T: morning page C: hello how are you T: it's good to see you up and about how are you feeling after your last little hospitalization C: well it was pretty scary I'm I'm definitely improving but I don't feel as well as I think I should um the COFF is a lot better but my breathing is still not what I think it should be right now T: so you're you're still struggling to breathe some C: I guess you could call it struggling I just when I walked to the mailbox or up the stairs I get out of breath easily T: exercise tends to make the breathing worse C: it does seem so yes T: so you're better but not quite where you want to be and C: I'm definitely not where I think I should be I feel like I should be better by now usually after a cough or bronchitis I'm able to breathe easily and it's not like that this time T: so you usually bounce back pretty quickly but this time is taking longer and that's a that's a real concern to you C: it was when I was with you in the hospital you gave me a little oxygen in the beginning and I just never thought I would be a person that would have to have oxygen that was scary too T: so that the oxygen piece is something that scary it almost feels like ear were really really sick when you needed oxygen C it does I never picture myself needing a I guess I'm scared of needing an oxygen tank and carrying it around with me and having the tubes in my nose um that I just don't see myself needing that I always think of myself as being healthy T: and now it seems like you may have some real or some permanent damage C: that's what it seems like T: Paige would it be okay if we talked a little bit about your disease process C: sure T: you know with a flare-up of bronchitis like this you very well may have done some damage to your lungs the good news is as you continue to heal I mean we have a spirometry today which is that breathing test that you did we compared that about six months ago it is quite a bit worse now a lot of that will get better with time but also a lot of that kind of depends upon whether you continue to smoke or not C: oh this one we're going to talk about my smoking huh T: well Paige we don't have to talk about anything you don't want to talk about um those are going to be decisions that only you can make I can't make you quit and so that's just going to have to be your decision I I want you to know though that I'm here to support you and even though we've talked about smoking cessation and some things that you could do in the past you've been kind of resistant about that I wonder if having this bout in the hospital has done anything to change your mind C: well I think I need to seriously think about it again I just evidently my health is on the line because it it was just a really bad experience for me T: so bad experience mm-hmm so if we look down the road maybe five ten years and you decided not to quit smoking what do you think that would look like for you C: probably not good I would see me not being able to breathe at all and again just my biggest fear would be needing oxygen every day all day that T: oxygen is a pretty strong motivator for you isn't it yeah well so it sounds like if it sounds to me like if if you didn't quit smoking that you feel like your overall health might really be at risk C: yes T: where does that where does that leave you C I need to start considering it more seriously than I have in the past if I want a different outcome if it's T: okay at this point Paige it's great and but let's talk about it's okay what's something called a decision balance so and involves four things to think about it's almost like writing it on a page but we're going to do it in the air or whatever so what are the good things about smoking that you like if you didn't side to quit what are some of the negatives about smoking if you didn't decide to quit and then if you did quit what would be some of the good things and then what would be some of the negative things if you did quit so tell me if you would what are some of the good things about that you like about smoking if you continue to smoke the way you are C: okay um I like the taste I like how it feels in my throat I love the social aspect of it I have smoking friends I have non-smoking friends and just when I'm with my friends that smoke it is just a lot of fun it's just something we do as loud as that sounds um and I love it with my coffee first thing whirring a lot T: so some of the good things are the taste we regularly with coffee and how it makes you feel and then it sounds like there's a big social component to smoking for you there is tell me about then what would be some of the negatives if you continued to smoke and didn't quit C: my health that would be the number one things that are negative about smoking the snow and my clothes my hair and that it's a lot of people that are surround myself with it's not socially acceptable anymore and that does make me uncomfortable T: so some of the negative things would be it's a impact on your health right the the smell clothes and so forth and then there's a lot of kind of social pushback C: yes there is T: with cigarette smoking I see what else C: well you know my husband Dan recently stopped smoking and was it yeah he's done quite well but now it's seems like he's righteous and I'm an addict and he says things like you could just do it if you'll just do it you know what those cigarettes are gonna do to you why don't you just stop I tell them I've stopped a hundred times and I'll stop when I'm ready but it you know that's put a strain on things T: it does sound like he's concerned about you and and concerned about your health and that he loves you C: I know it just doesn't feel that way sometimes but I know that he would be supportive because he wants what's best for me T: but it's on the other hand it's it's hard to put up with some of that stuff and I think I think it shows a lot of inner strength in you to put up with some of that even though it's kind of a pain C: well thank you I'd like to think so T: so what would be some of the positives some of the good things about quitting based on what you told me here today C: even if I have some permanent damage you encouraged me to believe that if I stopped that I could get better and definitely avoid the oxygen tank that would be the biggest positive the second positive was that Dan and I would have a little more peace in our home and get along better and he would see that I you know want to be on the planet my clothes would smell better my hair would smell better a car would smell better I wouldn't have to worry about you know sneaking somewhere when I wanted to smoke and it wasn't socially acceptable in the situation I'm in so there are a lot of positives okay T: so again on one hand there are a lot of good things that you enjoy about smoking and on the other hand there you've given me quite a list of things that if you did quit there would be a lot of ways that your life would be better so where does that leave you now C: but I just really need to do this and to concentrate on the good things and just be ready to stop I just need to stop T: sounds like you're pretty committed so honest let's talk about a scale then on in terms of being ready to quit zero being not ready at all and ten being like yeah I'm really ready to quit where are you on that do you think C: I'm gonna say an eight T: an eight why an eight not a five or six C: it all just goes back to this recent event and the fears that I have or where it would be I'll go back to your five to ten years from now and that's just not T: not a pretty picture no no it's not tell me some of the things that you are aware of that can help you in this quest C: well I'm very familiar with nicotine gum and nicotine patches I do wear the patch and they work very well for me um especially at work because I'm not allowed to smoke at work nor but I want to be smoking at work again with the people that I'm with um and that's really about all I've ever tried or called Turkey and that just never will I never want to offer you mm-hmm T: do you know about the NC quit line C: I've heard the commercials on the radio but I've never looked into it T: would it be okay if we talked about that for a minute sir this is a fantastic program page they have a lot of information but the great thing is you can actually have your own personal smoking counselor and you can call them or you can leave a message with them to call you but there's a tremendous amount of support there and that's been a very helpful thing and the great thing for me is they will actually call me and give me kind of follow-up information on how you're doing mmm how does that how does it sound C: sounds very intriguing sounds like it could be helpful yeah not just depend on Dan with my journey yeah T: so he's just uh sounds like more support right you wouldn't feel you wouldn't feel alone in this battle right yeah so I heard the nicotine patches and gum and then possibly the Quitline anything else that you've heard about or that you might be interested in there C: well I do know Dan um had a quit date is that something I have to do T: again decisions that only you can make H and but if it's okay I can tell you a little bit about the research about the quit date okay um most of the research shows that if indeed you can kind of look at your calendar and see a time that would be better to quit them than not it's really helpful to have a quit date and to tell as many people as you can about that this is the day I'm quitting again it tends to garner that social support and increases the commitment level how does that sound C: well that makes sense why it would be better than just today will be the day T: is there any time that would be better for you to get a quit date than another day C: we do have some plans coming up so I think a week from Monday socially would be better that's the day a week from it yes T: would it be okay if our office called you on that day to just begin to give you a little bit more support let you know that we're with you sure that would begin so let's go back to another one of those scales scale of to in terms of your confidence about doing this zero being no confidence being they have a lot of confidence about my ability to quit where would you be on that scale C: I think with everything we discussed today I would like to leave on a and that's how I feel that's tremendous it is tremendous good good feels good feels I could still be a little weary T: but it feels good C: yeah but it feels like you have a play on this time good as what I feel better T: well congratulations I think that's probably the biggest health decision that you could possibly make in your life particularly in light of what you've just been through so right I think this is a really good time and I have I applaud your courage doing it takes a lot to to make this decision so good for you C: well thank you T: so I will call you and we'll give you some information about the Quitline when you leave you can take care of the patches and and gums instead of over-the-counter and if it's okay let's schedule an appointment and two to three weeks out and get you back and see how things are going