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  • Letter from surgeon - smoking - Question

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    Old 05-06-2009, 01:24 AM   #1
    Jema X
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    Letter from surgeon - smoking - Question

    Hi guys,

    I'm hoping that someone can help me. I'm having an ACDF on the 11th May. I received my 'sign away my life' letter yesterday and I have a question.

    The letter says that you must have given up smoking 4 weeks before hand. I'm not a regular smoker (funnily enough, I hate it - but it's a compulsion) but I started smoking 3 -4 cigarettes a day about 3 weeks ago and am finding it near impossible to stop. I can stop once the stress is gone but it's so hard right now.

    Does the fact that I've been smoking lightly mean that I can't have my surgery now? I have a low body weight and apart from pain, I'm fit and healthy. The surgeon didn't say anything about it during our last appointment (probably because I wasn't smoking then) and now he's away on conference until the weekend.

    i just wondered if anyone else was in this situation before their ACDF.

    Thank you

     
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    Old 05-06-2009, 03:20 AM   #2
    PNo
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    Exclamation Re: Letter from surgeon - smoking - Question

    Oh my you do need to quit now! Tell your surgeon and let him decide if you go on schedule.. Not only is there risk to lungs and pneumonia after anesthesia, there is significant proof nicotine inhibits tissue repair, may affect fusion and finally inhibit proper blood flow in the tissues. This is something you want to follow to the letter for success.

     
    Old 05-06-2009, 08:42 AM   #3
    feelbad
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    Re: Letter from surgeon - smoking - Question

    yep, what NP just stated is the "whys" in all this. the one thing i did not know when I was told i needed to quit was that its the nicotine that inhibits fusion? so i DID manage to quit, but unfortnetly i did it using the nictine patch? did not really help matters any, but no one ever mentioned the "why" in quitting. i assumed it had something to do with my lungs and not with actual fusion inhabition. i did NOT fuse the first time around and ended up needing another surgery just to place hardware(plate and screws) nine months later.

    honestly juliet, if you are only smoking that many a day, you CAN do this, really. i was smoking alot more than you were and managed it(even with that patch it was still very hard). if you only started a few weeks ago, it wont be that hard for you hon, and you just really do need to think of what a huge impact this 'could' have on you and your fusion too.

    your brain really has not rewired itself too far as far as 'needing' the nicotine and the habit of the smoking "act" itself. there are some really good quit smoking books out there that can offer you some really good ways of doing other things when you feel that urge and just very empowering messages too. this should be all your brain should need right now.

    you CAN do this,trust me. anytime you may think of grabbing one, just think of me and how screwed up i did myself in with my fusion hon. it did suck having to go thru all of that surgery and collar crap AGAIN. there is also a quitting smoking forum here that can be very helpful to you right now too.

    i still have not been able to quit and i keep remembering what my dad told me many many years ago when he found out i was still smoking after i was already married and after my first child was born and i started back up again? one day in the future you will be so sorry you took this back up again. and he was soooo right on the money. i actually suffered a brain aneurysm back in 05 juliet,and still have not been able to just get his habit/addiction stopped(this is my only vice now). but i do also have an addictive mindset too. do yourself the best possible favor ever and just stop this now BEFORE you are really goin down that road with something that once it really gets ingrained into your brain, will keep control over you. you CAN do this hon. and its just THAT important. good luck juliet,Marcia
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    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

     
    Old 05-06-2009, 11:33 PM   #4
    Jema X
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    Re: Letter from surgeon - smoking - Question

    Hey Feelbad, thank you so much for your thoughts - I did not expect a heartfelt reply like that to something that people see as a 'filthy' habit. I have thought a lot about what you have written as I am also a cp patient. I have never ever (even when I'm in agony) felt like abusing my pain meds - that's why I don't get the smoking thing. I've worked out, from what you had to say, that I have a compulsion rather than addiction. I have no desire to smoke usually but I've had 3 major surgeries (including the removal of 9x8cms of my liver because of a tumour last year) in 3 years as well as financial and legal issues - and the stress has just gotten me down...or anxious is probably a better word. I didn't smoke after my liver surgery but 3 weeks before my ACDF, bang, no thought just a compulsion buy a packet of cigarettes. I hate the smell of smoke.

    I'm a med professional but certainly not a neurosurgeon - I know about smoking effecting healing, collagen production etc but I didn't realise it would prevent fusion. I know that I will not smoke after I am in hospital (the night before my surg) so I'll have 24 hours to clear the chemicals. That said, healing etc will already be depressed to some level. I have known my anasthetist for a long time, he is the best cp advocate - after my liver surgery he had to come into the hospital in the middle of the night after a nurse refused to give me adequate relief. No complaints, just his mobile number in case I need him. He also knows me pretty well and although he doesn't approve, he's not too worried about my lungs, we just have to make sure no more smoking 24 hrs before in case he uses ketamine. I'll chat to him tomorrow and see what he has to say.

    Thanks NP, I'll let the surgeon know - I'm seeing another neuro tomorrow for something different so I'll ask him too. I doubt very much that they'll cancel it. My packet/day usage is minimal. Still, it's better safe than sorry.

    **, again, thank you. I'm only smoking one a day since I've read your post and I'll be putting more energy into better stress control for next time around. I hope that you are well. I hope too that you can quit one day. Have you tried Champix? May have a different trade name in the US. It has a good profile but side effects may exclude you. I wish you the best of luck, you help so many people and you are always kind and your responses heartfelt. Thank you for taking some time for me

     
    Old 05-08-2009, 08:32 AM   #5
    feelbad
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    Re: Letter from surgeon - smoking - Question

    thank you hon. i really am happy you are only down to one and plan to quit post op. the post op is where it REALLY does matter soooo much. i told you my story hoping it would just show you how truely crucial it is to give that up ya know? it really is interesting in how that just started the way it did? i am thinking you simply were a bit scared of this upcomming surgery and tried to find a way to help cope? this is the very strong connection i have with smoking and pacing when my pain gets bad? its just insane really. the only way i am going to be able to truely kick this crap is by hypnosis at this point. i have simply tried every imaginable way to do it on my own. i need to break the pain/coping crap connection and i am hoping that with the help of hypnosis, it will help me finally get to the "other side"?

    by the way,i AM very proud of you hon. i do hope your surgery goes well and you fuse just fine. also,stay the heck away from ANY form of NSAIDS,as you probably already know, they too can inhibit fusion. no one(not my surgeon either) bothered to tell me any of this crap after or even before my surgery. just crazy when you consider the possible ramifications. please let me know how things are going,K? marcia
    __________________
    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

     
    Old 05-09-2009, 07:53 AM   #6
    Jema X
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    Re: Letter from surgeon - smoking - Question

    Hey Marcia,

    yes, I'll let you know how things go, I really appreciate you asking. Sometimes that's all you need to get through this - I hope you understand what I mean.

    I spoke to my anasthetist on Friday (about the things you mentioned) and he agreed completely - insisted on ringing my surgeon there and then to make sure he wanted to go ahead. I have promised not to smoke.

    It is absolutely about coping, the more stressed out I feel, the more I feel like smoking. I've just had one thing after another in the last 3 years - thoracic surg, house burned down, neck, liver tumour etc....but as you helped me see, that's not an excuse. We all have things going on in our lives.

    Wish me luck, I'll let you know how it goes

     
    Old 05-14-2009, 04:25 PM   #7
    gaa
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    Re: Letter from surgeon - smoking - Question

    My surgery is scheduled for May 26th. c3 thru T1 Posterior/anterior fusion with revision. My OS told me no smoking. I smoked a pack a day for 30 years. I quit cold turkey 2 weeks ago tomorrow. I have slipped twice with a cigarette am very proud of myself for quitting. I needed to because of a failed fusion from 2003. Now having to go through such a big surgery, I really didn't have any choice. I really think you can do this and lay them down. Do it. you will be so proud of yourself and feel much better going into this whole healing process!!!

     
    Old 05-15-2009, 08:37 AM   #8
    Jema X
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    Re: Letter from surgeon - smoking - Question

    Congratulations!!! Well done. I'd be proud of myself too. I've cut back to 1 a day and tomorrow is none. I think I'll be ok. I really hope your surgery goes well, sounds like you deserve some luck. Do you think your failed fusion had anything to do with smoking? Sounds like you are going in prepared for proper healing - a positive attitude makes a world of difference. I had thoracic surgery a couple of years ago and it was very tough but hey, I got through it and although I have bad nerve damage I'm a lot better than expected. Will they have to go through your rib cage (we call it trans thoracic in Aus, I think in the US it's called XLIF))? I hope they can do it through the posterior. I think you've posted above so I'll read that. Thank you for the encouragement - positive reinfocement like I've received from wonderful people (Feelbad and everyone else) is so much more motivating than being told off for smoking, if you know what I mean. Thank you for sharing your story

     
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