More Lessons Learned

Blog Post created by Giulia Champion on Apr 18, 2017

When I had my pre-op appointment with the surgeon who did my achilles surgery last week, he asked if I smoked. This is a standard question these days prior to surgery. And by doctors in general these days. I told him I had quit. He said, “good for you,” and we talked a bit about it. He explained WHY it’s good for us to quit in relation to surgery (aside for all the reasons of which we already know.) He explained that there’s a 500 fold increase in surgical complications with people who smoke. Let me repeat that - 500 fold increase in smokers.


He illuminated the lesson by speaking about a woman patient he had who had diabetes and was also a smoker. He told her she should stop smoking prior to the surgery. She didn’t. She ended up dying of a heart attack. (He didn’t say if it was during surgery or after she had gotten home.) He went on to explain that nicotine is a vaso-constrictor (narrows the blood vessels). Not only the large arteries, but the small arterioles. With a 500 fold increase in the narrowing of those vessels during surgery, you’re body is obviously under more stress and distress. It’s harder on the smaller vessels because they have less room to shrink. Also healing is impaired due to the narrowing of the blood vessels and thus lack of oxygen flow. Most of us who have done our homework on here know about this. I pass it on to those who don’t.


There is ONE benefit to smoking, however, which I learned from one of the nurses the day of my operation: it decreases the nausea potential from the anesthesia. I was given a Scopolamine patch behind my ear to prevent such because I had “two points against me.” 1) I didn’t smoke, 2) I was a woman. She said women experience more nausea than men regarding anesthesia and being a non smoker increases the potential also.  (That's all right!  I'll take that point.)   So be sure to keep smoking right up to your lung transplant to avoid nausea. (Ahem!)


Another interesting moment was when they placed a cannula over my ears with the two small prongs up the nose for added oxygen flow. I lay there thinking, wow - this is what people with severe COPD have to wear 24/7 while carrying around their small oxygen canisters. Gave me an immediate and visceral experience of what that’s like. For those who haven’t experienced it - I don’t recommend it. Quit smoking before the necessity becomes your reality.


And yet a fourth lesson - while I was being given the leg block by the anesthetist, he was talking to me and asking all sorts of questions - like what brought me to this area of the country etc. (just small talk) A few minutes later, after he had walked away, I felt my leg start to go numb and I said to the nurse, did he do the leg block? She said he had. I said I didn’t even feel it. She said “That’s because he’s real good at DISTRACTING.” Ah, so THAT’s why he was asking me all those questions. Brilliant! Reminded me of the tools we have here to stop cravings. Distract yourself by getting up and going for a walk, or learning a new skill, putting on some music and dancing, altering your focus, etc. Distracting really works to offset cravings!


If you haven't yet quit - may this help to give you an incentive to do so.  If you have, may this encourage you to maintain it!