Dr K K Pandey
If you survey a small town, to your surprise majority of our young people have become addicted to tobacco-based products like Zarda Paan Masaala ( a beetlenut and tobacco mixed product quite prevalent in Indian subcontinent). On a face value, they are just taking Paan Masaala; but in fact they are consuming tobacco.
In big cities or metros, smoking has become more or less a fashion statement. Why there is an increased percentage of smoking in big cities, it is due to three reasons. Firstly smoking in public is considered as a public statement of modernity, secondly it is considered as an exhibition of macho image, and thirdly it is supposed to be a remedy for the so-called bad mood. A very few people are aware of the simple fact that the basic harmful content of tobacco is called Nicotine which is present in cigarette, Bidi ( a local variant of cigarette made of tobacco leaves) Zarda, Khaini, Chaini and Mainpuri ( tobacco based products frequently used in Indian subcontinent). In other words all these products are just the different forms of the same harmful element nicotine, which is inseparable part of tobacco.
People have wrong notion about smoking
In developing countries, majority of the people have a notion, that use of cigarette or tobacco mainly harms our lungs, thus more or less spares other organs of the body. But unfortunately a very small percentage of people know about the lead role, tobacco plays in causing the pain in leg or hand so-called leg or hand angina and ultimate culprit is the same nicotine which is found in tobacco.
How to recognize harmful effect of smoking in an early stage ?
If you are a habitual smoker or a tobacco user and you have recently started feeling cold in hand or feet, in other words if you feel abnormal and excessive sensitivity to cold, you should realize you are suffering from early stage of a disease of blood pipe that carries pure blood & oxygen to hand & leg. This tobacco-induced disease of the artery is called Burger’s disease. If you feel pain and tingling sensation in hand and foot or leg while walking, take it for granted that Burger’s disease has completely overtaken your hand and feet and oxygen supply through pure blood to your limbs has drastically reduced. In an advanced stage of Burger’s disease, you feel a constant and unbearable pain in your fingers and toes especially during nighttime and if not treated in time, the color of your toes and fingers becomes blue or black.
Why is Burger’s disease caused by smoking ?
Burger’s disease is a disease of small and medium – sized arteries of legs and hands. In this disease there is inflammation or swelling of the arterial wall itself and side by side there is a collection of blood clot inside the tube. This causes disturbance in blood supply to feet and hand. Many a time it has been observed people do not take complaints of Burger’s disease very seriously. When their fingers and toes start getting black, they realize the gravity of the situation. Then it is too late and chance of amputation becomes very high.
The ulcers on feet and hands caused by Burger’s disease never heal without a correct treatment. Daily surgical cleaning and dressing of the wound is done in clinics, and a variety of antibiotics are tried and this continues for months with no improvement and ultimately patient is left with no other option except loosing the foot or hand.
In some cases, skin specialists for ulcer and eczema treat patients of Burger’s disease for months. In such situation, ulcer instead of healing gets worse and eventually results into a loss of the foot and hand. In some patients, leg pain of Burger’s disease is either mistaken for arthritis or sciatica and therefore they are advised to consult a Bone specialist.
What to do if you are suffering from Burger’s Disease
First of all, patients have to completely stop smoking cigarette or Bidi. Use of tobacco in any form is prohibited. There is no real benefit in reducing the frequency and number of cigarettes used per day. Even a single cigarette per day will keep the disease active. Therefore, complete abstinence from cigarette and tobacco is mandatory. Patient of Burger’s disease are also advised to keep themselves far away from smokers & smoker’s zone as well. According to one study, even only simple stoppage of smoking altogether reduces the possibility of amputation of leg by 50 percent. From this very observation one can assess the enormity of role of smoking in causation of loss of leg or foot.
Where to go for treatment of Buerger’s Disease?
The patients of Burger’s disease must consult a vascular or a cardiovascular surgeon instead of a general surgeon or a Bone specialist and under his guidance an active treatment should be carried out to reduce the possibility of amputation of leg.
The patients of Burger’s disease must go to a hospital where facility for angiography is available. They must ensure whether a full time service of a cardiovascular / vascular surgeon available or not. These two factors play a major role in effective treatment of Burger’s disease.
Burger’s disease requires super specialized and modern investigations like Doppler study, Echocardiogram and angiography. On the basis of the results of these investigations only, the correct management strategies can be formulated.
(The author is a Senior Consultant in the Depatment of Cardiothoracis & Vascular Surgery at Indraprastha Apollo Hospital, New Delhi.)
Follow our WhatsApp channel
