By , Spectrum Health Beat
Photos by Taylor Ballek
She had been living with breathlessness for years. She even worked as a hospice nurse caring for patients who had stage 4 chronic obstructive pulmonary disease.
And still, Michelle Pekel found herself taken aback earlier this year when a doctor diagnosed her with COPD.
“Hearing the letters ‘COPD’ is a wakeup call—a call that I continually ignored for 35 years,” said Pekel, 50, of Fremont, Michigan.
An umbrella term for a group of lung diseases, including chronic bronchitis and emphysema, COPD is a progressive disease in which the blocked airways make it increasingly difficult to breathe.
According to the Centers for Disease Control and Prevention, more than 15 million people have COPD, although this number may be as high as 25 million because another 10 million people don’t know they have it.
Pekel found herself in that latter category of Americans.
“I’ve smoked a pack a day for 35 years and the symptoms didn’t seem like symptoms to me, as this was my everyday life,” Pekel said. “I always had a shortness of breath, chest tightness and constant coughing. … Although abnormal for a non-smoker, (it) was something that I came to terms with and became my norm.”
Not everyone who has these symptoms has COPD, and not everyone who has COPD has these symptoms, said Sally Wagoner, RN, a tobacco treatment specialist with Spectrum Health Gerber Memorial.
Over time, the symptoms can add up and get in the way of simple tasks. They can make everyday activities like cooking, climbing stairs or carrying a suitcase seem like a challenge.
As a hospice nurse who knows what stage 4 COPD looks like, Pekel wanted to avoid this fate.
“I have two children and I knew that I needed to quit for me to be in their lives,” she said. “My father died at the age of 59 from a massive heart attack and my mother died at 64 with cancer—and both were smokers.”
By her own account, Pekel had been a committed smoker, burning through a pack of cigarettes a day.
She smoked in the mornings, in the evenings, in the hours in between and even throughout her two pregnancies.
“I can’t imagine what I was polluting my children with,” Pekel said. “My daughter begged me to quit, but I didn’t hear her. Now all I can say is, don’t wait until it’s too late, until you get cancer, a stroke or a heart attack. So many diseases, all because of cigarettes.”
Wake-up call
Not until her own COPD diagnosis—and a little nudge from her pulmonologist at Spectrum Health Gerber Memorial—did Pekel decide she needed to take control.
She registered for the smoking cessation program that Wagoner leads.
“Quitting tobacco is the single most important thing you can do for your health,” Wagoner said. “The Quit for Good program at Spectrum Health Gerber Memorial encompasses all the tools and knowledge you need to be successful in one-on-one, group sessions or family quit programs.”
The program includes weekly meetings that can be adjusted to fit a person’s schedule.
“The weekly meetings are really needed to see higher success,” Wagoner said. “And we recommend eight sessions, which ensures accountability and continued success.”
Pekel said she has smoked her last cigarette.
And while she’s taking her newfound smoke-free lifestyle one day at a time, she credits the special program at Spectrum Health Gerber Memorial for giving her the resources and strength to kick cigarettes for good.
“Without the class, I don’t think that I would have been successful,” she said. “The plan was a huge piece of the puzzle, and my quitting this time was successful—and it wasn’t before.
“I’ve never gone this long before without a cigarette, after 35 years of smoking, never,” she said. “I am amazed at my progress and can see and feel the change. My daughter is 14 and used to complain how her clothes smelled of smoke, and second-hand smoke is real. Now my house smells better, my car, my clothes. It’s a nice bonus to have.”
The journey didn’t come easy.
Registering for the class turned out to be the easy part.
“I had to mentally prepare myself to go to the first session,” Pekel said. “I was very anxious for my first class. I have tried to quit countless times over the years and I would make it two weeks and would be back to smoking again. Nothing seemed to work for me.”
Wagoner helped Pekel begin her journey as a non-smoker by first explaining the effects of smoking and describing the 4,000 chemicals that reside in cigarette smoke—dangerous toxins like ammonia, carbon monoxide, arsenic and formaldehyde.
“You see the commercials and you hear about this all the time, but this was an eye-opener for me,” Pekel said. “I didn’t realize I was smoking such harsh chemicals and toxins and for so long. I couldn’t believe what I was willingly doing to my body. Then it made me also realize the effects that I was having on others around me.”
Pekel said she still had doubts she could quit after that first session in January.
Wagoner was encouraging and enthusiastic, but Pekel doubted she could win the mental war with herself.
Among all U.S. adults who smoked in 2015, about 7 in 10 reported they wanted to quit completely, according to the Centers for Disease Control and Prevention.
Wagoner’s early suggestion—taper off gradually to quit cigarettes—proved more difficult than expected because she couldn’t smoke just two cigarettes a day, Pekel said.
She eventually chose a nicotine replacement. Wagoner worked with physicians to find a replacement method that would work for Pekel.
“I was 15 years old when I first started smoking, and like a lot of smokers I’m anxious about what life would be like without cigarettes,” Pekel said. “Sally didn’t push me, but she did show me how you can live life without cigarettes, how to make a plan for quitting, what to do when I crave a cigarette.”
Easy does it
When the craving for cigarettes sneaks up on her, Pekel said she gets busy.
She does something with her hands and focuses on an activity such as cleaning the cabinets, cupboards and closets. Her house is now constantly clean and much better-smelling without the cigarette smoke, she said.
“When someone is trying to quit tobacco, old routines and triggers can derail any progress,” Wagoner said. “So what we did was analyze Michelle’s routines, so we could break those up to avoid downfalls.
“For her, mornings were the worst times,” Wagoner said. “And she couldn’t give up her coffee, so we had her have her morning coffee at the kitchen table instead of in front of the TV or computer.”
Pekel said changing the routine meant cigarettes were no longer associated with those old habits.
“After meals was another huge trigger for me,” Pekel said. “And I’m happy to say that after 36 days, that trigger was no longer there. If I can do it after 35 years, anyone can do it.”
Another positive activity Pekel incorporated into her life was exercise.
Before she walked into Wagoner’s quit tobacco program, Pekel had never stepped foot inside Tamarac, the wellness facility west of downtown Fremont that houses an outpatient rehabilitation center, a skincare center and spa, a pool, a café and support programs like tobacco cessation and diabetes education.
There’s also a 12,500-square-foot gym with personal trainers and fitness trainers, as well as more than three dozen fitness classes.
“Now I’m working out at least three times a week,” Pekel said with a laugh. “Tamarac has so many resources, opportunities and support for people like me who want to turn over a new leaf and take our health back. Pound and Zumba are my go-to programs, and I go there three times a week.
“The first class after I quit smoking, I was short of breath within seconds,” she said. “And now after 30 days, I’ve noticed an improvement in my breathing and stamina in the class.”
Time and money
Getting healthy wasn’t the only benefit.
Pekel also saw a financial dividend from quitting cigarettes. Because she no longer smoked, she wasn’t spending $6 per pack, per day. That added up to $42 a week, or almost $170 a month.
The extra money was nice, Pekel said, although nothing beats waking up in the morning and being able to breathe deeply without any shortness of breath.
It’s a miraculous feeling to go through the day with more energy.
“It feels so good to have more energy and a better quality of life,” Pekel said. “The exercise is really helping me stay active and busy. I can enjoy my kids and my pets keep me active.
Said Pekel: “Being diagnosed with COPD was a real wake-up call that made me think about the consequences if I continued down this path. What would happen to my children and my pets if I would die? It’s a reality that you need to come to terms with. Who would take care of my children? Provide for them? Love them as I do? Smoking isn’t worth it.”
Despite the progress she’s made, Pekel is also a realist.
She knows that after smoking for 35 years, she’ll never regain full function of her lungs.
“I’m 50 years old, but I know that by quitting I can slow the progression of COPD,” she said. “Don’t wait until you get sick. Stop polluting your lungs, pick up the phone and register for a tobacco quit class.
“Don’t get into the mindset that you have smoked too long, that you can’t quit,” she said. “You can and you will—and I’m proof of that.”
