A few months shy of her 40th, Bridgette knew that she continued to beat the odds. Her vigorous workouts and healthy dietary ways had kept her in better shape at this age than she could have ever hoped for. Unfortunately, she just couldn’t kick her damned smoking habit, one that with her family history of heart disease, trumped any of the positives she was doing for her gracefully aging body. Sure, she justified it in her mind that she could “handle having tar stained lungs” so long as her daily ration of 10-15 Virginia Slims 120s continued to be the only detrement to her otherwise clean-living lifestyle. After all, other than a little apnea and a few heart palpitations from time-to-time, had she really felt the dreaded degradation of her quality of life the so-called “experts” always preached about long term smoking? Nope…must have a healthy enough chest then.
She started the day like any other, with a yawn, a reach, and Virginia Slims smoke in her beautiful brown lungs. She enjoyed the first cigarette like no other, with a nice nicotine buzz and a highly stimulated, rapidly pounding heartbeat she rarely felt with the other dozen or so she smoked the remainder of the typical day. She hardly noticed with the first few lungfulls the increasingly dull ache in her shoulder and back. With her vigorous exercise regime, heck, she was probably just cramped after a restless night’s sleep…or perhaps strained it on one of the weight machines. Not even a passing thought was given to the fact her mother, then a heavy smoker of only 42, had felt the exact same sensations two decades before…right before a massive myocardial infarction had stopped her heart in its tracks.
Brigette slipped out of bed…whoa! A little bit of a head rush there! Nothing to write home about, but kind of freaky in the AM. As she got in the shower, she noticed her heart was still racing, with a strange kind of heartbeat that felt like it was flutterring in her throat. She stopped scrubbing for a sec and took a few deep breaths…the kind that always helped when she was going through palpitations. A little better, the muscle pumping her blood temporarily slowed and regained a stronger, steadier rhythm.After grabbing a cup of coffee, she sat down for the paper. Using her now steadily beating heart muscle to pump a decent level of nicotine through her body, she proceeded to inhale a dozen or so huge puffs of Virginia Slims smoke deep into her lungs.
Now, Bridgette had a knack for double-pumping and holding the smoke inside her much longer than most women. By the time the smoke leaked out of her, most of the tar had been deposited in her lungs and the nicotine pumping through her bloodstream. Since she smoked a longer, lets face it, higher tar 120mm cigarette, she was putting pretty high levels of tobacco-derivative chemicals in her body. Never having taken this into account, Bridgette…always trying to meter her smoking habit so closely, was actually smoking the equivalent of close to a pack-and-a-half a day of regular king-sized cigarettes. Though she was gorgeous on the outside, and felt so on the inside, she totally underestimated the damage that had already occurred to her heart & lungs from her 25-year smoking habit…a total shame as she was to find out over the course of what would become an unusual day to say the least.
As she drove in on the freeway, she ran into some traffic troubles, her blood pressure was already quite high whe she lit up her second Virginia Slims of the trip from the stress of the road. Drivers on cell phones, with kids in all seats, eating, smoking, drinking…all at the same time. 8-lanes of hell in only a 12 mile trak. Bridgette always smoked at least one. The accident ahead allowed her to have 3. By the end of the third, Bridgette started to feel a little light-headed. Her heart was skipping beats, and she was having trouble catching her breath. She attributed it, of course, to the drive (a smokers habit is so ingrained…the culprit couldn’t have been the shotgunned cigarettes, could it?). So dense was she, that even a second and third sign of cardiac trouble went unnoticed. She figured she was coming down with something and would work it out at the gym later.
At work, Bridgette could not smoke. She went through the day with only her couple of lunch-time smokes to keep her calm and nicotine levels up. Wierd thing was, that she wasn’t her usual shaky self by the noon hour to rush up to the roof for a cigarette. SHe simply felt nauseous and was a little sweaty around the brow (though it was warm in the office…wasn’t it?). The ache had returned to her back, but wasn’t as bad as when she got out of bed this morning. Her heart was beating slowly now, too slow it seemed, but at least not that uncomfortable butterfly feeling from earlier. She resolved to duck out front to the cafe across the street at lunch. Unfortunately for her, her cravings came back on the way over…and she predictable lit up her first Virginia Slims 120 in 4 hours.
She sat there on the bistro chair sipping a bottle of water, waiting for her spincah salad…SMOKING a 120mm cigarette. Her friends thought her crazy…why go through the trouble, it won’t counter the smoking damage. But it can’t hurt, can it? Isn’t it better than couch-potatoing it? Why should I waste away AND still be hooked on ciggies? I go through the pain, so I CAN still smoke and not feel guilty, right? Oh…salad time…
The lunch made her feel a bit better. She wasn’t nauseous, but had developed a bit of a headache. She lit up another cigarette, proceeding to do as she always does when she knows this is the last for a while, chain-smoking it, while holding the thick, tarry smoke in until it settled out in her lungs. As she walked back…dammit! Her heart was back to screwy…going from a steady stimulated beat to a strange, syncopated pumping action. More breathing exercises at her desk helped a little, but her (now ischemic) heart continued to go through periods of skipped beats and flutterring the whole rest of the day.
Bridgette left work about 5:30 (she worked well over 8 stressful hours a day), lighting up as soon as she reached the open air. The tobacco ignited, a steady, light draw from her still supple lips sucked as much smoke into her mouth as it could hold. With one deep breath, she popped her mouth open and inhaled, filling her lungs with the sweet nectar of tobacco smoke (specially formulated for a lady of course…one of the reasons she started smoking Virginia Slims as a teen to begin with). The familiar light buzz and a rapid heartbeat returned, this time more normal, like it did with every cigarette she smoked. She had an uneventful drive home, with only one more smoke.
The keys went into the basket as usual. The purse went on the coat closet doorknob as usual, the cigarettes came out of the purse and tossed by the ashtray on the coffee table, as usual. The gym bag was pulled out of the closet, as usual. Bridgette sat for a while on the couch and watched the new before her workout…all as usual. The cigarette was the last in the pack. She fired it up and took a long double-pump of smoke deep into her brown, waiting lungs. Holding the smoke deep inside for a good 10 seconds, she slowly let out the light, wispy remains of whatever didn’t stick to her lung tissues. A second and third deep puff followed…
Then it happened…a large part of Bridgettes life-giving heart muscle, which had been crying out a number of tragically unheeded warnings all day, began to die.
No sooner than the third full puff of Virginia Slims 120s smoke filled her lungs, that she realized the smoke would have to stay there. She couldn’t breathe!!! Oh…my…GOD! My chest…the squeezing…can’t get air!
Deep inside her impressive 40-year old chest, a heart muscle of an age closer to 70 was in extreme distress. Years of smoking, working with a dire family history of coronary heart disease, had scoffed at her healthy eating habits and regular exercise regime, prematurely narrowing her coronary arteries with soft plaques. Unfortunately for her, she was in much too good a shape to really understand the feelings she had felt all day (come to think of it, for about two weeks now…awww SHIT!). The left circumflex artery of her heart received a tiny thrombus in its narrowed channel, almost blocking off completely the flow of nourishing blood to part of the pumping heart muscle below it.
The heart, to avoid going into shock, had been producing enzymes all day in an effort to anaerobically metabolize nutrients without the aid of what little oxygen that was getting through the 95% blockage and any redundant vascularization her heart had produced. Unfortunately, the artery had become completely blocked by spasm just as she had that third puff…(one toke over the line…not funny!). The heart had used up its reserves, the only thing it could do now was to rush white blood cells to the “crash site” and try to contain the damage to only one section of the heart muscle. Then hope for healing…
Bridgette dropped her cigarette as the crushing pain siezed her entire being. In her panic, she knew she had to dial 911…after all, this was the same thing that happened to her mom years ago. But things were beginning to spin in her head. She began to foam at the mouth trying to suck air in…which she was actually doing…but just didn’t feel like she was. Her heart was going into a tachycardic state, with very little blood being pumped with each stroke of the affected left ventricle. Thankfully, the actual muscle tissue (myocardium) was strong and efficient, thanks both to her exercising and keeping lower oxygen levels in her blood through her smoking habit. Her heart was literally used to smoking, and the exercise had made it smoother in its contractions. Thus, as she fianlly managed to reach the phone and call 911, she was able to stay conscious, with no futher degradation in her heartbeat to the dreaded fibrilation…the state of cardiogenic shock from which her mother had died of very quickly following her heart attack.
“I…heart attack…215 Laurel…hurry!!!”. Trying to catch her breath was not an option. She curled up in a fetal position and slowly slid into oblivion…
“Heart rate 110…BP 190/100…pulse ox 86…” What? she heard something, didn’t she? Dizzying light came through her slits of eyelids, with two people in white coats standing above her. Electronic beeps, bloops, and blips surrounded her very confused mind. “Ah…sleepyhead! Welcome back to the world. You were darn lucky the hospital was so close, miss” Without a response, everything she remembered up to the call cane flooding into her fuzzy brain. The horrible pain, not being able to breathe, the sickening fluttering and throbbing in under her breasts. It was all real. I have survived the heart attack my mother didn’t!
Oops…she said that last part out loud. “Uh…Ms. Thompson, you haven’t survived just yet. You have sustained an awful lot of damage to the left ventricle of your heart in this event. Must have been coming on for some time with the extent of injury. Had you been feeling ill lately?” All the questions, the interrogation….how could she have been so idiotic! One answer…”because I loved my Virginia Slims 120s more than life itself” She knew she would eventually die from her smoking habit, just like her mother before her. So she blocked it out, and justified it with living an otherwise healthy lifestyle.
She was still contemplating these thoughts when she lit up her 3rd Virginia Slims 120 of the day. “Screw the doctors. I did everything right, and I still ended up with a smoker’s heart attack. Lets get it pumping WITHOUT breaking a sweat!” She had lost about 20% of her left ventricle’s pumping abitlity to necrosis. But now, a month down the path of rehabilitation, she had shown remarkable resiliency. Her heart was healed with non-contractile scar tissue, but the muscle was still so strong, it was pumping at 95% efficiency after only 3 weeks of rehab.
She also realized she was a smoker. She would always be a smoke. Denial would not change that. Nearly dying from an MI wouldn’t change that. She would not live without tar-stained lungs. She would not live without a nicotine stimulated circulatory system. It wasn’t in the cards. And though harrowing the experience was…she knew she couldn’t just quit like all the other. She was still young, vital, and a smoker. She WOULD survive.