Tuesday, November 8, 2011

Tobacco and Your.... Feet?

Everyone is aware of the dangers of smoking to your lungs and heart. But the effects of smoking go far beyond your heart and lungs. Are you aware of what smoking can do to your feet? When I tell patients that smoking cigarettes can affect their feet, many are surprised. But the fact is that smoking can lead to serious problems with your feet.

First, when you smoke, levels of carbon monoxide become elevated in the bloodstream. Carbon monoxide displaces oxygen in red blood cells, and the result is that the blood is not able to carry as much oxygen. Since the tissues in your body (and feet) need oxygen, this is serious. Once oxygen is displaced from the blood cell by carbon monoxide, that blood cell can no longer carry oxygen for the rest of its lifespan (about 3 months).
Secondly, nicotine, which is found in cigarettes, causes the blood vessels to constrict and become narrower. This decreases the amount of blood (that’s the blood that already is carrying less oxygen) that can get to the tissues. The effects of nicotine diminish after two weeks, so quitting can improve circulation in a relatively short period of time.

Thirdly, smoking greatly increases the risk of PAD (peripheral arterial disease). This occurs when the arteries become clogged with plaques, further decreasing blood flow. Of the three main effects of tobacco smoking on circulation, this is the slowest to reverse itself after smoking is stopped (see www.padcoalition.org).

Why should you care if your feet are receiving adequate blood flow? Patients with poor circulation often will develop a condition called claudication, which manifests itself by causing severe pain in the legs when a person walks for short distances. In essense, the pain is a result of the muscles being starved of oxygen. When blood flow is poor, your body’s ability to heal itself (such as if you have an ulcer) is greatly diminished. Bones are also slower and more difficult to heal with a smoker who has poor circulation. In fact, when the circulation is bad enough, healing will not occur at all. This leads to tissue death (gangrene), and ultimately, amputation of a portion of the foot, or even the leg. This is very serious, because studies have shown that the 5-year mortality rate following a major amputation was 68%! This is higher than those diagnosed with colorectal cancer (39%), breast cancer (23%), Hodgkin’s disease (18%), and prostate cancer (8%). Losing a leg is not something to be taken lightly. Lung cancer, as it turns out, has a higher mortality rate (86%), but then again, tobacco is the major cause of that cancer too.

So what can be done? First, if you don’t smoke, please don’t start. I know very few people who are happy about the fact that they’re addicted to cigarettes. Secondly, if you do smoke, talk to your doctor about ways to quit. It probably will not be easy, but will most definitely be worth not only saving a foot, but saving your life!

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