12 January 2009

Why smokers suffer after operations

Many smokers who undergo serious operations take longer than other people do to recover.


Why do smokers, or former smokers, often have severe post-operative complications? Health24 spoke to a lung specialist.

Smokers unaware of health problems
“Many smokers are unaware of the fact that they have heart or lung problems, before they have operations,” according to lung specialist from Durbanville in Cape Town. “They often have blocked coronary arteries or emphysema, which may only be picked up when post-operative complications set in.”

But that does not mean that all smokers get emphysema. Only 15% of them do, but says the doctor, there are many other grim conditions to which smokers are more susceptible than non-smokers, such as mouth cancer, lip cancer and colon cancer, to name but a few. Emphysema is certainly not the only thing to worry about if you are a smoker.

He also mentioned that smokers produce more phlegm, which makes them more susceptible to airway and lung infections. Their lungs are also far more likely to collapse after they have had surgery.

What is a heavy smoker?
When asked when he would consider someone to be a heavy smoker he replied that anyone who smoked 15 or more cigarettes a day could be considered as that. But he also cautioned that that didn’t mean it was in order to smoke ten a day.

“Non-smokers are just generally healthier and stand a greater chance to get through operations and the effects of anaesthesia more quickly and without complications. It is very difficult to give exact figures, but smokers experience considerably more complications after surgery of any kind than non-smokers do.”

The doctor recommended that people should stop smoking at least a week before having surgery of any kind. In fact, they should try and stop completely, and not just because of having an operation.

It makes an enormous difference to the outcome of an operation when a patient’s lungs are clear. He mentioned that even two days of not smoking before an operation could make a difference.

When are tracheotomies performed?
Many people assume that if you have a tracheotomy done, your health has taken a turn for the worse.

Not so, says the doctor. Tracheotomies are often a lot more comfortable for patients, especially if they have been on a ventilator for a few days. While you have a pipe down your throat, you have to be kept under sedation, your teeth cannot be brushed, and you can’t eat anything.

But with a tracheotomy, you can eat, have your teeth brushed, sit up, read, and you don’t have to be kept under constant sedation.

Visit the SA Thoracic Society for more information

(Susan Erasmus, Health24, June 2006)


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