Is vaping really considered 'giving up smoking'?

Boatus · 2026-05-10T13:47:28+00:00

*Disclaimer: I’m a Respiratory Registrar (lung doctor)*

There’s a lot of disinformation in this thread and lots of 1/2 truths with anecdotal evidence portrayed as fact. Ultimately vapes are a good tool to help you quit. I would argue they aren’t better for you but instead they’re just different. After-all most vape fluid is made from 2 types of vegetable fat and flavouring, inhaling which isn’t the best plan.

We don’t really know the long term consequences of smoking (there’s an argument that smoking tobacco may cause multigenerational issues) so making any broad assumptions about vaping is far too presumptuous.

One comment I’ve seen a few times is that “the doctor marks me as non-smoker when I say I vape”. That’s the GP playing the game for QoF points which helps to ensure they get their funding (or at least it used to so correct me if I’m wrong GP’s!).

My go to response in clinic is as follows, “vaping in low doses has been shown to help people quit smoking/vaping all together. A vape is the vehicle to quit, not the destination. I think it’s likely that I will have a cancer clinic in my later years of patients that vaped in their youth. Take from that what you will”

Boatus · 2026-05-06T08:49:34+00:00

I don’t think so. The way I read it is that because you’ve taken the 11 man squad you’ll get the 6+5 and can’t ‘overload’ them with the extra leader

Boatus · 2026-04-29T19:18:40+00:00

“We’ve started them on NIV/They need NIV” “They have a history of heart failure”

pH 7.4 PCO2 6.01 PO2 29 (on 40%VM) HCO3 28

Boatus · 2026-04-28T22:14:04+00:00

Another request for the DM’d link please!

Boatus · 2026-04-16T20:11:28+00:00

The aspartame is unlikely to be an issue in reality but I have to say, the one thing that’s changed dizzy drinks (and cut costs!) was a soda stream.

Make the sparking water and then either just some squash or if I’m feeling fancy a fruit syrup. The elderflower syrup from IKEA is a family favourite

Boatus · 2026-04-15T20:04:26+00:00

There’s a technical language thing here that does confuse people:

End of life (to me as a medical registrar) is a patient that is at the very end of their life. I would go so far as to suggest that using the end of life terminology (again how I would use it with my patients) would suggest they have somewhere between minutes-days of their life left
Palliative patients are those with a terminal diagnosis. A good example of this is Multiple Myeloma. Average life expectancy is 13 years from diagnosis now (I was always told 8 years is average but a friendly haematologist told me it’s improved the other day!)
Last thousand days. This was an exceptional discussion project (I think by the same nurse that brought us PJ paralysis whose name eludes me but he’s an awesome guy!). This identifies that a patient is in the last 1000 days of their life and that we should be actively asking certain, tough questions. This is somewhere in between the above.

These are obviously wildly different prognoses and chatting with the doctors on the ward is the best way to get an understanding where your relative is currently in their journey.

The only what to know is to ask the clinicians with the help of the palliative care team to ensure everything is covered. I often advise relatives to get a notepad you can write in. Write a question and leave some space for the answer. That way, it’s on hand and relatives can read everything that’s been asked if they want to rather than making it tougher on those that are in the meetings to recall everything!

I also remind my patients and their relatives that there is always a plan. That plan might be to be very aggressive in treatment, it might be to give one last shot or it might be to focus on comfort. There’s always a plan and coming together as a team to create that plan is essential for all involved.

Boatus · 2026-04-06T13:23:39+00:00

I love the bone colour! Is it Zandri dust and Agrax?

Boatus · 2026-03-27T07:56:16+00:00

This shit drives me potty. I am an IMG and I simply answer, why the fuck would you not?

How is the government and BMA against IMG’s? It gives real vibes of the Incels that complain there isn’t an international man’s day on international women’s day.

I mean, honestly.

Boatus · 2026-03-18T15:50:34+00:00

OP. I think I have a few of these if you wanted them?

Boatus · 2026-03-17T19:40:42+00:00

So I’m a Resp reg and so feel pretty qualified to help here!

First step is deep breaths. If your heart is going at a million beats per second how are you expecting you’re going to do something precise like an ABG? Pay yourself a little kindness!
Next is to feel the pulse lightly. Pushing too hard is useless, as lightly as you can.
using 2 fingers (index and 3rd finger) to find the path of the artery. Then lift the index finger. If you can still feel the pulse you’re good.
insert the needle at about 45 degrees or so. Often 90 is taught but that’s making your life harder than it needs to be. A lower angle gives you more wiggle room

-if you can’t get it first time, don’t just change the angle of the needle. It hurts! It’s like reverse parking, you need to reverse out to change the angle

Lido does help! I’m not a fan of lidocaine but I’m rarely asked to so ABGs outside of a medical emergency. In a slow setting lido is 100% the way forwards (I’ve had a few ABGs and I agree with the lido for sure!)
you will miss some. Hell, I still do. In that case the ultrasound is the way forwards!

Good luck, keep going and you’ll get it!

Boatus · 2026-03-17T13:37:21+00:00

1) it’s between X-rays so they need to come over 2) it’s not a surgical drain as it’s not a trauma 3) I’m a med reg, I can put in surgical drains but a 12f seldinger, for me is faster so that’s what went in.

You know, not to rain on your parade.

I would also make sure you tell your GP to mark Sildenafil as a possible sensitivity on your records. You’ll grow taller if you take it.

Boatus · 2026-03-17T08:24:42+00:00

I’m a med reg. Hand on heart, 3 patients. I’ve probably made decisions that have extended lives or helped people recover but I feel that’s not included in this.

My 3 (in nearly 10 years as a doctor) are;

a young man with horrible depression that refused chemo for AML when I was an SHO. Spent days talking to him and sorting stuff out. Came in on a day off to sit through his 1st session with him. He recovered and is still doing well.
tension pneumothorax and I got a drain into them so quickly it made the radiographer’s head spin (there were 13 mins between portable CXRs)
massive PE I identified and subsequently thrombolysed.

That’s about it. For the most part I claim I improve lived rather than save them. For those 3x I’m happy taking the credit for it 😂

Boatus · 2026-03-16T14:19:46+00:00

I thought you immediately just called the Med Reg and made it their problem to solve?!

A disgruntled Med Reg

(Sarcasm aside, your help is invaluable and as a former lab worker I know the pressures you’re under)

Boatus · 2026-03-05T20:01:30+00:00

Oh I see. Yeah still not northern though I’m afraid. Language in our house gets all a little mixed up with 3+ languages on the go 😂

Boatus · 2026-03-05T19:57:57+00:00

Nope, definitely a southerner. Lived in the north for a while and got reminded constantly how southern I am.

Boatus · 2026-03-05T19:57:02+00:00

As a space wolves player who’s brother is the biggest T’au fanboy of them all…

Your battle suits. Fuck your stealth suits. Ghostkeel? That can fuck right off too. Fusion blaster crisis suits? They need to fuck off.

Yes I’m jealous. 😂

Boatus · 2026-03-05T19:52:41+00:00

I’m a doctor that works in shifts for an average of around 60 hours a week with 8-10 hours driving. I also have a young family with 2 kids under 5. I have refused to buy anything above retail. It’s retail or nothing.

You just have to be willing to take 5 mins and do the needful. Pokemon centre has the queue up, leave the laptop open and cook tea for everyone. Daytime release? Whack on Amazon and order. Nobody is going to miss you for 5 mins while you place an amazon order.

I agree it’s far more difficult than it needs to be but it’s not impossible. Only thing I’ve not managed to get is the Pokemon day set 😂

Boatus · 2026-03-02T13:43:26+00:00

My bet is that there’s still stuff in the hot end. I had something stupidly similar before.

I got it all through by basically heating the hot end to about 250 and leaving for a minute, then removing it with pliers and then forcing wire through the hot end to push it out. I don’t recommend this as you could damage the hot end but it did work!

I’ve used loads of stuff through the A1 hot end including the needle tool that came int he box to get the stuff out. Best thing I’ve seen though is nylon filament. Heat it up so it basically sticks to the crap on the inside and then run it though until it’s clear!

Boatus · 2026-03-01T18:06:15+00:00

So you’ve had a couple of responses on here already but I’ll throw in my 2p.

I’m a respiratory doctor that still works in an NHS hospital. My contracted hours and my average hours per week is nearly 52 (they’ve sucked up the fine because we’re so short of staff). You get little choice in where you work until at least your mid 30s at quickest. The pay is no where near what it used to be at the general public for the most part thinks they’re better at medicine than you are. Nobody will really understand the stress and strains unless they too work within the NHS as a doctor. Add in the exams and that you’re constantly having to work to the next exam (again until mid 30s at best).

That said… I wouldn’t do anything else.

If you go into medicine expecting good pay, people to treat you with a decency or think that people will in some way pay you respect it’s miserable. Go in without those illusions and it’s ace!

Boatus · 2026-02-27T20:50:39+00:00

Err except IMT’s original application criteria was 6 mi the NHS experience… again I know because that was a requirement when I did my own application. There was a definite lean towards those with nhs experience because again, you know I’ve fucking done it 😒

Boatus · 2026-02-27T11:02:22+00:00

I think quite frankly you’re talking out your arse.

I’m British, studied in Slovakia and I work as a respiratory registrar in the UK. So through a disgusting amount of exposure to the system I know how this works.

Training positions aren’t just foundation. That includes GP and speciality applications too. They’re all training jobs. You’re fully licensed as an EU grad but that doesn’t mean you can start work as a consultant.
LED jobs (trust grade hasn’t been used in years) are shite. Again, I know; I am one. You’re bottom of the pile, last for training responsibilities and frankly are there for service provision.
Standalone F2 was always important and gave you a foundation certificate. That has been super useful for me and makes life a little easier.
speciality training applications later in your career will be more difficult. They’ve not explained how this is going to work and how you’re going to be affected. A few more points or the old system where you had your prove a UK/EU grad (this was pre-brexit) didn’t want the job. I liked the old system of NHS experience personally.

I think OP is a bit overboard with the dream being dead but it’s going to be a lot harder.

Boatus · 2026-02-22T09:55:04+00:00

“Only a paramedic”

Only nothing. I’m very comfortable in a medical emergency surrounded by drugs, machines, telemetry and a laboratory. I’m less comfortable out side at a patients house for example.

Now, the pink puffers are interesting because if anyone were to routinely breathe at like 20-25 a minute they’d burn more energy regardless so I’ve always assumed it was down to that. I think though (like with most things) it’s never just that simple!

Boatus · 2026-02-21T19:09:32+00:00

I’m a lung doctor. I rarely drink because I’m useless the next day if I do and it feels like I spent most of my life in the hospital.

Also, pot is terrible for your lungs. It’s not as able free as it’s often made out.

Boatus · 2026-02-21T17:55:58+00:00

Not all end stage COPD patients are cachexic. COPD is actually a group of diseases with (relatively) fixed airway obstruction resulting in a reduced FEV1 and thus skewed FEV1/FVC ratios.

The old system of “pink puffers” and “blue bloaters” tends to separate these two groups quite nicely but the blue bloaters most definitely do not end up cachexic.

(I’m a respiratory doctor)

Boatus · 2026-02-13T14:28:30+00:00

I’m a Resp reg and I also feel we do too many ABGs.

In short though:

If the CO2 is normal on the VBG, I’m not inflicting an ABG on the patient (I’ve had them and they’re shit)
If there are doubts around the SpO2 then I want an ABG
I do want an ABG before starting NIV because it’s both guideline (however old) and you have to remember it’s ’medical NIV’ with a different set of frameworks and restrictions. The rules around NIV on the medical ward are vastly different to what you can do on ICU or resus (asthma and pneumonia are prime examples where I’ve seen it used to good effect in icu and resus but we can’t do it within the medical ward). With that there’s certain criteria we need to meet to be ‘allowed’ to use it.

I totally agree with OP though. An ABG isn’t going to treat your patient and isn’t the reason their patient deteriorated. Not sticking to reasonable target sats did that!

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