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Thread: Stopping smoking before spinal fusion surgery

  1. #1
    Join Date
    Mar 2011
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    Tallahassee, Fl.
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    Stopping smoking before spinal fusion surgery

    Hey all...i'm back. My son is coming up on his spinal surgery revision june 14th, but he is still struggling with stopping smoking. He has almost completely quit, but still smoking on some days maybe 5 or 6 cigs. This is such a mess. He was supposed to have stopped a month ago. He hasn't told the surgeon he is still smoking because he believes as long as he isn't smoking for at least 2 weeks before the surgery and doesn't smoke after he will be ok. Any input will be greatly appreciated. I keep telling him it's not worth going through this huge procedure if he doesn't give his body long enough to get rid of the nicotine. How long have others been told to stop smoking before? This is so messed up and me being his mother am in a pickle having taken time off work and taking out loan, fmla in place...etc. I will have a hard time getting my hours back at work...please help!!

  2. #2
    Join Date
    Jan 2009
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    Ames, Iowa
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    I hate to be the bearer of the message but 3 different doctors I saw said they won't even consider surgery on someone that smokes. One said they have to be smoke free for 3 months, and Dr. Lenke's rule was 6 months. I'm not sure but I think they might even have a test to make sure that you have been smoke free. The problem is fusion will not take hold. It is a big deal. Does his surgeon know he's still smoking? Good luck to you both. I wish it was an easier and better answer. Janet
    Janet

    61 years old--57 for surgery

    Diagnosed in 1965 at age of 13--no brace
    Thoracic Curve: 96 degrees to 35 degrees
    Lumbar Curve: 63 degrees to 5 degrees
    Surgery with Dr. Lenke in St. Louis--March 30, 2009
    T-2 to Pelvis, and hopefully all posterior procedure.

    All was posterior along with 2 cages and 6 osteotomies.

  3. #3
    Join Date
    May 2010
    Location
    Indianapolis area
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    966
    Oh, I'm sorry for the situation you're in. I agree with Janet; the chances of fusion being successful if you're smoking are dramatically reduced. I would suggest telling the surgeon and seeing if it makes sense to postpone. Maybe there is something medical the surgeon can offer to help with the smoking cessation. I know my Valium label said it was sometimes used for that. Valium isn't contraindicated for fusion, though it, too, can be habit-forming. Best of luck! Let us know what you do.
    age 44
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

  4. #4
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    Southern CA
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    All of the surgeons that I have seen have said the same thing .They will not even consider doing surgery on a patient who smokes. They all said the patient had to be smoke free for a period of time. I am afraid that your son is in a bad place right now. I wish that the news was different , but smoking interferes greatly with fusion

    Best of luck to you both
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  5. #5
    Join Date
    Mar 2011
    Location
    Tallahassee, Fl.
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    You are all making sense and I know I am going to have to call him and cancel. It just doesn't make sense to go through with this huge surgery...T1-S1 if he hadn't laid down the smokes. Jeez...what a major pain it is going to be for me with work and all. But...I have to put myself in the rear and consider his situation first! Thank you everyone.

  6. #6
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    Hopefully the fact that he cannot have the surgery until he stops smoking will be the push for your son to quit

    Good Luck
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  7. #7
    Join Date
    May 2010
    Posts
    345
    Quote Originally Posted by mabeckoff View Post
    Hopefully the fact that he cannot have the surgery until he stops smoking will be the push for your son to quit

    Good Luck
    I have heard that some smokers are trying to quit with the electric cigarette. It is maybe something to look into. It is suppose to look like a cig, but when you take a drag it lets off a smokeless vapor that is free off all the damaging things in a real cigarette. I guess that it gives you a little nicotine in your system as would any other sessation product such as nicotine gum or the patch,ect. So basically, it lets off a smoke free vapor and all you get is a small amount of nicotine to keep you from craving the whole thing so much. Saying all of this, you may want to google Electric Ciggarettes. It may not be right either. Just trying to help out. Good Luck! We want him to have a chance to get all better with this surgery! Sincerely, Linda
    Linda Brozik~~60 yrs. old at time of Lenke's first surgery. 62 now!
    Surgery 2006 L3/4 L4/5 double fusion/ instumentation/ With 2 cages
    This started adult onset scoliosis
    July 1st, 2010/ surgery ~~fused T10 to pelvis (long rods/ screws)
    Oct.20th 2010, extended rods to T4 / did osteotomy at L3
    Oct. 29th 2012 Dr. Lenke St. Louis Mo. T4 to sacrum osteotomy anterior cage L3/4 titanium rods
    May 30th 2013 revision
    May 8th cervicle surgery 2016
    May 31st Dr. Gupta revision 2017

  8. #8
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    Northern California
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    Hi...

    While inhibiting fusion is the big problem in this context, there is also the issue of his lungs being healthy enough to withstand a long surgery. I don't know if this is correct, but I've been told that it takes 10 days for all of the nicotine to leave one's system. If they have your son do a nicotine test, he likely would not pass. (At UCSF, most of the surgeons require that patients have 2 consecutive negative nicotine tests prior to surgery.)

    Having smoked for many years, I understand the addiction. Millions of people have quit. If we can do it, your son can as well. Hope you can convince him of that.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  9. #9
    Join Date
    May 2009
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    3,745
    when i quit smoking, years ago, a pharmacist told me the nicotine would be
    gone from my system in 72 hours, but that the habit would be with me a lot longer...
    i quit twice...it was before there were nicotine patches...there was only nicotine gum...
    the first time i quit, it was with the gum...it was awful...the gum made my mouth sore, and i hated it...
    the second...and last...time i quit, i did it cold turkey..hardest thing i ever had to do...
    i swear i didn't sleep for a month...doctor told me your brain waves change...

    the only way i know to quit is to decide that no matter what happens, smoking is not
    an option...
    i had a girl friend who quit when i did...she broke up with her boyfriend, used
    it as an excuse to smoke again....blamed stress, etc...
    it will not work as long as smoking is still an option...

    best of luck...
    jess...& Sparky

  10. #10
    Join Date
    May 2010
    Posts
    345

    Is it nicotine that the Drs. worry about?

    Just wondering, if he tries the nicotine gum and patch or whatever --is that bad too? Or is it the smoke and all the 100's of other things in the cig. that they're not liking? Just wondering what it would do if he tried the nicotine replacments. May not be good either. Cold Turkey sounds like the only way to get it done.Then there's no reason to worry about the effect it has on his fusion. SOOO hard~~~as is any addiction-- I'm guessing. Truley~~Linda
    Linda Brozik~~60 yrs. old at time of Lenke's first surgery. 62 now!
    Surgery 2006 L3/4 L4/5 double fusion/ instumentation/ With 2 cages
    This started adult onset scoliosis
    July 1st, 2010/ surgery ~~fused T10 to pelvis (long rods/ screws)
    Oct.20th 2010, extended rods to T4 / did osteotomy at L3
    Oct. 29th 2012 Dr. Lenke St. Louis Mo. T4 to sacrum osteotomy anterior cage L3/4 titanium rods
    May 30th 2013 revision
    May 8th cervicle surgery 2016
    May 31st Dr. Gupta revision 2017

  11. #11
    Join Date
    May 2009
    Posts
    3,745
    quitting cigarettes cold turkey was brutally hard, in my experience....
    i have heard doctors compare it to quitting heroin, though having
    worked in drug facilities, i do not know if i would take it that far...
    my withdrawal from nictotine did not inlclude the violent effects
    quitting heroin can cause...
    it did make me a nervous wreck, ruin my sleep for more than a
    month, and frazzle my nerves completely....
    the habits of smoking have to be broken...
    the hand gestures have to be broken...
    i started tearing napkins when i was out at restaurants, rolling
    the pieces into tiny balls, just to have something to do with
    my hands...

    i would ask the surgeon about nicotine patches, gum, etc...

    jess

  12. #12
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    Jun 2011
    Location
    Southern CA
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    Just want to add Good Luck to your son in this .
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  13. #13
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,793
    Think it's too late for anything (gum, patches) that still delivers nicotine into the blood stream.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  14. #14
    Join Date
    Mar 2010
    Posts
    2,755
    I can't speak for spinal fusion, but I can speak from other experience. My mom cut her fingers off in a table saw. The doctor said he wouldn't even attempt a reattachment surgery if she was a smoker. He was able to save four of her fingers and she can use them. She would have lost ALL five fingers. His reason for not trying to save fingers of smokers is due to the NICOTINE causing a constriction of the blood vessels. He had once operated on a young man that also cut his fingers off because the young man promised never to pick up another cigarette again. As soon as the young man got home he started smoking. He ended up losing all of his fingers.

    I would also be careful about e-cigarettes. I did some research on them because my son started using them as an anti-smoking aid. Some of them have anti-freeze (polyethelene glycol) as a propellant, others use propylene glycol (also used in asthma inhalers). I went to the FDA website to read about them. There are dangers. They have tested some that supposedly contain NO nicotine and found nicotine in them. Also, the cartridges can leak. They aren't as "safe" as the manufacturers claim. Also, it's the nicotine that causes the cardiovascular disease. The other "chemicals" in cigarettes cause cancer.

    I hope this was somewhat helpful. I think that proper bloodflow is important for healing in any surgery, but especially the really "big" surgeries. I'm sorry you are in this position with your son. I am frustrated with my kids for smoking and they don't have big surgeries to face. I wish you all the best and hope that your son can come to see the seriousness of this situation.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  15. #15
    Join Date
    Jan 2012
    Location
    Yacolt, WA
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    1,524
    I agree that healing is greatly disrupted by smoking. Anesthesia is also affected by smoking. You're just going to have to call the doctor's office and tell him the facts of the number of cigarettes that your son is smoking/day. The doctor or his PA is the one that needs to call your son back and tell him why he is cancelling the surgery and for how long he is cancelling the surgery and what blood tests he will do in the future to make sure that he is no longer smoking. You shouldn't look like the one that cancelled the surgery, it is between your son and his doctor. Your son needs to take responsibility for the smoking that he his doing, and the quitting that he is going to do to re-schedule the surgery. He needs to get together a plan with the doctor/PA on how he is going to do it and be accountible for that plan. Your son needs to man-up here.

    My heart goes out to you as his mom, but the surgery is tough as it is let alone having something like smoking decrease your son's healing. Also, the further that your son is from smoking when he has the surgery, the less likely it is that he will go back to smoking post-op.

    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

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