What a timely post! I just had a major and very complicated surgery. Because of the complexity I needed to surgeons working as a team. One of the team at pre-op asked mentioned my weight and asked me “what are you doing about it?” He told me the surgery would be more difficult and the outcome had a greater risk of complications due to my weight. Okay, so that was bad enough! Then in his post-op report, this surgeon made a point of focusing on my extremely higher BMI and that it significantly increased (3x longer) surgical time. The other surgeon on the team has never mentioned my weight, especially the surgery has nothing to do with my weight, and highlighted specifically that the length of the surgery was due to the significant complexity of the surgery. I am concerned that my insurance will deny adequate reimbursement for the surgery based on my weight!
Oof, that's terrible! As if thin people don't also need extremely complex surgeries with teams of surgeons sometimes! You should be focusing on recovery, and not navigating their unchecked bias. I wish you a speedy recovery.
In the spring of 2024, I consulted an orthopedic surgeon who was highly recommended by my (thin/white/male) neighbor. I bypassed our local docs, including at the state medical school, and went to the doctor, who was at a much-lauded private university-affiliated hospital in Atlanta. I’d had a partial knee replacement 10 years prior; now I needed a total in that knee. Dr. Charming said I needed to lose 25-30 lbs before he would do the surgery because of “increased rate of infection.” Turns out he was in charge of infection control at the hospital. He also said that “you gals never have trouble losing the weight, and it should take only 2-3 months). I’m 66, btw, and typically quite active, though I’d had to curtail those activities because of…you guessed it…knee pain. I went back home, called a local ortho with no such qualms, and had a wonderful experience. I was done with PT before I’d have EVER been able to lose that weight, if I could at all. In retrospect, I should have asked him for studies backing up his claim of increased infection rate, but I just wanted to get the hell out of there.
Was this Resurgens by any chance? They’ve done more joint surgeries for my in-laws than I can count. Don’t get me started on their building with the brass and marble lobby.
Begging everyone's pardon, because the language is about to get spicy.
I would be tempted to ask Dr. Ass Clown what in the French fried phucque he means by "you gals."
"Begging your pardon, my good bizznitch," I can picture myself saying with an upper-crust accent. "But am I to understand that I have just been You-Peopled?"
Heaven help any woman who made the unfortunate choice to attach herself to this arrogant misogynist.
This "gal" has extreme difficulty losing weight, as in, unless I'm deathly ill or there is some other radical change in my health, I don't lose it. This is partly due to my genetic makeup. Many of the women on my mother's maternal side of the family were fat. My mother, who was tiny and birdlike, was the exception. It is partly due to my many endocrine imbalances. Again, I can thank my mother's maternal lineage. My mother had PCOS, but it never caused her to become heavy, and she had two children despite being told she couldn't have children. She had slightly decreased thyroid function. My thyroid decided to off itself when I was in my early teens.
Above and beyond all the endocrine business, though, I attempted to hate myself thin through multiple failed dieting attempts and orthorexia. Put it all together, and it means that I could eat nothing but carrots for six months in an attempt to lose weight. While I might lose around five pounds due to fluid depletion, I would succeed in nothing but turning my skin orange.
I had an orthopedic surgeon tell me I needed to lose 50 pounds before he would perform surgery to correct my L4-L5 issues because of the "increased risk of infection" nonsense. My dude, if the surgery is done correctly and proper infection protocols are followed, I am not at significantly higher risk for infection than any other patient with well-controlled type 2 diabetes. I probably don't require a disc fusion anyway. There are other, less invasive procedures to correct the kind of problem I have.
It often blows my mind just how grossly ignorant and overtly bigoted highly educated medical professionals are. However, it never surprises me. Bias against larger patients was not only present in the curriculum at the nursing school I graduated from, but it was also encouraged. a
This has been my lived experience. I had a left total knee replacement in 2016 but gained weight after changing psych meds. I asked for the second in July of 2019 and was denied because of my BMI. Instead they referred me to dietitian who triggered my eating disorder and recommended weight loss surgery. My kneecap was permanently displaced, leaving my right leg shorter than my left This created additional stress on my already arthritic hips. Instead of the care I needed, in 2021 I was referred to a pain clinic for joint injections. Those were expensive since my insurance but the helped keep the pain more manageable. At this time I was also swimming five days a week. At this point i was using forearm crutches and needed a lift to get out of the pool. My weight dropped slightly. I also started working with a HAES dietician to address my disordered eating. Not going into specifics because I don’t wasn’t to trigger anyone.
As my hips became more unstable. In late 2023 I lost the ability to walk from the parking lot to the pool. In desperation, i started paying out of pocket for tirzepatide in 2024; the fifth surgeon I spoke with agreed to help me but only helped me but only if I continued the drug for an additional month until surgery. Apparently I was right on the line for his BMI cutoff and he wanted me to maintain my current weight. I’ve had three total joint replacements in eight months. Except for the first few days, my postoperative pain was far less than what I’d been living with all along. I also had influenza A between the first and and second surgeries. At a later physical my PCP questioned my stopping, even when I told her how much it cost. I’m slowing getting my stamina and mobility back. I’ll be working through this trauma for years.
TLDR: right knee pain, ED relapse, joint subluxation, $$$$$ pain clinic, reduced mobility, $$$ gulp-1 agonist, multiple joint replacements, concern trolling about my sizer
I read the operative notes and the mention of my size went something like this “Patient is (*bese,with a BMI of xx. Therefore I used longer instruments and allowed additional OR time.” It was revelation.
What a timely post! I just had a major and very complicated surgery. Because of the complexity I needed to surgeons working as a team. One of the team at pre-op asked mentioned my weight and asked me “what are you doing about it?” He told me the surgery would be more difficult and the outcome had a greater risk of complications due to my weight. Okay, so that was bad enough! Then in his post-op report, this surgeon made a point of focusing on my extremely higher BMI and that it significantly increased (3x longer) surgical time. The other surgeon on the team has never mentioned my weight, especially the surgery has nothing to do with my weight, and highlighted specifically that the length of the surgery was due to the significant complexity of the surgery. I am concerned that my insurance will deny adequate reimbursement for the surgery based on my weight!
Oof, that's terrible! As if thin people don't also need extremely complex surgeries with teams of surgeons sometimes! You should be focusing on recovery, and not navigating their unchecked bias. I wish you a speedy recovery.
In the spring of 2024, I consulted an orthopedic surgeon who was highly recommended by my (thin/white/male) neighbor. I bypassed our local docs, including at the state medical school, and went to the doctor, who was at a much-lauded private university-affiliated hospital in Atlanta. I’d had a partial knee replacement 10 years prior; now I needed a total in that knee. Dr. Charming said I needed to lose 25-30 lbs before he would do the surgery because of “increased rate of infection.” Turns out he was in charge of infection control at the hospital. He also said that “you gals never have trouble losing the weight, and it should take only 2-3 months). I’m 66, btw, and typically quite active, though I’d had to curtail those activities because of…you guessed it…knee pain. I went back home, called a local ortho with no such qualms, and had a wonderful experience. I was done with PT before I’d have EVER been able to lose that weight, if I could at all. In retrospect, I should have asked him for studies backing up his claim of increased infection rate, but I just wanted to get the hell out of there.
Was this Resurgens by any chance? They’ve done more joint surgeries for my in-laws than I can count. Don’t get me started on their building with the brass and marble lobby.
Begging everyone's pardon, because the language is about to get spicy.
I would be tempted to ask Dr. Ass Clown what in the French fried phucque he means by "you gals."
"Begging your pardon, my good bizznitch," I can picture myself saying with an upper-crust accent. "But am I to understand that I have just been You-Peopled?"
Heaven help any woman who made the unfortunate choice to attach herself to this arrogant misogynist.
This "gal" has extreme difficulty losing weight, as in, unless I'm deathly ill or there is some other radical change in my health, I don't lose it. This is partly due to my genetic makeup. Many of the women on my mother's maternal side of the family were fat. My mother, who was tiny and birdlike, was the exception. It is partly due to my many endocrine imbalances. Again, I can thank my mother's maternal lineage. My mother had PCOS, but it never caused her to become heavy, and she had two children despite being told she couldn't have children. She had slightly decreased thyroid function. My thyroid decided to off itself when I was in my early teens.
Above and beyond all the endocrine business, though, I attempted to hate myself thin through multiple failed dieting attempts and orthorexia. Put it all together, and it means that I could eat nothing but carrots for six months in an attempt to lose weight. While I might lose around five pounds due to fluid depletion, I would succeed in nothing but turning my skin orange.
I had an orthopedic surgeon tell me I needed to lose 50 pounds before he would perform surgery to correct my L4-L5 issues because of the "increased risk of infection" nonsense. My dude, if the surgery is done correctly and proper infection protocols are followed, I am not at significantly higher risk for infection than any other patient with well-controlled type 2 diabetes. I probably don't require a disc fusion anyway. There are other, less invasive procedures to correct the kind of problem I have.
It often blows my mind just how grossly ignorant and overtly bigoted highly educated medical professionals are. However, it never surprises me. Bias against larger patients was not only present in the curriculum at the nursing school I graduated from, but it was also encouraged. a
This has been my lived experience. I had a left total knee replacement in 2016 but gained weight after changing psych meds. I asked for the second in July of 2019 and was denied because of my BMI. Instead they referred me to dietitian who triggered my eating disorder and recommended weight loss surgery. My kneecap was permanently displaced, leaving my right leg shorter than my left This created additional stress on my already arthritic hips. Instead of the care I needed, in 2021 I was referred to a pain clinic for joint injections. Those were expensive since my insurance but the helped keep the pain more manageable. At this time I was also swimming five days a week. At this point i was using forearm crutches and needed a lift to get out of the pool. My weight dropped slightly. I also started working with a HAES dietician to address my disordered eating. Not going into specifics because I don’t wasn’t to trigger anyone.
As my hips became more unstable. In late 2023 I lost the ability to walk from the parking lot to the pool. In desperation, i started paying out of pocket for tirzepatide in 2024; the fifth surgeon I spoke with agreed to help me but only helped me but only if I continued the drug for an additional month until surgery. Apparently I was right on the line for his BMI cutoff and he wanted me to maintain my current weight. I’ve had three total joint replacements in eight months. Except for the first few days, my postoperative pain was far less than what I’d been living with all along. I also had influenza A between the first and and second surgeries. At a later physical my PCP questioned my stopping, even when I told her how much it cost. I’m slowing getting my stamina and mobility back. I’ll be working through this trauma for years.
TLDR: right knee pain, ED relapse, joint subluxation, $$$$$ pain clinic, reduced mobility, $$$ gulp-1 agonist, multiple joint replacements, concern trolling about my sizer
I read the operative notes and the mention of my size went something like this “Patient is (*bese,with a BMI of xx. Therefore I used longer instruments and allowed additional OR time.” It was revelation.
Excellent series of articles Ragen!