Doc's office says I can't vape before surgery tomorrow

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Sane Asylum

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According to this article: Basic science studies have shown that total smoke (cigarette smoke condensate) is worse than nicotine alone. Although nicotine may lead to cell death and the use of NRT may contribute to disk degeneration, no evidence in humans supports a negative effect of NRT.

Smoking Threatens Orthopaedic Outcomes

According to this study from 2012, on smoking and wound healing: Nicotine and nicotine replacement drugs seem to attenuate inflammation and enhance proliferation but the effect appears to be marginal.

Wound healing and infection in surgery: the pathoph... [Ann Surg. 2012] - PubMed - NCBI

I think there is a tremendous amount of misinformation out there and there are many, many medical professionals who 'confuse' smoking with nicotine, whether they are physicians or 'experts' dispersing information in organizations and websites. While I fully believe that nicotine is obviously not without negative effects, there is a lot of 'blaming' nicotine when it's 'smoking' that is the culprit.
 

yzer

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Sane Asylum

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I believe this study is still underway. This is the study on stem cells and healing of bone injuries I mentioned earlier. Smoking is clearly differentiated from nicotine use in NRTs. I haven't seen any results from this study yet.

USATODAY.com - Scientists study bone recovery in smokers

The study was funded by DOD who wanted information regarding the treatment of combat injuries.

DOD to Fund Research on How Nicotine Impairs Bone Healing - News Room - University of Rochester Medical Center

Interesting. This grant was given in 2005 or 6 but I can't find anything further specific on it. I did find this but it talks about the effect of 'smoking' on healing, not nicotine. Makes me wonder if nicotine wasn't the factor he was predicting. Or I just couldn't find it.

Toxicants from cigarettes enter blood stream, not just lungs | Orthopedics Today
 

Eranda13

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OK so here's the post-surgery wrap up LOL. For informational purposes, I had my gallbladder removed.

I asked the anesthesia tech AND the anesthesiologist about vaping. Both of them understood that it was NOT smoking, but neither of them had a definitive answer about whether it was a problem to vape before surgery as opposed to smoking. Both of them said they would "do some research on that". I was honest and told them both that I had no had nicotine since midnight the night before, but that I had vaped a zero nicotine juice. Neither of them had a problem with it.

My general impression, having dealth with doc's office personnel, the surgeon himself, the anesthesia tech and the anesthesiologist- was that none of them had any real answers about nicotine only vs. actual smoking. I don't think any of them really knew whether it was a problem or not. Or at least not enough to tell me- right then and there- if nicotine by itself was OK or not. Mostly they just seemed interested in it, and asked me a few questions, which fortunately I was able to answer knowledgeably.

Now for anyone who gave me grief about being pissy about it... I did what the surgeon's office instructed. Because of a great fellow vaper, I had some zero nic juice, and I only vaped that for the time period they told me. I had no bad reactions of any kind, although I have never had bad reactions to any kind of anesthesia before (thank god).

But what I discovered is that this subject is not one that doctors or hospital personnel are very used to dealing with, and they do not have a lot of knowledge about it. That in and of itself could be an issue, since we as vapers are basically in uncharted territory, medically speaking, when it comes to things like anesthesia.

But I can tell you that NO ONE in the hospital freaked out when I told them I was vaping, no one had any reaction other than interest and to ask questions about it. I think it's so new that even doctors are sometimes at a loss about how to deal with it. Depends on their personal level of interest and awareness as to whether they've done any research on how it applies to their patients.

But it will be interesting to me to discuss this with my orthopedist because I will be needing a hip replacement at some point in the next year. Because it's a orthopedic surgery, the rules may be different according to what people have written here. Perhaps the orthopedist will have a more informed opinion.

Anyway, I feel surprisingly good today considering that they removed one of my (admittedly not critical) organs yesterday. Not much pain aside from abdominal tenderness more like muscle stiffness, and a pretty good sore throat from the tube. I am eating fine and handling the stairs to the bathroom just fine. Moving a little slow, but otherwise not in any major discomfort. Which is awesome.

Thanks for all the input.
 

EvilZoe

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I know that this will sound terrible and ignorant (and it probably is) but I never listened to them about nicotine, even though I knew they were correct, and I never was any the worse for it. I'm pretty healthy overall, though. (My last surgery was also a gallbladder removal two years ago)

There is NOTHING that would have stopped me from smoking back then and I have little doubt that I would have found a way to vape, nowadays.

I freely admit to being an addict in the worst way.
 

Racehorse

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I have a harder time with nicotine affecting healing.

I didn't *need* any white papers or studies to know that nicotine impacts healing, esp. blood vessels, etc. due to being a vaso constrictor.

That is because I had the best surgeons from one of the best teaching hospitals in the US......

For the particular sugery I had, I was unable to find ANY surgeon, anywhere, who would do the surgery if I had ANY nicotine 6 weeks out from the surgery.

They werent' anti smoking nazis----- they were all surgeons who had experience (25+ years) with nicotine dependent patients and had records of post surgical "outcomes". Not just smoking, but nicotine patches, gum, etc. any kind of NRT.

Nicotine IS a vaso constrictor, and there are many many tiny blood vessels and nerves that are impacted during surgery, cutting, etc.

The incidence of certain stuff "dying" (which would then involve massive reconstructive surgery later on to fix) was just not worth it to me, and every surgeon I talked to have plenty of *experience* on this from doing certain surgeries over the years.

I therefore had no problem quitting cold turkey once I realized what a bad outcome "could look like" :blink: and I am glad I did not have any nic in my system for 6 weeks before the surgery.

No way would I have wanted to take a chance like that over a silly addiction. This was breast reduction surgery and i can tell you that you do not want to take chances on stuff like this. I helped several women thru this particular surgery as I was part of an advocacy group for this, and I can't tell you how heartbreaking it is to see a "bad outcome" ...... because it is rather um......disfiguring.

So people, do not ask non medical people on forums or read white papers on the internet.

Ask YOUR surgeon(s) and find out from them, over their vast years of doing a certain surgery, quite often, what THEY have seen. Then, take their advice.

Mine were caring human beings who wanted the very best outcome for me. They had no agenda other than that.

They are not making this stuff up, and anyone who thinks that is just in denial. :(
 
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Myk

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I didn't *need* any white papers or studies to know that nicotine impacts healing, esp. blood vessels, etc. due to being a vaso constrictor.

That is because I had the best surgeons from one of the best teaching hospitals in the US......

For the particular sugery I had, I was unable to find ANY surgeon, anywhere, who would do the surgery if I had ANY nicotine 6 weeks out from the surgery.

They werent' anti smoking nazis----- they were all surgeons who had experience (25+ years) with nicotine dependent patients and had records of post surgical "outcomes". Not just smoking, but nicotine patches, gum, etc. any kind of NRT.

Nicotine IS a vaso constrictor, and there are many many tiny blood vessels and nerves that are impacted during surgery, cutting, etc.

The incidence of certain stuff "dying" (which would then involve massive reconstructive surgery later on to fix) was just not worth it to me, and every surgeon I talked to have plenty of *experience* on this from doing certain surgeries over the years.

I therefore had no problem quitting cold turkey once I realized what a bad outcome "could look like" :blink: and I am glad I did not have any nic in my system for 6 weeks before the surgery.

No way would I have wanted to take a chance like that over a silly addiction. This was breast reduction surgery and i can tell you that you do not want to take chances on stuff like this. I helped several women thru this particular surgery as I was part of an advocacy group for this, and I can't tell you how heartbreaking it is to see a "bad outcome" ...... because it is rather um......disfiguring.

So people, do not ask non medical people on forums or read white papers on the internet.

Ask YOUR surgeon(s) and find out from them, over their vast years of doing a certain surgery, quite often, what THEY have seen. Then, take their advice.

Mine were caring human beings who wanted the very best outcome for me. They had no agenda other than that.

They are not making this stuff up, and anyone who thinks that is just in denial. :(

And yet the fact that it is a vasco constrictor is one of the suspected reasons it helps Ulcerative Colitis, the thing you say doesn't help healing somehow helps it.
BTW, while my specialist did know about the Ulcerative Colitis/nicotine link my GP did not. In spite of my specialist knowing about it she is still anti-nicotine and would be happy for me to get off nicotine and when I flare she will give me drugs that can cause lymphoma. I went with her opinion when there was a chance I had cancer or Crohn's, now it's just an anti-nicotine bias.
Doctors are humans not gods. They are professionals I hire to give me their opinion so I can form my own opinion after educating myself and that includes with the experience of non-medical people on forums and "white papers".
If you want to treat them like they're gods and blindly do whatever they say that's your non-medical person on a forum's opinion. Just remember the doctor who barely graduates is still a doctor. When they walk into a voting booth they vote based on their own biases just like everyone else, they are not immune because they have a PhD.
 

Sane Asylum

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And yet the fact that it is a vasco constrictor is one of the suspected reasons it helps Ulcerative Colitis, the thing you say doesn't help healing somehow helps it.
BTW, while my specialist did know about the Ulcerative Colitis/nicotine link my GP did not. In spite of my specialist knowing about it she is still anti-nicotine and would be happy for me to get off nicotine and when I flare she will give me drugs that can cause lymphoma. I went with her opinion when there was a chance I had cancer or Crohn's, now it's just an anti-nicotine bias.
Doctors are humans not gods. They are professionals I hire to give me their opinion so I can form my own opinion after educating myself and that includes with the experience of non-medical people on forums and "white papers".
If you want to treat them like they're gods and blindly do whatever they say that's your non-medical person on a forum's opinion. Just remember the doctor who barely graduates is still a doctor. When they walk into a voting booth they vote based on their own biases just like everyone else, they are not immune because they have a PhD.

I absolutely agree. Doctors are not gods and you are your best 'advocate' when it comes to your health and medical decisions. And when doctors give recommendations about your medical care, remember their information and guidelines very often comes from organizations who sometimes are biased and have their own agenda.
 

Racehorse

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And yet the fact that it is a vasco constrictor is one of the suspected reasons it helps Ulcerative Colitis, the thing you say doesn't help healing somehow helps it.

I have no idea what ulcerative colitis has to do with having a certain kind of surgery. Since I do not have UC, but was having surgery in which nicotine is highly contra-indicated, the fact that nicotine may help certain conditions such as UC is not even germane to the subject i was speaking on.


Doctors are humans not gods. They are professionals I hire to give me their opinion so I can form my own opinion after educating myself and that includes with the experience of non-medical people on forums and "white papers".
If you want to treat them like they're gods and blindly do whatever they say that's your non-medical person on a forum's opinion. Just remember the doctor who barely graduates is still a doctor.

Perhaps you missed part of my post. I wasn't talking about a doctor who barely graduates.....I'm talking about surgeons at a major world renown teaching hospital who have PERFORMED a certain surgery, ie. the one I was having, thousands of times. Thousands. So they are uniquely qualified to speak about outcomes.

Since the 3 surgeons i interviewed before my particular surgery were all in that category, yes, I believe they were uniquely qualified to give an expert opinion.

If you believe a internet forum members would have more insight than that, then you are welcome to that belief. I don't agree though.

And when doctors give recommendations about your medical care, remember their information and guidelines very often comes from organizations who sometimes are biased and have their own agenda.

Again, these were surgeons who actually performed a certain surgery, thousands of times over 20+ years.

Experiential, not people who are reading "information from organizations". :lol:
 
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Racehorse

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BTW, while my specialist did know about the Ulcerative Colitis/nicotine link my GP did not. In spite of my specialist knowing about it she is still anti-nicotine and would be happy for me to get off nicotine and when I flare she will give me drugs that can cause lymphoma.

And by the way, I am not disagreeing that there doctors like this. Quite frankly, I don't HAVE any of those in my arsenal.

All my doctors support my vaping. EXCEPT in the case of certain surgeries, in which nicotine, even if delivered by patch, etc. is contra-indicated. None of my doctors are biased against nicotine per se. As a matter of fact, my GP gave me a hand wave when I told him I was still vaping nicotine 1.5 years after quitting smoking. :)

Most anesthesiologists however, seem to be sort of anti nicotine in general. Of course, they are in charge of keeping you alive during surgery, so they tend to be a little more cautious. :)

Those are things i have discussed, most recently I had a minor procedure, in which I let everyone know I was "on" nictotine, and even though i was being put under, the nicotine wasn't *real* hazardous in this scenario, so I was pretty adamant about not avoiding nicotine for that.
 
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Myk

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I have no idea what ulcerative colitis has to do with having a certain kind of surgery. Since I do not have UC, but was having surgery in which nicotine is highly contra-indicated, the fact that nicotine may help certain conditions such as UC is not even germane to the subject i was speaking on.




Perhaps you missed part of my post. I wasn't talking about a doctor who barely graduates.....I'm talking about surgeons at a major world renown teaching hospital who have PERFORMED a certain surgery, ie. the one I was having, thousands of times. Thousands. So they are uniquely qualified to speak about outcomes.

Since the 3 surgeons i interviewed before my particular surgery were all in that category, yes, I believe they were uniquely qualified to give an expert opinion.

If you believe a internet forum members would have more insight than that, then you are welcome to that belief. I don't agree though.



Again, these were surgeons who actually performed a certain surgery, thousands of times over 20+ years.

Experiential, not people who are reading "information from organizations". :lol:

Actually it is pertinent to the subject of all of the non-medical personnel flat out claiming nicotine hinders healing. If it's not pertinent to give an instance where it helps then it's not pertinent to give your instance where it doesn't (assuming it doesn't). The OP wasn't having breast reduction just like they weren't having a bowel resection.
They don't really know why smoking helps UC and they only have some good guesses why nicotine improves the results in conjunction with other drugs, but the fact is that it helps many and one of the suspected reasons is the vasco constriction.

Major world renowned hospital has nothing to do with getting good doctors. I just heard from a IBD'er on Twitter than Mayo said she has had way too much radiation, oops. How many expert doctors do you suspect her team had at Mayo? The fact that they have done thousands of procedures didn't help, it hurt.
BTW, Mayo has a pretty well defined anti-smoking/anti-nicotine/anti-ecig bias and they freely spout quackery on the subject.

I don't believe anyone has more or less insight until after I hear them out. I take in all the information I can and make my own decision based on what they say rather than who they are.
In '05 I thought I had panic disorder and agoraphobia. I just happened to go to a place that had a doctor that did my GI testing at age 14, I even reminded him. Didn't phase him even though I was complaining of stomach pains, he didn't even suggest my childhood ailments have come back with age, in spite of him being the only doctor to come close to the correct diagnosis (he just didn't take the testing far enough).
One of the quacks on that team told me to get more sun. Another told me I was the wrong religion (he was also told about a feeling in my colon and insisted I thought it was more than I did, it turns out that feeling is one of my hot spots). All but one fought me every time I needed more Xanax in spite of my averaging one of the smallest dose pills a week.
Now 8 years later my colonoscopy has confirmed I have had UC for a very long time. Missed by doctors at 9mos, 14 years and 20 years (this last is the one that started me believing the panic disorder diagnosis). My specialist says Xanax helps the pain, a book I have recommended by Gastro says it's better than pain pills for the pain because it doesn't complicate the problem. My GP laughed when I asked about addiction because of the low amounts I take (yet that was the excuse the others used to argue with me).
Even this time in spite of the problem getting worse when I quit smoking and being an obvious GI problem, I got two wrong diagnoses from the ER and my GP. Had I not been so close to the age 50 colonoscopy I would have been sent on my way (that diagnosis was pretty much what I worked on believing between my 20's to late 40's).
My own bias of not wanting to go through what I went through as a kid had me more than willing to believe the wrong diagnosis because at that time I was skeptical of the benefits of smoking and nicotine with UC.

My sister's surgeon specialist drained her tumor and sent her on her way. When she came back complaining of pain they tried to put her on Paxil. They left her in pain with a tumor for months. A surgeon, a specialist, mistook a tumor for a cyst.

Doctors are not infallible.


And by the way, I am not disagreeing that there doctors like this. Quite frankly, I don't HAVE any of those in my arsenal.

All my doctors support my vaping. EXCEPT in the case of certain surgeries, in which nicotine, even if delivered by patch, etc. is contra-indicated. None of my doctors are biased against nicotine per se. As a matter of fact, my GP gave me a hand wave when I told him I was still vaping nicotine 1.5 years after quitting smoking. :)

Most anesthesiologists however, seem to be sort of anti nicotine in general. Of course, they are in charge of keeping you alive during surgery, so they tend to be a little more cautious. :)

Those are things i have discussed, most recently I had a minor procedure, in which I let everyone know I was "on" nictotine, and even though i was being put under, the nicotine wasn't *real* hazardous in this scenario, so I was pretty adamant about not avoiding nicotine for that.

I haven't had an anesthesiologist ask. I also remember when they didn't say to not smoke. They knew you smoked and they adjusted things to suit it.
I even told my last anesthesiologist that I'd been on anxiolytics for a long time so probably had a tolerance to the drugs she was going to use. She said that doesn't matter, they watch the monitors and do what is needed according to what they see. The instant I started to freak out on the table she asked what the problem was, I told her and she turned me off like she had a volume knob.

I don't doubt there are instances where nicotine would be a bad thing to have while healing. But to claim it is always bad for healing is flat out wrong. It's been shown to promote vascular growth (which is why it is thought to be a bad thing in the presence of cancers).
Also, what is not pertinent to the OP is everyone thereafter focusing on healing. The OP was about anesthesia not healing.
 

Robino1

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I didn't *need* any white papers or studies to know that nicotine impacts healing, esp. blood vessels, etc. due to being a vaso constrictor.

That is because I had the best surgeons from one of the best teaching hospitals in the US......

For the particular sugery I had, I was unable to find ANY surgeon, anywhere, who would do the surgery if I had ANY nicotine 6 weeks out from the surgery.

They werent' anti smoking nazis----- they were all surgeons who had experience (25+ years) with nicotine dependent patients and had records of post surgical "outcomes". Not just smoking, but nicotine patches, gum, etc. any kind of NRT.

Nicotine IS a vaso constrictor, and there are many many tiny blood vessels and nerves that are impacted during surgery, cutting, etc.

The incidence of certain stuff "dying" (which would then involve massive reconstructive surgery later on to fix) was just not worth it to me, and every surgeon I talked to have plenty of *experience* on this from doing certain surgeries over the years.

I therefore had no problem quitting cold turkey once I realized what a bad outcome "could look like" :blink: and I am glad I did not have any nic in my system for 6 weeks before the surgery.

No way would I have wanted to take a chance like that over a silly addiction. This was breast reduction surgery and i can tell you that you do not want to take chances on stuff like this. I helped several women thru this particular surgery as I was part of an advocacy group for this, and I can't tell you how heartbreaking it is to see a "bad outcome" ...... because it is rather um......disfiguring.

So people, do not ask non medical people on forums or read white papers on the internet.

Ask YOUR surgeon(s) and find out from them, over their vast years of doing a certain surgery, quite often, what THEY have seen. Then, take their advice.

Mine were caring human beings who wanted the very best outcome for me. They had no agenda other than that.

They are not making this stuff up, and anyone who thinks that is just in denial. :(

I had a breast lift and partial reduction. I healed fine. No disfiguring scars. Maybe with a more invasive procedure there would be more problems? I don't know. Also there needs to be taken into account that not everyone heals the exact same way. I believe that doctors figure for worse case and do a blanket rule for everyone.

Of course they would use you as an advocate for others. You followed their rules. Do you honestly expect them to use someone that continued to use nicotine and had nothing happen to them?
 

CommaHolly

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OK so a wonderful member here, who's local to me, has offered to make me a zero nic juice I can vape until I'm through surgery. How cool is that??? I should have thought ahead, but I guess I never really thought I wouldn't be able to vape. Lesson learned... and one more bit of evidence that the vaping community is freaking awesome :)

This is amazing :)

and great karma for your local friend there :)
 
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