into their lungs? Doesn’t the sticky tar stick to the walls of the lungs and break off in chunks as the smoker hacks up brown and black phlegm and lung tissue thus causing visible scarring? Is it in fact possible that any of these heavy smokers could have a chest x-ray that didn’t show damage?
For this damage not to occur seems impossible to me. I suspect that for one reason or another, the doctors are not giving the smokers the “straight dope.” The doctors may not be considering that even if the x-ray looks “good” that it would look better minus the smoking. The doctors may feel what’s the point if the smoker isn’t quitting anyway. The doctors may want the smoker to be cleared for a procedure (heart transplant) that makes the hospital a ton of money. The doctors may simply be bad doctors. The bar for what is considered healthy or unhealthy may have dropped…
What I am sure of is that smoking causes damage, and heavy smoking causes significant damage across the board. My friends contest this as they continue to puff away because their doctors said that their lungs are “fine.”
Deep down, most smokers probably know the truth. Closer to the surface the validation of their unhealthy choice by doctors is maddening.
Hey if I’ve a patient who is a smoker and his x-ray is normal, or his pulmonary function tests are normal, I’m going to tell him that fact. I will inform him that his continued smoking puts him at risk for premature disease and death, but I am not going to lie to him about his test results, or shade them away from the truth to try to accomplish that agenda.
I don’t know why you’re attacking doctors here. We’ve been working for decades to educate patients about the dangers of smoking.
The alternative is the doctors don’t tell the truth and that isn’t a very good option either. A local doctor I was friends with found “pre-diabetic” symptoms in almost every patient he had who was a certain amount overweight. In other words, he made stuff up to try and scare them into eating better and taking care of themselves. It didn’t work. By ten years into his practice it became clear, even to him, that he had more patients becoming full-blown diabetics than any of the other doctors in the practice. The short version of the psychology basically is “Since I already have the start of the disease, why change now - I’m doomed”.
Better if you play it straight - right now you are perfectly healthy but if you don’t change, that health will. When and how I can’t tell you but it will.
It’s also worth noting that some patients hear what they want to hear, no matter what their doctor actually said. When my mother-in-law (a heavy smoker) contracted lung cancer, she swore up and down and on the Bible that the doctor told her smoking didn’t cause lung cancer and she should smoke all she wanted during her chemo and radiation. Her niece, who was at that appointment with her and took notes for the rest of the family, states pretty much the doctor said the exact opposite.
Many patients are quite capable of morphing the doctor’s ‘your lungs are basically fine right now, but you’re showing early damage and need to quit’ into ‘your lungs are fine’.
Some smokers don’t inhale deeply, which could conceivably cause less tar and gunk deep down.
But, y’know, if you’re wheezing and hacking, you’re not “normal”. In nursing, we refer to that as “functional limitation”. It may not be a physical disability showing physical damage to the lung tissue, but it’s impairing the patient’s ability to breathe and do stuff.
Also, the range of what pulmonologists and respiratory therapists consider “normal” on pulmonary function tests overlaps considerably with what nurses consider Impaired Gas Exchange and/or Impaired Oxygenation and/or Activity Intolerance. My SO tests on the low border of “normal” and he’s got chronic wheezing, crackles all over his lungs, diagnosed COPD, obstructive sleep apnea, snores like a rhino and can’t walk more than 20 feet without getting winded. Pink lungs or not, that’s not “normal” from a *functional *standpoint. But give him enough hits of albuterol during the PFT, and we can get him into the “normal” range.
I’m inclined to agree with GythaOgg. Patients hear about 20% of what doctors and nurses actually say. Whether it’s a positive 20% or negative 20% depends much more on the person’s personality and skill at denial than how much positive or negative the doctor actually said.
Or at least trying to steer them toward a “FRESH” cigarette. Pics here of QTM as a young man. :D;)
Have you seen the pictures that show pink non-smoker lungs and nasty blackened smoker lungs? There is a problem with those pictures. They don’t actually show non-smoker vs smoker, they show non-smoker vs smoker who died of lung cancer.
If you (or most people without medical training) were shown pictures of the lungs of a non-smoker and the lungs of a typical smoker, you would not know which was which.
This is typical of the kind of misinformation the anti-smoking extremists use to wage their war. Smoking certainly isn’t good for you, but the idea that one puff of smoke from a cigarette 100 feet away in a park is dangerous is, apparently, effective propaganda.
My grandmother smoked Camels all her life, died in her 80s of well, old age (dementia, started inhaling her food accidentally, eventually was barely conscious; I watched her die). Didn’t cough much. Before her mind was totally gone, she stated, “I never expected to live this long.”
One of her daughters (my aunt) smokes the lightest brand there is but she lights one with the butt of the last one. She’s got emphysema and coughs a lot. She gives me her Advair prescription because she heard the medication could kill her. :smack:
I tried smoking in my 20s but didn’t get very far. Smoking doesn’t go well with asthma and I ended up in the hospital.
There’s the additional twist that they may not be being entirely truthful when they tell you what the doctor said. There are three things being said here:
Those three things may not be the same.
Also, people are very good at finding validation for what they want to do, even if a more objective observer would say such validation isn’t there. Your friends don’t want to quit smoking, and they manage to find validation for that choice. That’s not necessarily their doctors’ fault.
pkbites, Qadgop, GythaOgg and WhyNot, I thank you and the others for you input. I might have phrased the question and my follow up better; especially knowing this board! Lack of sleep last night and being tired this morning after waking at 7am after 4 hours sleep affected my focus.
To be clear (I hope): What I was hoping to determine was is it possible for a HEAVY (1.5 to 2.5 pack a day) smoker who has been smoking every day for 20 to 30 years not to exhibit - upon examination - evidence that their lungs are significantly compromised. One examination would be a “thorough” checkup and the other would be a pre-screening for a heart transplant.
I know two such people who tell me that their doctors told them that their “lungs are fine” and knowing these two very well, I can’t imagine this to be possible. I strongly allow for the possibility that the doctors told these people something different and that what was told to me was not what was told to them.
I probably won’t respond anymore to this thread unless directly asked to. I’ll try and keep it more concise next time as I really do value this board. Thanks again.
My dad smoked for something like 60 years and his doctor always told him his lungs were fine. At least, that is what my dad told us. Even when he actually had lung cancer and was clearly, to us, sick in some way he was telling us his lungs were fine. I’m sure dad heard what he wanted to hear and he told us what he wanted us to hear.
In my experience, “fine” means “it’s not good but I don’t want to tell you.” If my dad’s lungs were in good shape he would have told us that and would have let us see reports that showed that. As is was, all we got was “they’re fine.”
The OP’s friends could argue that their medical information is private and is not the OP’s business. There’s no legal obligation to disclose a medical condition to anyone who asks about it. Most people would probably say there isn’t a moral obligation if the condition isn’t going to directly affect the person who is asking (for example, asking someone you’re planning to have sex with about their STD status). If you called your friends’ doctors and asked about the status of their lungs, I’d bet you wouldn’t get that information.
I don’t think I have a legal or moral obligation to disclose details about my health to anyone who asks. Why should it be any different for the OP’s friends?
It is possible. My MIL was 2-3 packs a day for roughly 60/65 years and at autopsy her lungs showed “indications of smoking but otherwise healthy and normal”. This is under a microscope. So that a doctor could have totally missed it through an examination wouldn’t surprise me. (In defense of full disclosure she had not smoked the last two years of her life very much due to being in a nursing home situation)
OTOH I know someone who died of lung cancer after 5-6 years of roughly a pack a day and had lungs you could have used for an anti-smoking campaign. The human body and cancer can be like that sometimes.