Doctors refuse to fix builder's broken ankle unless he quits smoking

[GaryC 7]

A man with a broken ankle is facing a lifetime of pain because a Health Service hospital has refused to treat him unless he gives up smoking.

John Nuttall, 57, needs surgery to set the ankle which he broke in three places two years ago because it did not mend naturally with a plaster cast.

Doctors at the Royal Cornwall Hospital in Truro have refused to operate because they say his heavy smoking would reduce the chance of healing, and there is a risk of complications which could lead to amputation.

They have told him they will treat him only if he gives up smoking. But the former builder has been unable to break his habit and is now resigned to coping with the injury as he cannot afford private treatment.

He is in constant pain from the grating of the broken bones against each other and has been prescribed daily doses of morphine.

Mr Nuttall, of Newlyn, Cornwall, broke the ankle in a fall in 2005. Initially he refused surgery because he had caught MRSA at a different hospital four years earlier, and was terrified of history repeating itself.

He hoped the fractured bones would knit together with a standard plaster cast to immobilise his ankle.

But six months and three plaster casts later, it became clear that an operation to pin the bones was the only solution.

However, the hospital told Mr Nuttall, who no longer works because of smoking-related chest problems, that he would have to give up smoking before an operation could be carried out.

Mr Nuttall said: '"I am in agony. I have begged them to operate but they won't. I have tried my hardestto give up smoking but I can't. I got down to ten a week at one point but they said that was not good enough.

"I spent 12 months trying to give up and used patches and everything, but nothing works.

"I have smoked for over 40 years and it's not going to happen.

"We were brought up at a time when cigarette advertisements were everywhere and there were no warnings.

"I want to warn other smokers that they could be denied medical treatment and there is nothing we can do about it.

"I have paid my dues as a taxpayer-and now the NHS won't treat me."

Mr Nuttall, who is single, uses a walking stick to get around and fears his bones will now be so 'calcified' that an operation would not work even if he were allowed to have it.

"It is very painful," he said. "If I walk more than a few steps I can feel it grinding."

A spokesman for the hospital trust said: "Smoking has a very big influence on the outcome of this type of surgery, and the healing process would be hindered significantly."

http://www.dailymail.co.uk/pages/live/arti...d=1770&ct=5

[DeadPoolX 9]

Well, I understand what the physicians are saying. Smoking can greatly retard the healing process, since it causes vasoconstriction. By itself, that's not the best thing, but when dealing with the aftermath of a complicated surgery, serious problems can arise. Maybe he could stop smoking temporarily for the surgery and recovery period. Once he's over that hump, if he still felt the need to smoke, then he could go back to doing it. Otherwise, I don't see any reputable physician operating on him.

[almaty 19]

just wrong..

[thesnowman 1]

At the end of the day he has paid his takes (both income and the 80% tax imposed on tobaco) so he is entitled to the operation. Money from tobacco directly goes to the NHS.

[almaty 19]

At the end of the day he has paid his takes (both income and the 80% tax imposed on tobaco) so he is entitled to the operation. Money from tobacco directly goes to the NHS.

good

[DeadPoolX 9]

At the end of the day he has paid his takes (both income and the 80% tax imposed on tobaco) so he is entitled to the operation. Money from tobacco directly goes to the NHS.

Seeing as I don't know that much about the NHS, perhaps you can clear something up for me...

If the physicians operated on this man like he wants them to, continues to smoke, and eventually loses the leg because of it, can he sue the physicians (and the hospital) for his loss? If he can, then I don't see why the physicians and/or the hospital would allow the operation to proceed when the he has been warned and told to quit smoking before the procedure.

[Jasman0717 9]

Quitting the cigs is a good thing but to deny him medical attention....that just isn't right

[dalegg 143]

"

Mr Nuttall, who is single, uses a walking stick to get around and fears his bones will now be so 'calcified' that an operation would not work even if he were allowed to have it.

http://www.dailymail.co.uk/pages/live/arti...d=1770&ct=5

I love that the article makes a special mention of his status there. What are they trying to get this guy a date?

[Fandango 1,439]

Isn't there a 'first do no harm' oath? if the docs feel that the smoking and the op will cause greater risk to his foot...isn't it doing the right thing to preserve his life?

[William33 110]

Dr. Quack should do his freaking job. This international smoking "witch hunt" needs to plateau.

Edit for "international".

Edited September 18, 2007 by William33

[Ban Hammer 13,342]

Isn't there a 'first do no harm' oath? if the docs feel that the smoking and the op will cause greater risk to his foot...isn't it doing the right thing to preserve his life?

of course, they could always extend that reasoning to living is the cause of sickness/death, so why bother treating him at all........

[Fandango 1,439]

Isn't there a 'first do no harm' oath? if the docs feel that the smoking and the op will cause greater risk to his foot...isn't it doing the right thing to preserve his life?

of course, they could always extend that reasoning to living is the cause of sickness/death, so why bother treating him at all........

Having a smoking related respiratory chronic problem is going to be an issue to overcome re: the intubation. I'd be concerned!

When I had my surgery, my doctor told me categorically that I needed to quit smoking...granted, my surg was quite complicated and whatnot, but he explained that I ran a risk of not getting off the vent (extreme example) or the smoking prolonging the healing & somehow contributing to infection. I did quite smoking (for about a year that time), and I still got MRSA which almost killed me afterwards anyways. I'd hate to think at how bad it could have gone had I still been smoking.

But the article was not really equally slanted....yes it's all HOW DARE THEY!?!?!? but alls I'm sayin is if there are severe and dangerous consequences to this that really haven't been explained with all that great a degree, then there is that 'first do no harm' oath which may be the reason for the refusal.

Doc to his family: hey, we fixed his ankle, but he's now a cabbage stuck on life support....

Edited September 18, 2007 by LisaD

[Trumplestiltskin 5,791]

It would be clearly negligent to proceed with an operation if the man's smoking would cause him to lose his leg (or worse).

Still - how are they going to check that he's given up? Presumably some sort of blood test...?

[trailmix 77]

Interesting if you read the comments on the page where the article appears, they all say give him the surgery. One could assume many of those people are paying in to the same system.

I say give the guy his surgery, it's a disgrace any way you look at it.

[Fandango 1,439]

Interesting if you read the comments on the page where the article appears, they all say give him the surgery. One could assume many of those people are paying in to the same system.

I say give the guy his surgery, it's a disgrace any way you look at it.

I just think that we're all sat here playing armchair dr when none of us (to my knowledge) are medical drs, nor have we seen his chart with his medical history. Certainly if the specific Dr was being medically negligent, we're going to see more develop from this case. But until I hear otherwise, I'm going to err on the side of medicine because the article seemed completely biased, full of emotionally charged statements, and devoid of real facts concerning the whys and wherefors of the denial. It's easy to get on the 'they're persecuting me!' bandwagon without paying attn to the facts.

The thing that irritates me with this man is that he seems to be second guessing the docs all the way...first, when they were going to do the surg, he chose not to have it because he once had a staph infection, now that he's on the dole for a medical and a smoking related issue, he's told he should quit smoking or else suffer some consequence during surg - which he refuses to do yet demands the op...and then he's all 'oooh my bones are gonna calcify!'

Leave the diagnoses to the professionals, I say. Quit smoking, have the surgery, and for once listen to medical opinion.