Smoking After Gastric Sleeve Surgery

[Marnie85253 9]

I smoke electronic cigarettes and I love them! You still get the nicotine without the harmful toxins. It's just Water vapor, no tar, no carcinogens, no stinky smells! When I told the nurse at me pre-op bariatric class she said it was perfectly fine. I'm getting sleeved on weds and I plane on packing plenty of electronic digs for the journey! Good luck to you!

[feedyoureye 3,087]

Lets be honest here..if you thought it was perfectly fine you wouldn't have asked.

My doc wouldn't operate on anyone who had smoked 30 days before surgery.

Nicotine kills your circulation (hence smokers wrinkles) as well as other problems... other chemical components can cause problems too... Here is one medical paper that talks about it...there are many more listed on google...

http://www.ncbi.nlm.nih.gov/pubmed/1323208

I would say, if you must smoke, wait at least until your stomach heals... over 8 weeks. Please don't take these comments as rude... I think the people here are just looking out for your health and success... I am also an ex-smoker, and sometimes it is said that ex-smokers are the most down on smoking of anyone... I think this might be true!

Abstract

The association between cigarette smoking and delayed wound healing is well recognized in clinical practice, although extensive controlled studies have yet to be performed. The documented effects of the toxic constituents of cigarette smoke--particularly nicotine, carbon monoxide, and hydrogen cyanide--suggest potential mechanisms by which smoking may undermine expeditious wound repair. Nicotine is a vasoconstrictor that reduces nutritional blood flow to the skin, resulting in tissue ischemia and impaired healing of injured tissue. Nicotine also increases platelet adhesiveness, raising the risk of thrombotic microvascular occlusion and tissue ischemia. In addition, proliferation of red blood cells, fibroblasts, and macrophages is reduced by nicotine. Carbon monoxide diminishes oxygen transport and metabolism, whereas hydrogen cyanide inhibits the enzyme systems necessary for oxidative metabolism and oxygen transport at the cellular level. Slower healing has been observed clinically in smokers with wounds resulting from trauma, disease, or surgical procedures. The reduced capacity for wound repair is a particular concern in patients undergoing plastic or reconstructive surgery. Compared with nonsmokers, smokers have a higher incidence of unsatisfactory healing after face-lift surgery, as well as a greater degree of complications following breast surgery. Smokers should be advised to stop smoking prior to elective surgery or when recovering from wounds resulting from trauma, disease, or emergent surgery.

[Amanda 3.0 140]

My doctor didnt say s**t to.me saw me maybe 5 min after my surgery.. And yes he knew i was a smoker. And yes u actually came across rude n my opinion... But whatever. I was just asking a question. I got my answer thanks

The guy took time out to answer your post. I don't think he was rude.

Just because someone else smoked afterward with no problems doesn't mean you won't have problems. And, what if problems come three years down the road instead of immediately?

Disclaimer: Ex-smoker here, 1-1/2 packs for 25 years.

It is well documented that smoking impedes healing. Some doctors, especially cosmetic surgeons, will not operate on smokers. Their wounds do not heal as well or as nicely. Your wounds are mostly on the inside.

My insurance will not even pay for this surgery for smokers. I had to take multiple blood tests to prove I am not a smoker in order to be approved.

I understand it is hard to quit, trust me. I tried more than once before succeeding. But instead of looking for reasons why it is okay to smoke, why not do whatever you can to stay off the smokes? You will never regret NOT smoking.

[swizzly 901]

For me personally, the awesome thing about quitting smoking to have this surgery (PS, totally NOT required by my program at all), was that I couldn't eat and gain weight while quitting (which is what I usually did). So doing them both at the same time turned out perfect. I am coming up on one year since I quit smoking, no looking back.

Good luck!!

[Geri 5]

I am pretty surprised by many of the responses here. Chances are most of us on this board were addicted to food and required surgery to correct the weight issues that came along with said addiction. Any good doctor will advise that If the issues that contributed to the weight aren't worked on, then eventually the weight will return. Yes, smoking is bad. However, when one attempts to stop one addiction, chances are good that another obsessive behavior - be it shopping, exercising, cleaning, sex, drinking, smoking, etc. - will attempt to take its place as a relief mechanism.

My doctor knew I smoked. He said it was more important that I beat the food issues that contributed to my obesity AND that one should never try to beat 2 addictions at once. I continued to smoke for 3 months after my surgery with no healing issues. Then, I tried to quit (for my 6th time) and I literally felt like hanging myself: With no food crutch to fall on, it was one huge feeling of despair. Now that I am 8 months from surgery, I have started Wellbutrin (aka Zyban) to see if it will work for my 7th attempt, helping to keep those feelings at bay. I know the food issues are slowly diminishing - I am at a point now where eating is like doing laundry: Something one has to do but not something that is happily anticipated and planned. It's an amazing feeling and one that I am proud I was able to achieve. The surgery is just step 1 and anyone who thinks otherwise should rethink their plan.

Hopefully my next quit attempt will work. But to tell someone who is contemplating or recently had the sleeve that they need to cut off one addiction while having major surgery for another is, in my opinion, irresponsible. I was aware enough that I could recognize why I was feeling the thoughts I was having when I attempted to quite smoking right after surgery. Others may not be as in tune with their emotions. We all know any addiction is difficult to beat. We also all know that it didn't matter one bit when others would comment (with the best of intentions but judgmental nonetheless) on our food intake. Until one is ready, it doesn't make a bit of difference what others say, and any comments generally alienate and shame the intended recipient.

Just my 2 cents as a current smoker and one who is coming up on 100 #s down and keeping it off.....

[swizzly 901]

I am pretty surprised by many of the responses here. Chances are most of us on this board were addicted to food and required surgery to correct the weight issues that came along with said addiction. Any good doctor will advise that If the issues that contributed to the weight aren't worked on, then eventually the weight will return. Yes, smoking is bad. However, when one attempts to stop one addiction, chances are good that another obsessive behavior - be it shopping, exercising, cleaning, sex, drinking, smoking, etc. - will attempt to take its place as a relief mechanism.

My doctor knew I smoked. He said it was more important that I beat the food issues that contributed to my obesity AND that one should never try to beat 2 addictions at once. I continued to smoke for 3 months after my surgery with no healing issues. Then, I tried to quit (for my 6th time) and I literally felt like hanging myself: With no food crutch to fall on, it was one huge feeling of despair. Now that I am 8 months from surgery, I have started Wellbutrin (aka Zyban) to see if it will work for my 7th attempt, helping to keep those feelings at bay. I know the food issues are slowly diminishing - I am at a point now where eating is like doing laundry: Something one has to do but not something that is happily anticipated and planned. It's an amazing feeling and one that I am proud I was able to achieve. The surgery is just step 1 and anyone who thinks otherwise should rethink their plan.

Hopefully my next quit attempt will work. But to tell someone who is contemplating or recently had the sleeve that they need to cut off one addiction while having major surgery for another is, in my opinion, irresponsible. I was aware enough that I could recognize why I was feeling the thoughts I was having when I attempted to quite smoking right after surgery. Others may not be as in tune with their emotions. We all know any addiction is difficult to beat. We also all know that it didn't matter one bit when others would comment (with the best of intentions but judgmental nonetheless) on our food intake. Until one is ready, it doesn't make a bit of difference what others say, and any comments generally alienate and shame the intended recipient.

Just my 2 cents as a current smoker and one who is coming up on 100 #s down and keeping it off.....

Well, cigarettes have chemicals in them that cause a bona fide physical addiction, whilst food causes a psychological addiction at best. So quitting them both is possible, but definitely psychologically very difficult. I quit smoking prior to surgery, though it's not required where I am -- I just wanted to do so. I have been lucky to have found quitting to be relatively easy, I know others go through a hell of a time with it. Have you tried the e-cigarette? I have a friend here who absolutely swears by it (and you can 'smoke' it indoors as well, so no freezing required LOL).

That said, in my opinion it's not at all irresponsible to ask people to quit smoking before having surgery, to break the physical and psychological addiction all at one go. And also to help with a safer surgery and easier recovery, as cigarette smoking hinders both (and increases the risk for clots significantly). Yes, it's very difficult for sure -- and not everyone does it, which I understand. However, saying that people need to be gently enabled in one addiction so that they can 'cure' their other one strikes me as fairly absurd. "Transfer addictions" are a big danger indeed -- but one doesn't go ahead and provide or mollycoddle a transfer addiction for people to slide into. I think the real issue isn't giving up multiple problematic/compulsive behaviours, I think the issue is addressing the addictive personality or underlying need that is being met by addictive behaviours so that the person finds *healthy* coping mechanisms rather than easy transfers.

That ALL said, I am not one to tell people to quit smoking, never have been. I know full well that people only quit when they are *ready* to do so. But I'm not a surgeon -- and when they ask people to quit smoking, I think they are perfectly justified in doing so in order to try for the least risk and best outcome from surgery. I would never consider it irresponsible of *anyone* to encourage people to quit smoking when it's appropriate to do so -- though it's absolutely useless to bug smokers about quitting, which is why I don't do so.

Annoying and a waste of time, yes. Irresponsible, no, not at all. When people are in rehab for drug or alcohol addiction, smoking is the last thing I'd bother about -- so in that sense I agree with you. But there is no rehab for food -- and there are good reasons for that. It's really apples and oranges IMO.

[gettingthere 11]

I agree that people will stop when they are good and ready. I was a very heavy smoker for 20 years and tried numerous times to stop before i eventually did. Before that, I was fed up of people telling me i should stop, I already knew that!

People can look up the risks and make up their minds. Well done to those of you who managed to stop, good luck to those who want to stop but haven't managed it yet.

I found this: http://www.emaxhealth.com/1024/smoking-increases-risk-complications-bariatric-surgery

It talks about complications up to 14 months post op in smokers.

[Geri 5]

That said, in my opinion it's not at all irresponsible to ask people to quit smoking before having surgery,

With all due respect, it is not apples and oranges. An addiction is an addiction regardless of the substance, and all forms have a psychological component. There's a reason that those in rehabs are not asked to give up smoking at the same time as attempting to quit any other substance. And, yes, there are food rehabs as well. I totally understand that the healing process may be compromised, but the emotional component of food and its effects are just as powerful. The feelings of despair I encountered are not unique and no less dangerous than those physical ones associated to a medical procedure. To assume as such is, well, irresponsible. Why on earth do you think that there is a percentage of bariatric patients for which the surgery has failed? It's all a part of the addiction cycle. If one has difficulty stopping the pattern of addiction, then relapse occurs. Many people have the false notion that this surgery is a magic bullet, just like methadone for heroin addicts or Anabuse for alcoholics. The physicality is just the beginning. To disavow the importance of suicidal thoughts when attempting to break the cycle of any substance abuse issue is indeed, to me, irresponsible.

[swizzly 901]

An addiction is an addiction regardless of the substance, and all forms have a psychological component.

Of course all addictions have a psychological component. However, they do not all have an actual physical (ie, withdrawals and physical danger from stopping suddenly) component. So there are varying addictions for sure. When people start losing jobs, families, stealing from their pensioner mother, blowing dudes on the corner for food, then I'll be more inclined to see a true physical addiction. Until then, it's primarily a psychological addiction -- which is not less problematic AT ALL. It's just not the same as physical withdrawal and the medical problems relating to that.

The feelings of despair I encountered are not unique and no less dangerous than those physical ones associated to a medical procedure. To assume as such is, well, irresponsible.

If you are addressing me, you are putting words in my mouth. I was speaking about smoking cessation, which is virtually never in itself accompanied by suicidal ideation. Depression, despair and suicidal thoughts are of course very serious, I'd never say otherwise. "Treating" them by enabling addiction is not a good answer either. Rather than using an intensive, convoluted justification for smoking, it would be better to see a good therapist and be treated with appropriate medications to intervene for the sake of addressing the depression. That said, as I said earlier, I wouldn't be too fussed about getting all upset about the smoking whilst trying to address the depression -- but neither would I think continuing smoking in itself would do SFA to address the actual problem. Thus I wouldn't find it 'irresponsible' to still recommend smoking cessation if I were a medical professional dealing with such a patient. I wouldn't bang on about it or punish the patient (I got in trouble here once months ago for getting ALL pissed off at a doctor who denied surgery to someone, on the day, because they had fallen off the smoking wagon), just as I wouldn't carp on ANYONE dealing with depression and suicidal ideation.

Why on earth do you think that there is a percentage of bariatric patients for which the surgery has failed? It's all a part of the addiction cycle. If one has difficulty stopping the pattern of addiction, then relapse occurs. Many people have the false notion that this surgery is a magic bullet, just like methadone for heroin addicts or Anabuse for alcoholics. The physicality is just the beginning. To disavow the importance of suicidal thoughts when attempting to break the cycle of any substance abuse issue is indeed, to me, irresponsible.

Well, you're tilting at windmills here. I've never said the surgery was a magic bullet, I for sure don't think it's true personally. I don't think anyone who has even a vague clue thinks the surgery is a magic bullet, apart from the know-nothings who claim we are 'taking the easy way out.' I wasn't at all speaking about removing food from the equation, I was discussing the topic at hand -- which is smoking. Removing FOOD from people who are psychologically dependent on food as a mood-stabilising substance is indeed a very difficult process and many times requires professional intervention (or should do anyhow). Removing CIGARETTES from an otherwise healthy individual will never (shall I say 99.9% of the time?) cause suicidal depression. That's my entire point -- and there's nothing irresponsible about it.

[Geri 5]

I found this: http://www.emaxhealt...riatric-surgery

It talks about complications up to 14 months post op in smokers.

All good info. Even though the last line of the article indicates that the results are not statistically significant, I do believe this is an important factor but not the only factor. When I had ankle fusion surgery 4 years ago, the doctor would not operate on me if I did not quit smoking prior to, as the incidence of non fusion was an actual point of failure for the procedure. Because of this, I was surprised at my bariatric surgeon's stance initially, but after researching, the position made complete sense. As with most things, there are compromises with everything. My opinion is that one should not underestimate the power of addiction and its emotional affects when considering surgery - smoking or eating. Everyone brings different situation to the table and the importance of quitting smoking is relative when considering all the other factors in totality.

It will be interesting to see research on this topic as this surgery gets more and more prevalent. Any one who has experienced from people in their life the negativity and dismissiveness associated to bariatric surgery ("Oh, you can just exercise and stop eating") speaks to the emotional challenges of beating this thing. Again, it's all relative. I certainly am not a smoking cheerleader but have been on both sides of the fence. This surgery and its mental associations are much more complex than what people perceive it to be.

[Geri 5]

Removing CIGARETTES from an otherwise healthy individual will never (shall I say 99.9% of the time?) cause suicidal depression.

Your use of that statement indicates to me that you may not have a full understanding of what addiction entails. We can agree to disagree. Everything on these boards is opinion. I was stating mine.

[swizzly 901]

Your use of that statement indicates to me that you may not have a full understanding of what addiction entails. We can agree to disagree. Everything on these boards is opinion. I was stating mine.

I know plenty about it. But I'm fine to disagree. And I'm always liberal with my opinions, obviously.

[PdxMan 4,292]

Always enjoy a good exchange, for sure.

But, no surgeon is going to ask you to quit smoking on your surgery day. To imply this is irresponsible. From what I have read, most surgeons require a minimum 3 months non-smoking before they will even schedule the surgery. I've heard of 6 months as well. But, a lot of smokers are not honest with their medical team and do not admit to being smokers.

It is a risk to be healing from a surgery and smoking. Is it a necessary risk ...??

[Amanda 3.0 140]

Wow, what a turn of the thread.

If any smokers get suicidal when they put down the smokes for a few days, and I hope that comes out at the psychiatric evaluation. Also, the severe eating disorders are supposed to be discovered at that time. People should not be having this surgery until they have worked on their addiction issues, of all types. An out of control binge eater should be well on their way to recovery before ever setting foot in the operating wing of the hospital, and that was addressed during the quailification process, at least with my surgeon's team.

My surgeon won't even knowingly operate on an alcoholic or drug addict.

No one here answered irresponsibly, insensitively, or inappropriately. I do personally feel that it is irresponsibly of a patient to ask for internet forum advice that overrides that of a medical professional, but we see it all the time.

It amazes me (although it shouldn't anymore) when someone asks a question on the internet and then gets upset when a non-coddling answer is given. The internet is not a magic place where you get to ask a question and only get answers that support your side. Once a question is thrown out there, everybody gets to answer, and the answer is usually worth exactly what was paid for it.

Anyway, smoking: Of course it is far better for a person not to smoke after the surgery, and if someone wants a different answer than that, maybe they ought to find a pro-smoking forum and pose it there. We all have the phone number to our surgeon's office, and if we really wanted the honest answer, we would call up and ask. I would say that most surgeons are actually going to be pretty honest about what will and won't kill us, and most surgeons are going to tell you that if you absolutely must smoke, then go ahead. But at least discuss it with the surgeon instead of being upset at people on an internet forum.

On a side note, many people are able to make multiple health improvements at the same time, and for many, it is a great idea. We are already leaving the hospital with what should be a new outlook on life. It's an ideal time to try to turn over a new leaf. I actually gave up booze, cigarettes, and started an exercise regimen all on one day. I did great for a while, then fell off the exercise wagon. Never smoked again, and now I do drink a bit here and there. The smoking was hard, but a great accomplishment.

I do feel sadness when I see a patient sitting in their hospital gown in front of the hospital, smoking. It is getting less and less common now, as most hospitals in our area do not allow smoking anywhere on the grounds.

[Geri 5]

You've taken my points completely out of context and assumed things that were not stated. My point was that attempting to quit 2 addictive behaviors at once could very well cause psychological issues that bear more consideration than the type of replies the poster received.

I also find it interesting that the same bias that is generally applied to overweight people is being applied now to smokers. To have it come from the same folks who are or were once a target of that bias is disappointing.

I knew there's a reason I lurk and not post. Back to my cave....

Wow, what a turn of the thread.

If any smokers get suicidal when they put down the smokes for a few days, and I hope that comes out at the psychiatric evaluation. Also, the severe eating disorders are supposed to be discovered at that time. People should not be having this surgery until they have worked on their addiction issues, of all types. An out of control binge eater should be well on their way to recovery before ever setting foot in the operating wing of the hospital, and that was addressed during the quailification process, at least with my surgeon's team.

My surgeon won't even knowingly operate on an alcoholic or drug addict.

No one here answered irresponsibly, insensitively, or inappropriately. I do personally feel that it is irresponsibly of a patient to ask for internet forum advice that overrides that of a medical professional, but we see it all the time.

It amazes me (although it shouldn't anymore) when someone asks a question on the internet and then gets upset when a non-coddling answer is given. The internet is not a magic place where you get to ask a question and only get answers that support your side. Once a question is thrown out there, everybody gets to answer, and the answer is usually worth exactly what was paid for it.

Anyway, smoking: Of course it is far better for a person not to smoke after the surgery, and if someone wants a different answer than that, maybe they ought to find a pro-smoking forum and pose it there. We all have the phone number to our surgeon's office, and if we really wanted the honest answer, we would call up and ask. I would say that most surgeons are actually going to be pretty honest about what will and won't kill us, and most surgeons are going to tell you that if you absolutely must smoke, then go ahead. But at least discuss it with the surgeon instead of being upset at people on an internet forum.

On a side note, many people are able to make multiple health improvements at the same time, and for many, it is a great idea. We are already leaving the hospital with what should be a new outlook on life. It's an ideal time to try to turn over a new leaf. I actually gave up booze, cigarettes, and started an exercise regimen all on one day. I did great for a while, then fell off the exercise wagon. Never smoked again, and now I do drink a bit here and there. The smoking was hard, but a great accomplishment.

I do feel sadness when I see a patient sitting in their hospital gown in front of the hospital, smoking. It is getting less and less common now, as most hospitals in our area do not allow smoking anywhere on the grounds.