Excited for this series! The weight loss ransom is so unethical.
I know I've told this story before but I'll tell it again anyway: I have a grade 3 spondylolisthesis along with mild spina bifida but other congenital deformities in my spine. The spondy could be corrected with hardware, but I was only prescribed weight loss for many years, and now I'm in my 40s and I've adapted. (I use a wheelchair part-time. I walk as much as my body lets me. I try to maintain my strength, as well as my bladder and bowel function.)
Somehow, I got connected with someone who specializes in congenital deformities like mine. He was shocked to meet someone in their 40s who hadn't had surgery, and I could almost seem the realization on his face when I told him that I'd spent 20 years being told to lose weight. He said he could fuse it, but the surgery goes through the abdomen, and he'd need a thoracic surgeon's help for that. All the thoracic surgeons in the county (a big place-- Maricopa county, AZ) have strict BMI limits and wouldn't even consider helping me until I lost weight. He also said that I'd likely need revision surgeries every 1.5-2 years for the rest of my life.
I pointed out that I'd need to lose over half my body weight to be anywhere close to an acceptable BMI for these thoracic surgeons, and it would take years to do this. Even if I was successful, nearly everyone regains what they lost, so what happens when I need a revision surgery but my body does what nearly all bodies do? He said I wouldn't be able to get revision surgeries until I lost that weight again.
I declined. The excruciating pain of failed hardware on my spine sounds way worse than using a wheelchair for the rest of my life. But wow, my heart breaks for everyone in situations like mine who got the surgery and now can't get revisions. Talk about cruelty.
The excruciating pain of failed hardware is an apt way to phrase things. My brother is a former firefighter/paramedic who has had multiple spine surgeries after a catastrophic fall from a ladder truck broke five discs in his thoracic and lumbar spine. He says it now feels like his left foot is constantly being plunged into a bucket of hot water. He has to take high doses of muscle relaxers plus Valium to obtain any relief.
So, the wisest course of action might be to avoid the surgery in the first place, but they should give you the same options they'd give a slimmer patient. They're telling larger patients that they must inflict weight cycling on themselves to be worthy of surgeries that could increase their mobility. It's beyond disgusting.
oh gosh, my heart hurts for your brother. That's awful.
My paralysis/nerve damage makes my legs feel ice cold all the time. I hate it, but I'd rather be cold than hot, so I try to be grateful for that. But it's still some bullshit.
Weight loss is not a substitute for healthcare. Great phrase. Really puts some things into perspective! It can also come across as "my job would be a lot easier if you just lost weight." Or suggests I wouldn't even need the doctor if I lost weight, except maybe for whatever weight loss intervention they are promoting.
I had my PCP try to decrease my fibromyalgia med dosage as well as my antidepressants while I was in the middle of a major depressive episode - that was already being managed by my psychiatrist and therapist - because they can cause weight gain.
Honestly, I'm still using the same PCP because I have very little confidence that I can find one that treats higher-weight people like actual people. At least with her it's so blatant I'm more amused than hurt. My BMI has decreased since my last physical so I'm curious if she'll attempt to treat my actual health issues instead of obsessing over my weight this time.
As someone who lost 110 pounds in order to reach a BMI that would “qualify” me for total knee replacement, this article hits home—in an uncomfortable way. I especially like your emphasis on treating the patient “that exists.” Thank you!
Excited for this series! The weight loss ransom is so unethical.
I know I've told this story before but I'll tell it again anyway: I have a grade 3 spondylolisthesis along with mild spina bifida but other congenital deformities in my spine. The spondy could be corrected with hardware, but I was only prescribed weight loss for many years, and now I'm in my 40s and I've adapted. (I use a wheelchair part-time. I walk as much as my body lets me. I try to maintain my strength, as well as my bladder and bowel function.)
Somehow, I got connected with someone who specializes in congenital deformities like mine. He was shocked to meet someone in their 40s who hadn't had surgery, and I could almost seem the realization on his face when I told him that I'd spent 20 years being told to lose weight. He said he could fuse it, but the surgery goes through the abdomen, and he'd need a thoracic surgeon's help for that. All the thoracic surgeons in the county (a big place-- Maricopa county, AZ) have strict BMI limits and wouldn't even consider helping me until I lost weight. He also said that I'd likely need revision surgeries every 1.5-2 years for the rest of my life.
I pointed out that I'd need to lose over half my body weight to be anywhere close to an acceptable BMI for these thoracic surgeons, and it would take years to do this. Even if I was successful, nearly everyone regains what they lost, so what happens when I need a revision surgery but my body does what nearly all bodies do? He said I wouldn't be able to get revision surgeries until I lost that weight again.
I declined. The excruciating pain of failed hardware on my spine sounds way worse than using a wheelchair for the rest of my life. But wow, my heart breaks for everyone in situations like mine who got the surgery and now can't get revisions. Talk about cruelty.
I'm so sorry this happened to you. How horrific.
The excruciating pain of failed hardware is an apt way to phrase things. My brother is a former firefighter/paramedic who has had multiple spine surgeries after a catastrophic fall from a ladder truck broke five discs in his thoracic and lumbar spine. He says it now feels like his left foot is constantly being plunged into a bucket of hot water. He has to take high doses of muscle relaxers plus Valium to obtain any relief.
So, the wisest course of action might be to avoid the surgery in the first place, but they should give you the same options they'd give a slimmer patient. They're telling larger patients that they must inflict weight cycling on themselves to be worthy of surgeries that could increase their mobility. It's beyond disgusting.
oh gosh, my heart hurts for your brother. That's awful.
My paralysis/nerve damage makes my legs feel ice cold all the time. I hate it, but I'd rather be cold than hot, so I try to be grateful for that. But it's still some bullshit.
Weight loss is not a substitute for healthcare. Great phrase. Really puts some things into perspective! It can also come across as "my job would be a lot easier if you just lost weight." Or suggests I wouldn't even need the doctor if I lost weight, except maybe for whatever weight loss intervention they are promoting.
I had my PCP try to decrease my fibromyalgia med dosage as well as my antidepressants while I was in the middle of a major depressive episode - that was already being managed by my psychiatrist and therapist - because they can cause weight gain.
Honestly, I'm still using the same PCP because I have very little confidence that I can find one that treats higher-weight people like actual people. At least with her it's so blatant I'm more amused than hurt. My BMI has decreased since my last physical so I'm curious if she'll attempt to treat my actual health issues instead of obsessing over my weight this time.
As someone who lost 110 pounds in order to reach a BMI that would “qualify” me for total knee replacement, this article hits home—in an uncomfortable way. I especially like your emphasis on treating the patient “that exists.” Thank you!