Posted on 10/31/2014 3:14:25 PM PDT by lee martell
I was supposed to have surgery on one of my ankles to reduce chronic pain. Eventually, I will need flatfoot corrective surgery on the right foot too. I've been ready for quite some time, and miss being able to walk without limping like an old man. The procedure would be a Sub-Talar Fusion. I have Veterans' Health Insurance only. I was less than 3 days away from the surgery date when I got a call from one of the Resident Surgeons. Apparently, he had been told that I use e-cigs and sometime actual cigarettes. My actual cig use is very low, from one to three a day, if at all. The concern was that the level of nicotine in my system would make healing more difficult. Therefore, the surgery I had waited over a year for was off. However, I was offered a chance to take a blood test, and if nicotine levels were significantly lower, I could still have the procedure in the first half of November. Was I interested? Of course I said yes, put me down for that date. The thing is, not once was I told verbatim that if my nicotine levels were to exceed a certain threshold, the doctors would cancel the procedure. I was given advisories, but never a clear directive, a definition of a 'dealbreaker' from my end of it.
Not much later, I realized that by having my surgery then in the middle of November, I would screw up the work schedule for all my coworkers. I work at a Care Facility for mentally ill adults. I had hoped to be ready by mid December to take some of those shifts open because of other's taking their Christmas Breaks. I;m probably the oldest person on staff, and I don't want to take too many chances with my position, i.e., absences due to recovery times. I realized I would be better off just dealing with the discomfort until after the holidays. I'm now waiting to get a new surgery date that is hopefully in January or February. I dealt with the change of plans logically and I think stoically. However, I felt a crushing disappointment inside, knowing that I would not be starting on the road to repair after all. I was still stuck on 'Pain Island'. I requested to meet with one of the Attending Surgeons next week, just to give them an update view on my general health and demeanor. I wonder how common it is for hospitals to cancel surgery within the last three days prior to the procedure. I've somewhat recovered now, a week since that phone call. However, I don't think that I have felt quite so down in years. The last time I felt that bad was when my mother died. Now, I have less trust in the doctors, but, I'm stuck for now. Have others had this kind of experience?
I’m so sorry to hear of your experience. The only similar situation that I’ve heard about is overweight friends being denied knee replacement surgery. Well, if knees hurt, you’re not likely to exercise so it ends up being a chicken & egg situation. Wouldn’t going ahead & doing the surgery to ease the pain & make mobility better be the best thing?
I guess not.
Who told them this. If it was you why? Is it a condition of your policy?
This is a ‘Thanks Obama’ moment.
That sounds crazy.
what is the recovery time on that surgery?
I’m assuming the docs are getting paid.
Should have told them you were gay and if they don’t perform the surgery you’ll sue.
Cancelled or post poned because they don’t want you to have nicotine in your system prior to going under??
That’s insane!
I was needing to get on the Transplant list for a Liver last year, and was told I had to quit smoking to be eligible for a transplant. I asked what in the hell smoking had to do with my Liver, and they didn’t have a good answer. I could understand them telling me to quit drinking, but I already didn’t drink at all. I believe Nicotine leaves your system rapidly. It would likely be gone within a week or two. Just quit ahead of time before your next appointment.
Now days, it’s VERY bad to tell your doctor that you do ANYTHING perceived to be ‘unhealthy’, because you WILL be penalized for it, sometimes even years later. The computers never ‘forget’....
Most surgery patients who are smokers usually die after surgery. Second hand smokers don’t fare much better. If we had only known the relationship between post surgery deaths and cigarettes decades ago, we could literally have saved at least 10’s of millions of people.
you gotta wonder about all the surgeries since the 1920s that were done on smokers ... I think it is just more smoker Nazi hate. Suffer you vile smoker, and so on.
Like the orthopedic doctor told me when I asked how I could drive after a rotor cup operation as I have a stick shift - he said, “You should have gotten an automatic.” Bedside manner and all that doctor-patient schitk ... gone these days.
Going for a second opinion as I no longer trust that doc.
I guess if the insurers are looking for loopholes, full disclosure from the patient is not always the best policy. I’ll probably be put onto the schedule by March or sooner.
I consider it a lesson learned. I think many Nurse Assistants (who write up most the observations and advisories) have forgotten what it’s like from the patient’s point of view. I understand the need to compartmentalize and stick to ‘policy’, but some appear to stop being concerned with acting like human beings. I cannot be ‘fully mad’ at them about the cancellation until after I get my procedures done. Fine, I can play that game, now that I know the rules.
Sorry for your difficulty, but this is a known result of smoking. Would you like us to demand the surgeon perform the operation?
Sorry to hear. Went to WebMD and it seems conclusive that quitting smoking before surgery is smart. Smoking had three times the complications (18% vs 53%) and four times the chances of a second surgery (4% vs 15%). Wound related healing complications (5% to 31%).
It sounds like they are screening the blood of patients for nicotine. You said “and if nicotine levels were significantly lower” so maybe they’ve done a blood test already and found a high level of nicotine?
I know they’re very wary of smokers who have peripheral blood vessel disease and they want smokers to refrain from smoking two weeks before surgery but this sounds strange.
Sometimes there are lab errors. Whenever you get an unexpected test result you *must* ask for another test to rule out lab error.
The issue is continued nicotine use after the surgery. One could quit a week before and not smoke but it takes two weeks for cotinine to clear the system.
Patches won’t help because they contain nicotine and nicotine restricts the vasculature necessary to supply blood to the healing areas post surgery.
Middle aged men have a tendency to have vascular issues any way and surgeries in such areas while smoking made lead to avascular necrosis as the needed vasculature won’t form and the present vessels will be constricted so that healing won’t take place.
I’m not on an anti-smoking soap box here...just an RN whose seen treatment failures related to heavy smoking. It was good he told his docs....even if his surgery is delayed he’ll have a much better outcome staying off the nicotine for a while.
I quit cigs in 2003.
One of the several things I did to quit was to drink an 8 oz glass of water with a teaspoon of baking soda each day. The baking soda is supposed to absorb the nicotine and expel it from the body.
No, I would not want to demand such a procedure from a Doctor who didn’t believe it was what he should be doing. I would only ask that they not wait until I was so very close to the hour of reporting for the surgery. To me, that was unnecessary to the point of being cruel. I’m capable of quitting, and have done it before. After this big shock, I threw the my cigarettes and Bic lighters out of the car window while driving on the freeway. If that is the condition they insist on, then, so be it. They are dealing with ex-military people, veterans, like myself, used to taking orders or following clear instructions.
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