SRS, Recovery and Smoking

[Julie Marie]

This is something that was posted on another forum.  I think it's something that needs to be stressed, especially to those of us who plan elective surgery.  I have received permission from the author to distribute it.

"it is not just in the area of gender surgery that smoking is a big deal. I'm an orthopedist and whether a patient smokes or not determines the choice of treatments available for my patients for elective problems. When there is an emergency it still effects my choices because I know they won't heal as readily.

For example, smoking raises the risk of bony non union in the long bones by 500%. It is the usually cause of amputation for a tibia fracture that won't heal. Having smoked for years and the resulting vascular disease  means that I won't do bunion surgery on smokers. They have too many healing problems.

I've seen rotator cuff patients that smoke heavily and have required multiple operations before they healed their cuff. The tissue just sit there. It is frustrating for the doctor and the patient. Cost of care goes up greatly with any complication and smokers have more infections and wound problems too.

Today surgery pays less than it did in 1985 while cost of  operating a practice have more than doubled. Surgeons write a kind of insurance policy on their patients through global surgery billing in the USA. For example, with Medicare, the surgeons post operative care period is 90 days before billing again unless there is a repeat surgery. Then Medicare slashes the pay for that. I see a day not far away where smokers will not be offered any kind of elective surgery.

I recall the terrible healing problems that we had at the Veterians hospital where nearly every patient smoked. Back years ago we blammed it on the alcohol and their nutrition but in the last 10 years or so the blame has been more correctly shifted to the habit of smoking. Surgeons smell smoke on clients more than about anyone does. Hotels don't like it either. Is this discrimination? Is it fair? Don't add another discriminationto your transition.

Dr Debbie"

[Luc]

Okay, the last thing I plan to do is promote smoking, but one must be reminded that the patients to whom that article refers are heavy, long-term smokers. Personally, I had at least 2 sinus infections per year throughout high school, UNTIL I started smoking. I'm a light smoker, at about 2 cigarettes a day now, but have been smoking that way and socially since age 17 (I'm 24 now). I heal incredibly quickly, my resting heart rate is a healthy 64 beats per minute, I rarely get sick, despite being on medications for my clinical depression, and have had doctors compliment me on how good my lungs are (before I tell them I"m a smoker).

So is discrimination against smokers fair? I think it's easy for people to generalize about smokers, thinking that anyone who has a cigarette with friends at a bar on the weekend is automatically a chain smoker, like when a person is seen drinking a lot at a party and is assumed to be an alcoholic. Situational factors exist regardless of the person and the context in which you see him/her, and generalizing people on the basis of one habit is ridiculous.

The tone of this article seems to suggest that the last thing TSs should do is smoke, because they'll be subjected to further scrutiny than they already are, but this is just an overgeneralization, in my opinion. That's how many TSs end up being discriminated against.

Rafe

[Melissa]

I've never smoked anything in my life and I encourage people to not ever smoke if they haven't started or try to quit one way or another if they currently do.

Melissa

[Sheila]

I don't discriminate against smokers as long as they don't smoke in my presence. I don't like second hand smoke as it is deadlier than the smoke that goes down your lungs. Smokers lungs are black and non-smokers are bright pink.
Sheila