Answer
Patients with a history of smoking even though they have quit may have an underlying pulmonary problem that does not surface until they are stressed and placed under anesthesia. With a history of smoking or COPD, the patient may need a pre-operative consult with a pulmonologist for possible per-surgical therapies and for them to be consulted after surgery. This patient’s 25-year pack history put her at risk for pulmonary complications after surgery. She was placed on high flow oxygen, had a pulmonary consult, and was given nebulizer treatment.