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You catch up with your neighbor Bob - the Parliament 100s smoker and heart attack survivor from one of my earlier posts- a few months after that encounter with him.

You had noticed Bob coughing a lot and clutching his chest that night. Nothing happened to him that night, but a few days later Tammy drove Bob to the hospital because his chest pains were not going away and getting worse.

Turns out Bob didn’t have a heart attack, but an angina attack- a serious symptom of his congestive heart failure, which shows that disease is getting worse. The ER doctor referred him to his cardiologist, who ordered a full workup on Bob in light of this new symptom.

The good news as far as Bob’s heart is concerned is the doctor saw this as the natural progression of the disease, and adjusted Bob’s meds accordingly. As far as his lungs, though, that was a different matter- the scan his doctor ordered showed clear symptoms of COPD Stage 2. A pulmonologist confirmed this and Bob has an inhaler for flareups, an instruction to lose weight, and an order to quit smoking.

Tammy and Bob are fine with Bob’s meds and the inhaler. They’ve also both made plans to lose weight and become more active. On quitting smoking, though: the doctor’s orders are falling on pretty deaf ears. Tammy and Bob know they can’t and won’t quit for good. But Tammy is trying to cut down to a pack a day. She’s pretty clearly ordered Bob to cut down on his Parliaments, occasionally using guilt. Bob hears “Another pack? Bob, think about your heart,” if he opens a fresh box of his little white slavers after he’s been smoking heavily throughout the day.

Now, at the annual tropical-themed barbecue Tammy and Bob always throw for the neighborhood, you notice both of them have cut back a bit on their smoking. But then you notice Bob stepping from the backyard into the house every so often. Eventually, you follow him into the house and you realize he hasn’t cut down at all - he’s sneaking off and hauling away on a Parliament out of Tammy’s sight. So much for cutting back on cigarettes together!

You make an excuse about getting another beer while you watch an evidently hooked smoker, facing serious smoking-related diseases and who can barely breathe, suck away on his cigarette.

Who doesn’t need a bottle?