Post Operative Complications

Joel
Joined: 18 Dec 2008, 23:57

02 Dec 2005, 23:20 #31

Image I saw where one long-term member recently had to undergo three unrelated surgeries in the span of one month. This post highights the importance of being smoke free for people who ever has to undergo surgery for any kind of condition--whether treating a problem that was smoking related or not. It is not always possible to avoid the need for surgery, but it is always possible to minimize the risks of surgery and speed up the healing after a surgery by continuing to stick to your personal commitment to never take another puff.

Joel
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Sparky10191
Joined: 07 Jan 2009, 18:56

07 Mar 2006, 13:48 #32

yep, I wish I had been a little smarter. oh I'm okay and nothing dire at this time. when I was 23 or so I had some corrective surgery to my septum, it was deviated and causing chronic infections, etc. anyways, the surgery last about 2.5 hrs and afterwards the ENT told my mother that I really should quit smoking because apparently I had to be given an albuterol treatment while I was under sedation. no I didn't almost die or come close, however the anastheiologist that was watching over me did note the falling oxygen level. i really wish I had taken advantage of the "forced" withdrawl that came with the 10 day recovery/drugged up time. but you know I didn't stop thinking I was invincible until around 28 or so. and I didn't stop smoking until 32. NTAP. a bad day as an ex-smoker is still better than a good day as an active smoker.

Dave
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kattatonic1 gold4
Joined: 18 Dec 2008, 23:57

29 Mar 2006, 02:52 #33

For ImageCherylmcc today, and anyone who has not read this wonderful news for the ex-smokers.

Image We have many members who have benefitted from their quit by healing better after any ordeal ~ related to smoking or not.
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Sal GOLD.ffn
Joined: 16 Jan 2003, 08:00

08 May 2006, 20:04 #34

Last edited by Sal GOLD.ffn on 19 Sep 2009, 16:17, edited 1 time in total.
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John (Gold)
Joined: 18 Dec 2008, 23:57

05 Aug 2006, 22:58 #35

Guardsman's surgery postponed
August 4, 2006 - The Meridian Star
By Georgia E. Frye / staff writer

A surgery scheduled for Thursday for Sgt. 1st Class Grayson "Norris" Galatas was postponed until Aug. 24 when lab results showed nicotine in his system.

Galatas is currently at Walter Reed Army Medical Center in Washington, D.C.

Galatas has faced several surgeries since he was wounded when an Improvised Explosive Device exploded near his vehicle April 19, 2005, while he was on duty in Iraq with the 150th Combat Engineer Battalion.

Galatas suffered severe lacerations to his stomach and back and had shrapnel wounds over much of his body. The surgery Galatas was scheduled to undergo Thursday included removing a skin graft that covers a large section of his stomach and then reconnecting his stomach to his intestines.

Galatas' wife, Janis, said the doctors at Walter Reed said nicotine constricts the blood vessels and restricts blood flow to tissue, and getting Galatas off nicotine for three weeks will enhance his chance of healing.

Norris Galatas doesn't smoke, his wife said, but never thought about mentioning smokeless tobacco when he was filling out medical paperwork.

"Norris is understandably upset because he has been waiting since July 2005 to get this done," Janis Galatas said. "However, he has healed nicely with all the other surgeries and this will only make it better. He will get over it, he always does."

Janis Galatas will return home to care for the couple's horses and return to Walter Reed in time for the surgery.

"This time I'll wait until we get the final OK before I travel," she said, "But we had some fun together for a couple of weeks."

Story source: http://www.meridianstar.com/local/local ... 11209.html
© 2006, The Meridian Star
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Joel Spitzer
Joined: 13 Nov 2008, 14:04

28 Jan 2009, 23:31 #36

I noticed some of the posts on this board have not been viewed by any member since we moved our site. This post had no views yet. Now it is possible that new members are reading the materials at www.whyquit.com which is great. There are however numerous articles that we had at the old MSN board and now also at this new site that are not at the www.whyquit.com website. I will try to pop a few up a day for new members, but I do encourage people first joining to to through the boards that we have set up here and read through the articles. The more you read and understand, the more prepared you will be when encountering awkward times such as finding a pack or other kinds of unexpected triggers to stick to your personal commitment to never take another puff. Joel
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FreedomNicotine
Joined: 06 Dec 2008, 16:58

08 Nov 2009, 22:21 #38

From above:

From: Joel.
Sent: 2/9/2001 8:07 AM
This thread touches on another aspect of the denial of treatment string. I do realize it is a sensitive issue and I understand the line that it straddles and seems to cross to some people. But often the physician has the best interest of the patient in mind when taking such a hard line approach. I recognize it because it is not all that dissimilar to the hard line approach we take here at Freedom, and for the same reason, we recognize that success or failure in quitting is a life and death issue. Unless viewed that way a smoker is likely to push his or her luck, smoking till the very last moment, sometimes his or her actual last moment. When refusing treatments, physicians and dentists may not only be trying to minimize their liability, improve their statistics or accomplish any other self-serving goal, they are sometimes just trying to save the person's life in the best way they know how, influencing the smoker to quit and then letting them repair what damage they can.

I think the people who responded to this string months ago recognized this issue. I was at my dentist yesterday who coincidentally brought up this same topic. He was saying how periodontists often refuse procedures on smokers, one for the chemical irritation that smoking will do to the surgery and the other reason for the sucking motion on a cigarette causing problems with the sutures needed for procedures. He also brought up some issues specific to women and estrogen and smoking that apparently is playing havoc in some periodontal diseases. I am going to look into the issues when I get a chance.

Also when I was leaving the dental office, one of the office staff stopped me because her daughter had just left her a message on how she was going crazy after two days without smoking. I actually ended up in a 15 or 20 minute phone conversation with the daughter. Ended up missing my lunch but it was worth it if it gets her through that all critical third day mark.

I think it is important for everyone here to recognize that you all have been getting an education and an understanding of the nicotine addiction and its treatment that is helping you to stay nicotine free. But that understanding will not only be beneficial for you but for many around you. Most people don't know this information, even some of your medical professionals. Share with them your success and your knowledge.

You would be amazed at just how many people you may touch. When you are at your doctor or dentist, let them know you quit and how you did it and how you feel now that you quit. Don't assume this is uninteresting information, or something they have heard a thousand times before. It may have been told to them by others but they may not have actually heard it or assimilated the material. The most important message you can get across to them is your understanding of nicotine addiction.

Again, being medical professionals they may understand the danger or smoking but they often don't understand and have never been trained on the issue of the nicotine addiction. Share that information. The most important message you can share with them is your understanding of how you stay smoke free and how all their other patients can accomplish the same goal, if they simply understand the importance of remembering to never take another puff!


Joel
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FreedomNicotine
Joined: 06 Dec 2008, 16:58

03 Oct 2010, 16:38 #39

Nicotine's Role in
Failed Low Back Surgery

"The role of smoking in causing pseudarthrosis has been well studied in lumbar spine fusions with up to a fourfold increase in nonunion rates from 8% to 40% for lumbar fusions. Nicotine has a direct inhibitory effect on autologous cancellous bone graft revascularization as well as an increased rate of bone graft necrosis in a rabbit model of bone graft implantation. Systemic nicotine has also been linked to nonunion in spinal fusion animal models." 

Source:  http://www.springerlink.com/content/7r1k253384w92418/


But what neck disc fusion surgery where entry and disc fixation was accomplished was from the rear (posterior) instead of cutting into the front of the neck (anterior)?  The below new study found that although successful fusion rates were similar between smokers and non-smokers that "Smokers were nearly five times more likely to have a fair or poor outcome compared with nonsmokers."


Does Smoking Influence Fusion Rates in Posterior
Cervical Arthrodesis With Lateral Mass Instrumentation?


Clin Orthop Relat Res. 2010 Sep 22. [Epub ahead of print]

Eubanks JD, Thorpe SW, Cheruvu VK, Braly BA, Kang JD.

Abstract

BACKGROUND: Smoking is associated with reduced fusion rates after anterior cervical decompression and arthrodesis procedures. Posterior cervical arthrodesis procedures are believed to have a higher fusion rate than anterior procedures.

QUESTIONS/PURPOSES: We asked whether smoking (1) would reduce the fusion rate in posterior cervical procedures; and (2) be associated with increased pain, decreased activity level, and a decreased rate of return of work as compared with nonsmokers.

METHODS: We retrospectively reviewed 158 patients who had a posterior cervical fusion with lateral mass instrumentation and iliac crest bone grafting between 2003 and 2008. Fusion rates and Odom Criteria grades were compared among smokers and nonsmokers. The minimum followup was 3 months (average, 14.5 months; range, 3-72 months).

RESULTS: Smokers and nonsmokers had similar fusion rates (100%). Although 80% of patients had Odom Criteria Grade I or II, smokers were five times more likely to have Grade III or IV with considerable limitation of physical activity. Age, gender, and diagnosis did not influence fusion rates or the Odom Criteria grade.

CONCLUSIONS: In contrast to the effect of smoking on anterior cervical fusion, we found smoking did not decrease posterior cervical fusion with lateral mass instrumentation and iliac crest bone grafting. Posterior cervical fusion with lateral mass instrumentation should be considered over anterior procedures in smokers if the abnormality can appropriately be addressed from a posterior approach.
http://www.springerlink.c...ontent/7r1k253384w92418/

Smokers are likely to experience an Odom Criteria Grade of III or IV?  What does that mean?  This definition was provided in the full text of the study:
"The Odom Criteria have been used for decades to grade clinical outcomes after cervical spine surgery. It takes into account the patient’s daily symptoms, activity level, and ability to return to work and grades them on a scale of I to IV: Grade I (excellent) = no cervical spine symptoms, daily activities not impaired; Grade II (good) = intermittent discomfort, no substantial interference with work activities; Grade III (fair) = subjective improvement but major limitations of physical activities; and Grade IV (poor) = no improvement or worse compared with the preoperative condition."
 
Last edited by FreedomNicotine on 03 Oct 2010, 17:05, edited 1 time in total.
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JohnPolito
Joined: 11 Nov 2008, 19:22

11 Mar 2011, 17:23 #40

The below new study is about "perioperative" outcomes among smokers.  "Perioperative" is defined as "the period of time extending from when the patient goes into the hospital, clinic, or doctor's office for surgery until the time the patient is discharged home."  This paper reviews smoker risks that are no longer part of our life or future so long as all nicotine remains on the outside.  Still just one guiding principle ... no nicotine today!

Breathe deep, hug hard, live long,

John (Gold x11)




Smoking and Perioperative Outcomes
Anesthesiology. 2011 March 2. [Epub ahead of print]

Turan A, Mascha EJ, Roberman D, Turner PL, You J, Kurz A, Sessler DI, Saager L.

Abstract

ImageBACKGROUND: Patients are often concerned about the effects of smoking on perioperative risk. However, effective advice may be limited by the paucity of information about smoking and perioperative risk. Thus, our goal was to determine the effect of smoking on 30-day postoperative outcomes in noncardiac surgical patients.

METHODS: We evaluated 635,265 patients from the American College of Surgeons National Surgical Quality Improvement Program database; 520,242 patients met our inclusion criteria. Of these patients, 103,795 were current smokers; 82,304 of the current smokers were propensity matched with 82,304 never-smoker controls. Matched current smokers and never-smokers were compared on major and minor composite morbidity outcomes and respective individual outcomes.

RESULTS: Current smokers were 1.38 (95% CI, 1.11-1.72) times more likely to die than never smokers. Current smokers also had significantly greater odds of pneumonia (odds ratio [OR], 2.09; 95% CI, 1.80-2.43), unplanned intubation (OR, 1.87; 95% CI, 1.58-2.21), and mechanical ventilation (OR, 1.53; 95% CI, 1.31-1.79). Current smokers were significantly more likely to experience a cardiac arrest (OR, 1.57; 95% CI, 1.10-2.25), myocardial infarction (OR, 1.80; 95% CI, 1.11-2.92), and stroke (OR, 1.73; 95% CI, 1.18-2.53). Current smokers also had significantly higher odds of having superficial (OR, 1.30; 95% CI, 1.20-1.42) and deep (OR, 1.42; 95% CI, 1.21-1.68) incisional infections, sepsis (OR, 1.30; 95% CI, 1.15-1.46), organ space infections (OR, 1.38; 95% CI, 1.20-1.60), and septic shock (OR, 1.55; 95% CI, 1.29-1.87).

CONCLUSION: Our analysis indicates that smoking is associated with a higher likelihood of 30-day mortality and serious postoperative complications. Quantification of increased likelihood of 30-day mortality and a broad range of serious smoking-related complications may enhance the clinician's ability to motivate smoking cessation in surgical patients.

PubMed Link:  http://www.ncbi.nlm.nih.gov/pubmed/21372682
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