I see.

Post #292,976 by bepatient 9/15/07 12:16:49 PM Reply	I see. And so to help this poor sod kick an addiction, they use all their good doctoring techniques and prescribe him another highly addictive substance. Here bud, I know you can't kick this habit...so why not try >this one< instead? Sorry, I ain't buyin. If they were interested in the welfare of the patient, then they would check him in a week prior, load him up with Zyban and treat the man. They're not interested in helping him. Only themselves. Too much of today's music is fashionable crap dressed as artistry._{Adrian Belew}
Post #292,978 by Lily 9/15/07 1:17:09 PM Reply	Inpatient nicotine detox? I dont think so.
Post #292,984 by bepatient 9/15/07 8:51:47 PM Reply	Why not if its that important a factor to his general health...and NOT doing it forces the doctors to get him addicted to something else (morphine)...I'd say this guy might actually qualify for that. They inpatient detox for heroin and alcohol, don't they? Too much of today's music is fashionable crap dressed as artistry._{Adrian Belew}
Post #292,985 by Another Scott 9/15/07 8:55:55 PM Reply	It's elective surgery. He needs to do what is necessary to meet the requirements or he doesn't get a spot in the queue. As long as it's elective surgery, it's up to him. Cheers, Scott.
Post #292,986 by crazy 9/15/07 9:14:32 PM Reply	Oh bullsh*t Geetting 3 broken bones set is not elective. That would be an immediate emergency surgery here. Yeah, he's probably screwed becuase he delayed and was willing to put of with the pain, for a while, but he's reached the end of his rope. And yes, the smoking may affect his recovery. So what. Sign the waiver and fix him.
Post #292,989 by Another Scott 9/15/07 9:34:06 PM Reply	Disagree. If having an ankle repaired is emergency surgery, then there wouldn't be an issue. According to the Telegraph story, the no-smoking requirement only applies to elective surgery. Also, if it were an emergency, what physician would have signed-off on merely setting the ankle in a cast? It clearly isn't an emergency procedure - at least in his case. As long as medical care is a right, as it is in the UK, it has to be rationed. There will never be enough money to treat every condition that everyone has, so reasonable choices have to be made about timing, priorities, etc. That includes the right of the NHS to impose conditions before treatments are started. If Nuttall isn't willing to accept reasonable requests of him as a condition for his treatment, then he should travel elsewhere to get it done. I'm sure he could get his ankle treated for a very low cost in Albania or Sierra Leone or Burma with no questions asked. He could probably have paid for it with the money he's wasted on smokes. ;-) The NHS has no obligation to treat him if he won't accept reasonable conditions. Being asked to do without nicotine for 4 weeks is not an unreasonable request, and there are medically valid reasons for it. Sorry, Crazy old chap, but you're wrong about this. IMHO, of course. Cheers, Scott.
Post #292,990 by crazy 9/15/07 9:52:48 PM Reply	And WHO classified it as elective? The same people who don't want to do it. Conflict of interest, not to be trusted to make that judgement. Let's put it another way. If you broke your foot in 3 places, and your health plan said they were not going to pay for it because it was "elective", would you agree with them?
Post #292,991 by Another Scott 9/15/07 10:18:56 PM Reply	Come on now. [link\|http://www.timesonline.co.uk/tol/news/uk/health/article1875561.ece\|Times OnLine]: NHS managers want patients not to have smoked any cigarettes for a full month before surgery. But as they would be expected to take about two months to stop, operations could be delayed by up to three months. The managers do insist, however, that it is up to doctors to decide whether the surgery can still go ahead if the patient fails to give up. Some doctors argue that the policy could deter smokers from attending appointments because they believed that they would not qualify for treatment. By December next year, all patients will need to have had surgery within 18 weeks of having been referred to hospital by their GP, according to new government targets. To avoid endangering the targets, patients would not be added to waiting lists until they had given up smoking. His GP could recommend the surgery if s/he thought the NHS policy was wrong. The GP obviously doesn't think the smoking cessation is an onerous requirement. You ask: If you broke your foot in 3 places, and your health plan said they were not going to pay for it because it was "elective", would you agree with them? Like the story about whether [link\|http://z.iwethey.org/forums/render/content/show?contentid=292604\|Rudy was correct in saying that undocumented immigration wasn't illegal], it depends on what the words mean, doesn't it? [link\|http://www.medterms.com/script/main/art.asp?articlekey=14367\|Elective surgery] is different from [link\|http://www.answers.com/topic/emergency-surgery?cat=health\|emergency surgery]: Most surgery is elective and is performed after a diagnosis based upon a history and physical of the patient, with differential test results and the development of strategies for management of the condition. With emergency surgery, the team, as well as the surgeon, may have less information about the patient than would ordinarily be required and work under very time-dependent conditions to save a patient's life, help avoid critical injury or systemic deterioration of the patient, or to alleviate severe pain. Because of the unique conditions for urgent acute surgery, operations are usually performed by a surgical team specially trained for management of a critical, or life threatening event. Repair of Nuttall's ankle is elective surgery. Cheers, Scott.
Post #292,992 by bepatient 9/15/07 10:21:39 PM Reply	If you had enough pain to require daily morphine...how elective do you think >you< would feel it was? Too much of today's music is fashionable crap dressed as artistry._{Adrian Belew}
Post #292,993 by Another Scott 9/15/07 10:42:04 PM Reply	If I needed morphine every day... and I was healthy enough for surgery, then I would do what it took to qualify for surgery so that I wouldn't need opiates. Some people, like Nuttall apparently, make other choices. My FIL took morphine (MS Contin) daily for years near the end of his life, and took Percocet "as needed" during that time. He basically became an addict because he would lose track of how many he took during the day, and would call up his various physicians crying that he needed an emergency prescription before the end of the month (when the pills should have run out). Once he moved in with us, we were able to successfully wean him off the stuff over a period of time and the last year or two of his life he didn't need it (Tylenol was sufficient, and opiates were very bad for him because they suppress respiration). If an 85+ year old man with chronic back pain from scoliosis can be weaned off a long-term addiction to morphine and Percocet, then a 57 year old man can quit smoking for a month. I may not convince you and crazy, but you'll not convince me that Nuttall is being treated unfairly by his GP and the NHS. Cheers, Scott.
Post #292,994 by crazy 9/15/07 10:59:12 PM Reply	"alleviate severe pain." 3 broken bones. On a foot, which means either use a wheel chair or be in agony on every step. Just lovely.
Post #292,995 by Another Scott 9/15/07 11:02:07 PM Reply	"Life sucks, then you die". :-/
Post #293,003 by Arkadiy 9/16/07 1:56:53 AM Reply	Good Saying Do you want it to be the motto of your healthcare system? I've just read the thread - I am at a loss for words. To think that a doctor would use patient's pain as a leverage to get him to alter his lifestyle... In any decent system, the patient should be explained the risks, and if he chooses to go on, it should be his right to go on. ------ 179. I will not outsource core functions. -- [link\|http://omega.med.yale.edu/~pcy5/misc/overlord2.htm\|.]
Post #293,010 by Another Scott 9/16/07 9:12:46 AM Reply	It's from The Fools. [link\|http://www.thefools-band.com/FoolsMP3/lifesucks.mp3\|Life Sucks] (.mp3 excerpt). [link\|http://digitaldreamdoor.com/pages/lyrics2/nov_lifesucks.html\|Lyrics]. It's a good party song. ;-) In any decent system, the patient should be explained the risks, and if he chooses to go on, it should be his right to go on. I disagree; but I'd be repeating myself to say much more. Do note that the UK has recently [link\|http://news.bbc.co.uk/2/hi/uk_news/politics/4709258.stm\|banned smoking] in public enclosed places and private clubs. For medical reasons. In Scotland, where the ban was imposed last year, [link\|http://news.scotsman.com/health.cfm?id=1451402007\|heart attacks have dropped by 17%-20%]. It's not unreasonable to require that a surgery patient quit smoking before he gets a place in the queue. They're not refusing to treat his pain. Cheers, Scott.
Post #293,009 by pwhysall 9/16/07 8:14:58 AM Reply	If I had that much pain... ...I'd be doing whatever my doctors told me to, up to and including macrame models of the Eiffel Tower, if I thought it'd speed up the process. Peter [link\|http://www.no2id.net/\|Don't Let The Terrorists Win] [link\|http://www.kuro5hin.org\|There is no K5 Cabal] [link\|http://guildenstern.dyndns.org\|Home] Use P2P for legitimate purposes! [link\|http://kevan.org/brain.cgi?pwhysall\|A better terminal emulator] [image\|http://i66.photobucket.com/albums/h262/pwhysall/Misc/saveus.png\|0\|Darwinia\|\|]
Post #293,015 by Lily 9/16/07 12:04:08 PM Reply	Because Withdrawal symptoms from nicotine dont require an inpatient level of care and withdrawal from etoh and narotics sometimes do. A lot of docs will even do outpatient detox for etoh and opiates if the patient doesnt have severe withdrawal symptoms or serious comorbid conditions. It's a balancing act to provide adequate and appropriate treatment with the resources available.
Post #293,008 by pwhysall 9/16/07 8:13:11 AM Reply	Nonsense. The bloke's more interested in showboating for the media instead of growing some vertebrae, exercising some willpower and actually doing what his doctor tells him. He's not a "poor sod". He's an idiot. Peter [link\|http://www.no2id.net/\|Don't Let The Terrorists Win] [link\|http://www.kuro5hin.org\|There is no K5 Cabal] [link\|http://guildenstern.dyndns.org\|Home] Use P2P for legitimate purposes! [link\|http://kevan.org/brain.cgi?pwhysall\|A better terminal emulator] [image\|http://i66.photobucket.com/albums/h262/pwhysall/Misc/saveus.png\|0\|Darwinia\|\|]

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