Good fucking god.
Surgery always comes with risks. Being morbidly obese raises these risks to the point that it's not unlikely that you may die. If you're *already dying*, they have nothing to lose by attempting, regardless of the risks. If it is an elective or non-life saving surgery, the risks outweigh the benefits.
Why is that so difficult for them to understand?
> Why is that so difficult for them to understand?
Their thinking is entirely black-and-white, like a toddler.
If it's *possible* to operate on a grossly fat person then that's that. It's possible ergo there's never any reastnot to.
The idea that there are risks, that there are variable levels of risk and quality of life, that successful treatment is a sliding scale rather than a yes/no dichotomy is alien to childish minds.
It's the same reason they cannot imagine anything between constantly gorging or starvation.
Critical thinking has gone out the window.
It's too hard, which becomes some sort of anxiety cycle.
It's easier to accept obesity than it is to deal with the real shit underneath. It's sad, but now they're making it everyone else's problem.
It makes me wonder if they have borderline personality disorder, but instead of having substance abuse issues they are addicted to food. Borderline tends to present with an addictive personality, needing others in a very codependent way, black and white thinking, and a big dose of main character syndrome/everyone's out to get me.
I am obviously simplifying this but as someone with an in law who we suspect has it (she was committed at one point and diagnosed with bipolar but her mood swings are way too fast for bipolar - I've heard her go through every emotion from screaming in anger to sobbing with joy in an hour long phone conversation) a lot of these things really tick the boxes in my head. The in law who has it also doesn't have any substance abuse problems... But has eaten herself into a spot where she can't put her groceries away other than the cold stuff on the same day she goes out to buy them. She gets home from the store, puts away the fridge/freezer stuff, and passes out on the couch for a while. The shelf stable stuff she unloads the next day. She uses a riding lawn mower to get her mail because walking maybe 100 feet on her gravel driveway is too dangerous for her.
So yeah, we can't prove it but the whole "I hate you don't leave me" and black and white thinking really makes me suspect it.
The average person would be ill eating that much. I struggle eating enough to bulk up and thats not even 5000 calories
In the shows on TLC, their stomachs are slowly stretching for decades starting in childhood usually. Its crazy that parents can basically fuel a child's addiction to food and not realize it somehow. If we do that with pets it is basically considered abuse.
girl… i’m sorry but this is a really uneducated response.
Having a victim mentality & and eating disorder (its own mental health diagnosis) are not criteria to infer that someone has BPD. I firmly believe this is just someone who is delusional and has developed a victim mindset about being obese and is trying any way possible to avoid accountability for their weight.
Assuming someone has BPD based on one rant about fatphobia in the medical field is extremely unfair and contributes to the stigmatization of BPD that has been getting worse as a result of people like you trying to slap BPD diagnoses (a complex mental health disorder) on anyone exhibiting any kind of negative or unhealthy behavior. It’s clear you don’t know much about the condition so you shouldn’t be making these grand assumptions.
Believe me, this person sounds like a real nightmare. And I’m on this page for the same reasons you are. But as someone formerly diagnosed with BPD (im in remission now) ..: this is a really stupid and honestly harmful thing to say.
I’m so sick of people online thinking everyone has BPD. Black and white thinking isn’t unique to BPD, and neither are eating disorders like BED. The internet loves to diagnose people with BPD and it’s so annoying.
It’s like what they teach you in first aid for giving cpr to a baby when someone is worried about pressing too hard with their fingers; obviously don’t go apeshit but if you have legitimately determined that you are at the point of cpr, and aren’t right next to a hospital, you have nothing to lose anyways.
The first time I gave cpr I heard a rib snap and froze.
I hadn’t taken a cpr class before and was just frantically following the 911 operator’s instructions (which made me panic more and become hysterical because I thought I’d *hurt* my grandma) and the operator said something like ‘that’s the least of her problems right now, keep going’.
CPR is kind of brutal but it’s the lesser of two evils in some situations…just like emergency surgery vs elective.
CPR survival rates are pretty low anyway so it’s best to just go for it. My dad broke several ribs in a car accident once; it hurt to cough and laugh for a few weeks but he otherwise was fine and went about his usual activities.
It’s more likely that she had already passed, but I
thought maybe it was quick enough to help because she was still so warm…but I also sort of wondered if 911 just always opts for it on the off chance it helps (so much as they do to make the caller feel less useless)?
Now I realize it wouldn’t have ‘saved’ her either way (or at least not in a state/recovery she would have been happy with) but I didn’t know any of that back then.
Can confirm 911 will always offer to walk you through CPR. I found my friend after she'd been dead for 4 days, and they said "you don't even want to try CPR?"
i needed laparoscopic surgery, gallbladder removal. i was thin at that moment. i was told that there is a small change that they will have to cut open much more, but it's more likely for an overweight person. but they had to warn me, i had to sign a form that i know. everything went well, i have 4 small scars, all good.
my at that point future SIL needed the same operation, by her it was emergency because she went to the hospital after having an attack unlike me who went to the doctor and did tests etc. she was severely obese, and guess what? they opened from her navel to her chest almost. she told me she has a huge scar.
weird, that
I've seen that kind of gallbladder surgery scar, it's brutal. I had laproscopic gallbladder surgery when I weighed 190 pounds. Feeling ill from my gallstones had me lose 15 pounds in a month, which was a lot in a short period of time but I bet my liver shrunk a bit, thus making it easier to operate.
Exactly. They don't even consider the anesthesia and have no understanding how delicate of a balance it can be between patient waking up mid surgery and killing the patient or leaving them with brain damage.
Instead they think it's just that the actual surgeon hates fat people.
And waking up sucks. I've had 3 surgeries, and I've woken up all three times. The first being right around 2-3 years old. And I still remember it at almost 40.
My cousin went in for a tonsillectomy in the 70s. He was three.
The previous person was a 21 year old woman.
No adjustments made.
My cousin grew up in an institution, until he died at 50.
Depending on when in the 70s, pulse oximeters werent even invented yet. So trying to measure 02 sats wouldn't be a realtime process like it is now. And even today scientists don't really understand how anesthesia works in the brain, just that it does. Usually. And for a patient so small, he was probably just barely alive, and their brain was starved of oxygen long enough to cause serious permanent damage.
A lot of people still take for granted how much medical technology has improved in the last 50 years.
That’s on the nose. From bright boy to potato. Dad ran, couldn’t deal. His mom was a walking zombie because if she wasn’t fighting for him, she was drinking and popping pills.
Caused a major split in the family.
But, yeah, the FAs can whine about how it’s all fAt pHoBIa, when they are trying to lessen inevitable consequences.
This isn't even a specifically weight related concept. Non-obese people can also have health related risks that prevent them from getting surgery unless it's absolutely needed.
So weird that the doctors make decisions based on risks to the patient's life, /s
I had a hemithyroidectomy two years ago. My resting heart rate was over 200bpm and my blood pressure was getting high. I hate propranolol before my surgery but my heart rate went up again. The anaesthetist and my surgeon insisted I went straight to ITU afterwards as I was at a high risk for a thyroid storm.
I was told if I delayed it another couple of weeks then I would have had a heart attack and died.
I think it's one of the consequences of modern, effective medicine, in the same vein as antivaxers. Surgery is safer now than it ever has been, and it's sooooo easy to brush it off as 'just another routine medical procedure'. In reality, it's a drastic and often dangerous procedure.
It's the same as being instructed not to eat for 12 hours before surgery -- obviously there are people who need emergency surgery who have just eaten, but the risks are much higher, so it's best to mitigate that as best you can whenever possible.
they want to take the risk, they want the right to be able to take the risk, as that is a right adults usually have. but if it's too risky its basically assisted suicide, which there are laws around. (not to mention surgeons DO want to see people LIVE. theyre not psychos theyre people who can be traumatized by death just like us but anyways)also they dont believe they can do it. with any addiction, its easy to believe you cant possibly stop, until one day you hit rock bottom and you're nearly dead or wishing you were. i get it i'm just not a 'denial' type of person, but that pretty much sums up this whole subreddit, lack of education + lack of proper help for mental illness, especially addiction which seems to be more common than ANY mental illness if you ignore the substance and put them all in one group. Whatever the problem is in our brains needs to be studied and fixed, since even the people who ARE self aware still cant stop. & being unaware is prt of the illness sometimes, like how people with DID have NO idea they have it at the beginning
"They just won't do it unless they're dying."
"They had no qualms about operating on me."
So OOP is dying. Or has a condition so serious that the need for the surgery outweighs the risk.
Everybody knows that's how surgeries work. You aren't going to get an **elective** surgery if there is extreme danger because the benefits don't outweigh the risks. You will get surgery despite the risk if it's **necessary** to save your life.
The vet did bloodwork and an echocardiogram on my dog to make sure his heart was strong enough before they scheduled elective surgery. It's not because they wanted to be mean to the dog and deny him surgery because they see him as "lesser". It's because that's how medicine works. If they didn't care about the dog's survival, they'd just go ahead and do the surgery without the precautions.
FA's convincing each other that doctors are just out to get them and that medical opinions are not to be trusted is one of the most harmful aspects of their movement.
https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2023/october-2023-volume-108-issue-10/study-clarifies-link-between-obesity-and-surgical-complications/
These people can be spoonfed facts and still claim the world is out to get them. Surgeons make money doing surgery, why would they tell a patient to lose weight before a surgery if they didn’t need to
Exactly. Cue the Oppression Olympics. 🏆
It's not "as simple" as they make it seem, where all the surgeons have to do is scale the meds up for larger bodies, but they refuse to out of medical fatphobia... it's actually for safety and patient integrity. I am working with a client who previously had surgery and WOKE UP in the middle due to the miscalculation of anesthesia and her larger body size. This was (understandably) traumatizing to her, and she has since had bariatric surgery to help with weight loss efforts, however, she has lasting effects from that experience. 👀
I heard that the fatter a patient is, the harder it is to anaesthetise them. I don't know if that's true, but it's what I heard. The adipose tissue sucks up the anaesthetic, and thus it makes anaesthetising them much much harder.
The prolonged stationary period dramatically increases the likelihood of deep vein thrombosis and if that turns into a pulmonary embolism then they aren’t making it out of there
It's also harder to stitch an obese patient together, and their healing is rubbish because the fat is in the way of blood. So. Sure, it's possible to operate but it'll be a post-op shit show.
I know someone who got top surgery as an obese person. They were out of commission for weeks. I got a breast reduction as an overweight (now a healthy weight) person and was able to go for a walk and see a movie the day after. Not to mention take considerably less pain meds.
The two procedures are different, I'm sure, but I had been worried going into mine because this person wasn't able to do much of anything for so long afterwards. I think there's also a level of conditioning with bodies where if you've been an active person, your body wants to stay active.
https://www.asahq.org/madeforthismoment/preparing-for-surgery/risks/obesity/
https://www.asahq.org/madeforthismoment/anesthesia-101/types-of-anesthesia/anesthesia-risks/
Dollars to their too many donuts the patient will have comorbidities.
I wouldn't use the word "harder" for anesthesia. It's more dangerous, requires closer monitoring and has more risks of failling and killing them yes. Not just a matter of pumping more drugs into them. It's not like anaesthetic is super expensive in the first place, one hour is like 20 bucks, maybe jumps up to 70 for very obese patients.
A lot of anesthetics are redistributed into adipose tissue. The compounds then leach out of the tissue over the course of hours. Meaning if you have a lot of fat, you might need a lot more anesthetic to sedate you for surgery because it’s hiding in your adipose, but it might be harder to wake you up or extubate you because by that point, hours after anesthesia induction, the anesthetics are leaving your adipose and entering your bloodstream. You needed more to properly sedate you to begin with, and now what was hidden in the fat is coming out. You can see how this might pose a huge issue for anesthesia staff. It’s super hard to dose anesthesia in morbidly obese patients. There is a reason why all post-surgical patients have to hang out in recovery for a while, regardless of weight. You don’t know how anesthesia is going to affect everyone. So much riskier when you have excess body mass.
Pain relief and anaesthesia are weight based. I am pretty tiny and even the smallest dose of pethidine made me unable to hold my head up or speak properly, whereas in someone who weighs 10kg more than me, it would be the perfect dose.
I’m a neurosurgery nurse and I can 10000% confirm that it is outright dangerous to operate on very fat people for a plethora of reasons, the most serious being increased risk of bleeding, infection, and death. They’re difficult to anesthetize correctly. Their incisions often don’t stay closed and it’s harder for them to properly care for the incisions post op.
Doctors won’t do elective surgeries on fat patients because they don’t want the death of a patient on their hands, not because of FaTpHoBiA. And I don’t blame them.
I mean, there's a reason why Dr. Now tells his patients to lose weight before he will perform their bariatric surgeries. It's not because he hates fat people and wants to make this more challenging for them; it's literally that the likelihood of them dying during the operation is significantly higher. It's far more dangerous for them than it is for a healthy, normal sized individual to undergo surgery.
It's also true that the heavier the patient is, the more complicated and difficult their recovery is as well. Wound complications post op is nothing to be taken lightly. They're also at a much higher risk of developing blood clots post op, too.
There's a number of reasons to not perform surgery on an obese body. It's significantly more risky, but no. It's gotta be that they're seen as "lesser."
HAES people, there's nothing less than about you.
It’s absolutely unhinged that someone would rather go down ‘you’re fat phobic, I insist you operate on me’ than ‘it’s nice you are taking precautions to ensure I don’t die on the operating table’
Right? Like doctors don't take an oath to do no harm and are supposed to throw caution to the wind and just perform a surgery that is statistically more likely to kill them or leave them with complications post op than someone much smaller.
And their example of doctors only being willing to operate on them if they're dying is ridiculous. The doctors are put in a double bind in some situations. They have to make a judgment call about what will give their patient the greatest odds of surviving.
It’s so crazy. Why would you assume it’s because someone hates you rather than for more logical reasons? Doctors don’t refuse to operate on people because of gender, sexual or ethnicity because it doesn’t significantly impact chances of complications (I mean it can, but not to the point that weight does).
100%. Dr. Now operates on patients that other bariatric surgeons would reject outright. He takes on riskier cases and has built his practice around operating on heavier patients.
So if Dr. Now is telling you to lose weight, you really do need to lose the weight, because you’re too big for even him to take the risk. (He’s also checking to see if you are a cooperative patient who can follow directions and change your habits, for better post-surgery outcomes.)
I’ve always thought that should be a wake up call for patients, that you’re seeing a doctor of last-resort, because nobody else would see you.
Of course, there are more doctors over the last decade who have trained on Dr. Now’s techniques and contributions to the field who can do these riskier surgeries, but it’s still a handful.
Exactly. You can get weight loss surgery and won't do anything to help yourself afterward if you don't have the willpower to change your lifestyle. That's another reason to lose the weight prior. They just refuse to acknowledge it and insist on being in the victim olympics.
So they admit that obese patients are "problematic" but they don't believe that it's the weight that is causing the problem. What is it then? The attitude? The victim complex?
Also, do they really believe that emergency operations can be compared to regular scheduled ones? Obviously they chose to operate if the alternative is death but I bet the complication rate is a lot higher.
My doctor refused me top surgery at 600lbs but a few weeks later I got shot in the chest and he had zero qualms about opening me right up to remove the bullet and stop the internal bleeding. What a fatphobic asshole!!!
When my dad was diagnosed with colon cancer, he was advised to have his surgery at a particular hospital that had cardiopulmonary specialists on staff, because he was 81, although otherwise in good health (meaning he had no heart or lung problems and was very fit and active, swimming laps, gardening, and walking 1-2 miles a day).
Dad was a veteran and his regular hospital was the Army hospital. He was adamant that they do the surgery there, as it was where he was most comfortable and he had already been told that they didn't expect the surgery to be especially complicated.
So they did the surgery at the Army hospital. And Dad went into respiratory arrest in the ICU afterwards; it was almost 15 minutes before they got him breathing again and they were simply not equipped to handle the situation. He was ultimately airlifted to the very hospital they had advised him to have the surgery at in the first place, but there wasn't much they could do. He died after almost three weeks on a ventilator.
It's entirely likely that if he had listened and just had the surgery at the specialty hospital to begin with, he wouldn't have died. It didn't matter that he was overall in good health and that the surgery wasn't overly complicated. He was still an 81-year-old man, meaning there were still risks that may not have existed for a younger person.
Doctors didn't tell my dad he should have the surgery at the other hospital just because they were ageist. They had a good reason. He didn't listen, and it cost him his life.
Oppression typically implies a total lack of care or concern for the life of an individual or group.
Someone in authority (temporarily) denying you something because they're scared you'll die if you get it is as far from oppression as you can get.
Oppression would be an establishment proclaiming 'roll up roll up, free, elective, cosmetic, major surgery for all infinifats!', run by a Dr Nick Riviera style character who found a way to indulge his serial killer fantasies in plain sight.
Literally no 🙄 obese patients are always told to lose weight before getting on the operating table because being fat increases the risk that someone doesn’t make it out alive. Doctors won’t risk their licence just because some delusional people think that being obese is healthy 🙄
I'm an operating room nurse. We do surgery on obese patients all the time. Usually urgent/emergent procedures are way more likely to be over BMI 35, but there are absolutely surgeons that are uhhhh financially motivated and will take heavier patients for elective joints, spine surgery, etc. They are at higher risk for complications, and from the OR side it just makes everything more difficult/strenuous if they're extremely fluffy, but we get it done. For general surgery there are considerations about literally being able to reach the site they're operating on, whether it's with laparoscopic or robotic instruments or the surgeon/assist's literal human arms. I questioned why we didn't have wider beds when I first started in the OR, and it's because the surgeon needs to be able to stand at the bedside and access the site they're working on - if the bed's too wide they'd need to be like bent in half to get access for some surgeries where they're deep in the abdomen. Impaired healing is absolutely also a factor, but that's also the case with uncontrolled diabetes, smoking, and many other lifestyle things that patients do.
From the anesthesia side, obese patients are just harder to ventilate and will decompensate quickly. Again, it's more difficult but not impossible, and we do it every day for urgent procedures. We have an adjacent outpatient ambulatory surgery center attached to my hospital, and I know there's some kind of algorithm at work with higher BMIs and other factors with whether cases can be booked there. If the patient is very obese, they can't book a case at this outpatient building, because they need to be close to the ICU. It's not just obesity affecting this algorithm, it's also things like a history of obstructive sleep apnea, difficult intubation, malignant hyperthermia, etc.
I guess what I'm saying is that I think the attitude from both the FA side and this subreddit around surgery on obese patients is overblown. Some procedures just need to get done regardless of the patient's weight - we can't wait for 6 months for the patient to lose weight before taking out their about-to-rupture appendix, for example. Obesity complicates things, but so does meth use, smoking, and dozens of other things that humans do. Very obese patients were more of an issue to me as a nurse when I worked on the floor, because in the OR there is always an extra set of hands available - even for emergent surgery that you get called in for in the middle of the night there's at the very least you, the scrub tech, the anesthesiologist, and the surgeon there to position the patient. I have had a surgeon help me hold up a supermorbidly obese patient's leg for me to prep for an I&D - there's no way I would have been able to hold it with one hand on my own while I prepped with the other hand. But yeah, she was septic, and this abscess needed to be washed out. Nobody was going to put off her surgery because she was a high BMI, but it just made things that much more difficult. I think the kinds of surgery that FAs are getting denied for on the basis of obesity are almost all elective joints - which again, if they shop around they will probably find a surgeon who will do it because they need to buy a second yacht and don't care about their numbers - or top surgery, which involves a HUGE incision that is difficult to heal even on a normal-weight person. We only have one plastics doc at my hospital, and he mostly does post-radiation breast reconstruction, but he does occasionally do top surgery. I have seen him cancel procedures because the patient was supposed to quit smoking six weeks before the surgery, and they admit the morning of that they haven't. Is he prejudiced against smokers? No, he just wants them to have the best chance possible to heal this huge incision without complications.
Yes, they can operate on a obese patients when it's life and death situation, when not operating would result in a death of the patient or/and result in a way worse outcome, even when looking at the negative side effects of the surgery.
But no surgeon worth their salt will do an elective surgery where risks outweight the positives outcomes. Just like cardio surgeon won't perform even the simplest ablation if you have rotting teeth.
At this point I just assume their entire brain has saponified due to excess adipose tissue.
As a paramedic exceptionally overweight individuals are many magnitudes more difficult to work on, and some of these people are so fat I don't even have an IV needle long enough to reach their veins through the fat layer.
They can, it’s just statistically more likely they’ll die on the operating table or suffer post op complications and surgeons dont want that to happen. It’s the same as doing heart surgery on the average 90 year old. The risk of the anaesthesia and danger of the op on an already weak body usually outweighs the benefits.
Also if you need surgery on say, your joints, because your weight is crushing them, there’s very little point in fixing them if you don’t lose weight because the same thing will happen again. It’s like giving a 40 a day smoker a lung transplant. You’d prioritise helping the people who are actively trying to improve their health, not people who are just going to destroy all the benefits immediately. I’m based in the UK and the NHS has to choose who will most actually benefit and have long term health improvements from interventions. Probably different in the US.
No it's the same in the US. You have to prove you're not going to damage the organ you're getting before surgery or you're not going to get that organ.
As it should be. I remember seeing some articles during the pandemic of people who were anti COVID vaccination who were mad that they or their children who were on the list for organ transplant were being denied the transplant because they refused to get vaccinated. Sorry but someone else who is willing to protect themselves from the literal pandemic going around is getting the organ.
Anesthesia is dangerous. My mom's cat just died from it. She got through the surgery OK, they called my mom and said she was fine, and then she crashed and was dead before my mom could come pick her up. Though as sad as that was, she was a 15 year old cat with cancer, so the other option was a slower and more painful death. But doctors don't want to watch people die on the operating room table for no reason. That's why they insist you be a healthy a possible, or literally dying.
We are missing a lot of information from OOP. What kind of surgery did she have? Was it invasive? How necessary was it? And of course, how big is she? (assuming it’s a woman.)
I’ve watched enough of My 600lb Life to know that the fatter someone gets the more difficult it is to manipulate their fat so they can do things like shower, get dressed, etc.
Fat is unwieldy. It does not stay in place if you move it, it lolls and rolls about. It’s also heavy. If you cannot shower yourself, and if, in fact, you cannot get clean even with a helper, how exactly do you expect a doctor to be able to do it? How do you propose to keep yourself clean while you heal? How do you think you’re going to move around when you’re in pain? Lying around in bed post-op clogs up your lungs and can lead to pneumonia. You gotta get up and walk.
If you are not to that stage of obesity yet, your fat rolls are not better-behaved than the fat rolls of those bigger than you. Why take all the risks associated with surgery on an obese patient? Instead of having a hissy fit about being told straight facts, suck it up and cut the calories.
I really want these people to watch that documentary about the autopsy on an obese woman. There's so much fat that you can barely tell what organs are what, and it's completely wrapped around everything. It takes them way longer just to cut through and get to the organs than it would on someone with less fat too. When you're on a time limit with anesthesia etc that stuff matters.
I found one (not sure if it’s the same one.) but I had to stop at barely a minute in as I felt queasy. It was the fact they kept describing the fat as greasy butter. I find greasy foods make me feel sick anyway so the thought of it probably set my gag reflex off.
I skipped those couple of minutes and now I’m like woah this is interesting - I read anatomy books for fun as a kid so this is like the updated version of it.
I find the idea hilarious that there’re supposedly doctors out there giving patients medical advice based on them just not liking the way the patient looks lmao. Like: „There‘re no health benefits to this, but your big nose has been bothering me so I‘m gonna prescribe you a nose job, just for funsies“
I mean yes they can operate on obese patients, in fact they’ve gotten pretty good at keeping them alive with stuff like positive airway pressure, intubation, and humidification of the air going into your lungs, however even with all that it is still a risk to operate on someone larger and it is the doctors prerogative if they agree to operate on you or not.
We do a lot of stuff to people who are imminently dying that we don't do to people who expect to live a couple decades.
No time to fumble for a vein, we drill through your shinbone. Got a pulse back but we still need massive amounts of epinephrine to keep it? Add a femoral central line, no sterile prepping, just add an antibiotic to the mix. Oh you don't want this done to you under less emergent circumstances? No shit, neither do we
I've had several surgeries while obese (hip replacement at BMI 35 and some kidney related stuff at BMI of almost 40). I've never had any problems and have always recovered well.
BUT when my kidney transplant doctor told me I needed to get down to a certain BMI (34, not a big ask), I just fucking did it. I didn't whine about it or look for another transplant center with looser requirements. I ate less and exercised more and got on the list.
These people infuriate me.
Same here. I needed a bladder extension and a urinary stoma put in, and my surgeon (who I still see for regular treatments) said it would go better if I lost weight. 1 year and about 50 pounds lighter, I got the surgery. I didn't whine or bitch, I went on a diet. Even then I got an infection (partly because the stoma was leaking onto the incision site but also bc I couldn't keep under my belly clean well on my own). I can't really imagine how it would have gone at my biggest. Or how the surgeon on 600lb life does it.
I'll eventually need a transplant, and that's why I'm hustling my ass to lose weight. I can only get a kidney from family and friends (my condition would eventually wreck the new kidney, so no donor list for me) and I refuse to fuck their sacrifice up.
The people who cry fatphobia at doctors trying to do what's best for them pisses me off. Doubly so for elective operations.
The biggest danger for most routine surgeries is not from the surgery itself, but from the anesthesia. The bigger you are, the more that weight obstructs your breathing and makes it harder keep your blood oxygenated.
Being obese during surgery increases the risks of death or serious complications related to your inability to breath. It was explained to me very clearly when I had wls, and this strikes me as just refusing to understand. Yeah, they can perform the surgery. But many don't want to take the extra risks. If you are already dying and surgery is your best bet for survival, then it makes sense. If you are extremely overweight but in no danger, they may be hesitant to risk your life. And many obese people have fatty liver disease, causing additional risks and complications.
I work at a vet clinic, and we had a chunky dog show up for a routine spay.
I remember yelling for me to get a bunch of emergency equipment. I didn't know what happened until after, but what i was told was when suturing to the abdominal wall, the suture didn't attach to any muscle, just fat. This caused the suture to fail, and the pup started hemorrhaging. I don't know the specifics of how it happened (I'm only an assistant), but it was really scary.
Doggo is fine, but it's not about an 'easy way out' it's about safety.
If it's an emergency, of course, medical professionals won't wait. just like if a person has heart problems and in an emergency, they aren't going to be slow about trying to save them and get them into a hypothetical surgery to save their life.
Do they not realize digging through all that extra adipose tissue makes the surgery so much harder on the surgeon?
That should be so simple to understand.....
>in and out onto a patient that actually *matters*
umm i'm sorry what?!?! weight loss takes time, so if anything asking an overweight/obese person to lose weight is NOT a quick solution, and shows that the medical personnel care MORE about this person's health than the average, healthy weight person. they don't want to risk complications that would arise due to being obese. the mental gymnastics here!
quick tangent, i am fat asf and i hate it. what am i doing about it? diet, exercise, and on pre diabetes treatment to reverse my symptoms. i stopped giving in to my cravings for chinese, pizza, burgers etc. all the time and i cook at home! i am getting up and moving when i can (fuck you depression). what am i not doing? crying on the internet about how i am oppressed for being fat. i had a huge role (no pun intended) in getting to this size, and i am the only one that can pull myself out. my motivations -besides avoiding an early death and dying fat, miserable, and alone- are to feel better in my own skin and be healthier, happier. that and i am scared that i wouldn't be able to outrun a threat or escape a car crash or something.
Imagine, healthcare professionals not wanting to perform risky surgery, but willing to perform it only when the patient is at risk of or is actively dying.
It’s almost like, in an acute situation the risk of your imminent death and at least attempting to urgently save your life takes precedence over the risk of obesity-related anesthesia and intubation complications.
Oh they’d love to live in the UK where they literally ration joint replacement surgery and if you’re obese you don’t get one. Oh and losing weight reduces pain felt from arthritis!!
My dad’s a nurse anesthetist and I love bugging him with medical questions and there are so many reasons to not do surgery on obese patients. Obesity is a huge risk factor for sleep apnea, which obviously surgeons are concerned about while you’re sedated and paralyzed. Can be harder to find veins if they need to deliver meds during an emergency. Medication dosage changes with weight. It takes longer to wake up and recover from anesthesia the heavier you are. (All this info is also available on the American Society of Anesthesiologists) Plus there’s just a number of obesity caused diseases that can affect the safety of surgery. Number one being diabetes. Diabetic patients have a harder time healing and are more prone to infection. Refusing non emergent surgery to a morbidly obese person isn’t fat phobic, it’s simply trying to save them from the numerous elevated risks. Surgery always comes with risks, but they’re far greater when you’re obese.
This is so stupid. It is inherently more dangerous and difficult to navigate around fat tissue to achieve the same results. Medical tools have limits, surgeons have limits, no one wants someone to die because they could drop 15lbs for a medically invasive procedure.
It's the same reason male birth control is taking so long. The risks associated with BC are less than pregnancy so BC for women is considered an ok risk. Giving the healthy (male) body possible poor side effects does not when there isn't a health issue is not considered acceptable. Same with fat people. Some people WILL die if they don't get surgery, which MAY kill them. If the issue isn't bad enough (or is a cosmetic reason) the Drs won't do something that MAY causes harm.
Idk how they don’t understand the difference between “it’s a greater threat to your life for you to not get the surgery” and “it’s a greater threat to your life for you to get the surgery.” Like yeah man, if you’re not going to die from your condition but surgery to correct it has a high risk of killing you, they’re going for the option that doesn’t risk killing you.
Good fucking god. Surgery always comes with risks. Being morbidly obese raises these risks to the point that it's not unlikely that you may die. If you're *already dying*, they have nothing to lose by attempting, regardless of the risks. If it is an elective or non-life saving surgery, the risks outweigh the benefits. Why is that so difficult for them to understand?
> Why is that so difficult for them to understand? Their thinking is entirely black-and-white, like a toddler. If it's *possible* to operate on a grossly fat person then that's that. It's possible ergo there's never any reastnot to. The idea that there are risks, that there are variable levels of risk and quality of life, that successful treatment is a sliding scale rather than a yes/no dichotomy is alien to childish minds. It's the same reason they cannot imagine anything between constantly gorging or starvation.
Critical thinking has gone out the window. It's too hard, which becomes some sort of anxiety cycle. It's easier to accept obesity than it is to deal with the real shit underneath. It's sad, but now they're making it everyone else's problem.
It makes me wonder if they have borderline personality disorder, but instead of having substance abuse issues they are addicted to food. Borderline tends to present with an addictive personality, needing others in a very codependent way, black and white thinking, and a big dose of main character syndrome/everyone's out to get me. I am obviously simplifying this but as someone with an in law who we suspect has it (she was committed at one point and diagnosed with bipolar but her mood swings are way too fast for bipolar - I've heard her go through every emotion from screaming in anger to sobbing with joy in an hour long phone conversation) a lot of these things really tick the boxes in my head. The in law who has it also doesn't have any substance abuse problems... But has eaten herself into a spot where she can't put her groceries away other than the cold stuff on the same day she goes out to buy them. She gets home from the store, puts away the fridge/freezer stuff, and passes out on the couch for a while. The shelf stable stuff she unloads the next day. She uses a riding lawn mower to get her mail because walking maybe 100 feet on her gravel driveway is too dangerous for her. So yeah, we can't prove it but the whole "I hate you don't leave me" and black and white thinking really makes me suspect it.
I don't see how someone can maintain a 5000 calorie a day diet without being addicted to food.
The average person would be ill eating that much. I struggle eating enough to bulk up and thats not even 5000 calories In the shows on TLC, their stomachs are slowly stretching for decades starting in childhood usually. Its crazy that parents can basically fuel a child's addiction to food and not realize it somehow. If we do that with pets it is basically considered abuse.
I don’t think it’s impossible it’s very very very calorie dense foods and they’ve been eating that way since childhood so it is doable
girl… i’m sorry but this is a really uneducated response. Having a victim mentality & and eating disorder (its own mental health diagnosis) are not criteria to infer that someone has BPD. I firmly believe this is just someone who is delusional and has developed a victim mindset about being obese and is trying any way possible to avoid accountability for their weight. Assuming someone has BPD based on one rant about fatphobia in the medical field is extremely unfair and contributes to the stigmatization of BPD that has been getting worse as a result of people like you trying to slap BPD diagnoses (a complex mental health disorder) on anyone exhibiting any kind of negative or unhealthy behavior. It’s clear you don’t know much about the condition so you shouldn’t be making these grand assumptions. Believe me, this person sounds like a real nightmare. And I’m on this page for the same reasons you are. But as someone formerly diagnosed with BPD (im in remission now) ..: this is a really stupid and honestly harmful thing to say.
I’m so sick of people online thinking everyone has BPD. Black and white thinking isn’t unique to BPD, and neither are eating disorders like BED. The internet loves to diagnose people with BPD and it’s so annoying.
Only a Sith deals in absolutes~ Obi Wan Kinobe circa long long ago
Their thinking is in absolutes like the sith except they can’t shoot lightning
It’s like what they teach you in first aid for giving cpr to a baby when someone is worried about pressing too hard with their fingers; obviously don’t go apeshit but if you have legitimately determined that you are at the point of cpr, and aren’t right next to a hospital, you have nothing to lose anyways.
The first time I gave cpr I heard a rib snap and froze. I hadn’t taken a cpr class before and was just frantically following the 911 operator’s instructions (which made me panic more and become hysterical because I thought I’d *hurt* my grandma) and the operator said something like ‘that’s the least of her problems right now, keep going’. CPR is kind of brutal but it’s the lesser of two evils in some situations…just like emergency surgery vs elective.
CPR survival rates are pretty low anyway so it’s best to just go for it. My dad broke several ribs in a car accident once; it hurt to cough and laugh for a few weeks but he otherwise was fine and went about his usual activities.
It’s more likely that she had already passed, but I thought maybe it was quick enough to help because she was still so warm…but I also sort of wondered if 911 just always opts for it on the off chance it helps (so much as they do to make the caller feel less useless)? Now I realize it wouldn’t have ‘saved’ her either way (or at least not in a state/recovery she would have been happy with) but I didn’t know any of that back then.
Ah I’m sorry to hear that. Good on you for giving it a go. My condolences.
Can confirm 911 will always offer to walk you through CPR. I found my friend after she'd been dead for 4 days, and they said "you don't even want to try CPR?"
i needed laparoscopic surgery, gallbladder removal. i was thin at that moment. i was told that there is a small change that they will have to cut open much more, but it's more likely for an overweight person. but they had to warn me, i had to sign a form that i know. everything went well, i have 4 small scars, all good. my at that point future SIL needed the same operation, by her it was emergency because she went to the hospital after having an attack unlike me who went to the doctor and did tests etc. she was severely obese, and guess what? they opened from her navel to her chest almost. she told me she has a huge scar. weird, that
And then cue the argument, at least from the FAs, that the doctors intentionally butchered her because she was fat.
I've seen that kind of gallbladder surgery scar, it's brutal. I had laproscopic gallbladder surgery when I weighed 190 pounds. Feeling ill from my gallstones had me lose 15 pounds in a month, which was a lot in a short period of time but I bet my liver shrunk a bit, thus making it easier to operate.
i had gone down to 62 kilo because it took a while until i could get operated (6 weeks) and i was told if i don't eat fat it won't hurt. so i didn't.
Worse than death: wrong anesthesia, brain damage. As in vegetative state in a nursing home or back at your family home.
Exactly. They don't even consider the anesthesia and have no understanding how delicate of a balance it can be between patient waking up mid surgery and killing the patient or leaving them with brain damage. Instead they think it's just that the actual surgeon hates fat people. And waking up sucks. I've had 3 surgeries, and I've woken up all three times. The first being right around 2-3 years old. And I still remember it at almost 40.
My cousin went in for a tonsillectomy in the 70s. He was three. The previous person was a 21 year old woman. No adjustments made. My cousin grew up in an institution, until he died at 50.
Man. That’s horrifying.
You're saying he was institutionalized due to complications from being given too much anaesthesia?
Depending on when in the 70s, pulse oximeters werent even invented yet. So trying to measure 02 sats wouldn't be a realtime process like it is now. And even today scientists don't really understand how anesthesia works in the brain, just that it does. Usually. And for a patient so small, he was probably just barely alive, and their brain was starved of oxygen long enough to cause serious permanent damage. A lot of people still take for granted how much medical technology has improved in the last 50 years.
That’s on the nose. From bright boy to potato. Dad ran, couldn’t deal. His mom was a walking zombie because if she wasn’t fighting for him, she was drinking and popping pills. Caused a major split in the family. But, yeah, the FAs can whine about how it’s all fAt pHoBIa, when they are trying to lessen inevitable consequences.
I was thinking they’d have to have permanent ABG analysis through an arterial line and even then that requires a computer.
This isn't even a specifically weight related concept. Non-obese people can also have health related risks that prevent them from getting surgery unless it's absolutely needed. So weird that the doctors make decisions based on risks to the patient's life, /s
Yes. I had to have a thyroidectomy, but the surgeon insisted I get my BP down to a certain level before he would do it.
I had a hemithyroidectomy two years ago. My resting heart rate was over 200bpm and my blood pressure was getting high. I hate propranolol before my surgery but my heart rate went up again. The anaesthetist and my surgeon insisted I went straight to ITU afterwards as I was at a high risk for a thyroid storm. I was told if I delayed it another couple of weeks then I would have had a heart attack and died.
I think it's one of the consequences of modern, effective medicine, in the same vein as antivaxers. Surgery is safer now than it ever has been, and it's sooooo easy to brush it off as 'just another routine medical procedure'. In reality, it's a drastic and often dangerous procedure.
It's the same as being instructed not to eat for 12 hours before surgery -- obviously there are people who need emergency surgery who have just eaten, but the risks are much higher, so it's best to mitigate that as best you can whenever possible.
they want to take the risk, they want the right to be able to take the risk, as that is a right adults usually have. but if it's too risky its basically assisted suicide, which there are laws around. (not to mention surgeons DO want to see people LIVE. theyre not psychos theyre people who can be traumatized by death just like us but anyways)also they dont believe they can do it. with any addiction, its easy to believe you cant possibly stop, until one day you hit rock bottom and you're nearly dead or wishing you were. i get it i'm just not a 'denial' type of person, but that pretty much sums up this whole subreddit, lack of education + lack of proper help for mental illness, especially addiction which seems to be more common than ANY mental illness if you ignore the substance and put them all in one group. Whatever the problem is in our brains needs to be studied and fixed, since even the people who ARE self aware still cant stop. & being unaware is prt of the illness sometimes, like how people with DID have NO idea they have it at the beginning
It's not that's why they work so hard to deny it hahaha
"They just won't do it unless they're dying." "They had no qualms about operating on me." So OOP is dying. Or has a condition so serious that the need for the surgery outweighs the risk. Everybody knows that's how surgeries work. You aren't going to get an **elective** surgery if there is extreme danger because the benefits don't outweigh the risks. You will get surgery despite the risk if it's **necessary** to save your life. The vet did bloodwork and an echocardiogram on my dog to make sure his heart was strong enough before they scheduled elective surgery. It's not because they wanted to be mean to the dog and deny him surgery because they see him as "lesser". It's because that's how medicine works. If they didn't care about the dog's survival, they'd just go ahead and do the surgery without the precautions. FA's convincing each other that doctors are just out to get them and that medical opinions are not to be trusted is one of the most harmful aspects of their movement.
https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/bulletin/2023/october-2023-volume-108-issue-10/study-clarifies-link-between-obesity-and-surgical-complications/ These people can be spoonfed facts and still claim the world is out to get them. Surgeons make money doing surgery, why would they tell a patient to lose weight before a surgery if they didn’t need to
On a very special episode of “How Can I Be The Victim Today?”….
Exactly. Cue the Oppression Olympics. 🏆 It's not "as simple" as they make it seem, where all the surgeons have to do is scale the meds up for larger bodies, but they refuse to out of medical fatphobia... it's actually for safety and patient integrity. I am working with a client who previously had surgery and WOKE UP in the middle due to the miscalculation of anesthesia and her larger body size. This was (understandably) traumatizing to her, and she has since had bariatric surgery to help with weight loss efforts, however, she has lasting effects from that experience. 👀
Lmao
I heard that the fatter a patient is, the harder it is to anaesthetise them. I don't know if that's true, but it's what I heard. The adipose tissue sucks up the anaesthetic, and thus it makes anaesthetising them much much harder.
they are more likely to have cardio and pulmonary complications after surgery than someone who is not heavily overweight.
This among many other potential complications due to weight.
The prolonged stationary period dramatically increases the likelihood of deep vein thrombosis and if that turns into a pulmonary embolism then they aren’t making it out of there
It's also harder to stitch an obese patient together, and their healing is rubbish because the fat is in the way of blood. So. Sure, it's possible to operate but it'll be a post-op shit show.
I know someone who got top surgery as an obese person. They were out of commission for weeks. I got a breast reduction as an overweight (now a healthy weight) person and was able to go for a walk and see a movie the day after. Not to mention take considerably less pain meds. The two procedures are different, I'm sure, but I had been worried going into mine because this person wasn't able to do much of anything for so long afterwards. I think there's also a level of conditioning with bodies where if you've been an active person, your body wants to stay active.
Yeah if you're not up at once and at least moving a bit healing will also take longer. You definitely benefited from being smaller 💪🏻
I was relieved to be up and moving too. I was genuinely worried about getting stir crazy.
https://www.asahq.org/madeforthismoment/preparing-for-surgery/risks/obesity/ https://www.asahq.org/madeforthismoment/anesthesia-101/types-of-anesthesia/anesthesia-risks/ Dollars to their too many donuts the patient will have comorbidities.
I wouldn't use the word "harder" for anesthesia. It's more dangerous, requires closer monitoring and has more risks of failling and killing them yes. Not just a matter of pumping more drugs into them. It's not like anaesthetic is super expensive in the first place, one hour is like 20 bucks, maybe jumps up to 70 for very obese patients.
A lot of anesthetics are redistributed into adipose tissue. The compounds then leach out of the tissue over the course of hours. Meaning if you have a lot of fat, you might need a lot more anesthetic to sedate you for surgery because it’s hiding in your adipose, but it might be harder to wake you up or extubate you because by that point, hours after anesthesia induction, the anesthetics are leaving your adipose and entering your bloodstream. You needed more to properly sedate you to begin with, and now what was hidden in the fat is coming out. You can see how this might pose a huge issue for anesthesia staff. It’s super hard to dose anesthesia in morbidly obese patients. There is a reason why all post-surgical patients have to hang out in recovery for a while, regardless of weight. You don’t know how anesthesia is going to affect everyone. So much riskier when you have excess body mass.
Pain relief and anaesthesia are weight based. I am pretty tiny and even the smallest dose of pethidine made me unable to hold my head up or speak properly, whereas in someone who weighs 10kg more than me, it would be the perfect dose.
I’m a neurosurgery nurse and I can 10000% confirm that it is outright dangerous to operate on very fat people for a plethora of reasons, the most serious being increased risk of bleeding, infection, and death. They’re difficult to anesthetize correctly. Their incisions often don’t stay closed and it’s harder for them to properly care for the incisions post op. Doctors won’t do elective surgeries on fat patients because they don’t want the death of a patient on their hands, not because of FaTpHoBiA. And I don’t blame them.
I mean, there's a reason why Dr. Now tells his patients to lose weight before he will perform their bariatric surgeries. It's not because he hates fat people and wants to make this more challenging for them; it's literally that the likelihood of them dying during the operation is significantly higher. It's far more dangerous for them than it is for a healthy, normal sized individual to undergo surgery. It's also true that the heavier the patient is, the more complicated and difficult their recovery is as well. Wound complications post op is nothing to be taken lightly. They're also at a much higher risk of developing blood clots post op, too. There's a number of reasons to not perform surgery on an obese body. It's significantly more risky, but no. It's gotta be that they're seen as "lesser." HAES people, there's nothing less than about you.
It’s absolutely unhinged that someone would rather go down ‘you’re fat phobic, I insist you operate on me’ than ‘it’s nice you are taking precautions to ensure I don’t die on the operating table’
Right? Like doctors don't take an oath to do no harm and are supposed to throw caution to the wind and just perform a surgery that is statistically more likely to kill them or leave them with complications post op than someone much smaller. And their example of doctors only being willing to operate on them if they're dying is ridiculous. The doctors are put in a double bind in some situations. They have to make a judgment call about what will give their patient the greatest odds of surviving.
It’s so crazy. Why would you assume it’s because someone hates you rather than for more logical reasons? Doctors don’t refuse to operate on people because of gender, sexual or ethnicity because it doesn’t significantly impact chances of complications (I mean it can, but not to the point that weight does).
100%. Dr. Now operates on patients that other bariatric surgeons would reject outright. He takes on riskier cases and has built his practice around operating on heavier patients. So if Dr. Now is telling you to lose weight, you really do need to lose the weight, because you’re too big for even him to take the risk. (He’s also checking to see if you are a cooperative patient who can follow directions and change your habits, for better post-surgery outcomes.) I’ve always thought that should be a wake up call for patients, that you’re seeing a doctor of last-resort, because nobody else would see you. Of course, there are more doctors over the last decade who have trained on Dr. Now’s techniques and contributions to the field who can do these riskier surgeries, but it’s still a handful.
Exactly. You can get weight loss surgery and won't do anything to help yourself afterward if you don't have the willpower to change your lifestyle. That's another reason to lose the weight prior. They just refuse to acknowledge it and insist on being in the victim olympics.
So they admit that obese patients are "problematic" but they don't believe that it's the weight that is causing the problem. What is it then? The attitude? The victim complex? Also, do they really believe that emergency operations can be compared to regular scheduled ones? Obviously they chose to operate if the alternative is death but I bet the complication rate is a lot higher.
My doctor refused me top surgery at 600lbs but a few weeks later I got shot in the chest and he had zero qualms about opening me right up to remove the bullet and stop the internal bleeding. What a fatphobic asshole!!!
I thought at first when I read this that it had actually happened to you. That's quite an eventful life!
When my dad was diagnosed with colon cancer, he was advised to have his surgery at a particular hospital that had cardiopulmonary specialists on staff, because he was 81, although otherwise in good health (meaning he had no heart or lung problems and was very fit and active, swimming laps, gardening, and walking 1-2 miles a day). Dad was a veteran and his regular hospital was the Army hospital. He was adamant that they do the surgery there, as it was where he was most comfortable and he had already been told that they didn't expect the surgery to be especially complicated. So they did the surgery at the Army hospital. And Dad went into respiratory arrest in the ICU afterwards; it was almost 15 minutes before they got him breathing again and they were simply not equipped to handle the situation. He was ultimately airlifted to the very hospital they had advised him to have the surgery at in the first place, but there wasn't much they could do. He died after almost three weeks on a ventilator. It's entirely likely that if he had listened and just had the surgery at the specialty hospital to begin with, he wouldn't have died. It didn't matter that he was overall in good health and that the surgery wasn't overly complicated. He was still an 81-year-old man, meaning there were still risks that may not have existed for a younger person. Doctors didn't tell my dad he should have the surgery at the other hospital just because they were ageist. They had a good reason. He didn't listen, and it cost him his life.
Oh, that's sad 😔.
I'm so sorry
Oppression typically implies a total lack of care or concern for the life of an individual or group. Someone in authority (temporarily) denying you something because they're scared you'll die if you get it is as far from oppression as you can get. Oppression would be an establishment proclaiming 'roll up roll up, free, elective, cosmetic, major surgery for all infinifats!', run by a Dr Nick Riviera style character who found a way to indulge his serial killer fantasies in plain sight.
Literally no 🙄 obese patients are always told to lose weight before getting on the operating table because being fat increases the risk that someone doesn’t make it out alive. Doctors won’t risk their licence just because some delusional people think that being obese is healthy 🙄
I'm an operating room nurse. We do surgery on obese patients all the time. Usually urgent/emergent procedures are way more likely to be over BMI 35, but there are absolutely surgeons that are uhhhh financially motivated and will take heavier patients for elective joints, spine surgery, etc. They are at higher risk for complications, and from the OR side it just makes everything more difficult/strenuous if they're extremely fluffy, but we get it done. For general surgery there are considerations about literally being able to reach the site they're operating on, whether it's with laparoscopic or robotic instruments or the surgeon/assist's literal human arms. I questioned why we didn't have wider beds when I first started in the OR, and it's because the surgeon needs to be able to stand at the bedside and access the site they're working on - if the bed's too wide they'd need to be like bent in half to get access for some surgeries where they're deep in the abdomen. Impaired healing is absolutely also a factor, but that's also the case with uncontrolled diabetes, smoking, and many other lifestyle things that patients do. From the anesthesia side, obese patients are just harder to ventilate and will decompensate quickly. Again, it's more difficult but not impossible, and we do it every day for urgent procedures. We have an adjacent outpatient ambulatory surgery center attached to my hospital, and I know there's some kind of algorithm at work with higher BMIs and other factors with whether cases can be booked there. If the patient is very obese, they can't book a case at this outpatient building, because they need to be close to the ICU. It's not just obesity affecting this algorithm, it's also things like a history of obstructive sleep apnea, difficult intubation, malignant hyperthermia, etc. I guess what I'm saying is that I think the attitude from both the FA side and this subreddit around surgery on obese patients is overblown. Some procedures just need to get done regardless of the patient's weight - we can't wait for 6 months for the patient to lose weight before taking out their about-to-rupture appendix, for example. Obesity complicates things, but so does meth use, smoking, and dozens of other things that humans do. Very obese patients were more of an issue to me as a nurse when I worked on the floor, because in the OR there is always an extra set of hands available - even for emergent surgery that you get called in for in the middle of the night there's at the very least you, the scrub tech, the anesthesiologist, and the surgeon there to position the patient. I have had a surgeon help me hold up a supermorbidly obese patient's leg for me to prep for an I&D - there's no way I would have been able to hold it with one hand on my own while I prepped with the other hand. But yeah, she was septic, and this abscess needed to be washed out. Nobody was going to put off her surgery because she was a high BMI, but it just made things that much more difficult. I think the kinds of surgery that FAs are getting denied for on the basis of obesity are almost all elective joints - which again, if they shop around they will probably find a surgeon who will do it because they need to buy a second yacht and don't care about their numbers - or top surgery, which involves a HUGE incision that is difficult to heal even on a normal-weight person. We only have one plastics doc at my hospital, and he mostly does post-radiation breast reconstruction, but he does occasionally do top surgery. I have seen him cancel procedures because the patient was supposed to quit smoking six weeks before the surgery, and they admit the morning of that they haven't. Is he prejudiced against smokers? No, he just wants them to have the best chance possible to heal this huge incision without complications.
Yes, they can operate on a obese patients when it's life and death situation, when not operating would result in a death of the patient or/and result in a way worse outcome, even when looking at the negative side effects of the surgery. But no surgeon worth their salt will do an elective surgery where risks outweight the positives outcomes. Just like cardio surgeon won't perform even the simplest ablation if you have rotting teeth.
At this point I just assume their entire brain has saponified due to excess adipose tissue. As a paramedic exceptionally overweight individuals are many magnitudes more difficult to work on, and some of these people are so fat I don't even have an IV needle long enough to reach their veins through the fat layer.
lord, the logic. "i was dying so they didnt wait until i lost weight, see it's not a problem!"
What a bloody idiot
They can, it’s just statistically more likely they’ll die on the operating table or suffer post op complications and surgeons dont want that to happen. It’s the same as doing heart surgery on the average 90 year old. The risk of the anaesthesia and danger of the op on an already weak body usually outweighs the benefits.
Also if you need surgery on say, your joints, because your weight is crushing them, there’s very little point in fixing them if you don’t lose weight because the same thing will happen again. It’s like giving a 40 a day smoker a lung transplant. You’d prioritise helping the people who are actively trying to improve their health, not people who are just going to destroy all the benefits immediately. I’m based in the UK and the NHS has to choose who will most actually benefit and have long term health improvements from interventions. Probably different in the US.
No it's the same in the US. You have to prove you're not going to damage the organ you're getting before surgery or you're not going to get that organ.
As it should be. I remember seeing some articles during the pandemic of people who were anti COVID vaccination who were mad that they or their children who were on the list for organ transplant were being denied the transplant because they refused to get vaccinated. Sorry but someone else who is willing to protect themselves from the literal pandemic going around is getting the organ.
Statistically morbidly obese people have worse outcomes for surgeries. Are facts fat phobic as well?
Facts are the most fatphobic things of all!
"It's all because of weight stigma!"
Anesthesia is dangerous. My mom's cat just died from it. She got through the surgery OK, they called my mom and said she was fine, and then she crashed and was dead before my mom could come pick her up. Though as sad as that was, she was a 15 year old cat with cancer, so the other option was a slower and more painful death. But doctors don't want to watch people die on the operating room table for no reason. That's why they insist you be a healthy a possible, or literally dying.
We are missing a lot of information from OOP. What kind of surgery did she have? Was it invasive? How necessary was it? And of course, how big is she? (assuming it’s a woman.) I’ve watched enough of My 600lb Life to know that the fatter someone gets the more difficult it is to manipulate their fat so they can do things like shower, get dressed, etc. Fat is unwieldy. It does not stay in place if you move it, it lolls and rolls about. It’s also heavy. If you cannot shower yourself, and if, in fact, you cannot get clean even with a helper, how exactly do you expect a doctor to be able to do it? How do you propose to keep yourself clean while you heal? How do you think you’re going to move around when you’re in pain? Lying around in bed post-op clogs up your lungs and can lead to pneumonia. You gotta get up and walk. If you are not to that stage of obesity yet, your fat rolls are not better-behaved than the fat rolls of those bigger than you. Why take all the risks associated with surgery on an obese patient? Instead of having a hissy fit about being told straight facts, suck it up and cut the calories.
Why would they reject paying customers? Because they don’t want them to die or have other horrible outcomes obviously 🙄
I really want these people to watch that documentary about the autopsy on an obese woman. There's so much fat that you can barely tell what organs are what, and it's completely wrapped around everything. It takes them way longer just to cut through and get to the organs than it would on someone with less fat too. When you're on a time limit with anesthesia etc that stuff matters.
I watched that documentary. Halfway through, I felt a sudden need to go to the gym. I watched the rest when I got back.
I found one (not sure if it’s the same one.) but I had to stop at barely a minute in as I felt queasy. It was the fact they kept describing the fat as greasy butter. I find greasy foods make me feel sick anyway so the thought of it probably set my gag reflex off. I skipped those couple of minutes and now I’m like woah this is interesting - I read anatomy books for fun as a kid so this is like the updated version of it.
I find the idea hilarious that there’re supposedly doctors out there giving patients medical advice based on them just not liking the way the patient looks lmao. Like: „There‘re no health benefits to this, but your big nose has been bothering me so I‘m gonna prescribe you a nose job, just for funsies“
For healthy people they do seem to spend a lot of time at the doctors office.
I mean yes they can operate on obese patients, in fact they’ve gotten pretty good at keeping them alive with stuff like positive airway pressure, intubation, and humidification of the air going into your lungs, however even with all that it is still a risk to operate on someone larger and it is the doctors prerogative if they agree to operate on you or not.
We do a lot of stuff to people who are imminently dying that we don't do to people who expect to live a couple decades. No time to fumble for a vein, we drill through your shinbone. Got a pulse back but we still need massive amounts of epinephrine to keep it? Add a femoral central line, no sterile prepping, just add an antibiotic to the mix. Oh you don't want this done to you under less emergent circumstances? No shit, neither do we
I've had several surgeries while obese (hip replacement at BMI 35 and some kidney related stuff at BMI of almost 40). I've never had any problems and have always recovered well. BUT when my kidney transplant doctor told me I needed to get down to a certain BMI (34, not a big ask), I just fucking did it. I didn't whine about it or look for another transplant center with looser requirements. I ate less and exercised more and got on the list. These people infuriate me.
Same here. I needed a bladder extension and a urinary stoma put in, and my surgeon (who I still see for regular treatments) said it would go better if I lost weight. 1 year and about 50 pounds lighter, I got the surgery. I didn't whine or bitch, I went on a diet. Even then I got an infection (partly because the stoma was leaking onto the incision site but also bc I couldn't keep under my belly clean well on my own). I can't really imagine how it would have gone at my biggest. Or how the surgeon on 600lb life does it. I'll eventually need a transplant, and that's why I'm hustling my ass to lose weight. I can only get a kidney from family and friends (my condition would eventually wreck the new kidney, so no donor list for me) and I refuse to fuck their sacrifice up. The people who cry fatphobia at doctors trying to do what's best for them pisses me off. Doubly so for elective operations.
Good luck to you!
“If a risk is worth taking when you’re literally going to die, it’s worth taking for the lulz!”
The biggest danger for most routine surgeries is not from the surgery itself, but from the anesthesia. The bigger you are, the more that weight obstructs your breathing and makes it harder keep your blood oxygenated. Being obese during surgery increases the risks of death or serious complications related to your inability to breath. It was explained to me very clearly when I had wls, and this strikes me as just refusing to understand. Yeah, they can perform the surgery. But many don't want to take the extra risks. If you are already dying and surgery is your best bet for survival, then it makes sense. If you are extremely overweight but in no danger, they may be hesitant to risk your life. And many obese people have fatty liver disease, causing additional risks and complications.
I work at a vet clinic, and we had a chunky dog show up for a routine spay. I remember yelling for me to get a bunch of emergency equipment. I didn't know what happened until after, but what i was told was when suturing to the abdominal wall, the suture didn't attach to any muscle, just fat. This caused the suture to fail, and the pup started hemorrhaging. I don't know the specifics of how it happened (I'm only an assistant), but it was really scary. Doggo is fine, but it's not about an 'easy way out' it's about safety. If it's an emergency, of course, medical professionals won't wait. just like if a person has heart problems and in an emergency, they aren't going to be slow about trying to save them and get them into a hypothetical surgery to save their life.
Do they not realize digging through all that extra adipose tissue makes the surgery so much harder on the surgeon? That should be so simple to understand.....
>in and out onto a patient that actually *matters* umm i'm sorry what?!?! weight loss takes time, so if anything asking an overweight/obese person to lose weight is NOT a quick solution, and shows that the medical personnel care MORE about this person's health than the average, healthy weight person. they don't want to risk complications that would arise due to being obese. the mental gymnastics here! quick tangent, i am fat asf and i hate it. what am i doing about it? diet, exercise, and on pre diabetes treatment to reverse my symptoms. i stopped giving in to my cravings for chinese, pizza, burgers etc. all the time and i cook at home! i am getting up and moving when i can (fuck you depression). what am i not doing? crying on the internet about how i am oppressed for being fat. i had a huge role (no pun intended) in getting to this size, and i am the only one that can pull myself out. my motivations -besides avoiding an early death and dying fat, miserable, and alone- are to feel better in my own skin and be healthier, happier. that and i am scared that i wouldn't be able to outrun a threat or escape a car crash or something.
Yes I can drive my car without a seat belt, so seatbelts only exist to make it so authority figures can make us seem lesser.
Imagine, healthcare professionals not wanting to perform risky surgery, but willing to perform it only when the patient is at risk of or is actively dying. It’s almost like, in an acute situation the risk of your imminent death and at least attempting to urgently save your life takes precedence over the risk of obesity-related anesthesia and intubation complications.
Oh they’d love to live in the UK where they literally ration joint replacement surgery and if you’re obese you don’t get one. Oh and losing weight reduces pain felt from arthritis!!
My dad’s a nurse anesthetist and I love bugging him with medical questions and there are so many reasons to not do surgery on obese patients. Obesity is a huge risk factor for sleep apnea, which obviously surgeons are concerned about while you’re sedated and paralyzed. Can be harder to find veins if they need to deliver meds during an emergency. Medication dosage changes with weight. It takes longer to wake up and recover from anesthesia the heavier you are. (All this info is also available on the American Society of Anesthesiologists) Plus there’s just a number of obesity caused diseases that can affect the safety of surgery. Number one being diabetes. Diabetic patients have a harder time healing and are more prone to infection. Refusing non emergent surgery to a morbidly obese person isn’t fat phobic, it’s simply trying to save them from the numerous elevated risks. Surgery always comes with risks, but they’re far greater when you’re obese.
Because that would require accountability
This is so stupid. It is inherently more dangerous and difficult to navigate around fat tissue to achieve the same results. Medical tools have limits, surgeons have limits, no one wants someone to die because they could drop 15lbs for a medically invasive procedure.
Wait a minute… is their fun fact that they needed emergency surgery cause they were dying?
Toddler logic
"I had surgery done on me once, therefore I know more about surgery than people who do it for the living"
It's the same reason male birth control is taking so long. The risks associated with BC are less than pregnancy so BC for women is considered an ok risk. Giving the healthy (male) body possible poor side effects does not when there isn't a health issue is not considered acceptable. Same with fat people. Some people WILL die if they don't get surgery, which MAY kill them. If the issue isn't bad enough (or is a cosmetic reason) the Drs won't do something that MAY causes harm.
You must be in pretty bad shape if a surgeon decides your morbid obesity is less of a risk than not doing the surgery at all.
Idk how they don’t understand the difference between “it’s a greater threat to your life for you to not get the surgery” and “it’s a greater threat to your life for you to get the surgery.” Like yeah man, if you’re not going to die from your condition but surgery to correct it has a high risk of killing you, they’re going for the option that doesn’t risk killing you.