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

By CHRIS BROOKE
14th September 2007

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.


FUMING: John Nuttall was refused ankle operation because he smokes


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.


PAIN: John Nuttall was given morphine as treatment


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."

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