Quitting smoking has a host of benefits

DEAR DR. ROACH

» My husband is a smoker.He sleeps sitting up, with his legs hanging, because he has trouble breathing. This way of sleeping causes his feet and ankles to swell. His doctor ordered diuretics and urged him to quit smoking. He also recommended that he sleep in a bed, with his legs elevated — that would help with the swelling. My husband doesn’t agree. My husband reads your column every day. Maybe you can convince him. — G.U.

DEAR READER » Smoking is one of the hardest habits to break. Many people who have stopped using heroin have told me that quitting smoking is harder. However, anyone can do it, and he needs to.

Sleeping with the legs hanging off the bed is a serious red flag. The first thing we are taught to look for in people who demonstrate this behavior is critical blockages in the arteries of the legs. People find that they don’t have leg pain when they do this, but blockages could be so severe that urgent treatment is needed — a surgical repair or an alternative procedure, like angioplasty, where blockages are opened with a balloon.

However, your husband also is noting shortness of breath, and this should prompt concern about both blockages in the arteries to the heart and heart failure, which is the inability of the heart to squeeze out enough blood AND relax under low pressure. Heart failure causes foot and ankle swelling, but sleeping with the feet dangling could do that in absence of heart failure.

Quitting smoking will help with all of the three potential problems, but right now he needs urgent evaluation of his heart, and if he has any symptoms of leg pain or heaviness, especially with exercise, he also should have a vascular study to look for blockages in the arteries of the leg.

I hope this helps. Husband of G.U.: Please get evaluated, and ask your doctor for help in quitting smoking. There are many treatments available to make it easier.

The booklet on COPD explains both emphysema and chronic bronchitis, the two elements of COPD, in detail. Readers can obtain a copy by writing: Dr. Roach Book No. 601 628 Virginia Dr. Orlando, FL 32803 Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow 4-6 weeks for delivery.

Contact Dr. Roach at ToYourGoodHealth@med. cornell.edu.