Are You Still Smoking?

Fifty years after the release of the US Surgeon General report on smoking, the percent of adult smokers has gone down from 42% to 18%. With it, the number of people dying of lung cancer has decreased somewhat. But smoking remains the number one direct cause of death in the US!

The cost of tobacco use to the USeconomy is close to $300 billion (yes, with a "b") a year in direct medical cost and productivity loss. For every dollar spent on cigarettes, $5 are spent on related health care. And for every cigarette you smoke, you are likely to lose more than 20 minutes of life.

More than 440,000 people die in the USeach year as a direct result of smoking, of which 10% are innocent, second hand tobacco smoke inhalers. Most frequently, these are the children of smoking parents. Many more suffer from chronic, tobacco related lung and heart disease.

In my book, the main issue remains the “hard core” smoker. He or she has more than a 50% chance of dying of  lung disease and spending years with an oxygen mask. But the more casual smoker is also at risk.

It’s my hope that, if you are a smoker, the horrible statistics I brought to your attention would give you pause. Stop smoking now, before it’s too late. Do it for yourself, for your spouse, for your kids and your friends.

There are several ways to quit, from “cold turkey” to stress management, to hypnosis and medication. In our practice, we have seen many successful quitters, and most of them did it on their own.

Remember that stopping to smoke is one of those times when becoming a quitter is really becoming a winner.

Fitness and Conditioning: Why is VO2 Important?

If you exercise regularly, if you exercise vigorously and want to know if you could do even better, you may want to know your VO2 max.

When you exercise, your oxygen consumption increases. It does so within limits which vary from person to person. Your VO2max (where V stands for Volume and O2 stands for oxygen) is your maximal ability to consume oxygen during exertion, measured in milliliters of oxygen per kg of body weight, per minute.

Oxygen is inhaled from the atmosphere by the lungs, where it diffuses into the blood stream, and then
propelled by the heart throughout the body. Some of the oxygen is then taken up by the cells and is used in aerobic metabolism for energy production and a variety of metabolic processes.

Normally, the limitation to VO2 max is dictated by the ability of the heart to pump the blood. This max can be impaired in cases of heart disease, especially in congestive heart failure, but it can also be limited by a lung disease – asthma, and COPD for example – and can be further limited by genetic factors.

For individuals in good health, VO2 max can be “trained” to its ultimate maximum with a suitable exercise/fitness program. This may take several months, sometimes up to 18 months of regular exercise.

Your VO2 max is usually tested on a treadmill. It’s a graded exercise test, similar to cardiac exercise testing, with the addition of a small mouth piece through which air composition is analyzed, and the VO2 is computer-calculated during the test. Once you reach VO2 max, your oxygen consumption plateaus, as seen in the graph. Most people complete the exercise within 12-16 minutes (the Olympic athletes will take longer…).

Knowing you exercise VO2 and its relationship to your max allows us to assess your level of conditioning, and better prescribe an exercise/fitness routine in order to improve your performance.

At our facility, we have been cardiopulmonary function testing, which includes both a VO2 max test and cardiac exercise for over 20 years. To my knowledge, we are the only ones in the County who are doing this test outside the hospital. Many of our patients, including some high profile athletes, have benefited from it by safely increasing their exercise capacity and performance.

Insurance may cover some or all of the test; and we have an affordable fee schedule for the uninsured and the under-insured.

Does this whet your appetite? Any questions? Call (203) 853-1919.

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