“Hi, this is Dr. Silvester, and I’m going to talk to you about the importance of not smoking and how that affects your lower extremities. Most people are totally aware that smoking hurts their heart, lungs, and kidneys, but what I’m going to talk to you about is how it affects your lower extremities, and this is important.
For some reason, tobacco plants have nicotine in them, and nicotine is the most addictive drug that we’ve been able to find. Inside your artery, there is a little receptor for nicotine, so when you smoke nicotine goes into your blood stream and goes down there and binds on that receptor. When nicotine gets to the artery, it shrinks and compresses down. If you can imagine, if you have large hose that is delivering water, and then it suddenly shuts down to a smaller size, you’re not delivering as much water. The same is true of your arteries and the blood they deliver. The body then has trouble getting blood down to the foot.
The second thing is that over a period of time, if you smoke a lot, you get plaque on the inside of your artery. This plaque blocks the flow of the artery, decreasing the flow of blood.
By far, the most devastating condition that occurs when you smoke regularly is carbon monoxide poisoning. That sounds pretty dire – most people know that carbon monoxide can kill you. There is, however, low-dose carbon monoxide that doesn’t kill you. Each red blood cell has a bunch of hemoglobin molecules on the inside. These molecules carry oxygen from the lungs and carries it down to your foot and then lets it go. Oxygen binds very loosely to that site, carbon monoxide, however, binds very strongly to that site. The binding of carbon monoxide in that site is 200 times stronger than oxygen.
Let’s say you have a train going from the suburbs (the lungs), down into town (your foot). On this train are a group of men wearing white shirts (oxygen), and a few men wearing black shirts (carbon monoxide). The men wearing white shirts aren’t held very well in the train seats, but a man wearing a black shirt is so firmly secured that it would take 200 men wearing white shirts to pull him out of that seat.
If you smoke regularly, a lot of your hemoglobin molecules aren’t even carrying oxygen. If you smoke, your foot gets less flow because of nicotine and plaque, and the blood that it does get doesn’t have much oxygen. As a result, your ability to heal wounds is greatly compromised. It’s been proven that people who have chronic pain syndromes are much more likely to be smokers that don’t. It’s been proven that bone healing is dramatically slowed by cigarette smoke – so if you smoke, you can count on about twice as long to heal a fracture or a surgery if a bone has been cut, or a bone is being fused together.
This is just one more reason to quit smoking, because it has a profound impact on your foot. If you’re diabetic and you have a foot ulcer, you can count on it taking twice as long to heal as well, if you continue to smoke. Talk to your family doctor about quitting smoking and understand that it does have an effect on your foot as well as your lungs and your heart. I’m sorry for the bad news, but that’s the way it is. If I can help you in any way to quit smoking, I’d be happy to do that. Thank you.”