PRESSING AHEAD

[PeeJay]

Picking on the smokers again just heard on the radio
is it reasonable to deny smokers any kind of operations under the NHS
No good saying you packed up just to get the operation because they breath test to see if you got nicotine in your body.

Are you sure the breath test isn't the lung capacity test where you blow through a tube? I'd have thought you'd have to do a blood test to establish the presence of nicotine and even that would be affected by a patch.

[Shaun]

Fat people are a bigger problem for the NHS.

[Shaun]

Are you sure the breath test isn't the lung capacity test where you blow through a tube? I'd have thought you'd have to do a blood test to establish the presence of nicotine and even that would be affected by a patch.

There was talk about it last year, denying people treatment on the NHS because of lifestyle choices - being Fat or smoking the main ones. Unless they stopped and changed their lifestyle they wouldnt treat them but it was quickly brushed over when people kicked up a fuss.

[Emaresee]

this explains the tests quite well...

http://labtestsonline.org.uk/understanding/analytes/nicotine/tab/test/

A family member was asked to reduce his smoking (an ex-serviceman) ahead of a substantial operation to correct a broken neck sustained (without his knowing!!) while serving some 30+ years earlier. The rationale did seem to be that he needed to be in good nick for the operation, and that post-op he would need to cope without a smoke for longer than he might like due to reduced mobility. So a reduction of intake, and being used to it, so he could recover better was one factor, the overall health outcomes were the other.

I am sure a medic should chime in here (@simon bolivar perhaps?) but there are similar considerations around blood presure, blood oxygen etc etc when under anaesthesia for smokers, and the morbidly obese. I had a modest op a few years ago. I carry too much timber around my body, and they looked very hard at my blood pressure etc in the pre-op checks. Thankfully despite being 'well padded' my vitals are (for now) pretty robust - to the dismay of my GP who rightly advises me to shift some weight - and I was not asked to postpone etc.

In reality, the message to quit cigarettes is spot on... there are many other 'vices' that are genuinely quite bad for you. But the sense of well being gained from responsible participartion/consumption of just about anything in moderation could be argued to be worth the health risk. Afterall an abstemious life doesnt guarantee you longevity or immunity from frailty and disease etc... nor does it sound like too much fun.

But lord knows the media loves a headline to incite uproar about civil liberties. Most people would choose the path that gives them the best chance of success from any given operation. And if an operation could be avoided due to a lifestyle change it's probably the right choice. It's just messaged badly by the media - "if you smoke we'll leave you to rot on the hospital steps... etc to fat to climb the steps - we arent going to help you... " doesnt sound as good as "we'd like you to think about your health, act and ensure we maximise the chances of success in any given care pathway" .... ho hum.

I mentally wish every ambulance good luck when they pass on a road - a quiet personal tribute. Good luck for them, and the person(s) they are helping... this morning it was x4 incident response vehicles, x4 first responders on bikes and two regular ambulances all heading towards the motorway. Pretty sure it was a car not a cigar that they were racing to.

[PeeJay]

Like I said, not a breath test

[TonyN]

The criteria also mean smokers will only be referred for operations if they have stopped smoking for at least eight weeks, with such patients breathalysed before referral.

[Emaresee]

The criteria also mean smokers will only be referred for operations if they have stopped smoking for at least eight weeks, with such patients breathalysed before referral.

this will be about health outcomes and getting fit for an operation then... basic risk management.

[TonyN]

Not too sure about that emaresee if your under the hospital say every few months you need to go for check up and blood tests depending what the problem is they will know if they breathalyse you every time you go.

[cigarmo]

Lets face it the NHS will be gone and replaced with some sort of private service soon. In the mean time they have to think up new ways to save money, so the fat cats can keep the cash flowing into there pockets.