Doctors giving you a hard time about smoking

As a MEDEVAC Pilot, I get a thorough physical every year. When the Doctors ask if I smoke, I tell them 3-5 sticks a week. They usually laugh and ask me which cigars are my favorite, and do I have any recommendations for them.

One of my doctors told me the following once. "Something will kill us one day. You can maybe die a year or two early because of cigars, or spend the rest of your life missing them."

Will

[troutbreath]

Glad the surgery went well. Perhaps your anesthesiologists was worried because he works with gasses -- could be a fear of flames.

[croatan]

I had surgery on Thursday. Was asked by about six different doctors whether I smoke. I answered: "cigars" to each and every one. None of them said another word about it. Now, I didn't volunteer that I had had three the night before the surgery, including a RyJ Cazadore at midnight that was just a nicotine bomb, but they didn't ask about that .

By the way, I have now gone over 48 hours without a cigar. I think it's time to get back on that smoking wagon

[kaisersozei]

Ironic

that an anesthesiologist

who makes his living by injecting into peoples' bodies

all sorts of

manufactured, mind-altering, legal but arguably lethal substances,

was giving you a hard time about enjoying the occasional

organic, mind-altering, legal but arguably lethal substance.

(he must have taken the Hypocritical Oath...)

Glad the surgery went well!

[mash]

Obviously, we're big time cigar enthusiasts here, some of us are physicians too. I totally understand that no one likes to be told what they should do, but some of the criticism here makes no sense to me. The guy is aware of a health hazard, and he feels it's his job to try and modify your behaviour by letting you know. That anesthesiologist has likely seen hundreds of people on his table that are there because they have smoked.
To attribute other motives to what he is doing, calling him a hypocrite, comparing general anesthetic agents to tobacco etc. is just dumb. You don't want to listen to the guy, no worries. All of us lead our own lives. He's done his job.

[Tenor CS]

Originally Posted by mash

Obviously, we're big time cigar enthusiasts here, some of us are physicians too. I totally understand that no one likes to be told what they should do, but some of the criticism here makes no sense to me. The guy is aware of a health hazard, and he feels it's his job to try and modify your behaviour by letting you know. That anesthesiologist has likely seen hundreds of people on his table that are there because they have smoked.
To attribute other motives to what he is doing, calling him a hypocrite, comparing general anesthetic agents to tobacco etc. is just dumb. You don't want to listen to the guy, no worries. All of us lead our own lives. He's done his job.

I thought my OP was pretty respectful, if a little upset. I also see no need to resort to name calling and personal attacks on the anesthesiologist. Really, all I wanted was to hear other stories about other BOTL who may or may not have had a doctor give them a hard time about smoking, in various situations.

PS I know your post wasn't really directed at me. I actually agree with most of what you said in your post.

[mash]

Originally Posted by Tenor CS

I thought my OP was pretty respectful, if a little upset. I also see no need to resort to name calling and personal attacks on the anesthesiologist. Really, all I wanted was to hear other stories about other BOTL who may or may not have had a doctor give them a hard time about smoking, in various situations.

PS I know your post wasn't really directed at me. I actually agree with most of what you said in your post.

It was, the issue wasn't with your post at all.

[kaisersozei]

Originally Posted by mash

That anesthesiologist has likely seen hundreds of people on his table that are there because they have smoked.

Perhaps, but... smoked cigars? Doubtful.

Originally Posted by mash

To attribute other motives to what he is doing, calling him a hypocrite, comparing general anesthetic agents to tobacco etc. is just dumb.

I said it was ironic.

It's not the anesthesiologist's job to try modifying the patient's behavior immediately before surgery. His job is to make sure the patient goes under & wakes up. If cigar smoking has a bearing on that, then certainly he has a need to know. But it doesn't sound like the lecture was necessary, as Waynegro1 points out.

It really frustrates me that a man about to put you under the knife felt the need to "preach" to you about cigar smoking. As if you didn't have enough on your mind as it was. The most he should of said concerning cigars would be that nicotine may slow down the healing process due to white cell count etc. This is not a time to change a persons habits with scare tactics.

Leave it to some holier than thou delicate genius to use this tact. When I had my back surgery a few weeks ago I didn't mention the cigar smoking. I did however mention that I had a few (or more) drinks of Jameson a week. It's funny how they never preach to a person about drinking, but God forbid you light up a premium cigar once in a while.

When I was an (uneducated) young fella I used tell my pop not to smoke cigars because my teacher said they were bad for him and they will end up killing him. He would say "How willa I get ta heaven ifa I don'ta die-a" in very broken Italian English.

I'm very glad your surgery went well, Christian. Get well soon and prayers going out for a speedy recovery.

Here is some interesting reading concerning this topic:

http://www.stogiefresh.com/journal/C...igarettes.html

[karmaz00]

glad things are ok

[shilala]

The way I figure is that cigars relax me.
Killing someone is going to be far worse for my human development than any cigar could possibly be.

As many will correctly presume, I am on Mash's side.

What you may not realize is that, many things are occurring during an interaction with a doctor; many more things than you are aware of. They are assessing risks, doing statistical calculation, assessing what complications can be expected, what information should be gathered up front to make decision making easier/better/quicker when the possible complication does occur etc. But, also deciding what counselling to do at that time. Anesthesiologists can be pretty busy; many times their current interaction with you may be the last conscious/competent interaction you have with them (they will probably talk to you after you wake up, but amazingly most people completely forget this interaction). So, they have to guage what the chances are that you are "falling through the cracks" with getting appropriate counselling from other sources. And, with all doctors getting more and more pressured to work faster, alot IS falling through the cracks. Any time a doctor doesn't give you a hard time about smoking, might not be because they think it is fine, or they understand the APPARENT differences between cigarettes and cigars. It is probably as likely they just "can't be bothered" either because they are too busy, they don't think it is likely to result in you changing etc. Since they have limitted time and think they may never see you again, "scare tactics" might just be a way to make the greatest impact with the hopes that this impact continues. While this has not been proven effective, docs are human too and will jump at these options just like any other person who feels they have to get the "point across right here, right now" (how many times have parents here found themselves being more stern with their children just to get the point across eg:"child wanders away from parent at mall, but comes back when parent is starting to call out in a panic", "child steps out onto road of an otherwise vacant street but then gets heavily scolded" etc). If the doc didn't care, you wouldn't have gotten any grief at all.

But, I don't think they called you any names. "Leave it to some holier than thou delicate genius"; that's just simply an ad hominim attack for no good purpose.

Lastly, you probably won't find many doctors versed in the risks of cigars and how they differ from the risk of cigarettes. The only "specialists" of tobacco subtypes in the physician world are those docs that do have the occassional cigar and have gone out seeking the information in order to justify that its not going to harm them more than they are willing to accept. The rest of the physician population will be "generalists" in that information. Thus, they will know the risks of cigarettes, by far the MOST common form of tobacco consumption. Erring on the side of caution, they will lump cigars in with cigarettes. It seems the more reasonable/ less dangerous approach for the generalist.

Imagine a generalist deciding whether you need surgery for your prostate cancer, or whether it is safe just to "wait and watch" that cancer....you would probably want them to err on the side of caution and send you to the specialist who could cut it out.

But, I just got done a 24 hour shift and need to sleep. If the above rant seems meandering and deluded....just imagine how my last patient felt like 2 hours ago.

Finally; "manufactured, mind-altering, legal but arguably lethal substances,"...the way you use it is nothing more than scare tactics as well. So now who's taking the hypocritic oath? Of course you realize that the use of those substances is to allow the surgeon to do what could never be done without those drugs...cut deep into your body, alter the anatomy in a controlled and skillful fashion and then get out without putting you through easily the worst pain in your life. Of course these drugs can kill you, that's why the anesthesiologist has to decide which exact concoction to use for you, control it every step of the way, know how long (to the minute sometimes) each drug will take effect, know what subtle signs your body gives that things are going wrong, and how to pull you from the brink of death if they do go wrong. That's whay it takes 9 years to become a fully trained (yet still green at that point!) anesthesiologist.

There is nothing delicate about a 36 hour shift either.


Cheers

Please take my comments with a grain of salt. I sound aggressive in digital, but I assure you I would smile and shake your hand even after this exchange


Cyanide (I know, ain't it just a deliciously ironic monicer)

[14holestogie]

Regardless of which side you're on, any medical personell who doesn't counsel tobacco users about the risks are not doing their job. You still have the choice to listen or not, but that is, after all, their job.

[DocLogic77]

Originally Posted by Cyanide

As many will correctly presume, I am on Mash's side.

What you may not realize is that, many things are occurring during an interaction with a doctor; many more things than you are aware of. They are assessing risks, doing statistical calculation, assessing what complications can be expected, what information should be gathered up front to make decision making easier/better/quicker when the possible complication does occur etc. But, also deciding what counselling to do at that time. Anesthesiologists can be pretty busy; many times their current interaction with you may be the last conscious/competent interaction you have with them (they will probably talk to you after you wake up, but amazingly most people completely forget this interaction). So, they have to guage what the chances are that you are "falling through the cracks" with getting appropriate counselling from other sources. And, with all doctors getting more and more pressured to work faster, alot IS falling through the cracks. Any time a doctor doesn't give you a hard time about smoking, might not be because they think it is fine, or they understand the APPARENT differences between cigarettes and cigars. It is probably as likely they just "can't be bothered" either because they are too busy, they don't think it is likely to result in you changing etc. Since they have limitted time and think they may never see you again, "scare tactics" might just be a way to make the greatest impact with the hopes that this impact continues. While this has not been proven effective, docs are human too and will jump at these options just like any other person who feels they have to get the "point across right here, right now" (how many times have parents here found themselves being more stern with their children just to get the point across eg:"child wanders away from parent at mall, but comes back when parent is starting to call out in a panic", "child steps out onto road of an otherwise vacant street but then gets heavily scolded" etc). If the doc didn't care, you wouldn't have gotten any grief at all.

But, I don't think they called you any names. "Leave it to some holier than thou delicate genius"; that's just simply an ad hominim attack for no good purpose.

Lastly, you probably won't find many doctors versed in the risks of cigars and how they differ from the risk of cigarettes. The only "specialists" of tobacco subtypes in the physician world are those docs that do have the occassional cigar and have gone out seeking the information in order to justify that its not going to harm them more than they are willing to accept. The rest of the physician population will be "generalists" in that information. Thus, they will know the risks of cigarettes, by far the MOST common form of tobacco consumption. Erring on the side of caution, they will lump cigars in with cigarettes. It seems the more reasonable/ less dangerous approach for the generalist.

Imagine a generalist deciding whether you need surgery for your prostate cancer, or whether it is safe just to "wait and watch" that cancer....you would probably want them to err on the side of caution and send you to the specialist who could cut it out.

But, I just got done a 24 hour shift and need to sleep. If the above rant seems meandering and deluded....just imagine how my last patient felt like 2 hours ago.

Finally; "manufactured, mind-altering, legal but arguably lethal substances,"...the way you use it is nothing more than scare tactics as well. So now who's taking the hypocritic oath? Of course you realize that the use of those substances is to allow the surgeon to do what could never be done without those drugs...cut deep into your body, alter the anatomy in a controlled and skillful fashion and then get out without putting you through easily the worst pain in your life. Of course these drugs can kill you, that's why the anesthesiologist has to decide which exact concoction to use for you, control it every step of the way, know how long (to the minute sometimes) each drug will take effect, know what subtle signs your body gives that things are going wrong, and how to pull you from the brink of death if they do go wrong. That's whay it takes 9 years to become a fully trained (yet still green at that point!) anesthesiologist.

There is nothing delicate about a 36 hour shift either.


Cheers

Please take my comments with a grain of salt. I sound aggressive in digital, but I assure you I would smile and shake your hand even after this exchange


Cyanide (I know, ain't it just a deliciously ironic monicer)

Excellent post John...and I couldn't agree more.

[Nimbus]

I had my physical a few months ago and I told my doctor that I occasionally smoke cigars and he did said that is fine. Everything in moderation is ok.

[mosesbotbol]

You have lie lie lie about smoking and drinking with your primary. You don't want that on your medical record as it will come back to haunt you when you want life insurance.

My neighbors are in medical claims and recommended this to me. "Don't drink, Don't smoke" has to be your mantra when getting a physical.

Ya, once again....in the case of cigars, everything in informed moderation is OK. You just need to know where the line lays vs the risk you want to take. And, with cigar smoking there IS a line for "minimal risk" that still involves some useage.

For completeness, the line of "minimal risk" has not been defined for cigarettes though. Recent studies show that even 4 cigarettes a day still noticibly increases your risk for heart disease. Remember, that's cigarettes.

Cheers out

[shilala]

I always like to read these debates.
With me it always gets tempered by the fact that life is progressive and fatal.
Odds are real good that I can be fat, smoke, drink, fight, eat bad things, and survive to a ripe old age. My family has done it for generations.
None of us eat sweet potatoes though. They make me gag just to think about them. As far as I know, I might be one sweet potatoe away from imminent death. It's probably my kryptonite.
"Carpe Diem" is the only defense I can muster.
If I'm lucky, I'll go out with a JJ maduro in my hand and a smile on my face.

[macpappy]

Humans are the only animals on earth concerned with circumventing what nature and God intended. That we are born, we live and then we die. While there are instances in nature where animals eat their young, they do not consciously abort the pregnancy. While other animals do not willingly let another animal kill and eat them, most do eventually lay down and die when they have grown too old to survive. The majority of humans do everything they can to stay alive and many even prefer being hooked up to machines that breath for them, pump their blood through their bodies and even extract natural waste to prolong life.

If God had intended for us to me immortal than we would all be gods.

[BlackIrish]

Originally Posted by Tenor CS

Many of you know I had surgery today. When the anesthesiologist came in to talk to me, one of his questions was "Do you smoke?"

I answered, "Yeah, I smoke an occasional cigar, maybe 1-3 per week."

His reply: "Oh, come on man!" Followed by reading me the riot act and calling cigars "death sticks."

Granted, I am grossly overweight, and I have high blood pressure. But my General Practitioner (the one who put me on the high blood pressure meds) is perfectly ok with it, my brother in law is an emergency room doctor and a fellow BOTL, and one of my colleagues at work is an MD and agrees that the occasional cigar will not likely do me any major harm.

So, have any of you other guys or gals been given a hard time by your doctor(s) re: your smoking?

Glad you're ok, Christian, and sending thoughts for a speedy recovery.

I'm wondering: do you get grief from the opera community about your cigars and whatever effects they might have on your vocal cords?