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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

Turned down for NHS Surgery (Smoking)

27 replies

Smoulderagon · 01/06/2021 11:48

More of a is it ok for me to feeling this bleurgh about this situation as I do sort of understand the reasons behind it.

Ages, and ages, ago I quit smoking - I had been referred to NHS surgery during this time but was turned away due to my mental health being precarious.

I didn't smoke for ages, but a really awful situation with two people close to me dying, losing a pregnancy, being made redundant and lockdown 389742398432098 meant that I brought a packet of cigarettes and started to smoke again.

I re-referred myself to the stop smoking clinic two months later; they are not accepting referrals. I've been trying to find somewhere to take me but it's not been easy.

I was then, and very unexpectedly, re-referred to NHS Surgery as my condition has worsened to the point that there's some pretty serious secondary issues going on (which I was unaware of).

I've been turned down again - due to the fact I re-started smoking.

I'm not sure if I am pissed off at anyone, pissed off at me, pissed off at the decision makers or just so fed up of this entire pandemic shit wank bag stain.

I cannot be re-referred for six months at least, have been offered support from the service that is not accepting referrals and nothing more.

The really stupid thing is, I haven't actually smoked since the day before the referral was made (due to having no money).

Referrer wants to refer me somewhere else but it's ultimately my choice - my smoking status would be forgotten in the referral letter; I would just be able to be honest and say at the first appointment I only stopped smoking just before the referral was made.

It's going to be a few months before they see me for the initial appointment I am guessing.

OP posts:
Original poster
Smoulderagon · 01/06/2021 11:52

That should say the decision making people told me to contact the stop smoking service which is not accepting referrals (I did get back in touch to confirm this was the case)...

OP posts:
EKGEMS · 01/06/2021 11:56

I'm sorry you're experiencing this. A smoker will definitely take longer to heal and will be at more risk for breathing issues with general anesthesia and at higher risk for post surgical pneumonia. Your pain relief will be less effective as well. Is there any way you can get a nicotine patch and withdrawal
slowly?

Original poster
Smoulderagon · 01/06/2021 12:19

Thanks - the thing is I basically think I just need a once a week check in with someone - this is how I did it last time at least.

I guess I am upset as it was just an automatic "no" with no discussion with either myself or the person who had referred me initially.

I do understand the elevated risks associated with healing time and GA; and it is a surgery with a long recovery time. Had I had a heads up that I would have been referred again (or even the possibility) I would have tried to sort this out earlier, but I had no idea that it was going to happen.

OP posts:
NotYourAverageDaisy · 01/06/2021 12:21

I'm so sorry OP, no advice but just want to send my sympathies for such a hard time you've been through Thanks

ChangePart1 · 01/06/2021 12:30

So they don't just want assurance you've quit smoking, they want to know you've engaged with a specific service?

That's really unfair when the service isn't accepting referrals. I would absolutely challenge that. However, if they want to wait six months since you last smoked then that's something you'll have to abide by. I'm guessing they have a lot of patients who promise that they've quit smoking or promise that they will either lie about it or renege on that promise, so they'll be wary when allocating resources.

Whatever happens, don't let the stress and frustration around this situation be the thing you use to give yourself permission to smoke. You have every right to feel frustrated and annoyed by this, it's your health and it sounds like you did fantastically well to quit for a while

Original poster
Smoulderagon · 01/06/2021 12:30

@NotYourAverageDaisy thank you it is very much appreciated.

I think I just needed to get everything off my chest. This pandemic has been such a bloody mind screw for so many people.

OP posts:
Original poster
Smoulderagon · 01/06/2021 12:33

@ChangePart1 No - they don't want to wait six months until I have stopped smoking - they won't even touch a referral with a smoking positive status on it.

The surgery wouldn't happen for more than six months anyway - so they could have plenty of time to engage with my currently non-smoking self. I think the time from initial appointment is around 8 months to surgery.

I do understand all the risks, I am not sure I am comfortable with the automatic "No" decision with no discussion. The referring person has tried to speak to them but they have said it is always a "no".

Weirdly enough if I was smoking cannabis and not cigarettes that would have been fine apparently!!

OP posts:
Original poster
Smoulderagon · 01/06/2021 12:34

Definitely not smoking now by the way, it's been a major kick up the (in line with NHS weight guidelines for surgery) backside

OP posts:
ChangePart1 · 01/06/2021 12:37

But you've been offered the chance to be referred somewhere else with your ex-smoker status being left off the referral, right?

I'd go with that to be honest. Sounds like whoever would be writing that referral wants to help you and knows that's the best way.

Original poster
Smoulderagon · 01/06/2021 12:46

@ChangePart1 Yes - I am very grateful that has happened, I think I am going to go with that option.

OP posts:
LyingWitchInTheWardrobe · 01/06/2021 13:01

How frustrating for you, Smoulderagon. I'm an ex-smoker myself and know how precarious that can be. I don't know what you used to quit in the first place but I really rated Allan Carr's easyway to stop smoking book.

I hope your referral goes well and that you're back on the list as soon as you can be.

sparemonitor · 01/06/2021 13:13

Smoking can really wreck wound healing - I've got a couple of patients who have been discharged with 'refer back when off cigarettes for 6 months as it isn't safe to operate while smoking'.

Branleuse · 01/06/2021 13:14

Can you take up vaping

FixTheBone · 01/06/2021 13:21

I think it's a really hard one ethically and morally.

As a foot and ankle surgeon, I know that the risk of wounds breaking down, bones not healing, and needing re-do operations roughly doubles if you smoke. I used to give people a chance to stop smoking, and if the could, great, if not they could proceed, understanding the risks.

Now, with a massive waiting list, I'm more inclined to push smokers down the queue, as, not only is their surgery less likely to be successful, the re-do procedures when it goes wrong, take twice as long and are often urgent, and therefore mean two other patients can't have their operations...

With limited resources we are obligated to do the most amount of good, for the most amount of people, which is of no consolation if you're not one of those...

ChangePart1 · 01/06/2021 13:22

@Branleuse

Can you take up vaping
OP isn't smoking currently so that would be a step backwards I think.
Original poster
Smoulderagon · 01/06/2021 13:23

@Branleuse I really honestly don't want to do that. I don't think its as healthy as people claim to be honest.

OP posts:
Original poster
Smoulderagon · 01/06/2021 13:23

@LyingWitchInTheWardrobe thank you, I've just ordered a second hand copy of that! Cheers for the suggestion - it is very much appreciated.

OP posts:
Branleuse · 01/06/2021 13:25

[quote Smoulderagon]@Branleuse I really honestly don't want to do that. I don't think its as healthy as people claim to be honest.[/quote]
Its never claimed to be healthy. Its claimed to be much less damaging than smoking, which it is. It also means you get to say youre a non smoker for purposes of getting your surgery, amd it makes it much easier to ditch the fags

Original poster
Smoulderagon · 01/06/2021 13:30

@sparemonitor thank you for your post, I do get why they haven't accepted the referral, and I totally get why they didn't last time. Last time I did make it to the initial appointment phase but they passed something in front my face without warning and I thought I was about to get punched. Hence there was a big meeting and it was decided my MH was to precarious (obviously there were reasons that happened, and referrals elsewhere to sort it out which I did do).

Hopefully the new, slightly dubious smoking status left off referral does work!

OP posts:
Gibbonsgibbonsgibbons · 01/06/2021 13:31

I think FixTheBone's post lays out the nhs position really clearly.
Unfortunately smoking is wildly addictive & patients saying they have not smoked despite knowing that the CO monitor shows they have is not unusual.

I think you should take the offered referral & consider how to support yourself staying off cigarettes- have you explored what your local pharmacy have to offer? Or is there a friend you could check in With weekly or even a thread here? It really depends what support works for you.

I'm so sorry for your losses Flowers

Shehasadiamondinthesky · 01/06/2021 13:35

Trusts have to use money wisely, my trust doesn't refuse surgery on smokers and we have loads of very seriously ill vascular surgery patients whose surgery and stents fail because they will not give up their 40 a day habit, so their surgery is wasted.
But other trusts will just say no full stop regardless.

QueenPaw · 01/06/2021 14:01

I would definitely consider a vape IF you think you will smoke again just to have to stop you smoking
I quit a 30 a day habit with one, had a 5hr op and healed perfectly despite still vaping, the surgeon had no issues with me vaping

EKGEMS · 01/06/2021 15:05

@FixTheBone I worked on a vascular surgery ward about ten years ago and the surgeons were having to do amputations for various reasons but if they operated on a smoker they'd tell the patient "Time to schedule your next amputation since you're still smoking" and they were serious.

DeflatedGinDrinker · 01/06/2021 15:56

I think they have been fair.

mangoontoast · 01/06/2021 16:02

I second the Alan Carr book. I quit after 28 years of 20+ a day. i haven't smoked in 2.5 years and haven't wanted to.

I don't think vaping is a useful tool in quiting smoking, and neither are other nicotine replacement products. They're just money spinners.