Hello everyone, I'm new to this community and I need some advice. Following a visit to a specialist I have been informed I need a stent fitted in my right leg.
I previously had a stent fitted 6 years ago and I have also had bypass surgery.
The specialist is refusing to sanction the operation to have a stent fitted on the NHS because I cannot give up smoking. I have tried very hard to give up smoking but I can't.
So, does anybody know of a ptivate hospital in England or mainline Europe that will do this surgery for me privately?
Many thanks for your help.
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Happyphotos
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Hello and welcome to the forum! Most private hospitals will have (a) vascular surgeon (s) on their books so finding one should not be difficult. Because smoking is one of the major causes of PAD some surgeons may not be willing to operate. Have you tried to quit smoking alone? Many GP surgeries now offer support for this.
And pharmacies. My wife is a Smoking Cessation Advisor in a pharmacy shop and has helped hundreds of people to give up. See what help is available in your area.
There is one big problem with your mindset regarding quitting smoking and that’s the word ‘can’t’ because you can .. If I can then anyone can.. (btw I’m not taking the moral high ground here) but you have to change your thinking . Everything is achievable if you want it hard enough. I have smoked since I was 18 now 53. Use to smoke ready made and then went to roll ups. Had my Heart Attack in August, I made sure my handbag with roll ups came with me in the ambulance, whilst in recovery after the emergency stent I told my partner to throw everything related to smoking away; clean out the ashtrays and car ( it was the happiest day of his life and the best day of mine). I didn’t do the patches or smoking sticks, I went cold turkey. I couldn’t face sitting in front of my cardiologist (who saved my life) at my review and saying to him/her thanks for all that you have done and the money/time spent on my care, but I can’t give up smoking, as I feel they would be well with in their right to say that they can’t do anymore for me!
The mind has to change as well as your routine and habits too. Think about the circumstances that would lead you to have a cig and change that lead up to something else. Within society you are seeing less and less smokers, so there is no longer that peer pressure to smoke. Most situations I found myself in, prior to quitting, it was much more difficult to find somewhere to smoke. Please believe I am not making any judgement on you .. just sharing my story. But I know that you can give up and life will be so much nicer. More money in your pocket , your health will improve dramatically, no more worrying about if you have enough to last to the morning, day or week . It sounds cliche, but you feel a sense of freedom. As Jimmyq has suggested go to a smoking cessation clinic. Good luck from a reformed fag hag !! (yes I know it can mean something else too !😉)
I quit smoking, and then I quit the nicotine lozenges that I'd subsequently become addicted to. I'm very proud of both achievements.
Still, I don't agree with the surgeon's refusal to operate.
None of us know the circumstances behind the original poster's addiction, so it's not for us to decide if they should or shouldn't be capable of quitting.
Furthermore the surgeon is on really thin ice with this decision. What about a smoker who has just the occasional cigarette at social occasions? Or a smoker who has quit on multiple occasions and may well relapse again, would the surgeon be justified in saying they have to remain tobacco free for six months, or twelve months, or some other arbitrary period?
And how would we feel if the surgeon had refused treatment to a terrorist or an enemy combatant? Or what about a murderer or a rapist? And if you say okay to those then what about a burglar or a drunk driver?
And if it's okay to refuse treatment to a smoker then surely it's also correct to refuse treatment to someone who's obese. But then should treatment be refused to those who are merely overweight? After all, they are pretty arbitrary lines that divides the morbidly obese from the obese, and the obese from the merely overweight.
And is it okay to refuse surgery but still offer medication? And would that still be okay if the medication was some of the ruinously expensive cancer medication that is crippling the NHS? Incidentally, this is not a hypothetical question. There is currently a proposal to conduct random screening for lung cancer, but the cost/benefit analysis says it only makes sense if the screening is offered exclusively to smokers, where as the "innocent" people who live in the household with smokers, and are therefore passive smokers, would not be offered the screening. Hmm, doesn't feel quite right does it?
I had a debate with a doctor on this very issue just a few weeks ago. Interestingly he said there is a growing trend for doctors and surgeons to take exactly this kind of harder line. He also made an intriguing speculation, musing that this tougher approach to personal responsibility is growing in step with the decline in status and respect that many doctors report from their patients, and he wondered if the two things were connected in some way? That's probably a far more insightful suggestion than the obvious statement that it's a rational response to growing financial pressures within the NHS.
A surgeon told me he refused to operate privately on someone whose BMI as he felt she might suffer respiratory failure. On her next appointment she said she had lost 7lb and would he now go ahead. She got a firm no. The operation was joint related and the chances of success minimal at that weight. He said some people might operate but he would not want it on his conscience if the worst happened. Would you?
Now that raises another interesting question. It's surely a good thing that the mortality rates for hospitals and even individual surgeons are published. However there's a hidden snag to that policy.
If a surgeon or a hospital knows that their success rate will become a matter of public record, then might that nudge them towards rejecting the higher risk patient (ie someone who is older or who has a comorbidity) in favour of younger, fitter patients who have less chance of "embarrassing" complications?
Indeed! When I was in my twenties there was a surgeon who took on cancer patients that others had sent home to die. Yes quite a few died under the knife or within a few days but many were very grateful to him being either cured or having more years of life. Statistically poor but in reality a brilliant surgeon!
Never for one moment did I suggest that it would be ok for Happyphotos or anyone else to be refused treatment . Because I wouldn’t be here today if the Cardiologist had refused to treat me when I presented as an emergency at the catheter suite in August with a total blockage to my circumflex. My statement was about me and how I personally wouldn’t feel able to easily face the doctors knowing that I had continued smoking after my heart attack. Also, I was not deciding whether they should or shouldn’t be capable of quitting, I was merely trying to be positive and enable Happyphotos to make that decision for themselves knowing that others in a similar situation have successfully done so.
I agree that there should be a harder line in regards to personal responsibility. If people don't care enough about there health to make positive lifestyle changes why should the doctors.
Very hard to implement though but as financial pressures on health services increase I think this will happen more often.
Hi Happyphotos. I too used to find it hard to give up smoking after 40 years. But I went forward and was prescribed 'Champix'. This was great until my second week when the dose was slightly higher. It made me extremely nauseous but I persevered and halved the dose but kept with it. I am now a non smoker and have been for 3 years plus. Champix works as I am told by blocking sensors and the craving for nicotine. Everyone I know has managed to stop by using Champix. (Prescription only ) and have never managed to complete a full course before they stopped successfully. I am no specialist but it may be worth mentioning when at the surgery. In all cases good luck and best wishes.
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