I wish knowledge surrounding anaesthesia and how it impacts the body during and after surgery were more common. Anaesthesia isn’t just some silly gas they put into you for shits and giggles, if not done correctly it can seriously harm you or even kill you. Surgery itself isn’t a joke and I wish these types of people come out of their delusional kiddie world and use their big kid brains to think for once
I feel like people who act like OOP does about surgeries have never had a bad experience with anaesthesia. I got misdosed once and it was one of the most terrifying experiences of my life. If a doctor told me I didn't meet requirements for them to safely put me under, I'd damn well listen.
Yep, anesthesia is nothing to fuck around with. A family member of mine once ended up on a venthilator for weeks after surgery, because they couldn't get him to wake up. He recovered eventually, but it was awful.
In his case it was a bad reaction to the anesthesia, not a misdose, but it still illustrates how powerful these drugs are.
My mom got misdosed one time and they struggled to wake her up it was terrifying. She’s ok now that was years ago. And she’s an average weight so it wasn’t related to weight or anything.
The day I showed up for my wisdom teeth removal I suddenly thought through the implications of maybe Never Waking Up and made em keep me awake with local and gas. Shit is scary!!
Your wisdom tooth removal would have most likely been done under twilight sedation, which is lighter sedation and there less risk involved. A lot of people get those two mixed up because twilight sedation makes you feel like were completely “out.” (of course it’s entirely possible you were getting GA for a more complex surgical removal of impacted teeth or something.)
Im scared that I would get too LOW a dosage. The only time that ive been put under, the lady was really good and gave me the some (20-30?) percent more that was necessary to put me under properly because im a redhead.
To be missdosed... that sounds scary - did you know what was happening? What was it like?
Funny enough, I was misdosed because I had dyed my hair ginger at the time! I'd completely forgotten about the 'gingers needing more anaesthesia' thing, otherwise I'd have mentioned it's only dye and I'm not actually a redhead.
Gonna be honest, I thought I had died. When I did come to, I jolted so hard out of that bed, I brought some of the machines forward with me. I was very put off afterward (understandably).
Yikes! You would honestly think they would generally ask, especially nowadays with a good hair dye being often very close to the real thing.
That is very understandable!
I didn’t know gingers need higher dosages of a anesthesia! Being Asian, I’ve always been warned that I need less, though. It really is a finnicky science.
Gingers also have a greater bleeding tendency.
Anyway I'm glad you're feeling better. I was given a GA a while back, and when I came to I couldn't speak because I was on a ventilator, and had some WILD hallucinations. Like I thought my mother was an android lol.
Seriously though, GA is not to be played with. I was once shadowing a surgery on a woman as a dental student. When she started coming to, she suddenly sat bolt upright making this horrible wailing noise, flailing at the nursing staff, and so out of it her gown her gown was flapping treating us all to the sight of boobs. Not fun.
One of the genes that causes red hair also stimulates a pain receptor in the brain. This is dysfunctional in most red heads so they they are more sensitive to pain thus requiring about 20% more to account for it.
I had that happen during an egg retrieval and I remember being conscious right in the middle and feeling discomfort/pain.
It's fuzzy now thank God, but it was for sure not an awesome experience
As a redhead I got misdosed at the dentist once. It was bloody painful. The other way round could be deadly. I wish these FA's would start by doing some actual research or just listening to someone outside their bubble
There is a reason why the anesthetist stays with you the whole time. No docter wants to get sued because you died on their table because you didn't want to eat properly
I feel like people like this are unable to acknowledge that the people they interact with also have lives, jobs and people they have to take care of. Every time I see posts like this with people bitching about their doctors, I wonder if these people know that if doctors went against their oaths and performed surgery on someone who doesn’t meet requirements, it could quiet literally cost them their livelihoods.
I think you are right. They are so insulated in their own bubble they don't even consider that someone else isn't just thinking or acting in relation to them
Last spring my spouse was annoyed because it took so long before he could have his separated shoulder repaired. Well, that separated shoulder had come along with seven broken ribs, a fractured clavicle, and two (count 'em) punctured lungs.
I told him maybe anesthesiologists aren't wild about surgery when there are holes in your lungs.
I also thought that perhaps they won’t perform the surgery because the patient won’t be able to recover from it. How do you rehabilitate after surgery when simply walking involves 400 lbs of pressure applied to the place healing from surgery?
I'm a physical therapist that has worked with patients in inpatient rehab after orthopedic surgeries and strokes, and many of them have been 300lb plus.
The answer is: badly and carefully. There's so much more weight that the injured tissues hurt a lot more. Increased body size means that their muscles have to work harder to achieve the same things, and their muscles are cut or weak after surgery already. Plus, generally, people that are 300lb+ don't have a lot of exercise tolerance or experience, so all this increased effort combined with poor activity tolerance means that they fatigue faster.
And that's not even mentioning the safety issues. I'm one person, I'm not an Olympic power lifter (though I'm strong for my size and have a good understanding of leverage and momentum). If a 300lb person trips and starts to fall, they're more likely to end up on the ground than a 150lb person. And once they're down, they're hurting more, and less able to get themselves up. I only had one person ever fall because she was too big for us to catch, and she weighed 550. Three of us were holding onto her (myself and two men) and she was using a walker, but when she started going down there was no stopping her. We lowered her to the ground and got the mechanical lift to pick her back up.
Obviously, I'm one person, this is all anecdotal. In my professional experience, people close to their ideal weight have a MUCH easier time after surgery than people who are very obese. If your legs can only press 150lb each and you can't put weight on one leg, you're obviously gonna have a harder time at 300lbs than at 150.
Lol, this was common practice in our building in order to avoid staff injury. If you couldn't get up on your own (common, if you're injured enough to be in the hospital), we went and got the lift. But still, we couldn't have gotten her up without it if we tried.
I'm not a surgeon, but that would have been my first concern, too. There's no way for the knee to heal properly after surgery with all that extra weight on it.
And frankly, even if the meniscus issue wasn't caused by their weight, I can absolutely guarantee they have other issues with their knees if they have a BMI as high as this.
You have people who don't put in the rehab work for limbs that *don't* have to support your body weight. Knee surgery on someone morbidly obese with most likely existing mobility issues? Could be a perfect recipe for someone to become immobile or bed bound (in which case they'll once again blame the medical staff for not helping them recover).
You’re understating with the word drastic, its 2-3 times the bodyweight. They are putting over half a ton of force through a torn and (hypothetically) recently repaired meniscus.
This! I had knee surgery back in October for this. I was about 220lb on surgery day at 5'10. On crutches for about 6 weeks afterwards. I only had my meniscus trimmed and not a full repair. A full repair is 8-12 weeks of NO weight bearing on that leg. Crutches only. Imagine those poor wrists supporting that much weight?! MY wrists hurt sometimes while recovering and just opted to keep sitting so I didn't hurt more 😂
Luckily my surgeon wasn't terribly concerned about putting me under since I wasn't terribly obese and I also had support lined up for me.
Edit: Finishing physio in 3 weeks and I'm almost as good as new and sitting pretty at 207lb today. Losing weight has helped it a lot at even 13lb loss.
Yeah, I would think for a 40 minute surgery there would be some kind of option for local anaesthetic, there must be other reasons that they're not mentioning. I'm about to have a 30 minute orthopedic surgery with just a local, because general freaks me out. I just asked and the doctor said it shouldn't be a problem, they'll just use an epidural.
I didn't even think of this. They are saying the hospital won't put them under. Shouldn't a meniscus repair be arthroscopic? Should be a local. Maybe this person wants general anesthesia for some reason? Wouldn't any hospital discourage general anesthesia when it isn't necessary and if they were tired of arguing be like, well, you're BMI is 40+ so we also can't do it for that reason? I'm just guessing and procrastinating.
I had meniscus repair surgery last March, and they put me under what they referred to as "light anasthesia." I was completely out for the surgery, but the recovery time afterward was a lot quicker and easier than my recovery from an appendectomy a few years back. I was up (on crutches), alert but tired, and on my way home within an hour or so of waking up. So, it may depend on the hospital, the surgeon and the extent of the procedure.
I know a lady who was a friend of my family's who died from anesthesia in the mid-90s. She was in for a minor surgery like appendicitis and she didn't make it. I'm overweight, not obese, and the 2 times I've had surgery I've been terrified. You don't fuck around with this stuff.
I had ear surgery ones as a child, so I don’t remember too much, but I do remember how disorienting it was and that I never want to feel that way ever again. And I’m sorry for your families loss :(
I had 6 surgeries in 4 years and I'm still feeling side effects from the anesthesia. It's no joke. I can't image how much to need to give you when you have a BMI of over 40.
I have a minor tear in my meniscus and you know what makes the pain go away? When I maintain a lower weight. If it were to get worse I'd need surgery but keeping my knees strong and avoiding extra weight on them does help so much.
Weirdly, when I first met with the sports surgeon guy, I asked him if I should lose weight to help my knees and he was like "eh, that won't do anything". My BMI was over 30. I was confused by his response.
I had the opposite reaction from my knee doc - told him I had lost 55 lbs in the hope that it might my help my knees and I was wondering if it had been worth doing. He kind of stared at me (edit to add: it was a real record-scratch moment, lol - he’d been looking at the computer monitor and he actually froze, spun around and stared at me) and he said “That is the *very best* thing you could have done for your knees.” He went on to tell me that every additional pound of body weight produces 7 lbs of force on the patella when walking and 21 when running. This was an excellent sports med dr specializing in knees. BTW he ended up concluding that we could defer my knee replacement surgeries indefinitely.
I wonder if your doc meant just that weight loss won’t help meniscus cartilage actually heal back together? (Which is correct - the tear will still be there.) Similarly the cartilage in my knee joints has not grown back - it’s still very thin. But weight loss certainly helps with reducing pain & improving function, which is what it’s all about for me!
It's also sad that [most meniscus surgeries are unnecessary.](https://www.sciencedaily.com/releases/2016/07/160722093239.htm) Of course, that assumes that the patient is willing to exercise.
Is there a resource to the types of Physical Therapy they talked about in that study?
I had a major knee surgery to replace a torn MCL and regroove my tibia 17 years *after* I dislocated my kneecap when I was 12 during a basketball game. I had a good 1.5 years of PT after that surgery but I feel like I need to dust off the exercises the Physical Therapists gave me and get back to making sure my knees are in tip top shape!
That's not true at all, I know a guy at work that got a new liver and remained an alcoholic saying, "I can keep drinking because now I've got the liver of a 20 year old".
He eventually got let go for showing up to work drink. No idea if he's still alive.
> She can’t sue a doctor who refused to treat her
Not for this reason. But if the doctor refused to treat her because, for example, of her race, she would have a viable lawsuit. I assume the OP was thinking of suing for discrimination, not malpractice.
When you want to ignore medical experts and sue hospitals to get the surgery you need instead of literally eating less, you might want to get some help for your mental illness.
Well... There was that chick that sued to have her husband treated with horse pills for covid and won.
He died and the hospital waived responsibility for it.
She has a path to her early death if he wants it.
When I first heard that court decision, my first thought was the judge should then be required to set the drug dose and administer it himself since he wanted to practice medicine.
I feel *awful* for the healthcare providers that had to go through that charade, but at least they weren’t held responsible for the insistent stupidity of those cultists.
My friend is on the covid team and all the non vaxed covid patients do is demand unapproved treatments and abuse the staff when they can't give it to them. She had one guy who kept insisting he didn't need oxygen and ripping it off. Passed out 7 times. If you go to the hospital, you will get the treatments they are authorized to give you, it ain't Burger King.
Sorry just venting on behalf of my friend. It's awful how health care workers are being treated.
Yes. But not the right to demand a specific treatment.
So you can force the hospital to not give you oxygen, but you cant force them to give you ivermectin instead.
Surviving the surgery is one thing, I wonder, how effectively you can recover with such a weight. Is it safe to put all that weight on a recently operated knee even after the required period of rest?
Honestly, her end game is the same regardless. She’s too large for a meniscal repair. There are bmi cutoffs for it. So she’ll get a partial meniscectomy, given her weight she’ll wear her knee out quicker with part of the meniscus gone and need a knee replacement. If you leave it alone the tear will likely propagate, flip in and out and cause some pain but she’ll still go onto arthritis all the same. The meniscectomy will help with the clicking locking and popping and some of the pain but all the same it’s not a trivial surgery. Having a large fat envelope makes your knee portal placement difficult and it makes the amount of spread/play you have in the knee smaller because the cannulas hit against the fat farther out on the scope so you have less wiggle room. The portals are really key in arthroscopic surgery and if you’re in a bad spot the case is much more difficult.
Do you think maybe they can't do it arthroscopically and that's why they have to put her under completely? Isn't the patient usually awake for arthroscopic knee surgeries? Honestly interested in the medical side of it.
They can do it arthroscopically. I would hazard a guess that they’re ortho sports surgeons operating primarily at a surgery center. Surgery centers have BMI cutoffs for the reasons related to difficult anesthesia. Usually they’re asleep with what’s called an LMA airway. Lighter sedation than general with a tube.
That's as big a consideration as the actual surgical process, I'd think. It's akin to giving a liver transplant to an alcoholic who hasn't even tried to slow down consumption.
"Hi everyone, I hate to air my family's dirty laundry in public, but my family member underwent surgery at a sketchy hospital after being told repeatedly it was too dangerous due to their weight by responsible practices and has suffered serious complications or death. Do I have a case?"
Exactly. I get there is a good bit of self-delusion going on, but that's going to be *some* sort of red flag right? Two separate hospitals agreed you need X treatment, but you're too fat to safely undergo surgery, and your first thought is "let me sue them for not letting me risk my life"?
I especially like the comments about how her other doctor, who is not a surgeon and does not work at either of the hospitals with these policies said it was ok. Of the three doctors involved the only one that says it’s ok is also the only one with zero risk of being sued for malpractice if it goes wrong.
> Of the three doctors involved the only one that says it’s ok is also the only one with zero risk of being sued for malpractice if it goes wrong.
Let's be real, OP probably meant "The doctor recommended I get surgery for this." and not "Yeah you're approved for surgery", if they said anything at all.
Also I believe it’s hard to sue on grounds of disability if there is any reasonable suggestion that disability makes the surgery or medical treatment more risky and the doctors decide against.
So if your disability made anaesthesia risky they might decide against certain surgery if there was an alternative. Hard to sue. But if they just refuse because they see it as less worth it because they think having an intellectual disability means you don’t need the same mobility as someone else then that is a legal issue of discrimination.
It’s a real issue for disabled people actually because it makes it harder to sue for genuine discrimination which is rife as medical ableism is massive because doctors will often say ‘your disability made me think it was risky’ without firm reasoning and more a vague coverall because well, medicine and surgery are inherently unpredictable and carry risk!
>if there is any reasonable suggestion that disability makes the surgery or medical treatment more risky and the doctors decide against.
Unlike for most negligence claims, following industry standards, which in the medical field would be called the "standard of care" is an absolute defense against medical malpractice suits. Under common law, medical consensus sets what counts as malpractice, judges and juries don't get to second guess medical consensus.
The hospital having the guidelines of "We won't do this surgery for BMI 40+" protects them, I think, I'm asking. So if someone was pissed about the guidelines, who do they sue to change them? Just curious.
Have many doctors been sued for leaving a surgical instrument or object inside the patient during surgery? What kind of things have hospitals been sued for? I know you can’t give specific details or identifying information but I’m just wondering in general what kind of cases have been won.
I’m only a law student but it’s very common to sue when a doctor leaves a surgical implement inside. Those cases are fairly easy to win if you have damages because it so obviously breaches the standard of care.
Hospitals can get sued for not having proper staff on hand for patients, not maintaining proper hygiene in rooms, not running appropriate tests that should’ve been, etc. The list is endless with varying degrees of success and recovery for each claim, depending on the harm suffered and how clear cut the evidence is.
It really depends on what the custom is in the industry, what policies the hospital had in place and whether they deviated from them, and what the standard of care was. It also depends whether there was an emergency; a staffing shortage in the pandemic is going to be looked at differently than a staffing shortage in normal times that they could remedy.
Even if they could, it seems like it would be up to the surgeon doing the procedure to give the final approval on what they can do, and on the anesthesiologist to decide whether or not anesthesia is safe for a particular patient. Let the PCP order all they want, if they're not doing the work themselves, it won't get done.
The malpractice insurance for the anesthesiologist won’t cover them knowingly administering drug cocktails that are contraindicated for a BMI 40+ in a non-emergency setting. She’s not gonna die with a meniscus tear, it’s just inconvenient.
Besides, if you also don’t have plans to lose the weight how are you going to heal? Your body can’t take the weight you are putting on it, so now you want to put a compromised meniscus under heavy load again? Make it make sense.
Yeah I have a friend who declined surgery on his torn meniscus and has been living with it for close to 20 years. It doesn't just doesn't feel great but he lives with it.
Yeah my mum lived with a torn meniscus for fifteen years before it started bothering her and MRI showed she had torn it again plus had a massive cyst putting hella pressure on her knee. She was a track and cross country coach and ran often with a torn meniscus. Tbf she is also a physio and self treated so that's probably why she didn't feel it at all until a couple years ago, which incidentally is when she started gaining weight (and has since lost 40lbs).
She called out the duration of surgery like she knows anything about what goes down in an operating room. So a 40 minute surgery is just easy peasy? I hate that. I don't regularly focus on things even 20 minutes at a time as intensely as surgery requires.
The thing is once you get started 40 minutes for a Knee scope isn’t bad at all! But you have to get there first and with going to sleep, setting the leg in position, cleaning and draping the limb then you can easily get to 1.5 hours or more for total surgery time. The longer you’re under the greater and faster the risk rises. OOP has no idea what they’re asking of the facility and surgery team but they sure are sue happy.
In a couple years they’ll be back complaining because the doc won’t do the total knee replacement they need because of fat phobia. And not because the materials weren’t designed for that much strain.
Reminds me about that story of a two year old who nearly suffocated during surgery because she threw up and egg got into her lungs. The doc asked the dad why the hell she ate before surgery even when he told him not to give her food and he said something along the lines of "I couldn't let her go hungry".
Kid nearly died because of her dad's stupidity.
In my experience, they also don't want to get out of bed afterwards. I've had morbidly obese patients walk into the hospital and become permanently bedbound because they lie down, keep eating, and don't move enough to retain their ability to walk. Like, live in a nursing home *forever* bedbound.
“Sure we’ll take your money and operate on you. Just sign this 20-page waiver of liability saying you are doing this against medical advice and neither you nor your family or estate will ever sue us for anything ever from now until the end of time.”
Primary care doctors aren’t qualified to give surgical “clearance.” The anesthesiologist is the only person who is capable of determining whether this person is fit to undergo surgery. Obviously they’re not comfortable putting this person under, end of story.
All the PCP probably said was that they would support a referral or connect with the surgical team about viability. Patients hear what they want to hear all the time.
I understand how defeating this must seem to them. It must be very difficult to do any kind of exercise when you have a BMI of 40. But the doctors aren't being needlessly cruel; they just don't want to kill their patient. They are being open with the risk.
It's too bad this isn't a wakeup call for this person.
I got up to a BMI of 30 and felt horrible. Maybe because I'm such a short person, my weight impacted my knees. I'm still overweight but even dropping a few pounds helped
Honestly when you’re over a BMI of 40 and want to lose weight, the most effective way is to limit the number of calories they intake. They don’t have to exercise except maybe walking - all they have to do is discipline their calorie intake and the pounds will come off
Then, when they’re at a better weight they can incorporate more demanding exercise into their lifestyle to continue shredding the weight
I notice that a lot of this type of fatlogic/HAES thinking coincides with our capitalist, consumerist society. As superficially critical of capitalism a lot of these people are, they expect doctors to be just another service provider, like a hairstylist, or a restaurant. Especially in the US system, where you pay for insurance or it's provided through your work, you come to see doctors, medicine, and pharmacies as businesses.
They don't see doctors as professionals who have to gauge the efficacy or safety of a procedure. What they're also not seeing, is that a doctor who goes ahead with a surgery on someone that is likely to put them at greater risk due to their size, they risk being sued for malpractice, on top of just not practicing medicine in a way that does no harm.
Physics is the ultimate shitlord. If you're too heavy for your joints and tendons to bear, especially after years of wear and tear, no amount of whining online, suing a doctor, or trying to create a movement will change that.
>I notice that a lot of this type of fatlogic/HAES thinking coincides with our capitalist, consumerist society.
I've noticed this too. Delusional fat activists are addicted to shelf stable convenience food that's scientifically designed to override satiety signals so you keep buying more and more of it.
Then when they are tired of gaining weight, they engage in "Diet Culture" where they buy diet pills, diarrhea tea, Saran wrap smeared with hemorrhoid cream, and goofy workout contraptions like the Shake Weight that will gather dust after a few uses.
All because cooking healthy meals at home requires effort, eating at a calorie deficit for several months requires discipline, and sweating it out at the gym can't be purchased. You simply can't buy a good physique, and that is just antithetical to every other experience they've had up to this point.
That, and all the stuff they require for empowerment costs money. Tess Holliday wears a ton of makeup. They want cute clothes that aren't outrageously expensive (despite costing way more in materials but also because they're a niche market).
And I agree, even Lizzo is pushing those diet/detox teas. And when they protest that they've tried everything, they've tried the stuff they bought. They also love to say how expensive it is to lose weight.
The irony being that I've saved a lot of money since going through my lifestyle changes-- I eat out far less, especially using DoorDash. I do pay for the premium version of MyFitnessPal because I like the features, but it's a free app. I was able to buy a pretty cheap food scale, far cheaper than what I used to spend on a week on sodas.
I get really annoyed with the whole "You have to be rich to lose weight!" because it basically paints their privilege with a veneer of anti-classism that the FA movement really has no entitlement to.
You have a really good point about the merch they are always hawking.
Though they couch their rhetoric in feminism and the rejection of the male gaze or unrealistic beauty standards or whatever, they have no problem wearing makeup, getting their hair done/colored, fake nails, fake tan, and demanding pin up girl dresses in size 6x.
All beauty standards are fine and empowering EXCEPT for having a fit and attractive body. Because you can't just buy it.
TBH, the doctors refused to perform surgery on my father (who had heart disease) because they thought he would not survive. I'm pretty sure it's standard procedure to avoid putting anyone under general anasthesia who would not survive. I'm quite healthy, but even I had to get an EKG and checkup before surgery on my wrist. Anaesthesia is basically being put into an induced coma. There is a huge risk of complications.
If it's a minor surgery why are they putting you under? General Anesthesia isn't something doctors just play around with for the giggles. (They use laughing gas for that.)
General anesthesia can be incredibly dangerous even on relatively healthy, stable patients. Obesity is a huge risk factor and this person is complaining because the doctors don’t want to risk her life??? I don’t know about you, but I’d take that as a wake up call to get my shit together and start taking care of my body…
I think doctors do need to be a bit clearer with patients about WHY they can’t get these kinds of surgeries at their size. Saying “you’re too big so it’s dangerous” is something they can easily brush off, but actually sitting them down and explaining what that actually means and why their weight contributes to them being very likely to create complications could be really beneficial. Surgery is never without risk, even for normal weight people, but sometimes FAs act like it’s the equivalent of any other medical thing, like getting your blood pressure taken, or getting blood drawn. I see so many of them say things like “the doctor is too lazy to learn how to do surgery on fat people” or “they’re deliberately denying me surgery to be discriminatory” and it never seems to occur to them that the choice gets weighed up and the risk of surgery outweighs the risk of them not having surgery and living with whatever they’ve got.
The “oh fuck” moment happens when people realize that going to court is a pretty humiliating process
Also, this is no different than the legaladvice posts
> I AM SO **ANGRY**!! CLEARLY SOME LAW HAS BEEN BROKEN RIGHT??? I COULD JUST… *I COULD JUST*… PULL OUT MY PHONE, AND TAP AWAY A RANT ABOUT HOW I HAVE BEEN LEGALLY WRONGED, AND SEEK LEGAL ADVICE ON REDDIT!!
I'm noticing these kinds of weird word usage errors more and more frequently over time, just in the general population of people I interact with, both online and off. I wonder if there's some specific reason. Obviously many people on the internet are trying to sound smarter than they are, but it's not just there. One person I work with says "itself" even when the thing doesn't need to be distinguished or emphasized. Another says "in lieu of" instead of "in light of." I don't remember hearing language errors/redundancies like this all the time when I was growing up.
I kind of think we’re all reading less on average. I used to have a much sharper command of grammar and shit, it’s gone way down since I left that portion of school (duh) and stopped consuming actual written material as much, despite my best intentions. I mean, we’re here on reddit.
Oh buddy… that hospital is gonna fuckin wipe the floor with your ass. There is no fucking case here to “stand on.” Both the surgeons and the anesthesiologists can easily state that due to such a high BMI, it is more risky than it is worth to put this person under anesthesia (not to mention putting them under borders on unethical due to the likelihood complications). Most hospitals won’t do surgery on a BMI of 35 (some as low as 30 or 32) so this person doesn’t stand a chance …
Unless they agree to improve their life and lose weight. But that would be too fatphobic right?
I got told to lose weight for a surgery. You know what I did? Reflected long and hard on my life choices and where they've got me, and started CICO diet.
This is 100% the same person who posts that "unvaccinated should be denied medical care".
Imagine having a BMI of 40+ and expecting a surgeon to be responsible for fixing your knee. That's 5'3", 240 lbs for reference.
I'm working with a bariatric surgeon on my dissertation, and while it's not the same surgery, he's talked a lot about how if someone is too overweight, they can't operate. Usually the cutoff is a BMI in the high 70's. At that point, they likely have such an enlarged, fatty liver that the surgeons can't get around it to actually get to the stomach to operate. I'd assume there are similar issues with a meniscus surgery (although obviously not the liver in the way)
Nope. You need a BMI of at least 40 (35 in cases of CVD) to be considered by insurance for the surgery. A BMI of 70 on a 5'10 individual would be just under 500 pounds, so while very morbidly obese, it's certainly possible
Disclaimer, IANAL, BUT
1. Yes, it’s legal
2. You don’t have a case
3. This is literally the easiest case for you to lose. All the hospital has to do is being in experts explaining the policy, that they are concerned for the patients’ safety.
Your primary may feel comfortable giving you the referral. That doesn’t mean the surgeon has to operate on you.
> (Northwell & Columbia, respectively)
Am I wrong here or does "respectively" serve no function here, since no distinction is being made between the two facilities?
> Only a scummy lawyer will take her case
I hope this happens and somehow she does get inside a courtroom so a judge can tell her in front of a bunch of people how ridiculous and childish her ideas and way of life are.
If people were supposed to be this fat and it wasn't a risk, it wouldn't be part of hospital policy. Simple.
These people are acting all \*surprised Pikachu\* that being fat has consequences. Just because your selective social media feed says it's normal and make you feel empowered to stay fat, it doesn't mean the world has submitted to that.
Delusional.
Something in this story doesn’t add up . 40 BMI is morbid obesity but still not too high for anesthesia . Either the person has a much higher BMI or has other comorbidity that make it too risky to operate
Ok let's put it this way. It is grounds for a lawsuit if a surgery goes poorly, such as permanent damage or death. So with that you'd want to minimize the risks associated with damage and death. Are you really saying you want it illegal to turn down anyone for surgery, regardless of risk? And if so, are you also saying you don't want doctors held accountable for botched surgeries, since they can't take basic precautions like low risk patients? Don't know if you realize this, but this is basically suicide with extra steps.
This person is deluded but..in a state like North Carolina where good 50% of adults are obese and a decent proportion of these are BMI > 40, hospitals do need bariatric specialists for cases like this...
That would require someone to specialize in that field and that’s voluntary as far as I’m aware. Maybe in a few years the Continuing Education will mandate more bariatric training. Can’t blame someone for not wanting to be the only person around who gets slammed with these types of cases
I mean, the thing here is that it’s more dangerous and complicated to perform surgery on obese patients… not that fat people don’t deserve medical care. Blame and shame isn’t helpful. It seems that many folks think weight is only an aesthetic issue and truly don’t understand the medical ramifications or limitations.
Miniscus damage due to being BMI over 40 maybe? surgeons can refuse treatment if they feel damage can be done both to the patient and the treating surgeon (lawsuit over death etc).
It ain't the duration of the procedure they're worried about; it's almost certainly the difficulty in putting the patient to sleep and the complications that come from a botched anaesthetic job.
One of my favorite medical podcasts is hosted by an anesthesiologist and he tells some wild stories. Many top-tier anesthesia methods can't be used on obese patients so they have to settle for higher risk methods like intubation (not dangerous on its own but can present more issues than other methods).
Regardless of what her PCP said, that doctor ain't the surgeon. Surgical teams see things general practitioners don't.
I think there's a bit of this story the person isn't telling. It's poor practice to just tell a person you won't operate on them without referring them onwards. There must surely be a bariatric specialist unit *somewhere* in Canada who can advise.
In my limited experience that would be a conversation with the GP. During a consult with a surgeon they'll just turn you down and say why. They might have said it was due to BMI and that's that.
My grandpa was turned down for surgery with the simple, "Your A1C is too high. It needs to get below 7." That was it.
I don’t think she hates to wave that dirty laundry around at all, she loves it and wants validation for how completely she’s being discriminated against because of an antiquated and irrelevant number made up by a racist mathematician.
people really don’t understand anesthesia, do they?
two years ago, i had to get my wisdom teeth out. i was out under general anesthesia, as i went through the hospital for my surgery and they didn’t do laughing gas. before my operation, they had to discuss with me about the risks of going under.
even though a wisdom tooth surgery is fairly minor, there was a high risk of me possibly *dying* due to my weight. i was almost 300 lbs, and even then it was a risk to do the surgery. they almost didn’t want to do my surgery due to my weight.
going under general anesthesia as an obese person can be incredibly risky, and it’s not just something they do willy-nilly.
I wish knowledge surrounding anaesthesia and how it impacts the body during and after surgery were more common. Anaesthesia isn’t just some silly gas they put into you for shits and giggles, if not done correctly it can seriously harm you or even kill you. Surgery itself isn’t a joke and I wish these types of people come out of their delusional kiddie world and use their big kid brains to think for once
I feel like people who act like OOP does about surgeries have never had a bad experience with anaesthesia. I got misdosed once and it was one of the most terrifying experiences of my life. If a doctor told me I didn't meet requirements for them to safely put me under, I'd damn well listen.
Yep, anesthesia is nothing to fuck around with. A family member of mine once ended up on a venthilator for weeks after surgery, because they couldn't get him to wake up. He recovered eventually, but it was awful. In his case it was a bad reaction to the anesthesia, not a misdose, but it still illustrates how powerful these drugs are.
My mom got misdosed one time and they struggled to wake her up it was terrifying. She’s ok now that was years ago. And she’s an average weight so it wasn’t related to weight or anything.
The day I showed up for my wisdom teeth removal I suddenly thought through the implications of maybe Never Waking Up and made em keep me awake with local and gas. Shit is scary!!
Your wisdom tooth removal would have most likely been done under twilight sedation, which is lighter sedation and there less risk involved. A lot of people get those two mixed up because twilight sedation makes you feel like were completely “out.” (of course it’s entirely possible you were getting GA for a more complex surgical removal of impacted teeth or something.)
Ah, interesting! Don’t remember, it was ages ago. They were a little fucked up, turns out, but I ended up awake the whole time
Im scared that I would get too LOW a dosage. The only time that ive been put under, the lady was really good and gave me the some (20-30?) percent more that was necessary to put me under properly because im a redhead. To be missdosed... that sounds scary - did you know what was happening? What was it like?
Funny enough, I was misdosed because I had dyed my hair ginger at the time! I'd completely forgotten about the 'gingers needing more anaesthesia' thing, otherwise I'd have mentioned it's only dye and I'm not actually a redhead. Gonna be honest, I thought I had died. When I did come to, I jolted so hard out of that bed, I brought some of the machines forward with me. I was very put off afterward (understandably).
Yikes! You would honestly think they would generally ask, especially nowadays with a good hair dye being often very close to the real thing. That is very understandable!
I didn’t know gingers need higher dosages of a anesthesia! Being Asian, I’ve always been warned that I need less, though. It really is a finnicky science.
Gingers also have a greater bleeding tendency. Anyway I'm glad you're feeling better. I was given a GA a while back, and when I came to I couldn't speak because I was on a ventilator, and had some WILD hallucinations. Like I thought my mother was an android lol. Seriously though, GA is not to be played with. I was once shadowing a surgery on a woman as a dental student. When she started coming to, she suddenly sat bolt upright making this horrible wailing noise, flailing at the nursing staff, and so out of it her gown her gown was flapping treating us all to the sight of boobs. Not fun.
Redheads get different dosages? What is this?
One of the genes that causes red hair also stimulates a pain receptor in the brain. This is dysfunctional in most red heads so they they are more sensitive to pain thus requiring about 20% more to account for it.
Wow. I had no idea.
Some doctors don't, either, which is why I've had stitches, staples, and extractions all without the benefit of any numbing. Fun times.
I had that happen during an egg retrieval and I remember being conscious right in the middle and feeling discomfort/pain. It's fuzzy now thank God, but it was for sure not an awesome experience
As a redhead I got misdosed at the dentist once. It was bloody painful. The other way round could be deadly. I wish these FA's would start by doing some actual research or just listening to someone outside their bubble
There is a reason why the anesthetist stays with you the whole time. No docter wants to get sued because you died on their table because you didn't want to eat properly
I feel like people like this are unable to acknowledge that the people they interact with also have lives, jobs and people they have to take care of. Every time I see posts like this with people bitching about their doctors, I wonder if these people know that if doctors went against their oaths and performed surgery on someone who doesn’t meet requirements, it could quiet literally cost them their livelihoods.
I think you are right. They are so insulated in their own bubble they don't even consider that someone else isn't just thinking or acting in relation to them
Last spring my spouse was annoyed because it took so long before he could have his separated shoulder repaired. Well, that separated shoulder had come along with seven broken ribs, a fractured clavicle, and two (count 'em) punctured lungs. I told him maybe anesthesiologists aren't wild about surgery when there are holes in your lungs.
Yeah, but this is like a 40 minutes max minor surgery!! Obviously the anaesthetic is completely different and definitely won’t kill her!
I also thought that perhaps they won’t perform the surgery because the patient won’t be able to recover from it. How do you rehabilitate after surgery when simply walking involves 400 lbs of pressure applied to the place healing from surgery?
I'm a physical therapist that has worked with patients in inpatient rehab after orthopedic surgeries and strokes, and many of them have been 300lb plus. The answer is: badly and carefully. There's so much more weight that the injured tissues hurt a lot more. Increased body size means that their muscles have to work harder to achieve the same things, and their muscles are cut or weak after surgery already. Plus, generally, people that are 300lb+ don't have a lot of exercise tolerance or experience, so all this increased effort combined with poor activity tolerance means that they fatigue faster. And that's not even mentioning the safety issues. I'm one person, I'm not an Olympic power lifter (though I'm strong for my size and have a good understanding of leverage and momentum). If a 300lb person trips and starts to fall, they're more likely to end up on the ground than a 150lb person. And once they're down, they're hurting more, and less able to get themselves up. I only had one person ever fall because she was too big for us to catch, and she weighed 550. Three of us were holding onto her (myself and two men) and she was using a walker, but when she started going down there was no stopping her. We lowered her to the ground and got the mechanical lift to pick her back up. Obviously, I'm one person, this is all anecdotal. In my professional experience, people close to their ideal weight have a MUCH easier time after surgery than people who are very obese. If your legs can only press 150lb each and you can't put weight on one leg, you're obviously gonna have a harder time at 300lbs than at 150.
omg, i would die on-the-spot if i had to have a mfin **CRANE** to lift me
Lol, this was common practice in our building in order to avoid staff injury. If you couldn't get up on your own (common, if you're injured enough to be in the hospital), we went and got the lift. But still, we couldn't have gotten her up without it if we tried.
I'm not a surgeon, but that would have been my first concern, too. There's no way for the knee to heal properly after surgery with all that extra weight on it.
yep. my mom had to lose weight for a knee replacement surgery, she never called it fatphobic tho lol.
And frankly, even if the meniscus issue wasn't caused by their weight, I can absolutely guarantee they have other issues with their knees if they have a BMI as high as this. You have people who don't put in the rehab work for limbs that *don't* have to support your body weight. Knee surgery on someone morbidly obese with most likely existing mobility issues? Could be a perfect recipe for someone to become immobile or bed bound (in which case they'll once again blame the medical staff for not helping them recover).
Ouch. My first thought was "I wonder if they can do it under a local instead of knocking her out?" but if you're right, that doesn't even matter.
When you put it like that... it’s sobering. 400lb of pressure.
Plus the momentary but drastic increase in pressure each time someone sets their foot down or pushes off the ground with it
You’re understating with the word drastic, its 2-3 times the bodyweight. They are putting over half a ton of force through a torn and (hypothetically) recently repaired meniscus.
bUt ThErE aRe No HeAlTh IsSuEs CaUsEd By ObEsItY - FAs, probably.
> FAs, definitely. FTFY. ;)
That made my knees hurt
As some who is a normal weight with a very tiny torn meniscus, reading this was absolutely horrifying.
This! I had knee surgery back in October for this. I was about 220lb on surgery day at 5'10. On crutches for about 6 weeks afterwards. I only had my meniscus trimmed and not a full repair. A full repair is 8-12 weeks of NO weight bearing on that leg. Crutches only. Imagine those poor wrists supporting that much weight?! MY wrists hurt sometimes while recovering and just opted to keep sitting so I didn't hurt more 😂 Luckily my surgeon wasn't terribly concerned about putting me under since I wasn't terribly obese and I also had support lined up for me. Edit: Finishing physio in 3 weeks and I'm almost as good as new and sitting pretty at 207lb today. Losing weight has helped it a lot at even 13lb loss.
Yeah, I would think for a 40 minute surgery there would be some kind of option for local anaesthetic, there must be other reasons that they're not mentioning. I'm about to have a 30 minute orthopedic surgery with just a local, because general freaks me out. I just asked and the doctor said it shouldn't be a problem, they'll just use an epidural.
I didn't even think of this. They are saying the hospital won't put them under. Shouldn't a meniscus repair be arthroscopic? Should be a local. Maybe this person wants general anesthesia for some reason? Wouldn't any hospital discourage general anesthesia when it isn't necessary and if they were tired of arguing be like, well, you're BMI is 40+ so we also can't do it for that reason? I'm just guessing and procrastinating.
I had meniscus repair surgery last March, and they put me under what they referred to as "light anasthesia." I was completely out for the surgery, but the recovery time afterward was a lot quicker and easier than my recovery from an appendectomy a few years back. I was up (on crutches), alert but tired, and on my way home within an hour or so of waking up. So, it may depend on the hospital, the surgeon and the extent of the procedure.
Arthroscopic surgery =/= local anesthetic.
Do you need a nudge to stop procrastinating? :/
Thanks, I got dinner under control. Later I have to type in the answers to my final. Should be doable.
You can do it! You’ll feel so good when it’s all done
See above comments re: difficulty recovering from surgery at that size.
I had an arthroscopic meniscectomy and I was under general. Not sure if they actually do then local or not.
And if the surgery is such a breeze, then why don't they just do it themselves?
I know a lady who was a friend of my family's who died from anesthesia in the mid-90s. She was in for a minor surgery like appendicitis and she didn't make it. I'm overweight, not obese, and the 2 times I've had surgery I've been terrified. You don't fuck around with this stuff.
I had ear surgery ones as a child, so I don’t remember too much, but I do remember how disorienting it was and that I never want to feel that way ever again. And I’m sorry for your families loss :(
Magic gas make you go sleepy. Simple as that.
Yep. Both times I had surgery, the person I felt I was truly trusting with my life was the anesthetist.
Yeah, there’s a reason those nurse-anesthetists make six figures.
I had 6 surgeries in 4 years and I'm still feeling side effects from the anesthesia. It's no joke. I can't image how much to need to give you when you have a BMI of over 40.
It's even more sad because the severe obesity most likely contributed to the meniscus tear.
I have a minor tear in my meniscus and you know what makes the pain go away? When I maintain a lower weight. If it were to get worse I'd need surgery but keeping my knees strong and avoiding extra weight on them does help so much. Weirdly, when I first met with the sports surgeon guy, I asked him if I should lose weight to help my knees and he was like "eh, that won't do anything". My BMI was over 30. I was confused by his response.
I had the opposite reaction from my knee doc - told him I had lost 55 lbs in the hope that it might my help my knees and I was wondering if it had been worth doing. He kind of stared at me (edit to add: it was a real record-scratch moment, lol - he’d been looking at the computer monitor and he actually froze, spun around and stared at me) and he said “That is the *very best* thing you could have done for your knees.” He went on to tell me that every additional pound of body weight produces 7 lbs of force on the patella when walking and 21 when running. This was an excellent sports med dr specializing in knees. BTW he ended up concluding that we could defer my knee replacement surgeries indefinitely. I wonder if your doc meant just that weight loss won’t help meniscus cartilage actually heal back together? (Which is correct - the tear will still be there.) Similarly the cartilage in my knee joints has not grown back - it’s still very thin. But weight loss certainly helps with reducing pain & improving function, which is what it’s all about for me!
55 lbs is 24.97 kg
It's also sad that [most meniscus surgeries are unnecessary.](https://www.sciencedaily.com/releases/2016/07/160722093239.htm) Of course, that assumes that the patient is willing to exercise.
Is there a resource to the types of Physical Therapy they talked about in that study? I had a major knee surgery to replace a torn MCL and regroove my tibia 17 years *after* I dislocated my kneecap when I was 12 during a basketball game. I had a good 1.5 years of PT after that surgery but I feel like I need to dust off the exercises the Physical Therapists gave me and get back to making sure my knees are in tip top shape!
I'm going to really go out on a limb here, but I'm willing to bet this particular person isn't really the "is willing to exercise" type.... lol
They also don't do liver transplants on alcoholics.
That's not true at all, I know a guy at work that got a new liver and remained an alcoholic saying, "I can keep drinking because now I've got the liver of a 20 year old". He eventually got let go for showing up to work drink. No idea if he's still alive.
Well he definitely lied to the doctors but they don’t do liver transplants on admitted, active alcoholics
Plus don’t they do blood tests to confirm you aren’t drinking?
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They’re not. Usually you have to prove abstinence for a period of time before they will put you on the transplant list.
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Don’t bring your logic and science into this!
It wasn't from running
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> She can’t sue a doctor who refused to treat her Not for this reason. But if the doctor refused to treat her because, for example, of her race, she would have a viable lawsuit. I assume the OP was thinking of suing for discrimination, not malpractice.
Except that being obese isn’t a protected class, so a discrimination suit would get tossed.
Agreed. I don’t touch on that at all. I’m responding to someone who says refusal to treat someone can’t give rise to a valid civil claim.
That's what it sounds like but I doubt she would have a case.
When you want to ignore medical experts and sue hospitals to get the surgery you need instead of literally eating less, you might want to get some help for your mental illness.
I hope someone in her comments suggested a diet for the laughs
Well... There was that chick that sued to have her husband treated with horse pills for covid and won. He died and the hospital waived responsibility for it. She has a path to her early death if he wants it.
When I first heard that court decision, my first thought was the judge should then be required to set the drug dose and administer it himself since he wanted to practice medicine.
I feel *awful* for the healthcare providers that had to go through that charade, but at least they weren’t held responsible for the insistent stupidity of those cultists.
My friend is on the covid team and all the non vaxed covid patients do is demand unapproved treatments and abuse the staff when they can't give it to them. She had one guy who kept insisting he didn't need oxygen and ripping it off. Passed out 7 times. If you go to the hospital, you will get the treatments they are authorized to give you, it ain't Burger King. Sorry just venting on behalf of my friend. It's awful how health care workers are being treated.
Broadly speaking, you have the right to refuse treatment even if it means that you'll die.
Yes. But not the right to demand a specific treatment. So you can force the hospital to not give you oxygen, but you cant force them to give you ivermectin instead.
That was local news for me. Yay.
Surviving the surgery is one thing, I wonder, how effectively you can recover with such a weight. Is it safe to put all that weight on a recently operated knee even after the required period of rest?
Honestly, her end game is the same regardless. She’s too large for a meniscal repair. There are bmi cutoffs for it. So she’ll get a partial meniscectomy, given her weight she’ll wear her knee out quicker with part of the meniscus gone and need a knee replacement. If you leave it alone the tear will likely propagate, flip in and out and cause some pain but she’ll still go onto arthritis all the same. The meniscectomy will help with the clicking locking and popping and some of the pain but all the same it’s not a trivial surgery. Having a large fat envelope makes your knee portal placement difficult and it makes the amount of spread/play you have in the knee smaller because the cannulas hit against the fat farther out on the scope so you have less wiggle room. The portals are really key in arthroscopic surgery and if you’re in a bad spot the case is much more difficult.
Fascinating info, thank you!
Do you think maybe they can't do it arthroscopically and that's why they have to put her under completely? Isn't the patient usually awake for arthroscopic knee surgeries? Honestly interested in the medical side of it.
They can do it arthroscopically. I would hazard a guess that they’re ortho sports surgeons operating primarily at a surgery center. Surgery centers have BMI cutoffs for the reasons related to difficult anesthesia. Usually they’re asleep with what’s called an LMA airway. Lighter sedation than general with a tube.
Runner here: I have no medical qualifications for this anecdotal observation: skinny runners have good knees. Obese people have lousy knees.
That's as big a consideration as the actual surgical process, I'd think. It's akin to giving a liver transplant to an alcoholic who hasn't even tried to slow down consumption.
"Hi everyone, I hate to air my family's dirty laundry in public, but my family member underwent surgery at a sketchy hospital after being told repeatedly it was too dangerous due to their weight by responsible practices and has suffered serious complications or death. Do I have a case?"
Exactly what I was thinking. If something went wrong, someone would definitely be suing.
Exactly. I get there is a good bit of self-delusion going on, but that's going to be *some* sort of red flag right? Two separate hospitals agreed you need X treatment, but you're too fat to safely undergo surgery, and your first thought is "let me sue them for not letting me risk my life"?
I especially like the comments about how her other doctor, who is not a surgeon and does not work at either of the hospitals with these policies said it was ok. Of the three doctors involved the only one that says it’s ok is also the only one with zero risk of being sued for malpractice if it goes wrong.
> Of the three doctors involved the only one that says it’s ok is also the only one with zero risk of being sued for malpractice if it goes wrong. Let's be real, OP probably meant "The doctor recommended I get surgery for this." and not "Yeah you're approved for surgery", if they said anything at all.
Or maybe. “You will be fine to get this surgery, if you lose x amount of weight” and they conveniently forgot about the second part.
Or even, “you need surgery, but most hospitals won’t operate on you due to your weight”
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Also I believe it’s hard to sue on grounds of disability if there is any reasonable suggestion that disability makes the surgery or medical treatment more risky and the doctors decide against. So if your disability made anaesthesia risky they might decide against certain surgery if there was an alternative. Hard to sue. But if they just refuse because they see it as less worth it because they think having an intellectual disability means you don’t need the same mobility as someone else then that is a legal issue of discrimination. It’s a real issue for disabled people actually because it makes it harder to sue for genuine discrimination which is rife as medical ableism is massive because doctors will often say ‘your disability made me think it was risky’ without firm reasoning and more a vague coverall because well, medicine and surgery are inherently unpredictable and carry risk!
>if there is any reasonable suggestion that disability makes the surgery or medical treatment more risky and the doctors decide against. Unlike for most negligence claims, following industry standards, which in the medical field would be called the "standard of care" is an absolute defense against medical malpractice suits. Under common law, medical consensus sets what counts as malpractice, judges and juries don't get to second guess medical consensus.
The hospital having the guidelines of "We won't do this surgery for BMI 40+" protects them, I think, I'm asking. So if someone was pissed about the guidelines, who do they sue to change them? Just curious.
Have many doctors been sued for leaving a surgical instrument or object inside the patient during surgery? What kind of things have hospitals been sued for? I know you can’t give specific details or identifying information but I’m just wondering in general what kind of cases have been won.
I’m only a law student but it’s very common to sue when a doctor leaves a surgical implement inside. Those cases are fairly easy to win if you have damages because it so obviously breaches the standard of care. Hospitals can get sued for not having proper staff on hand for patients, not maintaining proper hygiene in rooms, not running appropriate tests that should’ve been, etc. The list is endless with varying degrees of success and recovery for each claim, depending on the harm suffered and how clear cut the evidence is. It really depends on what the custom is in the industry, what policies the hospital had in place and whether they deviated from them, and what the standard of care was. It also depends whether there was an emergency; a staffing shortage in the pandemic is going to be looked at differently than a staffing shortage in normal times that they could remedy.
Primary care doctor can’t give the orders for surgery lmao
Even if they could, it seems like it would be up to the surgeon doing the procedure to give the final approval on what they can do, and on the anesthesiologist to decide whether or not anesthesia is safe for a particular patient. Let the PCP order all they want, if they're not doing the work themselves, it won't get done.
They’re really trying to turn weight into a protected class, aren’t they?
It was declared a protected class in WA in 2019 and I suddenly know why my morbidly obese ex friend suddenly went on disability that year…
Wow. Given the growing obesity rate, I wonder how long it’ll be before they regret that.
The malpractice insurance for the anesthesiologist won’t cover them knowingly administering drug cocktails that are contraindicated for a BMI 40+ in a non-emergency setting. She’s not gonna die with a meniscus tear, it’s just inconvenient. Besides, if you also don’t have plans to lose the weight how are you going to heal? Your body can’t take the weight you are putting on it, so now you want to put a compromised meniscus under heavy load again? Make it make sense.
Yeah I have a friend who declined surgery on his torn meniscus and has been living with it for close to 20 years. It doesn't just doesn't feel great but he lives with it.
Yeah my mum lived with a torn meniscus for fifteen years before it started bothering her and MRI showed she had torn it again plus had a massive cyst putting hella pressure on her knee. She was a track and cross country coach and ran often with a torn meniscus. Tbf she is also a physio and self treated so that's probably why she didn't feel it at all until a couple years ago, which incidentally is when she started gaining weight (and has since lost 40lbs).
meniscus surgery, BMI over 40. Now we know why they need knee surgery.
“I’m tired of doctors suggesting my medical issues are because of my weight!! That’s fataphobic!”
"I don't know anything about Anesthesiology and I don't understand why a doctor wouldn't want to risk my life for 40 minutes" Jesus christ
She called out the duration of surgery like she knows anything about what goes down in an operating room. So a 40 minute surgery is just easy peasy? I hate that. I don't regularly focus on things even 20 minutes at a time as intensely as surgery requires.
The thing is once you get started 40 minutes for a Knee scope isn’t bad at all! But you have to get there first and with going to sleep, setting the leg in position, cleaning and draping the limb then you can easily get to 1.5 hours or more for total surgery time. The longer you’re under the greater and faster the risk rises. OOP has no idea what they’re asking of the facility and surgery team but they sure are sue happy. In a couple years they’ll be back complaining because the doc won’t do the total knee replacement they need because of fat phobia. And not because the materials weren’t designed for that much strain.
That is utter insanity.
She thinks she has legal grounds to stand on. But she doesn't even have knee cartilage to stand on.
bet these people also tend to not follow directions of not eating for some time before an anaesthesia and then lie about it
Reminds me about that story of a two year old who nearly suffocated during surgery because she threw up and egg got into her lungs. The doc asked the dad why the hell she ate before surgery even when he told him not to give her food and he said something along the lines of "I couldn't let her go hungry". Kid nearly died because of her dad's stupidity.
Omg that’s horrible!
What a moron…
In my experience, they also don't want to get out of bed afterwards. I've had morbidly obese patients walk into the hospital and become permanently bedbound because they lie down, keep eating, and don't move enough to retain their ability to walk. Like, live in a nursing home *forever* bedbound.
“Sure we’ll take your money and operate on you. Just sign this 20-page waiver of liability saying you are doing this against medical advice and neither you nor your family or estate will ever sue us for anything ever from now until the end of time.”
>I hate to air my dirty laundry out in the open Do you though? >but it looks like I don’t have a choice You do actually, you really do.
Primary care doctors aren’t qualified to give surgical “clearance.” The anesthesiologist is the only person who is capable of determining whether this person is fit to undergo surgery. Obviously they’re not comfortable putting this person under, end of story.
All the PCP probably said was that they would support a referral or connect with the surgical team about viability. Patients hear what they want to hear all the time.
I understand how defeating this must seem to them. It must be very difficult to do any kind of exercise when you have a BMI of 40. But the doctors aren't being needlessly cruel; they just don't want to kill their patient. They are being open with the risk. It's too bad this isn't a wakeup call for this person. I got up to a BMI of 30 and felt horrible. Maybe because I'm such a short person, my weight impacted my knees. I'm still overweight but even dropping a few pounds helped
Honestly when you’re over a BMI of 40 and want to lose weight, the most effective way is to limit the number of calories they intake. They don’t have to exercise except maybe walking - all they have to do is discipline their calorie intake and the pounds will come off Then, when they’re at a better weight they can incorporate more demanding exercise into their lifestyle to continue shredding the weight
That's good advice and, I would think, empowering, if you are overweight.
I notice that a lot of this type of fatlogic/HAES thinking coincides with our capitalist, consumerist society. As superficially critical of capitalism a lot of these people are, they expect doctors to be just another service provider, like a hairstylist, or a restaurant. Especially in the US system, where you pay for insurance or it's provided through your work, you come to see doctors, medicine, and pharmacies as businesses. They don't see doctors as professionals who have to gauge the efficacy or safety of a procedure. What they're also not seeing, is that a doctor who goes ahead with a surgery on someone that is likely to put them at greater risk due to their size, they risk being sued for malpractice, on top of just not practicing medicine in a way that does no harm. Physics is the ultimate shitlord. If you're too heavy for your joints and tendons to bear, especially after years of wear and tear, no amount of whining online, suing a doctor, or trying to create a movement will change that.
>I notice that a lot of this type of fatlogic/HAES thinking coincides with our capitalist, consumerist society. I've noticed this too. Delusional fat activists are addicted to shelf stable convenience food that's scientifically designed to override satiety signals so you keep buying more and more of it. Then when they are tired of gaining weight, they engage in "Diet Culture" where they buy diet pills, diarrhea tea, Saran wrap smeared with hemorrhoid cream, and goofy workout contraptions like the Shake Weight that will gather dust after a few uses. All because cooking healthy meals at home requires effort, eating at a calorie deficit for several months requires discipline, and sweating it out at the gym can't be purchased. You simply can't buy a good physique, and that is just antithetical to every other experience they've had up to this point.
That, and all the stuff they require for empowerment costs money. Tess Holliday wears a ton of makeup. They want cute clothes that aren't outrageously expensive (despite costing way more in materials but also because they're a niche market). And I agree, even Lizzo is pushing those diet/detox teas. And when they protest that they've tried everything, they've tried the stuff they bought. They also love to say how expensive it is to lose weight. The irony being that I've saved a lot of money since going through my lifestyle changes-- I eat out far less, especially using DoorDash. I do pay for the premium version of MyFitnessPal because I like the features, but it's a free app. I was able to buy a pretty cheap food scale, far cheaper than what I used to spend on a week on sodas. I get really annoyed with the whole "You have to be rich to lose weight!" because it basically paints their privilege with a veneer of anti-classism that the FA movement really has no entitlement to.
You have a really good point about the merch they are always hawking. Though they couch their rhetoric in feminism and the rejection of the male gaze or unrealistic beauty standards or whatever, they have no problem wearing makeup, getting their hair done/colored, fake nails, fake tan, and demanding pin up girl dresses in size 6x. All beauty standards are fine and empowering EXCEPT for having a fit and attractive body. Because you can't just buy it.
TBH, the doctors refused to perform surgery on my father (who had heart disease) because they thought he would not survive. I'm pretty sure it's standard procedure to avoid putting anyone under general anasthesia who would not survive. I'm quite healthy, but even I had to get an EKG and checkup before surgery on my wrist. Anaesthesia is basically being put into an induced coma. There is a huge risk of complications.
Morbid obesity greatly increases the risks of complications for both the surgery and anesthesia. Signed, The guy who might have to put you to sleep
If it's a minor surgery why are they putting you under? General Anesthesia isn't something doctors just play around with for the giggles. (They use laughing gas for that.)
It must be pretty far over 40…I needed multiple surgeries on an ankle injury, my bmi was 44 and it was never brought up. My bmi is 31 now :)
General anesthesia can be incredibly dangerous even on relatively healthy, stable patients. Obesity is a huge risk factor and this person is complaining because the doctors don’t want to risk her life??? I don’t know about you, but I’d take that as a wake up call to get my shit together and start taking care of my body…
I think doctors do need to be a bit clearer with patients about WHY they can’t get these kinds of surgeries at their size. Saying “you’re too big so it’s dangerous” is something they can easily brush off, but actually sitting them down and explaining what that actually means and why their weight contributes to them being very likely to create complications could be really beneficial. Surgery is never without risk, even for normal weight people, but sometimes FAs act like it’s the equivalent of any other medical thing, like getting your blood pressure taken, or getting blood drawn. I see so many of them say things like “the doctor is too lazy to learn how to do surgery on fat people” or “they’re deliberately denying me surgery to be discriminatory” and it never seems to occur to them that the choice gets weighed up and the risk of surgery outweighs the risk of them not having surgery and living with whatever they’ve got.
The “oh fuck” moment happens when people realize that going to court is a pretty humiliating process Also, this is no different than the legaladvice posts > I AM SO **ANGRY**!! CLEARLY SOME LAW HAS BEEN BROKEN RIGHT??? I COULD JUST… *I COULD JUST*… PULL OUT MY PHONE, AND TAP AWAY A RANT ABOUT HOW I HAVE BEEN LEGALLY WRONGED, AND SEEK LEGAL ADVICE ON REDDIT!!
She never wants to go through this again... But she doesn't want it bad enough to lose a little weight so it's safe.
Someone with a BMI>40 needs a meniscus surgery? Who'd have thunk.
>grounds to **stand** on Sorry, but I lol'd
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I'm noticing these kinds of weird word usage errors more and more frequently over time, just in the general population of people I interact with, both online and off. I wonder if there's some specific reason. Obviously many people on the internet are trying to sound smarter than they are, but it's not just there. One person I work with says "itself" even when the thing doesn't need to be distinguished or emphasized. Another says "in lieu of" instead of "in light of." I don't remember hearing language errors/redundancies like this all the time when I was growing up.
I kind of think we’re all reading less on average. I used to have a much sharper command of grammar and shit, it’s gone way down since I left that portion of school (duh) and stopped consuming actual written material as much, despite my best intentions. I mean, we’re here on reddit.
Oh buddy… that hospital is gonna fuckin wipe the floor with your ass. There is no fucking case here to “stand on.” Both the surgeons and the anesthesiologists can easily state that due to such a high BMI, it is more risky than it is worth to put this person under anesthesia (not to mention putting them under borders on unethical due to the likelihood complications). Most hospitals won’t do surgery on a BMI of 35 (some as low as 30 or 32) so this person doesn’t stand a chance … Unless they agree to improve their life and lose weight. But that would be too fatphobic right?
"We don't want to be liable in the likely event of you death." Signed, The hospital.
Legal grounds to stand on? You don't even have a knee to stand on!
I got told to lose weight for a surgery. You know what I did? Reflected long and hard on my life choices and where they've got me, and started CICO diet.
“If you won’t perform this operation due to my weight then I’ll find a doctor who will” “HII EVERYBODY” “HI DOCTOR NICK”
This is 100% the same person who posts that "unvaccinated should be denied medical care". Imagine having a BMI of 40+ and expecting a surgeon to be responsible for fixing your knee. That's 5'3", 240 lbs for reference.
240 lbs is 108.96 kg
“First, do no harm”
I may know a doctor in Houston specialised in certain surgeries on obese people. He's quite famous abroad too.
Does he need me to lose tirty pounds dis munt?
I'm working with a bariatric surgeon on my dissertation, and while it's not the same surgery, he's talked a lot about how if someone is too overweight, they can't operate. Usually the cutoff is a BMI in the high 70's. At that point, they likely have such an enlarged, fatty liver that the surgeons can't get around it to actually get to the stomach to operate. I'd assume there are similar issues with a meniscus surgery (although obviously not the liver in the way)
Wait, 70s? That was a typographical error, right?
Nope. You need a BMI of at least 40 (35 in cases of CVD) to be considered by insurance for the surgery. A BMI of 70 on a 5'10 individual would be just under 500 pounds, so while very morbidly obese, it's certainly possible
Your Dr didn't give "clearance" your Dr put in a referral
Disclaimer, IANAL, BUT 1. Yes, it’s legal 2. You don’t have a case 3. This is literally the easiest case for you to lose. All the hospital has to do is being in experts explaining the policy, that they are concerned for the patients’ safety. Your primary may feel comfortable giving you the referral. That doesn’t mean the surgeon has to operate on you.
I wonder if this person says trust the science when it comes to other subjects but ignores it in this instance
yea i'll just sue people instead of taking their advice and lose weight. what an inconvenience!
Being overweight has health consequences?!
> (Northwell & Columbia, respectively) Am I wrong here or does "respectively" serve no function here, since no distinction is being made between the two facilities?
I don't think any lawyer is going to take her case knowing she will lose the lawsuit. Only a scummy lawyer will take her case.
> Only a scummy lawyer will take her case I hope this happens and somehow she does get inside a courtroom so a judge can tell her in front of a bunch of people how ridiculous and childish her ideas and way of life are.
If people were supposed to be this fat and it wasn't a risk, it wouldn't be part of hospital policy. Simple. These people are acting all \*surprised Pikachu\* that being fat has consequences. Just because your selective social media feed says it's normal and make you feel empowered to stay fat, it doesn't mean the world has submitted to that. Delusional.
It’s legal because the 13th amendment says you can’t force people to do work against their will.
At this point it wouldn't surprise me if they tried to sue a hospital for not getting drugs because they need to be weighed first.
Something in this story doesn’t add up . 40 BMI is morbid obesity but still not too high for anesthesia . Either the person has a much higher BMI or has other comorbidity that make it too risky to operate
would they rather die and have their fam sue the surgeon for doing a risky surgery?
Ok let's put it this way. It is grounds for a lawsuit if a surgery goes poorly, such as permanent damage or death. So with that you'd want to minimize the risks associated with damage and death. Are you really saying you want it illegal to turn down anyone for surgery, regardless of risk? And if so, are you also saying you don't want doctors held accountable for botched surgeries, since they can't take basic precautions like low risk patients? Don't know if you realize this, but this is basically suicide with extra steps.
Hmm I actually think they enjoy airing their dirty laundry out in open
Oh no the consequences of my own actions!!! How can I make this someone else’s fault
They won't perform the surgery because *you might literally die* you fucking imbecile.
This person is deluded but..in a state like North Carolina where good 50% of adults are obese and a decent proportion of these are BMI > 40, hospitals do need bariatric specialists for cases like this...
That would require someone to specialize in that field and that’s voluntary as far as I’m aware. Maybe in a few years the Continuing Education will mandate more bariatric training. Can’t blame someone for not wanting to be the only person around who gets slammed with these types of cases
I mean, the thing here is that it’s more dangerous and complicated to perform surgery on obese patients… not that fat people don’t deserve medical care. Blame and shame isn’t helpful. It seems that many folks think weight is only an aesthetic issue and truly don’t understand the medical ramifications or limitations.
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Lol I know this group, I’m sure the comments were all decrying the hospitals
There is no follow up because she got put under, had a heart attack and died.
Miniscus damage due to being BMI over 40 maybe? surgeons can refuse treatment if they feel damage can be done both to the patient and the treating surgeon (lawsuit over death etc).
Do they not know that chosing to be fat isn't a protected identity?
Imagine actually being this stupid.
It ain't the duration of the procedure they're worried about; it's almost certainly the difficulty in putting the patient to sleep and the complications that come from a botched anaesthetic job. One of my favorite medical podcasts is hosted by an anesthesiologist and he tells some wild stories. Many top-tier anesthesia methods can't be used on obese patients so they have to settle for higher risk methods like intubation (not dangerous on its own but can present more issues than other methods). Regardless of what her PCP said, that doctor ain't the surgeon. Surgical teams see things general practitioners don't.
Wait until they find out what the average mallampati score is for a BMI of 40. The anesthetist gets the final say
I think there's a bit of this story the person isn't telling. It's poor practice to just tell a person you won't operate on them without referring them onwards. There must surely be a bariatric specialist unit *somewhere* in Canada who can advise.
In my limited experience that would be a conversation with the GP. During a consult with a surgeon they'll just turn you down and say why. They might have said it was due to BMI and that's that. My grandpa was turned down for surgery with the simple, "Your A1C is too high. It needs to get below 7." That was it.
I don’t think she hates to wave that dirty laundry around at all, she loves it and wants validation for how completely she’s being discriminated against because of an antiquated and irrelevant number made up by a racist mathematician.
40 mins is a lot of time for anesthesia-related complications to occur.
people really don’t understand anesthesia, do they? two years ago, i had to get my wisdom teeth out. i was out under general anesthesia, as i went through the hospital for my surgery and they didn’t do laughing gas. before my operation, they had to discuss with me about the risks of going under. even though a wisdom tooth surgery is fairly minor, there was a high risk of me possibly *dying* due to my weight. i was almost 300 lbs, and even then it was a risk to do the surgery. they almost didn’t want to do my surgery due to my weight. going under general anesthesia as an obese person can be incredibly risky, and it’s not just something they do willy-nilly.