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over weight spine patients

karenlkkarenl Posts: 42
edited 06/11/2012 - 8:45 AM in Degenerative Disc Disease
to all over weight spine patients or orthopedic patients have you ever gone to a MD specialist ( surgeon) and found them not to take much interest in your pain. However they went on and on about you weight. I guess they forget that you see your self ever morning when you pull you self out of bed stand there in pain trying to wash up. Now if it was the foods you ate you would have gained 100 pounds the first year just sitting around. The problem is as we all know lack of movement and that is due to pain. But the specialist look at you as a waste of time , after surgery you wont help you self and you will continue to gain weight. You will not be a success story for them. Over the past year I have been to so many Dr.s I have spoke to some Dr. about how I feel about some of these specialists and they have agreed there are Dr.s out there that are bias and how they label over weight patients. I was just wondering how many out there in spine world has come across some.


  • I know I am about 30 lbs over weight. And I had 20 of that before this all started. So while not terribly overweight I know that I am not where I want to be. But as you say it is hard to control the weight now between the meds and the restrictions both from doctors and pain.

    I just went to my GP this week about my weight. She ordered blood tests to determine if the meds I am on are causing the weight gain in which case she can prescribe something to couteract the weight gain. Other than that I'm kinda on my own. I have thought about the weight products that are on the market but I'm concerned about mixing with the prescription meds.

    Back to your question - yes I do think some doctors judge patients and the likelyhood of successful outcomes. I have had ultra healthy doctors who look at me and I know they think I am lazy because I'm not a size 2. In their defense doctors do need to evaluate the whole patient. So if a 400 lb patient comes in they need to consider the likelyhood of a successful surgery given the weight and activity level.

    Where I think this goes wrong is the doctor who only uses his eyes and his personal perjudices to make a decision on a patients healthcare. A good doctor will explain what he thinks and talk about his concerns. Generally a 400 lb person is not healthy or active. But I have known some very overweight people who are active. So unless the doctor asks the questions he may make very poor decisions.

    When I sense that a doctor is judging my weight I try to be proactive by saying I know I need to lose some weight. And ask what they suggest.

    The world is full of judgement. How you deal with it is what makes a difference.
  • I am lucky I had good Dr.s who knew I was not lazy work hard and held a great job. Two of my Dr.s had sent me to specialists and was furious with their lack of interest to help me. They knew I had serious spine problems both MRI's showed that. When I lost my job due to unable to to work one of my Doc wrote a nasty email to this surgeon I now have him calling me to take me on as a patient. Out of respect of my doc I will go to him but I won't hold back.. I hold him responsible for me losing a lot of what my life was. If he treated me like a thin person as my doc said my life today may have been back to the way it was instead of sitting in the house all day in pain.
  • We all make decisions and take action based upon the personal experiences that have shaped our lives. A doctor who has had one or more bad experiences with an overweight patient, is going to be influenced by those experiences. If for instance there was a case of failed back surgery syndrome and the doc could clearly identify the patient's weight as being a large part of the problem. Would it not be in the best interest of the rest of his patients for him to use his experience/s in a manner that will give the patient the best odds for a successful surgery and recovery. Does it make a doc a bad person when he/she tries to help someone by pointing out that their weight is a huge risk factor? Are we not always looking for the straight up truth from our docs in regards to our condition and the expected outcome of any surgical procedure?

  • That's something to think about. I've lost 45lbs since I last saw the Orthosurgeon and wonder if the new Dr. I'm seeing will say anything different to me. I know I left one PM Dr. because he kept saying it's hard to get the needle(epidural) through all this tissue. I guess I was offended but it's tough because you already know you're overweight but sure isn't an incentive to lose the weight. I stopped going to him because who needs to be insulted?

    I like to believe that if you really need surgery and nerve compression is going on it doesn't matter if you're overweight first of all, it's your urgent nerve compression that's the real issue.

    It's even harder to lose weight when you're not able to exercise much but I had to cut my food intake and drink lots of water because I was hungry. I don't even crave the stuff I used to eat. Anyway I have a hard time looking at my Dr. consult notes saying thank you for referring this pleasant obese patient. Who likes to see that? I'm still called that and I'm size 14. I was size XXL or 2X when I was first ill. We know that weight brings up a lot of health risks but so does high cholesterol and you can be thin and have that. My brother had to have major surgery and the Dr. told him to lose weight or the Anesthetist wouldn't do his surgery because there's major respiratory risks involved. Also where I work if you're over 330 lbs and you have surgery you're put in the ICU mainly due to blood pressure and resp. problems.

    Sorry I wrote so much but understand what you mean. I have the same pain I did when I was more overweight now I'm thinking maybe that's why they never took me seriously. I hope you find a Surgeon to help you out. I'm still awaiting a 4th consult. Best wishes. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Wow!! That was a large post for you! :) I was around 45 pounds above my "normal weight" after surgery and introduction to Lyrica. I have trimmed 23 pounds of it - though you wouldn't know looking at my belly!!! lol!!! I am not enough over weight to be "pre-judged" but I can understand it. My NS sees my "happy me" is gone, and as such thinks some of my pain is due to being bummed. Okay..... I can deal with that.

    What stinks about society, never mind doctors, is the ole "first impression" game. Doctors are the same, they see us chunky and label us! I have found if they "see" you are working on getting rid of the weight, they are more amicable to our situation? I HATE stereotyping period!!!!

    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • However I don't have high blood pressure 110 over 60, my cholestoral is 172. I don't smoke , drink, or due recreational drugs.My Numbers are probaly better then people half my weight.
    But It does stop there I was sent to another doctor about a problem in my hands. When the dr asked me to explain the problem, I told him when I use my hand it swells up and the pain is intense. He comes back and says how can you tell your hands are swollen your hands are so big any ways. Yes my hands are big , but my entire family has large hands. Sisters and brothers. I have sisters 1/2 my size that wear the same size ring as I do. But these are the comments that I have endured. Or the overweight Dr. given me the physical to start a new job, way over weight stinking of smoke and tells me to loose weight. I told him I know I looked in the mirror this morning , did you ?
    To end this The surgeon I was talking about wants to operate on me right way , says I need to have it done and he would be more the happy to help get well. I think some told him I was not lazy , I was always a hard worker. Worked the past 29 years in pain. You can understand why I prefer to stay way from spcialists.
  • Before I had my surgery I weighed in at 487 pounds, and all the doctors kept telling me to lose the weight and my back would get sooooo much better. Well when you cannot walk, or sit or stand, how are you to exercise. I had my surgery, and 5 years later i have lost 257 pounds and still counting, so there is hope, granted, I do still have alot of pain, but my surgery was put off way too long. But do NOT give up hope. I almost did, but I kept trying, and now I am glad I didn't.
  • Some doctors are jerks and some struggle to explain themselves well. From what I have read, the risk of hardware failure is greatly increased in lumbar fusion patients with a BMI over 40. My surgeon is a very kind man, and has done a microdiscectomy and lumbar laminectomy on me while I was obese. However, when I needed a fusion he told me, as is his responsibility, that to be succesful I would need to lose weight.
    For that reason, as well as other health concerns, I decided to have gastric bypass. My fusion is scheduled for 9/9/10. Yes, my back still hurts, but my lower leg pain has improved some.
    Physically, I understand the rationalle that weight loss can improve back pain, but I donn't think that is true for everyone. In my case I think I have just done too much damage maybe.
    Like someone said, it is awfully hard to lose weight when you are in extrordinary pain. We all have to decide what is best for ourselves. Hopefully our doctors will learn how to tactfully guide us toward health.
  • I first started having back pain when I was 7 years old. From childhood until my mid 20'S I was for the most part, underweight. (at 12 I was just over 5 feet tall and weighed approx. 85-90 lbs. By the time of my knee surgery when I was 17, I was just under 5'10" and weighed in at 130lbs. I, like many others I know, gained weight when I started working a full time job and purchased a car (before that I walked everywhere). Laziness (FOR ME!) and poor eating choices had my weight going up with every year.

    Did my increased weight harm/cause/increase my back pain? I'm sure it didn't help it. But, I had several episodes of such bad pain in my pre and early teens that I'd miss weeks of school from not being able to stand upright or walk unassisted, the pain was so bad... and it had nothing to do with my weight.

    I have no doubt that my pain would at least decrease in a way if I could lose some of the weight... if for no other reason than that I'd be able to walk better and possibly increase muscle mass.

    I've been somewhat lucky in that most of my doctors over the years have been able to treat me without blaming it ALL on weight... part of that could be that I tend to stick with the same docs over the years, hehe... I tend to outlast them usually, sadly.

    I would find it remiss if my doctor didn't bring up my weight problems and it's possible effect on my health. I wouldn't see a doctor that had "problems" with fat people... I'm fat, I know it... now tell me what I can do about it... not just blame it on that.

    If you've got a doctor putting it all on your weight, it's probably time to start looking around... I mean, if you aren't comfortable with bringing it up yourself ... but for them not to mention it at all... that would get me wondering as well.
  • I think some of this is "shooting the messenger". If weight is felt to be a big issue in your condition then it would be a very bad doctor who did not tell us so! The fact is that it is fairly common sense to realise that my weight will have an impact on my back - a bit of a no brainer really. I think we've all become far too sensitive about this issue. The doctor has a clear *duty* to mention what he or she sees as contributory factors. If we start wanting doctors who will only diagnose what we want to hear then we may as well just ask our plumber or newspaper boy for medical advice! As people say, if you are not active because of your condition then it is hard to lose weight, but thats not our doctor's fault either. I've managed to lose weight before mine got out of hand, but as I can't do much in the way of excercise, it took a complete radical re-education of my diet and a couple of years. I'd much rather have a doctor who told the truth than one who would only tell me what I'd like to hear.
  • I too have experienced the weight discrimination by surgeons. Before I injured my back, I was a healthy 24 year old "fluffy" woman. Since I have been on so many steriods, steroid epidurals, and the fact that I was in severe pain, I definitely gained even more weight. I went to the first spine surgeon, and while he said my weight has definitely sped up this problem, it was NOT the cause of my unique condition. After having a bone scan, he determined that my case was "too critical and too unique" for him to take on, he passed my case over to the University of Kansas Medical Center. They were supposed to be the dream makers that took on more high risk patients.
    When I went for my appointment, the first think they did was weigh me. I was 228 pounds. For the 3 hours I was there, the surgeon never once came in! He send in his PA and said that my case wasn't severe or critical and then gave me 2 surgical options. He told me that they didn't know which one would be better, and that I would have to choose. Then he says, "your weight today was 228 pounds, and the limit on our operating tables is 175. In order for us to do the surgery of your choice, you need to drop 50 pounds. Here's our card, call us when you've lost the weight and we will schedule the surgery." I tried to explain that when you are in so much pain you can't walk, sit, stand, and your entire left leg is numb from the discs compressing on your leg...it is a little difficult to exercise and lose weight. He said that I would have to find a way to make it happen.
    I went back to my PCP to see what my options were, and of course he said the weight limit on the tables were 300-500 and that they basically didn't want to takemy case because I was fat and it would affect their success rate. I was beyond stunned. So long story short, my PCP put me on Adipex to help me from gaining any more weight, and I will not be going back to that surgeon. I now have a neurosurgeon who is fantastic. it really makes me sick to see how people who are overweight are discriminated against.

  • When I first saw my ortho, I told him I was doing Weight Watchers....he told me that weight has little impact on most back problems. Funnily enough, when conservative treatments didn't work, he told me that losing weight would in fact help....he then told me that I would be a potential candidate for ALIF of the L5/S1 but he didn't want to do the fusion on someone of my age (28 at the time), told me to call him back when I was having more severe nerve problems, and referred me to pain management.

    Whether weight impacts successful fusion...I'm not sure. However, weight cycling is more harmful to one's overall health than staying fat in the first place. I'd rather just find a doctor that is honest and caring about my pain and my spine needs than someone that won't admit the 95% failure of weight loss.
    1/16/2013 Minimally invasive TLIF with rods, screws, and cage on L5/S1 joint to treat grade 2 spondylolysthesis, pars defect, degenerative disc disease. Dealt with chronic pain & nerve issues since at least 2007.
  • I am 38, back in Feb 2010 I was diagnosed with severe disc degeneration of the L5 S1. When I saw my Mri results I couldnt believe what I was seeing. There was literallly what looked like a dust speck that was all that was left of my disc. I literally had bone rubbing on bone (tailbone). I met with my neurosurgeon in May and sched my surgery for Oct 20, 2010. He told me to try and lose 30 lbs before having my surgery. Losing weight would help benefit in my recovery. I can only imagine the pain others feel, all I know is that some mornings I cried getting out of bed. However, in talking with the neurosurgeon since he was albe to tell me that the pain I had after exercising wasnt making my spine worse. I did wht I had to do. I managed losing around 20-25 pounds. I had a lumbar fushion. back pain totally gone. Only experiencing muscle pain. Per neurosurgeon total recovery time is 6 months-1 year after surgery..... I have noticed a difference in things I do around the house now, I dont have the back pain like before... Stay positive....
  • I'm a 61yrs woman and have severe osteoarthritis in every joint in my body, have had both hip and knee replacements, extensive back surgery, and more to come.
    About 3 yrs ago, my ankle, which has NO cartilage left-just bone on bone, finally got so bad my PCP referred me to a podiatrist for possible fusion or joint replacement. I am 5'2" and weighed about 137lb at the time; I'm truly "big-boned"-large hands and feet, really wide shoulders, and muscular build. The podiatrist, a total A-hole, says he doesn't do that type of surgery, and says "lose some weight" before sending me away. I was OUTRAGED! After that I developed really severe back pain, between the pain and the meds, I felt so awful for so long, I didn't eat much, and dropped 25lbs in 6 mos. without even trying. I found that even tho I still felt awful, it was MUCH easier to walk! I'm still gonna need the surgery eventually, but its bought me 4-5 yrs of being able to walk almost normally without it. So, don't dismiss all the drs who tell y'all to lose weight! With any type of orthopedic problem in legs and back, it makes an enormous difference! Everyone says at 113 lbs, I really look pitiful, like I have cancer or something, but I sure can walk better!

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