Dr Walton-Shirley performs invasive cardiology, nuclear cardiology, and stress echocardiography in a private practice in Glasgow, KY.
Her chief medical interests are CHF/hypertrophic obstructive cardiomyopathy and the promotion of primary PCI for acute MI. Recently she played a significant role in helping to launch an ambitious pilot study of primary PCI in Kentucky, the Kentucky Primary Angioplasty Pilot Project. She has also participated in the TIMI 19, Duke-HF, NRMI, and CRUSADE trials and is proud to have been an advocate of the first smoke-free initiative in Kentucky (2011). She champions a smoke-free America.
Dr Walton-Shirley received her undergraduate degree at the University of Kentucky and went to medical school and did her residency and fellowship at the University of Louisville. She is married with two daughters. Her interests include singing, writing poetry and songs, fitness, and, of course, theheart.org.
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Heartfelt with Dr Melissa Walton-Shirley
View all posts »"Teachable moment" for smoking patients: Would you allow yourself to be "killed" in order to live smoke-free?
Nov 17, 2009 15:45 EST-
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Dr Geoffrey Tofler of Royal North Shore Hospital, Sydney Australia, kept his word today. He actually brought the gadget to the press area that helps smokers quit. It's a method that builds on the fact that many smokers won't quit until they have their first heart attack or bypass surgery. This premise of this program is that it propels the smoker into his future demise with such intense drama that he will then want to quit.
A patient's face is inserted into a digital program that lets them witness their own heart attack. I was warned that it was a tough 8½ minutes to watch, but I was curious about any intervention that caused seven of 13 smokers to quit and stay quit at six months. After all, the best we can do with varenicline is around 40% success rate over the same period of time. Anything that hints at competing with that success or building upon it deserves a look.
These weren't just any smokers. Several of them had tried everything to no avail. Many had tried unsuccessfully to quit at least three and four times. All of them were allowed to continue on their nicotine-replacement or smoking-cessation aids. They also received counseling and motivation from a psychologist who specializes in tobacco addiction. Each patient made a trip to the doctor's office for a digital photograph. They returned the following day for the first 8½ minute viewing and then returned again in one week for their second viewing. They were evaluated at one week, three months, and six months for smoking sobriety.
Then it was my turn. I positioned the headphones and listened intently. The "doctor" on the program told me that he wanted to tell "me" about a patient who was a smoker and had tried everything to quit. The "test patient's face" appeared before me and it was easy to imagine myself in the same image. He told me, "the patient," how each cigarette "I" smoke carries me closer to my fate by increasing the risk. I saw a risk meter rise like a warm thermometer in a simulated cartoon alongside "my" image. An actual picture of those "I" would leave behind appears on the screen. "I'm" then helping someone in a grocery store parking lot with her groceries when "I" suddenly fall to the ground. EMS is summoned, and the parking lot crowd is standing over me. Two scenarios are played out. Either "I" don't survive, and "I" fade from the screen, leaving my spouse behind, or "I" live with the possibility of a major disability.
As the digital scenario was played out, I felt my pulse rate rise a bit and actually teared up at the thought of my leaving my family and friends behind. I definitely felt uncomfortable and even very sad. I could feel myself grimacing as I fell to the ground in the simulated image. After it was over, I quipped that I hoped he would develop something similar for my chocolate addiction and handed Dr Tofler his earphones.
Quitting smoking is tough, but it's worth just about any amount of hassle or discomfort to manage sobriety. With this new tool that actually kills you in the cyber world, a smoker could have the best opportunity yet to live to a normal life expectancy; the only trick is . . . you have to die first.
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