Hernia? Lose 100 lbs or we can’t fi

CJ writes:

Two years ago, I found out that I had endometrial cancer. A total abdominal hysterectomy was scheduled by my gynecologist (who I adore and has never treated me with anything but complete respect). The surgery went off without a hitch. I reviewed the surgery report after I had recovered and noted that the surgeon who had assisted my gyn had made a very random note in the middle of the factual recount of the surgery: “The surgery was very difficult due to the patient’s obesity.” I shrugged it off and moved on.
I developed a hernia. After two years, it was starting to bother me and the surgeon felt it was time for repair. I went with the same surgeon because he was familiar with the case and I did not want to wait 4-6 months to get an appointment as a new patient with another surgeon.
Yesterday was the surgery. Or it should have been. I told the anesthesia doctor that I had been told I was a difficult intubation during my last procedure for kidney stones. I’ve never been a difficult intubation before and have been operated on at my current weight in the past. He assured me they’d prepare for a difficult intubation and that from what he was seeing, he’s sure I’d be fine.
I woke up in the recovery room to the news that the surgery had been aborted. They attempted to intubate me 25 times according to what the surgeon shared with my family.
He further told my family that my options were to lose 100 pounds and try again or do an “awake intubation” where I am awake and help by swallowing while they’re intubating me. My husband indicated to the doctor that I’d been operated on at this weight before and it wasn’t an issue.
I’m in a great deal of pain today but the worst part is feeling completely helpless. Once again the problem is my weight and the prescription is to lose the magical 100 pounds. I’m at a loss where to turn or what to do next. I don’t want to go back to this fat phobic surgeon but don’t know what to do next.

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  1. Rhonwyyn

     /  July 7, 2009

    Oh, wow. I feel your pain. I weigh around 365 pounds (just guessing, since the last time I weighed myself was four weeks post breast-reduction surgery when I was down to 350, but I’m sure I’ve gained back the weight in the three months since then), and it’s mostly fat, except for my legs, which are muscular. So if you weigh less than I do, I can’t imagine why the surgeon balked like he did!

    If you weigh more, I can kind of relate, because when I was scheduled to have my BRS, the first anesthesiologist refused to handle my surgery at the outpatient surgery center. Something having to do with my airway. So I got somewhat freaked out. When I went for my surgery at the hospital, that day’s anesthesiologist assured me there was nothing risky about my body type. “those young ones just get scared too easily,” he said. I came through the surgery with flying colors, just a touch of a sore throat, which was from air blowing into my throat, not from intubation like I thought.

    CJ, I hope you find a surgery team that’s more accommodating (and experienced?). Here’s a test for them: If you were going in for bariatric surgery, would he tell you to lose weight first?

  2. lilacsigil

     /  July 7, 2009

    Some people do have problems with intubation, but I’ve never heard of it being related to weight. Good luck in finding a capable surgeon.

  3. I just had endometriosis & PCOS related surgery to make sure it wasn’t cancer. I am about 65lbs overweight and considered obese. The surgeon fixed my hernia and adhesions while she was removing the bad stuff. And I have lost 10lbs since the surgery (which was NOT for weight loss) because the cysts were causing my PCOS hormonal stuff to be much worse.

    I was intubated too.

    Keep looking and do not give up – there is someone out there to help you – they can NOT be the only surgeon in your town. Have you tried ObesityHelp.com

  4. Actually they often do ask people getting WLS to lose some weight first. It reduces the size of the liver so they can get to things better.

  5. Most people who are knocked out for WLS are well into the “deathfat” category, even if they lose some weight first. Anesthesia doesn’t “know” the difference between one type of surgery and another; if they can figure out how to knock people out for WLS, they can figure out how to knock them out for other things. OTOH, there may be a legitimate physical reason for not being able to intubate, as lilacsgil said, but fat alone is not an acceptable excuse. Get a second opinion. Good luck!

  6. Bree

     /  July 7, 2009

    When I had gall bladder surgery in 2001, I weighed about 340 lbs. There were no problems with anesthesia, tubing, and nobody mentioned how hard it was to cut through all my layers of fat to remove my gall bladder. As a matter of fact, the surgeon said I was one of the easiest operations he’d ever done.

    You definitely need a second opinion. There may be other reasons for not being able to intubate besides “you’re too fat, we can’t do anything.”

  7. j

     /  July 7, 2009

    I had my gall bladder out in 2001 and was probably 220lbs. I recently had a hernia (I’m 280lbs. now), the surgeon took one look at me and said “This is NOT your fat, it is NOT your genes, it is NOTHING you did, and nothing you could have done would have prevented it. The ONLY cause of this hernia is that the surgeon removing your gall bladder didn’t seal up the muscle wall very well.” I admitted to years of pain after the surgery that were inexplicable, as it turns out, a better surgeon found it very explicable. He didn’t even suggest loosing weight after the surgery, the only real concern was that during recovery I might strain more with normal activity. I feel great now, I hadn’t even realized how much pain and hindrance was resulting from the hernia.

    Intubation has been somewhat odd, but post-surgery, I found out during an exam by a Sleep Medicine doctor that everything in my airways is very small and at unusual angles – loosing weight won’t change that fact.

    Perhaps getting a whole new set of doctors will be a better solution? Maybe see an ear/nose/throat doctor to check on the shape of what’s in there, and find a new surgeon who knows what he’s talking about!


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