Need a D&C? Nope, need to have WLS first.

Sarah writes:

I’ve been fat all my life. I was only a few months old the first time my mother tried to put me on a diet, but fortunately the pediatrician she consulted told her that babies simply don’t overeat and to feed me as much, or as little, as I wanted.

From reading the stuff in here, it sounds like I’ve had extremely good luck in doctors. I’ve had a few problems over the years, but for the most part they’ve been overshadowed by the good ones, which is what has kept me going to doctors, and has kept me honest with them.

A recent experience, however, has left an extremely bad taste in my mouth. I’m in my 40s, probably 150 pounds over my ‘ideal’ weight and I recently needed a D&C. Before the minor surgery I needed to pass a medical with the head anesthesiologist. He took one look at me and decided that I wasn’t fit enough for the surgery and set out to prove it. He scheduled me for test after test – blood pressure, EKG, treadmill test, echocardiography (ultrasound of the heart), various blood tests. I jumped those hoops and went for each test – all passed with flying colours. He didn’t contact me after the tests, but neither did he deny nor approve the surgery – just kept postponing the surgery until I took more tests. My gyno kept prodding him, and he finally agreed to see me again. He said I needed to lose weight. I asked him about the test results, about which showed problems that precluded the surgery. He had to admit that nothing was found to contra-indicate the surgery (but just because they didn’t find anything, that didn’t mean I was healthy). He recommended bariatric surgery (note this is major surgery – far and above more serious and life threatening than a D&C). I asked him why, if I was healthy enough for this kind of major surgery, I couldn’t have the D&C. His response was that the bariatric surgery was necessary to “save my life” – that, even though I happened to be healthy enough for surgery right now, that within a few years I would be at death’s door and wouldn’t be able to have any surgery at that time, so I had to have the bariatric surgery now. All this took over a year, between scheduling tests, bouncing back and forth from my gyno, my GP and the hospital. And he still wouldn’t approve the surgery. Between his comments and several discussions about exercise and diet, I finally concluded that the man lived a pretty miserable life, he denied himself all pleasures, forced himself to exercise, never had a pleasant meal, no smoking, no alcohol – a life totally bereft of pleasure, and he takes one look at me and assumes that I must indulge in everything, and deny myself nothing. So he was going to deny me a needed surgery in order to pressure me into living my life the way he deemed I should – and incidentally get his anger and frustration out in a way that he could fool himself into believing was for my own good. In my final appointment with him I ended up yelling at him, I didn’t accuse him of half the stuff I wanted to, but I told him that my habits weren’t going to change, I sure as hell wasn’t going to fuck up my life with bariatric surgery, but in spite of that I was healthy enough for this surgery and he had no right to deny it. In the following week I saw my GP who asked me where we were on the surgery. Now, I had written down a little speech, because I knew my anger would end up erupting and I would say stuff that would get him defending his colleague. I told him very simply that I was healthy enough for the surgery, but the anesthesiologist was denying the surgery in an effort to blackmail me into a healthier lifestyle. My GP didn’t believe me – basically said that no doctor would do that! Yes, it was a doctor’s role to point out things a patient did that could affect their health (smoking for example), but there was no point in haranguing them over it, and it was not their business if the patient chose to continue the behaviour after the warning. In spite of his lack of belief, he said he would follow up with the anesthesiologist. A week later my D&C was scheduled. My GP was angry, he finally understood that I had under reported that idiot doctor’s attitudes and I really felt vindicated. I never had to see the idiot again, I got my surgery, which went extremely well, by the way, woke from the anaesthetic feeling well and chipper, with very little pain and discomfort from the surgery. But this should never have taken a year to accomplish! I also have to wonder about how many other fat people he denied for surgery, not because they weren’t healthy enough, but because of his stupid prejudices. Or worse, how many gave in to his manipulations.

On a side note this stupid doctor kept forgetting my actual medical conditions while obsessing about my weight. I have Grave’s Disease – this is a HYPERthryoid condition (extreme weight loss being the defining symptom – yeah, yeah, so I’m anomolous I’m fat with Grave’s, unusual but not unheard of). This anesthesiologist, in one appointment, referred to me as HYPOthyroid three separate times, I corrected him each and every time, and yet it could not penetrate his thick skull. Yes, I’ve had plenty of doctors assume I was using the wrong word when taking a medical history, but after confirming that I knew what I was saying, they dealt with it, but not this guy.

PS: I ran the spell checker and it wanted to replace bariatric with barbaric. Strange how the spell checker seems to know better than some doctors.

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13 Comments

  1. O.C.

     /  August 24, 2009

    What is with these doctors who seem to think that surgery is a right afforded only to HEALTHY people? Did they never do a rotation in an emergency room? If you were 100% healthy you wouldn’t need the surgery!

    Reply
  2. vesta44

     /  August 24, 2009

    The thing is, other than her need for the D&C, she was healthy. She passed every test he could come up with with flying colors. It was his fat-phobia and prejudice that assumed that just because she was fat, she was unhealthy and therefore didn’t deserve a D&C and would die a few years down the road without WLS (and let me tell you, if she had had the WLS, THAT could have killed her a LOT sooner than her fat ever would have). Those kinds of assumptions are what keep fat people from getting the care they need when they need it.

    Reply
  3. Doc

     /  August 24, 2009

    Anesthesiologists cancel obese surgeries a lot. It’s part of their job to prevent complications. Sometimes the obese shouldn’t have surgery.

    Reply
    • vesta44

       /  August 24, 2009

      Doc – That may very well be, but in Sarah’s case, there was no need for him to say she should have a much more dangerous WLS surgery BEFORE she had a D&C. I would almost bet that if she had had the WLS, there is no way she would have been healthy enough AFTER the WLS to have had a D&C. It was sheer fat-phobia on his part, and I would venture to say you’re somewhat fat-phobic too if you’re defending him.

      Reply
      • Lori

         /  August 25, 2009

        I can’t imagine any situation in which a person would be healthy enough for extremely serious surgery like WLS but not healthy enough for a relatively minor surgery like a D&C. If it would be dangerous to put somebody under anesthesia for a D&C, it would seem to be negligent to suggest that they be put under for a longer, more serious procedure.

        Reply
    • Sniper

       /  August 24, 2009

      What the hell are “obese surgeries”?

      Reply
  4. lifeonfats

     /  August 24, 2009

    It’s frightening that some doctors insist fat patients have WLS, which is a very life-altering and risky surgery with many physical complications, yet refuse to do lesser, more basic operations. Not everyone who is overweight or obese needs WLS to live a quality life. Good for you for sticking up for yourself and questioning this doctor’s prejudice.

    Reply
  5. O.C.

     /  August 24, 2009

    Yes, Vesta, of course. Maybe I should have been clearer that I am responding to a pattern we’ve seen in the stories on this site of doctors refusing to operate on fat people until we lose weight and thus become “healthy”. When the point of surgery is to correct a health problem.

    Reply
  6. Lori

     /  August 24, 2009

    I’m so sorry you went through this. I wonder, if you had gotten WLS, how long would it have taken you to have been well enough for the D&C? I would imagine it would take a long time to be strong enough to safely undergo another surgery after such a serious one. I just cannot believe that a relatively minor procedure would be withheld from a healthy person, in an effort to bully her in into getting a far more serious and medically unnecessary procedure.

    Reply
  7. Piffle

     /  August 24, 2009

    I chuckled at the spell-checker comment, thanks for that!

    Well, now we know why fat people cost more: fatphobic doctors make them prove themselves healthy enough for minor surgery with a battery of tests they’d never prescribe for a thin person. It’s all so clear now!

    Reply
  8. Wow, that’s disturbing. Most D&Cs can’t be put off for a whole year. (Often it’s problematic to put it off for a month.) I’m glad you were finally able to get the care you needed, and I hope the delay did not damage your health.

    Reply
    • Sarah

       /  August 25, 2009

      Thanks. Fortunately the delay did not cause damage, inconvience for me, certainly, but no damage to my health. Although it easily could have, since part of the surgery was diagnostic, checking for cancer and so forth. If cancer had been found, a year’s delay could have been catastrophic.

      Reply
  9. MargB

     /  August 24, 2009

    Where is the unfuckingbelievable button when you need it? Yes, some obese people have medical complications. So do some people who are their ideal weight. It is perfectly reasonable for an anaesthetist to double-check that your heart isn’t likely to give out under the pressure of an operation. It is not reasonable for him/her to lecture you on your long-term health/refuse to operate/recommend alternative major surgery when you pass such tests with flying colours.

    Really glad that you have a supportive GP whose focus is you and your health, not his own insecurities.

    Reply

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