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Thread: Detrimental effects of e-cigarettes on surgical outcomes

  1. #1
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    Detrimental effects of e-cigarettes on surgical outcomes

    A letter was published in BMJ. I can't even find an abstract for this letter, but the responses to the letter by well known e-cigarette researchers give you an idea of how rediculous the letter was.

    Professor John Britton:
    Holmes and Southern report that patients who use electronic cigarettes as inpatients "no longer benefit from the mobilisation needed to reach a designated smoking area".

    Does this mean we should now all be encouraging inpatients to smoke?
    Dr. Chris Bullen:
    Roberts and Davies letter, entitled “Dangers of using e-cigarettes before anaesthesia” should have been framed as a question because they provide no evidence that using e-cigarettes is dangerous. They preface their assertions of harm with ‘probably’ and ‘maybe’ and imply that the use of e-cigarettes by patients to deliver ‘high doses of nicotine’ to alleviate nicotine withdrawal symptoms while awaiting surgery is ‘far from safe’, unsupported by evidence.
    Dr Konstantinos Farsalinos:
    Judging from the impressive title of the letter by Holmes and Southern [1], we were at least expecting to read one or few case reports in which the detrimental effects of e-cigaretes would be presented together with an attempt to directly associate such effects with the use of e-cigarettes. Instead, we observed that the content of the article was just a theoretical assumption about the potential adverse effects of e-cigarettes on surgical outcomes, unbacked by any kind of evidence.
    Read their full responses here.

  2. #2
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    Quote Originally Posted by mavinry4 View Post
    A letter was published in BMJ. I can't even find an abstract for this letter, but the responses to the letter by well known e-cigarette researchers give you an idea of how rediculous the letter was.

    Professor John Britton:


    Dr. Chris Bullen:


    Dr Konstantinos Farsalinos:


    Read their full responses here.
    I underwent surgery in January (gallbladder removal). When the anaesthestist did his pre-op check he looked at my history. "Ah, good man", he said "you gave up smoking a long while back?". "Yes", I replied, "I now exclusively vape". So he did the stethoscope/breathe in/breath out test. "Crikey", he said "you're breathing's almost equivalent to a never-smoker". The smokers amongst the other patients-in-waiting had to have pre-op chest x-rays.

    Clinicians are coming round..................slowly.
    Noe, GirlyPantz, margyb and 5 others like this.

  3. #3
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    I have wondered about this whole smoking and surgery thing. When I had the last lot of surgery on my knee, I was warned by my doc to stop smoking or I was at risk of being put at the bottom of the waiting list, despite my need for the surgery to be done quickly.

    So I lied, and told him I was giving up. (I didn't give up). When it came to the day of the surgery, and I was having the pre op examination by the anesthetist, he spent a good 5 minutes telling me how good my lung capacity was, and how my blood pressure and heart rate were better than most people who have never smoked, etc etc etc. I was smoking 20 rollies a day at that time. My recovery was also quicker than most, and I never had any problems with wound healing.

    This has led to me questioning if some of this attitude towards smoking and surgery, is just down to propaganda, and the discrimination that smokers face by the medical profession is based more on the hatred of smokers, rather than evidence.

    I'm not saying there is no evidence of smoking having a bad effect on people's health, and ability to heal after surgery, but that this effect has been greatly exaggerated in order to vilify smokers, and discriminate against smokers.
    All opinions expressed by me, are my own, I do not represent, or speak for, anyone but myself.






    STOPPED SMOKING 11/08/13 STARTED VAPING 11/08/13

  4. #4
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    well, how very ridiculous. what do the non-smokers do? they never benefited from the mobilisation needed to reach designated smoking areas. looks like the smokers had it right all along. over the last couple of years, i've had several general anesthetics, and every single time, i've worn a nicotine patch into surgery, so not only was i getting nicotine beforehand, i was getting it while i was under. i must have been so far from safe it isn't even funny.

    stupid scaremongering claptrap! pfft!!!

    (oh, and every time i had a general, i would have my last smoke in the parking lot of the hospital right before i walked in to be admitted, or even pop out for one once i was admitted if i had to wait long)
    Last edited by kay67kay; 09-03-14 at 01:28 PM.

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    Actually Spud brings up a good question about the surgery/ expert waiting lists and the discrimination extended to smokers by throwing them to the bottom of the list... I wonder if ecig users will face the same b/s?
    GirlyPantz, spud and Rebel1 like this.
    ďBut I donít want to go among mad people," Alice remarked.
    "Oh, you canít help that," said the Cat: "weíre all mad here. Iím mad. Youíre mad."
    "How do you know Iím mad?" said Alice.
    "You must be," said the Cat, "or you wouldnít have come here.Ē
    Lewis Carroll, Alice in Wonderland






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  6. #6
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    Quote Originally Posted by rebelagainstthemachine View Post
    Actually Spud brings up a good question about the surgery/ expert waiting lists and the discrimination extended to smokers by throwing them to the bottom of the list... I wonder if ecig users will face the same b/s?
    What is interesting is that they simply can't tell the difference anyway, despite the propaganda. My friend, also a smoker, had the same experience as me, she just told them she was a non-smoker, and they wouldn't have been any wiser.

    If I had told them I was a smoker, I would have been put through at least 3 extra tests, including a chest xray, lung function test, and extra blood tests, (all of which cost the taxpayer money, (and as a taxpayer, cost me money), for totally unnecessary tests. Not to mention the discrimination of being put at the bottom of the waiting list.
    All opinions expressed by me, are my own, I do not represent, or speak for, anyone but myself.






    STOPPED SMOKING 11/08/13 STARTED VAPING 11/08/13

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    "They preface their assertions of harm with ‘probably’ and ‘maybe’ "
    makes me smile whenever I think about the fact that these are the only words our opposition can use with any of their "theories"
    GirlyPantz and spud like this.

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    All these pre-op procedures actually have sound medical foundations, at the very least in terms of risk mitigation.

    During surgical day procedures, they usually knock you out with short-acting intravenous Propofol. This generally doesn't keep you out for the whole operation. At some later point they switch to an anaesthetic breathing system (ie, aspiration with a tube down your airway). If your chest's in a bad way this could lead very quickly to a catastrophic emergency, for example a pulmonary embolism. That spells almost instant death. This would be a worst case scenario, but there's plenty of lesser complications.

    Of course, most people will 'get away with it' most of the time................but, if you choose to fib on your pre-op questionnaire then that's your lookout. It might help you get to the front of the queue — the crematorium queue!

    So, no, they don't ask all these questions to be awkward, difficult or discriminatory. And remember, "Do you smoke?" is only one of a raft of questions they ask. From recall, my pre-op questionnaire ran to 4 pages!
    GirlyPantz and margyb like this.

  9. #9
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    Quote Originally Posted by rebelagainstthemachine View Post
    Actually Spud brings up a good question about the surgery/ expert waiting lists and the discrimination extended to smokers by throwing them to the bottom of the list... I wonder if ecig users will face the same b/s?
    And the Government uses the excuse that the huge tax on cigarettes is to offset the fact smokers increase those waiting lists. If we pay the huge taxes for the privilege of smoking then there is no excuse for the discrimination by being put to the bottom of any waiting list.
    GirlyPantz, tom32, JenJ and 2 others like this.

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    Quote Originally Posted by spud View Post
    What is interesting is that they simply can't tell the difference anyway, despite the propaganda.
    I think this is very true. I wonder if they looked at a few anonomous test results how accurately they would be able to say which were smokers and which weren't?

    I had a chest Xray a couple of weeks ago because I wanted to know what the damage of 30 years of heavy smoking was to my lungs. I've read so many times that all 20+ year smokers will have some early signs of emphysema. So I figured I must have some mild signs.

    Results of Xray were, and I quote:

    Clinical History: Ex-heavy smoker

    Findings: The heart, lungs, mediastinum and pleural spaces are radiographically normal.


    I was a bit confused by this, radiographically normal for a heavy smoker? Or just normal full stop? I'd hoped for a bit more information. So I asked a friend in the business (haven't been back to my doc yet) and she said it means simply normal in every way, no visible signs of any smoking related issues. So I wonder if a doctor would be able to spot from this Xray whether it was the lungs of a long term smoker or a non-smoker? I guess not.

    So much for all long term smokers having lung damage. They seem to be allowed to say whatever unsubstantiated bullshit they want if it's about smoking these days.
    GirlyPantz, margyb, spud and 1 others like this.

 

 
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