Under the endoscope, what does a 50-year-old lung look like? Doctor: Like a piece of rag that crumbles when pinched

"If I am addicted to smoking, I will hide and smoke, and never take out a lighter in front of the patient."

Shi Hongwei (pseudonym) is a doctor. He has smoked for nearly 20 years, but he can't quit.

1. The doctor's long journey to quit smoking

01. The first time I quit smoking ended in failure

At the age of 20, Shi Hongwei was a sophomore medical student who learned to smoke. After becoming a clinician, his work pressure became more and more serious, and his smoking addiction became heavier and heavier. He had to smoke a pack of cigarettes a day.

As a doctor, Shi Hongwei is well aware of the dangers of smoking , so he never smokes in front of patients, and hides to smoke when he gets addicted. This sneaky feeling made him very uncomfortable . He thought about quitting smoking, but after 20 years of smoking, can he quit all at once?

Later, Shi Hongwei suffered from chronic bronchitis and often coughed and produced sputum. The idea of ​​quitting smoking came up again. Coupled with the fact that his son was just born, he was afraid that second-hand smoke would affect his son, so he finally made up his mind to quit smoking.

As Shi Hongwei expected, quitting smoking was not as easy as he imagined .

After gritting his teeth and persisting for more than a month , his temper became irritable, and finally he failed to quit smoking at a friend gathering. On the day of the party, everyone present smoked. Shi Hongwei lit a cigarette with the idea of ​​" trying only one". , Every time he finishes smoking, he is surrounded by anxiety and self-blame, which makes him feel very painful.

02. "I also smoke, how to persuade patients to quit smoking?"

At the beginning of 2022, the hospital where Shi Hongwei works is preparing to set up a smoking cessation clinic. The hospital requires Shi Hongwei to participate in training and take on the job of a smoking cessation doctor .

Shi Hongwei felt very awkward: "I am a smoker myself, how can I persuade patients to quit smoking?"

During the training, Shi Hongwei fell into a cigarette addiction again, so he had to sneak out of the classroom. Standing in the ice and snow, he looked at the people smoking around him, and thought for a long time: "I don't want to smoke secretly again!"

He made up his mind, cut off the cigarette in his hand, and threw the cigarette case and lighter into the trash can.

03. Be your first patient

In this way, Shi Hongwei became his first patient.

According to the knowledge he learned in the training, he took the smoking cessation medicine on time every day. However, after a week, his addiction to smoking still made him want to move.

But Shi Hongwei also knows that it usually takes 1 to 2 weeks for smoking cessation drugs to work . He suppressed his anxiety and still took the drugs on time. A miracle happened. On the 8th day of taking the medicine, he found that he rarely thought about smoking. On the 10th day after taking the medicine, Shi Hongwei had completely quit .

While taking smoking cessation drugs, he began to change his lifestyle: he got up at 7:30 in the morning, went to the hospital for a day of work , and went home in the evening to exercise for an hour and a half. After persisting for 20 days, Shi Hongwei found that his cough became less and his body was recovering day by day. His heart was filled with joy and an indescribable sense of pride .

Today, Shi Hongwei has successfully quit smoking and helped many smokers stay away from cigarettes.

2. Smokers doubt: what does the lung look like after smoking? Can I come back in vain?

Case 1: Lungs from 20 years of smoking

Uncle Li from Hubei is 50 years old and has been smoking for 20 years. He takes one pack a day. In July last year, Uncle Li had a constant dry cough and bloody sputum. He went to the hospital for an examination and found a mass of tissue density in the left upper lung, with a diameter of 1.8cm.

Doctors suspected a malignant tumor and suggested a lobectomy. After the operation, Uncle Li saw his "smoky lungs" and vowed to quit smoking and never touch cigarettes again...

Source: Yichang Central People's Hospital

Case 2: Lungs from 50 years of smoking

In the medical documentary "My White Coat" , there is such a scene.

A 67-year-old man started smoking when he was a teenager. The doctor observed the man’s lungs through an endoscope and couldn’t help but gasp: “His lungs are of poor quality, like a piece of rotten clothes that have been exposed to the sun for a long time. If you pinch it, it will shatter."

Source: "My White Coat"

As we all know, the longer you smoke , the darker your lungs will be " smoked ", and the risk of lung cancer will also greatly increase. Will my lung health improve if I quit smoking?

The answer is "yes"!

After quitting smoking, the extent to which the lungs can recover is related to factors such as smoking age, smoking amount, age, physical condition, and also depends on the shape and function of the lungs. After long-term smoking, the toxins of cigarette smoke will continue to adhere to the cilia of the lungs, and it is difficult to discharge them, so it is difficult for the lungs to fully restore their shape .

But after quitting smoking, the function of the lungs will gradually recover . About 1 week after quitting smoking, the lung cilia will begin to regenerate; after 3 months of quitting smoking, the function of the cilia will return to normal . With the extension of smoking cessation time, the function of the lungs will gradually increase and gradually approach normal.

Sadly, smokers' lungs are unlikely to come back completely "white". The self-cleaning function of the lungs can be gradually restored, and some "waste" can be discharged, but the color cannot be completely restored to the original, but it will not continue to deteriorate .

3. Choose the right drug to make quitting smoking easier

Shi Hongwei succeeded in quitting smoking by taking drugs. On the one hand, smoking cessation drugs can relieve withdrawal symptoms and reduce the chance of relapse; The lure of smokers.

So, what are the smoking cessation drugs in China? The following three types are currently approved for use:

1. Varenicline

Varenicline is a selective nicotine acetylcholine receptor partial agonist , which can reduce smokers' craving and withdrawal symptoms, reduce the pleasure of smoking, prevent relapse, and increase smoking cessation rate . It is recommended by the " Chinese Clinical Smoking Cessation Guidelines " First-line smoking cessation drugs.

Usage: Varenicline tablets are available in two specifications of 0.5mg and 1mg. One course of treatment is 12 weeks, which is divided into 3 medication cycles ( day 1-3, day 4-7, day 8 to the end of the course of treatment ), each cycle The dosage varies according to the dosage , please refer to the drug instructions.

**Precautions:**It may cause adverse reactions such as nausea and sleep disturbance, and it is contraindicated for patients with depression, pregnant and lactating women, and minors.Those who cannot tolerate it should reduce the dose, and the elderly and those with liver and kidney impairment should use it with caution.

2. Bupropion

Bupropion was originally an antidepressant, which can relieve anxiety during the process of quitting smoking, and is easy to take orally and convenient to use.

Usage: Generally start oral administration 1 week before quitting smoking , the course of treatment is 7-12 weeks, divided into 3 medication cycles ( 1-3 days, 4-7 days, 8 days to the end of the course of treatment ), the dosage of each cycle It is different from the number of times of taking the medicine , and you need to refer to the medicine instruction .

Caution: There may beAdverse reactions such as dry mouth, irritability, insomnia, headache, and dizziness are contraindicated in patients with epilepsy, those taking monoamine oxidase inhibitors, anorexia or excessive appetite.

3. Nicotine replacement therapy

Nicotine replacement therapy drugs include nicotine patches , nicotine chewing gum , nicotine sublingual tablets, etc. The standard course of treatment is generally 8-12 weeks, and the maximum is no more than 6 months .

Usage: The nicotine patch has high medication compliance, but it needs to be released quantitatively and cannot be individualized. Nicotine chewing gum has two specifications of 4mg and 2mg. 4mg is suitable for smokers who smoke ≥20 cigarettes a day, and 2mg is suitable for smokers who smoke ≤20 cigarettes a day. The course of treatment is 8-12 weeks. Nicotine sublingual tablets currently only have a specification of 2mg, which is gradually reduced after 4 weeks of use, and the course of treatment is 12 weeks.

Note : It is an over-the -counter drug, but the failure rate of smoking cessation is still high when used alone . It is recommended to follow the doctor's advice as a supplement to the above two smoking cessation drugs.

Quitting smoking is a test of one's self-control, and those who can succeed are "warriors"! No matter how long you have been a smoker, as long as you quit smoking, you can regain your health. If you are determined to quit smoking, it is recommended to go to the smoking cessation clinic as soon as possible to receive professional help, strengthen your confidence, and be mentally prepared for a protracted battle !

References:

[1] Liao Yanhui, editor-in-chief. Scientific smoking cessation: theory and practice [M]. Central South University Press, 2020.10.

[2] National Health and Family Planning Commission of the People's Republic of China, Wang Chen, Xiao Dan. Guidelines for Clinical Smoking Cessation in China (2015 Edition) [J]. Chinese Journal of Health Management, 2016.

[3] Qi Wenhui. Changes in lung function of smokers after quitting smoking [J]. Public Health and Preventive Medicine, 2002, 13(001):29-30.

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