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Carl Maronich (Host): And today, on the podcast, we are joined by Michelle Stauffenberg. Michelle is a respiratory therapist at Riverside. Michelle, welcome to the podcast.

Michelle Stauffenberg (Guest): Thank you so much for having me.

Carl: Glad you could join us. And today, we are going to be talking about smoking cessation and how important it is not to smoke or be around smoke and the health benefits of that. But let’s first start with your background. You have been at Riverside

Michelle: For, it will be 32 years in June.

Carl: It’s hard to believe, you have been working that long. You must have started as a child. But in that time, always in the area of respiratory?

Michelle: Yes, all 31 years, I have been working in respiratory therapy.

Carl: And originally from?

Michelle: I’m from Manteno. I have lived there my whole life and still live there. My husband grew up there as well. And our kids now have grown up there and so it’s been a great community to live in.

Carl: Very connected to the community. That’s wonderful. And how is it that you got into respiratory therapy and that kind of work?

Michelle: I am a severe asthmatic and I have been my entire life and I remember going to the emergency room as a kid and as I got a little older thinking this is what I want to do. I want to give breathing treatments. And so right out of high school, I went to Kankakee Community College and through the respiratory program and became a respiratory therapist and I got hired at Riverside and I have worked her ever since.

Carl: Wow, all in that same area. But as we were talking before we started with the podcast, you mentioned even although it has all been in respiratory, a lot of different things you have been able to do.

Michelle: Yeah, it’s been – it’s really been a – I consider it a blessing. It has been really neat to be able to do a lot of different things and I have a real passion because I have a lung disease and I have been able to help a lot of people in different areas and different ways to manage their lung disease. I have done asthma education program. We just recently did a program in pediatrics. I have been able to do pulmonary function testing. I work on the floor and currently I am also working in the lung cancer screening program. So, it’s been neat to do different things within the field, but be able to help people with lung disease which I can relate to.

Carl: Sure. Yeah, breathing is important. People need to breathe. There is no doubt about that.

Michelle: Yeah and also when you are struggling to breathe, it can be very – it’s taxing emotionally, physically and I feel like I have that compassion because I know what that feels like. So, I’m happy to help people because it can be – it can be really hard to struggle with it.

Carl: Whether in water or any time you are unable to breathe, or you have that feeling of oh my gosh, I’m not going to be able to breathe, it is a panic inducing thing. So, I can imagine if folks that struggle with that really you said emotional issues along with the physical part of it. And you mentioned that the as a child going to the ER because, so is that some of your time or there are respiratory therapists that get called to the ER at times when there are patients that need that help in the ER?

Michelle: Oh yes, all the time. Especially when I was on the floor. I mean a respiratory therapist who works on the floor in the hospital, we are in the emergency room a lot of the time for people with asthma and different lung disorders, giving them breathing treatments and drawing arterial blood gasses, things like that.

Carl: It could be a traumatic incident that causes breathing issues too, I’m sure the ER sees that.

Michelle: Oh yeah, definitely. That illness, pneumonia, chronic illnesses, asthma, COPD, RSV for children, there’s a lot of different areas and different reasons that we treat people for having a hard time breathing.

Carl: And as we said, we have established breathing is very important, yet there is something that people do that causes them breathing difficulties, but they continue to do it and that of course is smoking. And smoking cessation is something that we offer – that is offered at Riverside. Talk a little bit about that program and how important it is.

Michelle: We, at Riverside we actually offer a Freedom from Smoking program. It’s a program that we offer twice a year. It’s a support group which is really neat, and I have really enjoyed – I have been a Freedom from Smoking facilitator for about eight or nine years now and at first, I thought well maybe I won’t be good at it because I have never smoked, because I have asthma. I have always been sick. But I bring my dad along who actually finally quit smoking, is struggling with COPD and he’s fantastic to share. He can really relate to what they are feeling, and I can relate to what they might feel like if they don’t quit. Because I know what it feels like to be short of breath. But we offer that program and it’s a really neat program. The first three weeks we prepare to quit. Week four we quit. And the last three weeks, we support each other. And it’s been very successful. So, we offer that. We also as an inpatient, if you are at Riverside, somebody will go up and talk with you about Freedom from Smoking, give you information. If you are going into pulmonary rehab, we follow up with that as well. We do have the lung cancer screening program and we heavily talk about smoking cessation there. I do follow up calls with everyone I see to see how they are doing, see if there is anything else we can do for you, give them additional resources to help them. Because this is an addiction.

Carl: Yeah. Sounds like a very thorough program.

Michelle: Yes, we do. We try really hard to help people.

Carl: I love the name of it. Freedom from Smoking. It has more of a positive goal-oriented kind of name as opposed to just quitting which is important, but just the word choice makes it –

Michelle: Freedom. And I love when people actually quit, and I can say to them you are a nonsmoker. And even if it’s been two days, they are like I am? And I’m like you are. So, it’s really been a neat – I have enjoyed it and we get really close for those eight weeks and we celebrate at the end. Our class gets to choose their celebration. We have gone to different restaurants and you really feel a connection.

Carl: Sitting in the smoke free section. There isn’t a smoke free section anymore because now in Illinois anyway, there is no smoking, which is great. It has been a blessing I’m sure.

Michelle: Yes, very thankful for like for people like me, I’m so thankful I can go and not have to be around that. So, yes.

Carl: So, is the celebration when everybody is done, and do you track the success rate? I mean I’m sure like with any addictive behavior, you quit but some people fall off the wagon so to speak and get back to it and it may take a few times before they are finally successful for the long haul. Do you find that?

Michelle: Yes, definitely and we do try to track and actually it’s interesting, when I have talked to past people from my classes, they really want us to do a follow up program. So, we have actually talked about that and I think we might be implementing something like that for anyone who has come to the program, they can maybe once a month or every other month we meet and continue to support each other. Because that is key because nicotine – I don’t know if I’m getting ahead of myself here, but nicotine is a highly addictive substance. It’s been, what I have read it’s up there with heroin and cocaine and people think oh my gosh, but it is. It passes the blood-brain barrier in ten seconds. So, it’s not just oh someone doesn’t have will power or someone – it’s a bad habit. It is an addiction and when I went through the program to get certified, I really gained a real compassion for people, because it’s an addiction and a lot of people they don’t know that when they start.

Carl: Yeah, well with that thought in mind, how is it that you start – when people first start the program, what is it you do to help them kind of get a handle on it and set the path for them to be able to quit because it is so difficult?

Michelle: We talk a lot about – we take three weeks to prepare. So, we talk about what do you think triggers you. What do you think causes you? We have something called Track Packs and they fill them out and when they smoke, they put am I happy, am I sad, am I stressed, and you would think people would know that, but they really don’t until they really consciously look at it. So, we help people figure out why am I smoking, what triggers me to smoke, what are my fears of quitting, what are my motivations to quit, family, people I love, I want to be here, that’s the big one, my health. But finances, it has become very expensive so people, we talk about what are you going to do with the extra money and people plan vacations or why not buy a car or things like that. So, we really prepare but we really talk a lot about – it’s a three link – three chain link addiction. It’s physically, it’s socially, and it’s emotional or mental. So, we really try to dig deep as to what’s causing you to do this. But we know the physical addiction at this point is what’s really driving it. But what triggers it?

Carl: Yeah in those first three weeks, is there something you are doing to help with the physical component. Is there something you can do to prepare to quit physically that is going to help better the odds that you are going to be able to do it?

Michelle: We talk in-depth about medications and different nicotine replacement programs. Nicotine is highly addictive, but also in tobacco, there are over 4000 carcinogenics in the tobacco. So, we – yes, we ultimately want to be tobacco and nicotine free, but if nicotine replacement will help the person be able to stop the tobacco; that’s a good thing. So, we talk about patches, and I have seen a lot of success with that, gum, we talk about there are different inhalers, nose inhalers, we talk all about that and then also prescription medications that they can go and talk to their physician like Chantix and Wellbutrin. There’s different medications that do something in the brain to help prevent the urge. So, we have a whole section on that, that we talk about. We talk about it every week, but we really talk about it prior and then people make a decision is this something I want to do.

Carl: And talking to your primary care provider is part of the process.

Michelle: Yes, for anything. Even – I even recommend if they want to use some a patch or gum because nicotine can affect the blood pressure and the heart rate and things like that and so we want to make sure that if you start on something that you are not starting with more nicotine than you already had. So, we recommend having your primary care involved and then talking to a pharmacist maybe in regard to okay this is how much I smoke, where should I start with these over the counter things.

Carl: You mentioned that the social component and family. Does family get involved? You mentioned you bring your dad. Does family get involved and I have to think that if they do, it’s going to better – it’s going to be better success rate if they have got loved ones who are helping them as opposed to heh, I want to keep smoking even if you are going to quit, which I’m sure comes up as well.

Michelle: Definitely. Family is welcome to come. I have had a few classes where a wife – a spouse will come, not a lot of times do they bring their family members, but they are always welcome to. And that is key, because one of the things I find that’s difficult is a lot of people say well my husband or my wife smokes. That’s hard to quit when someone else is still. So, if you can do it together, and a lot of times, but I have had people bring their spouses and it’s very good and supportive. So, yeah, I think support is very important, that’s why I think our program is effective because even if they don’t have the support at home, they have each week to come together and share and they can all relate that this is – I have had people say I feel like I’m losing my best friend. And then other people say I know. Where someone who doesn’t – hasn’t been there doesn’t get that. But to have someone say I get it, that’s why I bring my dad because he can get it more than I can.

Carl: I’m sure some people who have smoked a long period of time think well, I’ve already done the damage, what’s the point in quitting now. But there is a benefit, no matter when you choose to quit, there’s still going to be health benefits to that, is that correct?

Michelle: Definitely. I actually brought a little sheet Carl, that I would like to refer to because I hear that all the time. I have smoked for 50 years, it’s too late and it’s not. And you will get health benefits within 20 minutes after you quit. In 20 minutes, your heart rate and your blood pressure drop. In eight hours, after quitting carbon monoxide levels drop in your blood and oxygen level in the blood increases to normal. In 48 hours nerve endings start to regrow, the ability to smell and taste gets better. I mean so very quickly, things improve because one thing we teach in the Freedom from Smoking class is smoking is not a normal state. And so, your body is trying to always get back to normal. So quickly, it will try to once you have quit and then like I don’t know if you want me to go on, but there are 2 weeks, one month, I mean up to ten years after so many years, you are almost at the same risk as a nonsmoker for certain diseases.

Carl: So, all those benefits when you quit. Almost makes me want to start smoking. Just so I can quit and have all those benefits.

Michelle: You could have a lower blood pressure.

Carl: It probably doesn’t make a lot of sense though to think that way.

Michelle: No, do not start Carl.

Carl: One of the things you mentioned also was Riverside has a lung cancer screening program. Talk a little bit about that.

Michelle: It’s a fantastic program. It is a free program. I will say that again. Free. Because nothing is free. And you do not need a physician order. You can refer yourself here and if you have been – if you are a current or a past smoker, depending on the different – I think it’s 30 days one pack a day or more, but like I said, I don’t know all the exact particulars.

Carl: Thirty pack years I think is the term that they use which means a pack a day for 30 years. Or two packs a day for 15 years or some combination. There is math involved, but some combination like that. So, if you have smoked for a period of time, then the testing is free to you.

Michelle: Then you are eligible. And don’t get hung up on what we just said. I mean call. We will let you know. If you think that that is something you want to do, call and try to make an appointment and we will let you know if you are eligible. But yes, you come, and you get a free lung CT and then if you are a current smoker, you also get a free pulmonary function screening for COPD as well. And so, that’s been - and that’s what I do Carl. So, that’s been really a neat thing to be a part of. And then of course we always – we follow up afterwards with everybody to see if there is anything we can do to help them in becoming smoke free.

Carl: And as I understand, the program they test for three years, so they will see if there is something they can monitor, right and see if it is something that in turn you go on to get taken care of.

Michelle: Yes, sometimes they will find a nodule, very, very small and they will just follow it and it becomes nothing. Sometimes everything is fine and then sometimes we do find things but by catching it early, lung cancers – we have come a long way and there’s a good survivorship. So, catching it early, so that’s why we do it and it’s free.

Carl: Such a huge benefit to catch those things early. Well Michelle is somebody hears this, and they want to take some action, how can they contact you? What should they do?

Michelle: They could – if they want to call and schedule for the lung cancer screening program they can call 815-935-7531 is our outpatient scheduling department.

Carl: Give that again.

Michelle: 815-935-7531. I hope I gave the right number Carl. I’m pretty sure. Anyway, they can call and get information and get scheduled. They could always call our respiratory care department for information 815-935-7517. Any of the respiratory therapists would be happy to talk more about our programs.

Carl: And there is information on the Riverside website about all that as well.

Michelle: Yes, there is. And you can even call the main hospital and say I want to talk to somebody about Freedom from Smoking, they will connect you. So, there’s lots of ways and we are here to help because definitely, smoking is the number one cause of emphysema, so it’s so important to help people and not only is it just the lungs, it affects every organ in the body. Nicotine narrows the blood vessels to every organ. So, it’s not just your lungs, it’s your whole body and we want to really help you be the healthiest you can be, so you can enjoy your life and enjoy your family and so we really – we have a mission for this right now. We really do.

Carl: That’s great. Well we appreciate you coming today and sharing all this information. Is there something else you want to mention?

Michelle: Yeah. There might be one more thing. A couple of other things, there is an Illinois Quit Line that is a fantastic resource. You call there, and you get a coach and I have heard it’s amazing and I hear the coach is available almost 24/7 for you and you can do it from the convenience of your home. And they also, I have heard, if you stay connected to their program; that they will send you free gum, nicotine gum or patches.

Carl: Okay, I like that idea. Free gum, who doesn’t want free gum.

Michelle: Yeah, and I can give the phone number for that as well. 1-866-QUITYES, 1-866-QUITYES which is 1-866-784-8937. But it is a fantastic program that I have heard a lot of people have really enjoyed and it’s not intimidating because you can just do it from home and call. You don’t have to go somewhere. If you have a busy schedule, you could still make a quick phone call and talk to your coach.

Carl: Yeah, so there are a lot of resources available. So, if someone is struggling with quitting, there are a lot of options for them to look into.

Michelle: Yes, and even something just to mention. A lot of people that I follow up with they say okay yes, I have cut back. If I smoked 20 cigarettes a day, I’m going to do 15 for two months and then I’m going to do 10 for two months and I just want to stress that even cutting back matters. So, and another thing we teach in our Freedom from Smoking class is if you have been smoking for 30 years, you have practiced that addiction, that habit a lot so even if you have tried to quit smoking in the past and you haven’t been successful; it’s okay. It’s going to take practice to quit as well. So, even if you weren’t successful, I think about okay what triggered that or what caused me to relapse and do it again. Don’t give up. Because this could be the time that you are able to beat it. So, don’t give up. I would really want to encourage the hope that you can. Millions and millions of Americans have quit smoking and you can too. And we are here to help for sure.

Carl: Very good. Well Michelle, we appreciate you coming by. Michelle Stauffenberg, Respiratory Therapist at Riverside. Thanks for sharing all that great information.

Michelle: Oh, you are welcome. Thank you so much for having me.