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Ask A. Schuyler, NP Your Own Question

A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 14925
Experience:  Board Certified NP, MS, RN. Private practice & hospitalist
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hello there my dad says he has a thick head and at the moment

Customer Question

hello there my dad says he has a thick head and at the moment he is wearing a nicabate patch and smokes like half a cigrette every 20 mins so could he have an overdose at all.. please get back to me asap and he has gone to have a sleep and need to know asap if it could be a nictoine overdose..
Submitted: 4 years ago.
Category: Health
Expert:  A. Schuyler, NP replied 4 years ago.
Chat Conversation Started
Schuyler_ANP :

Hello, Welcome to Just Answer and thanks for your question. Yes, Tesa, it is possible to overdose with both cigarettes and the patch. If he's going to smoke, there is no point in using the patch. Can you tell me which patches (what dose of Nicobate) he is using. Also the brand of his cigarettes? Does the label say how much tar and nicotine per cigarette?

Customer :

no it dont say how much tar is in the cigrettes and can he die from the overdose

Schuyler_ANP :

You can die from an overdose of nicotine, but this isn't likely to happen. What does happen is he gets as much (or possibly more) nicotine from a combination of patch and smoking than he might get from smoking alone. It is the nicotine in the cigarettes/patches that will prevent him from having surgery when the time comes.

Customer :

so u can die from a overdose of nicotine

Customer :

before he went to lay down he told me he feels thick in the head. and now he is in bed asleep and hasnt had a cigrette for like 30 mins

Schuyler_ANP :

It is possible to die from an overdose of nicotine. It is a poison. Whether he gets enough from the patch and smoking would be what needs to be determined. In the States, every package of cigarettes has to state how much tar and nicotine are in each cigarette.

Customer :

no it dont in australia

Customer :

he smokes 2 mg cigrettes

Customer :

hes echo that he had a his hert was very good and the doctor that did it told him that my dad's doctor would be very happy with the results

Customer :

you there

Customer :

hello??

Schuyler_ANP :

I'm glad that he has quit for at least 30 minutes. What is the brand name of the cigarettes he smokes. I will see if I can find information online about the nicotine content.

Schuyler_ANP :

Nicobate patches come in 3 strengths that deliver 21 mg, 14 mg or 7 mg per 24-hours. Do you know which one he is using?

Customer :

he makes his own with abit of smoker leaf and mentrol drum

Customer :

he is still breathing in the room and could he have had a overdose if he is sleeping now. and how would i know if he has overdosed when he is asleep

Customer :

mixed

Customer :

and smokes like half a cigrette so he only has 4 cirgettes though the day he dont smoke 40 a day now

Customer :

and that has been going on 4 cigrettes a day for 2 weeks

Schuyler_ANP :

Then it is difficult to tell how much nicotine he is getting. The idea with Nicobate is to use the 21 mg patches fro two weeks, and then quit smoking completely. Then the 21 mg patch is continued for a few weeks, followed by teh 14 mg patch, the 7 mg patch, and finally nothing. He isn't getting an overdose if he has cut back that much. That is really good to go from 40 cigarettes a day to just four.

Schuyler_ANP :

I'm glad he is making a serious effort to quit.

Customer :

someone going to help me

Schuyler_ANP :

I have been helping you.

Schuyler_ANP :

Read the chat. You seem to have missed my replies.

Customer :

hey there

Customer :

why u keep going offline in middle of chat

Schuyler_ANP :

Hello again

Customer :

why u keep going offline in middle of chat

Schuyler_ANP :

i don't go offline. I go to healp other people while you decide what you want to type. For instance, it has been an hour since your last reply. I can't sit and wait for you for an hour while there are other people waiting for answers.

Customer :

it said u were offline

Customer :

it was an hour as i thought you had gone

Schuyler_ANP :

well, you can't believe everything a computer says.

Customer :

oh ok

Schuyler_ANP :

Just keep typing and I will get back to you. Ignore what the computer says.

Customer :

ok

Customer :

so my dad only has 4 cigrettes a day insted of 40 cigrettes and he says he aint sure if it him but he said foe a couple of days when he strated on the patches that it felt like it was working and now he not sure if its working or not.

Schuyler_ANP :

It's still working. It is great to go from 40 to 4 cigarettes in just two weeks. He is making real progress. Encourage him to keep up the good work!

Customer :

how long can he stay on 4 cigrettes a day

Schuyler_ANP :

He should gradually taper down. Maybe 3 cigarettes a day for a day or two, then two a day, then one a day, then none.

Customer :

i dont know if he could do that so fast

Schuyler_ANP :

He can certainly try. He has done very well so far.

Customer :

i know and that was will power

Customer :

and why was it on tuesday nite whenn i was cooking dinner i was very very breathless like i was going to die as when i took a deep bresath then i could get a deep breath in that well

Schuyler_ANP :

Most people have a lot more willpower than they think they do. It takes a lot of strength to change habits of a lifetime.

Schuyler_ANP :

Your symptoms are due to anxiety disorder. Once it is treated you should feel a lot better, and worry a lot less about things you can't change.

Customer :

also the other day at the doctors i had this feeling in my head like my head was jumping up and down like i was on a trampaline

Schuyler_ANP :

Same thing.

Customer :

why i feel strange in the head and dizzy

Schuyler_ANP :

anxiety disorder.

Customer :

i didnt like when i had that feeling today when i was in the shed it was like a shawow come in front of me it was very weird

Schuyler_ANP :

No doubt it was a weird feeling. That doesn't mean that it had any particular physical significance though. Anxiety disorder causes a lot of strange physical symptoms.

Customer :

could i hav sumthing wrong ion my brain

Schuyler_ANP :

Other than an anxiety disorder, probably not.

Customer :

what u mean probley now

Customer :

and today i was looking at this thing then i felt like i was going to pass out or fall over

Schuyler_ANP :

I mean that it is highly unlikely you have anything wrong with your brain other than the anxiety disorder.

Schuyler_ANP :

Get the anxiety disorder controlled and you will get rid of all these strange things.

Customer :

the doctor wants me to see a psychirstist but cant get an appointment till the 13 of october

Schuyler_ANP :

That's a shame that you have to wait so long. A psychiatrist would be the best specialist to see.

Customer :

as the doctors have tried like 6 driffent antidepressants but they havent worked and i have stayed on them for 6 to 8 weeks at a time

Customer :

then had tpo stop the meds before i could go onto another one

Customer :

what will he do for me

Schuyler_ANP :

It doesn't sound like antidepressants are what you need. Your problem seems to be anxiety, not depression.

Customer :

i did a mental health plan at the doctor yeasterday and he gave me a referal to a pvt psychiatrist as there is like a 3 to 4 month wait for public

Schuyler_ANP :

Hopefully, the psychiatrist will combine talk therapy with medication. There has to be some reason that you are so obsessed with dying.

Schuyler_ANP :

Talk therapy plus medication works better than medication alone.

Customer :

what u mean there must be a resaon that i feel i am dying

Customer :

i dont know why maybe that just a feeling i get with my anxiety

Customer :

and also so so worried about getting lukimia

Schuyler_ANP :

No, what I said was there must be some reason that you are obsessed with thoughts of dying. You worry about things that can kill you or someone else. For instance tonight you wanted to know if nicotine can kill your father instead of can it make him sleepy.

Customer :

and what are the symptoms of lukimia

Customer :

as i had like 5 ct scans in like 8months

Schuyler_ANP :

Why on earth would you worry about a thing like that? Your doctor would find indications in routine blood tests before you ever had any symptom.

Customer :

i am scared as know overdoses kill u and worried of losing him

Customer :

how would he find if i had lukimia when i dont have symptoms

Schuyler_ANP :

Far too much worry for someone so young.

Customer :

and worried as u cant be cured with lukimia

Schuyler_ANP :

A routine blood test would show abnormalities in blood counts. Also, some leukemias can be cured.

Customer :

why did i feel like i couldnt breath on tuesday nite when i was making dinner

Customer :

so a PSA level is that done with a full blood count at all

Customer :

and how long b4 prostate cancer spreads

Schuyler_ANP :

You felt breathless because you have an anxiety disorder. A provider has to specifically request a PSA test. The length of time before prostate cancer spreads varies from person to person and with the type of prostate cancer. It can be as short as months to as much as years.

Customer :

hes gleason score was a 7

Schuyler_ANP :

That refers to the patterns of cancer within the biopsy sample they took. Gleason scores go up to 10 with 10 being the worst. However, Gleason scores are only part of the picture.

Customer :

and the prostate surgon said that hes stageing is 1 out of 4 i think i was

Schuyler_ANP :

A stage 1 would indicate no metastasis (spread).

Customer :

so is that bad

Schuyler_ANP :

No, that means that it hasn't spread outside the prostate. That is a good thing.

Customer :

so how long b4 it could as they say its slow growing

Schuyler_ANP :

It could be years. Since he will have his prostate removed, that will stop any possibility of spread to other organs.

Customer :

yes i know but he was digansed with cancer about 5 month ago back in may this year

Schuyler_ANP :

It may take years to spread or it may never spread. Since it is slow growing, that is a good thing.

Customer :

so it can take years

Customer :

and worried about him having oparation as he will be on a 22% incline with his feet up and head down

Schuyler_ANP :

Yes, it can take years. The incline is the way it is typically done.

Customer :

why on a 22% incline with head down and feet up\

Schuyler_ANP :

It helps control bleeding and it is the best position for the surgeon to work in.

Customer :

how does it control bleeding

Customer :

also my dad has bad sinus everyday and worried he will still have heaps of creane

Schuyler_ANP :

Gravity.

Schuyler_ANP :

Why are you worrying about things you can't control? The surgeon and anesthesiologist would not operate unless he was a good candidate for surgery. Let them do their jobs.

Customer :

what about sinus

Schuyler_ANP :

What about it? Nobody dies of a sinus congenstion.

Customer :

but wont that go into his lungs

Customer :

and he will be at a risk of phumoina and broncaspasms\

Schuyler_ANP :

Good grief, Tesa! He is no more at risk during the surgery than he is today.

Customer :

you sure

Schuyler_ANP :

Yes. Risk is just that. He may not have a sinus infection when he has surgery. In that case it would be totally impossible. Even if he did, there is still no guarantee that it would become pneumonia. You are focusing on the worst possible things you can possibly imagine and obsessing over them.

Schuyler_ANP :

I have to sign off and get some sleep. It is 11:30 p.m. here and I have hospital rounds at 7 in the morning.

Customer :

ok and is it possible that he could have high risks

Schuyler_ANP :

If he did, his doctors would have told him so.

Customer :

what do you do at the hospital and what hospital u work at and do they do robitic surgery at the hospital u work at

Customer :

has anyone die from the robitic surgery

Customer :

what do they mean when they say major surgery or minor

Customer :

hello there

Schuyler_ANP :

I am a nurse practitioner and I do rounds on any of our patients who are at two hospitals in my city. They do robotic surgeries at both of them. Robotic surgery just means that the surgeon performs the surgery with the use of mechanically controlled tiny surgical instruments. The advantage is that the tiny instruments cause less damage in the area than a larger incision and big hands might. People are no more likely to die from robotic surgery than from non-robotic. Of course, people do die after surgeries, but it is rarely from the surgery itself. It is usually from some infection that they developed after surgery, or from some condition that they already had. Major and minor surgeries are just what they sound like. An open-heart surgery is a major surgery. It involves complicated surgical techniques and takes a long time. An appendectomy is minor surgery.

Customer :

i am worried about dad getting an infection and ding

Customer :

dying

Schuyler_ANP :

It can happen, but it is rare.

Customer :

so if it does happen none of the doctors czn do anything about it

Customer :

what people have died that you have been looking afetr and how long b4 they die after sugrey

Schuyler_ANP :

Infections can usually be well controlled with antibiotics. It sounds like your father is in good shape and is not in any danger of dying from prostate surgery.

Customer :

but he was a heavy smoker

Schuyler_ANP :

People I've seen die after surgery were very old and in very bad shape to begin with, or they had surgery after accidents that left them near death. Surgery was done to save their lives. Sometimes they can't be saved. There is nothing you can do about his having been a heavy smoker and no use worrying about it. Evidently his doctors don't consider that he is in any great risk to have surgery. Trust their judgement.

Customer :

i would have very very bad anxitey if i lost my dad after surgery

Schuyler_ANP :

Good night. I have to go now.

Customer :

and he weighs like 89 kgs and has a pot gut and he is not a drinker and hes been like that since he was a teenager

Schuyler_ANP :

You already have very bad anxiety. Hopefully you will get it properly treated so you aren't so miserable worrying about things all the time.

Customer :

hey there u back

A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 14925
Experience: Board Certified NP, MS, RN. Private practice & hospitalist
A. Schuyler, NP and 4 other Health Specialists are ready to help you
Customer: replied 4 years ago.
why dont you want to help me i am very veryu very scared here. please help asap please and i will be accepting anwsers tomorrow morning when i get my payment.. please help me as i am panicing so badly. i have just had 20 mgs of valium as very very scared

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