It’s 2015. If doctors don’t know how to operate on fat bodies. Then they shouldn’t be doctors. We have enough resources an equipment to deal with “obese” patients. There is no need for the medical community to continue fat shaming.
Let’s talk a little bit more in depth about how obesity affects surgical procedures.
In most serious, intensive surgeries, you’re probably going to be under anesthesia, right? And you’re probably going to have medications to take afterwards. Stuff like this filtered through the kidneys and liver.
Obese patients have much higher rates of renal hypertension, which affects the kidneys, and morbidly obese patients have a 90% likelihood of having abnormalities in their liver.
That all adds up to a really bad time, and drugs being filtered out of the system quicker and therefore not working as intended. And you really want your anesthesia to work right when people are cutting into you.
In addition to this, some weight-based drugs are affected by fatty tissue, and some are not, so this can cause problems in determining the proper dosage.
Obese patients are at a higher risk for deep-vein thrombosis – this is when a blood clot forms in a deep vein, like in the leg. Surgery is recognized as a risk factor for DVT, and so obese patients undergoing surgery are doubly at risk.
Finding veins in the patient is also made difficult – it’s the difference between finding the edge piece in a 1000 piece puzzle, vs finding it in a 100 piece puzzle.
It’s harder to monitor blood pressure in obese patients as well, as standard cuffs may not work due to there being too much fatty tissue between the blood vessel and the cuff.
When you’re performing surgery, you have to pull back the flesh and muscle to get to where you’re trying to operate on – the more you have to pull back, the more difficult this becomes.
This image shows how much more you’re having to work through when doing an operation on an obese person:
So no, it’s not a matter of doctors being bad at their job. Surgery by itself is a difficult and risk-laden process – adding obesity on top of that adds an uneccessary layer of additional risk and complexity.
Sources:
Palmer M, Schaffner F. Effect of weight reduction on hepatic abnormalities in overweight patients. Gastroenterology 1990; 99: 1408–13.
Albert S, Borovicka J, Thurnheer M, et al. Pre- and post-operative transaminase changes within the scope of gastric banding in morbid obesity. Schweiz Rundsch Med Prax 2001; 90: 1459–64.
Ramsey-Stewart G. Hepatic steatosis and morbid obesity. Obes Surg 1993; 3: 157–9.
Clain DJ, Lefkowitch JH. Fatty liver disease in morbid obesity. Gastroenterol Clin North Am 1987; 16: 239–52.
Marik P, Varon J. The obese patient in the ICU. Chest 1998; 113: 492–8.
Ribstein J, duCailar G, Mimran A. Combined renal effects of overweight and hypertension. Hypertension 1995; 26: 610–5.
Braekkan SK, Siegerink B, Lijfering WM, Hansen JB, Cannegieter SC, Rosendaal FR. Role of obesity in the etiology of deep vein thrombosis and pulmonary embolism: current epidemiological insights. Semin Thromb Hemost 2013
Allman-Farinelli MA. Obesity and venous thrombosis: a review. Semin Thromb Hemost 2011; 37:903-7.
This is very true. When I had open heart surgery, there were various complications as well as problems with the anesthesia because of how fat I was. Thanks be to God my surgeon was top notch. But the fact of the matter is that if I was a thinner patient, the surgery would have been far less traumatic. In fact, if I had not put on so much weight, my aortic valve would have lasted me longer. So, yeah, biological and scientific realities are at stake when you carry too much weight.
I have seen some communities on tumblr try to push a “body positive” self esteem agenda by dismissing health risks of obesity as fat bias.
Yes. You can be beautiful no matter what your body looks like.
No. You cannot always be healthy regardless of what your body looks like, and while self confidence is important, taking care of yourself and addressing health problems-including being overweight- is important.
Thanks for someone being honest and real about the risks of obesity and the medical field
Im glad this didnt explode and now ive learned a little more about health risks and obesity. Thank you tumblr
I know it’s illegal but whenever I get antibiotics from the doctor I save a few and give them to friends or coworkers who don’t have insurance so that when cold season comes they might be able to shorten their illness
That is not good- that’s not quite how antibiotics work.
Antibiotics kill some bacteria, but don’t manage to kill other bacteria. Just like when you get a particular sickness (or a vaccination), your body can protect you from future infections, any bacteria that came into contact with the antibiotic is protected from future doses of that antibiotic. Bacteria are very virulent breeders, so they spawn more resistant bacteria.
If you take the full dose of antibiotics, your natural antibodies can deal with the cells that are resistant while the medicine kills off the bacteria that isn’t resistant. If you don’t take the full course of antibiotics, then your body has to deal with both the resistant and the non-resistant strains of bacteria, and it can become overwhelming. Also, most bacteria are able to pass on genes between still-living cells, so that previously non-resistant strains become resistant, and you have inadvertently cultivated a stronger strain of bacteria.
Furthermore, colds and the flu are viral infections, so antibiotics don’t work against them anyway. The best protection against viral infections are vaccinations, as there are not many viruses that we have developed anti-viral medication against, once you already have the disease. If there are anti-viral medications, it is even more important that you take the full dose of the medication, because anti-viral medication is even harsher against the body than antibacterial medication is.
Yeah, not how it works at all. I get your intent there with health care access, but that’s literally worse than not taking any antibiotics for your friends, on pretty much every level.
Sharing is not caring when it comes to medication It is risking the health of everyone involved
This. Because we have clients who save their animals’ antibiotics and give them to their other pets when they get sick or injured to save money.
being a female means needing to see 10 different doctors to get a proper diagnosis because they always think you’re exaggerating and/or lying
define proper diagnosis. I mean, does that just mean the diagnosis you want?
no :) it means going to 10 different doctors who disbelieved your symptoms until the 11th found cysts on your ovaries :) which may mean infertility :) sit on a cactus :)
I call bullshit
Of course you do. Like the first 10 doctors. 😒
I call bullshit on the story. If you think you have an issue you should see a specialist not just your PCP.
Like the 4 “specialists” I saw for the crippling numbness in my face and legs I had for over a year while they told me it was “stress”? When it was finally found that I had scars on my brain and spine? Those “specialists” we’re male neurologist who wouldn’t give me an MRI because “women stress too much”. Go fuck yourself.
MY SPINE WAS BROKEN FOR 2 YEARS BECAUSE MY DOCTORS TOLD ME I JUST HAD BAD CRAMPS AND REFUSED TO TAKE XRAYS. FUCK YOU AND YOUR ENTIRE LIFE. WHEN WILL BOYS REALIZE THEIR EXPERIENCES ARENT STANDARD???? I ALSO LOVE THIS IDEA THAT YOU CAN JUST GO TO A SPECIALIST WHENEVER YOU WANT LOL IF OUR PCP DOESNT BELIEVE US WHEN WE TELL THEM OUR SYMPTOMS THEY ARENT GONNA REFER US TO A SPECIALIST YOU FUCKING MOLDY WALNUT
My parents began noticing something large in my throat, saw a specialist….Guess what? Told me to lose some weight..even though I wasn’t overweight. I would have my period for weeks at a time. Was told that it was teenage hormones and stress.
Two fucking years later I attempted suicide they ran a battery of tests as required and bam! They find out that I have untreated Hashimoto’s. The “thing” was a goiter. Possible symptoms of an untreated thyroid disease is the goiter, unexplained weight gain, and depression. All they had to do was test my blood, but they said young people don’t have thyroid problems. 😒
-Allie
Ten years ago, my mother—who is a pretty tough cookie—started feeling both ridiculously wired, anxious, and incredibly emotional. Every doctor she saw told her she was going through early menopause, even though she was still menstruating. Her health declined to point where she was barely sleeping, losing weight, and crying constantly, which was a huge red flag because my mother never cries. Finally, she went to see another doctor 2.5 hours away who referred her to an endocrinologist. And what did the endocrinologist say? He diagnosed her with one of the most advanced cases of Grave’s Disease he had even seen, and said if she had gone just a few more months without being treated, she could have FUCKING DIED.
Also, it turned out that her thyroid levels had been moving out of the normal range in a progressive pattern for years, but nobody bothered to look at her past test results until after the diagnosis. They would just do a test, see that it was “in the normal range” and leave it at that. She could have caught it before she even had symptoms, instead of basically being accused of having hysteria.
i had a brain aneurysm/hemorrhage ten years ago, doctors still tell me im faking my disability BECAUSE YOU CAN TOTALLY FAKE LIMITED MOVEMENT OF THE LEFT SIDE
My sister had intercranial hypertension which was causing headaches, dizzy spells and loss of vision, and you know what the hospital told her? She was being a hysterical girl and making it up. A few weeks later she spent roughly a month in hospital and had several lumbar punctures to relieve her RECORD HIGH spinal pressure that was causing so much strain on her brain and optic nerves she was being sent blind.
Everytime I see this post (and it’s been a good 5/6 times), it has different stories and experiences of women who have been horribly mistreated by doctors and it just blows my mind that this is so big. It’s absolutely disgusting how terribly women are treated in the medical world and something needs to be done about that.
my friend lea had back pain, then pain in her legs and feet, and then numbness. despite seeing 7 different doctors over 2 years, by the time they found the cancer it was inoperable. chemo and radiation didn’t work. the cancer spread. she died and left behind a 5 year old daughter.
A few years ago I would go through spells where I literally could not stand on my own and I couldn’t get out of bed. I would be freezing and too weak to eat. I would keep having heart palpitations as well. I got up the money to go to a clinic and they told me it was just stress and to basically just work on chilling out. I saved up money for a few weeks to do this and I pretty much get a “chill out” from them.
As time went on it got worse, most noticeably the heart palpitations were happening almost constantly. I went again to a different clinic and was told it was normal and that it was probably stress. They did no tests, and they told me it would “just go away”.
Two weeks later I ended up collapsing going down some stairs, and at the hospital it was discovered that I had such severe anemia that my heart could barely keep up with trying to get enough oxygen to my body. I had developed left ventricular hypertrophy (my heart muscle is too big) and because of them ignoring me and dismissing me I’m at a much higher risk of heart attacks and stroke now.
I went to the doctor with severe intermittent pain in my upper right stomach area that was so bad I had to miss school. Despite the fact that my period has been on a regular 3 month cycle for years, and I still had two months left until my period, my doctor told me it was period related cramps and or indigestion. 2 months later I’m in the hospital getting my gallbladder removed. It was so obstructed that there was gangrene developing my my system.
So…everyone who’s given me shit for that one post (about medicine and equal treatment and shit) can just read this because I’m sick of defending my case.
HOSPITALS. ARE. ALREADY. REQUIRED. UNDER. LAW. TO. PROVIDE. LIFE. SAVING. EMERGENCY. CARE. REGARDLESS. OF. ABILITY. TO. PAY. OR. EVEN. CITIZENSHIP.
Stop acting like Americans have no access to emergency healthcare unless we socialize medicine.
IF. YOU. GO. AND. CAN’T. PAY. YOU’RE. STILL. THOUSANDS. IN. DEBT. THIS. IS. NOT. ACCESS.
This hospital in my city just threw out a homeless man
The hospital which took me in after I collapsed from the fist sized tumor over my heart, released me after refusing to diagnose it as cancer, which would have forced them to give me some kind of treatment. The doctor at the county hospital which took me in looked at their tests and said, “this is CLEARLY cancer, why didn’t they diagnose it? We can’t let you leave.”
Hospitals find ways when they want to, to avoid helping people when they want to.
“Oh that’s illegal, you should sue” “ with what money and how will I get the time and energy when I’m busy recovering from chemo?”
People who can’t afford treatment also can’t afford to protect their rights.
Absolutely this: “People who can’t afford treatment also can’t afford to protect their rights.”
Hey, ever heard of somebody who just dropped dead of a heart attack suddenly, nobody thought they had anything wrong with them? Everybody thought they were perfectly healthy?
Know why they were never diagnosed with heart problems, never had a chance to get preventative treatments?
Fatphobia.
Medical anti-fat bias means that many thin people never get tested for cholesterol or other things that are indicative of heart disease, because many doctors think there’s no need to test them. Meanwhile, fatties with no history of any problems with these things get tested every single time. Often when they go in to see a doctor for something totally unrelated, doctors want a cholesterol check.
Because a correlation between fat and heart disease exists, some — too many — doctors assume that only fat people are likely to have it.
Fatphobia in medicine isn’t only killing fat people. It’s killing thin people, too.
-MG
Literally experienced this, thin privilege backfiring on me. My small fat roommate and I were the same age. We both went in for a physical at around the same time. She got a whole shitload of bloodwork that gave her cholesterol level, blood sugar, and told her about many vitamin deficiencies. I asked for the same, and was told my insurance wouldn’t cover it. I had better insurance than her.
I had to beg to get my b12 level tested, because my family has a history of depression and I’d heard there was a relationship, and my doctor kind of fudged a reason to check that and one other thing. Later, I got a bill, because my insurance refused to cover it.
Turned out my b12 was DANGEROUSLY low. I was well into the “psychiatric side effects” range. (I’d just gotten used to hiding in the bathroom and sobbing multiple times a week at work. I… don’t do that anymore.)
What other vitamins am I deficient in? I have no idea. I’m taking C and D and kind of hoping for the best.
Because fatphobia and healthism say that because I’m thin and relatively young, I can’t possibly be unhealthy.
Weight first treatment kills everyone
This is why I shy away from the doctor. Every single ailment I have is because I’m fat according to them. It hurts my feelings a lot. Maybe I’m just sick because I’m sick?
My doctor actually recently (two weeks ago) had the gall to try to diagnose me for sleep apnea and allergies (caused by the sleep apnea) because I made an appointment for a check up because I was sick, congested, and had a sore throat.
He gave me a prescription for fucking Zyrtec and told me I should get a sleep study done because my weight was likely the cause.
I went and got a second opinion from a local walk in clinic and turns out I had a fucking upper respiratory infection (caused by a virus) and it was on its way to becoming pneumonia. It had NOTHING to do with my weight.
I’m lucky I didn’t actually end up in the fucking hospital over it.
Yeah, you should let your doctor know that the one study that claimed to prove that fat physiologically caused sleep apnea turned out to have been falsified. The researcher admitted to it, retracted the study, and accepted censure. We’ve posted about it a couple of times now. The researcher’s name is Robert Fogel, and if you look around, you can find the official retraction. Maybe take that in to your doctor.
On the other hand, poor sleep does seem to cause weight gain, which suggests that for any correlation between fat and sleep apnea, the causation runs the other way.
-MG
The amount of fatshaming in medicine is ridiculous. I noticed during the very first year of my medical studies that doctors will try to pin everything on people being fat, including the flu or too thin hair. They will even say stuff like “but they weren’t even overweight????” when a person dies of heart failure as THE FIRST THING they can think of. They never say “but they didn’t even smoke” or “they didn’t even have high cholesterol”. They say “wait they weren’t fat why were they ill”
It gets even worse in Psychiatry. “Well if you lost weight maybe that would help the depression”, “I don’t understand why he’s still so unsure of himself. He lost about 40 pounds, he looks great.”
I have literally heard someone say to a rape victim “He chose you because he knew from your body type that you weren’t likely to outrun him.”
For decades, my mother-in-law had been a bit rounder than most women - mostly genetic, as many women in her family have been that way historically, and been perfectly healthy - but was experiencing a strange, seemingly randomly-occurring symptom of blood in her urine from time to time.
Doctor after doctor would look for the cause, but most fell back on some variation of her being overweight. Meanwhile, she continued steadily gaining weight, year after year, even though she ate less and less.
At the beginning of Thanksgiving week 2010, she went in for a checkup with her new primary care physician. They went over various things - like how tired and drained my mother-in-law felt, for a start - and as they were about to leave, the doctor had them drop off a blood sample, because she had a hunch and wanted to check something (creatinine levels, in case anyone is curious).
When they got home from the visit, the phone was ringing. It was the doctor.
“Good news! I know what your problem is. Bad news, your kidneys are failing. Go to the hospital now.”
Her kidneys had dropped below 10% function, the minimum for healthy living. It turned out, after extensive testing and a lucky incident, that she’d been having small, minor kidney infections for decades, which had been slowly chipping away at her kidney function - hence the ‘random’ blood in her urine.
Doctors had mostly just told her to lose weight and get more fit - when it reality, she was retaining water because her kidneys were slowly failing. She was otherwise completely asymptomatic for kidney failure.
The first week of dialysis, they extracted fifty pounds of water from her. It was agony to go through, but she felt amazingly better after that (wonder of wonders, a working faux-kidney, and she felt better? gasp).
But the fat-shaming didn’t stop there. Later, once we’d determined I could give her a kidney, her assigned transplant doctor’s first statement upon entering the room (she’d been previously instructed to lose weight to a certain point, to make the surgery safer, which she’d actually been doing just fine, if a tad slowly) was, “Your problem is portion control.”
At that point in time, she was eating no more than 800-1000 calories per day, and feeling full from that, but he didn’t believe that she was being truthful, and for the duration of the time she had to interact with him, he continually insisted she was eating too much. (She still eats less than everyone else in the house, and she’s the only one ‘classically’ overweight, though much less so than before the transplant).
By the time of the transplant, she was down to only 3% kidney function, despite dialysis six nights a week. Had this not been caught when it was, we probably would have lost her by then.
Thankfully, since giving her one of my kidneys, she’s been able to maintain a healthy weight and be more active, though she will always remain ‘rounder’ because of her genetics.
For years, doctors assumed all her problems were because she was overweight when, in fact, her being as overweight as she had been was a symptom of an underlying problem.
Unfriendly remind that ~25% of thin people have “obese” problems which leads to awful things, like has been said. If you’re thin, please be careful about believing doctors who just say, “you’re not overweight, so you’re fine!” b/c fatphobia is shit.
This is so obnoxious. I am very small built so not only does everyone think I’m very healthy, but they think I am skinny and constantly comment on how little I must eat. As a small child I was a bean pole and light as a feathery. Then I suddenly gained weight with puberty. I am 5'3" and when I was fifteen I weighed 160 LBs. I was miserable and uncomfortable because I am small boned and lethargic regardless of my weight so I couldn’t handle the extra weight. Literally doctors told me that my weight was healthy. My bmi must have been twice what it is now at 135 LBs. I had chronic knee pain. But because I was “so tiny!” and “not fat just have a cute little double chin!” Because I wasn’t “fat” in other people’s perceptions I was ignored when I complained that my weight bothered me. I eventually lost the weight through vigorous exercise, 90 minutes a day on a bike. (and in hindsight was really over working myself) I still don’t know if that is the cause because due to neglect, poverty and financial abuse I still haven’t received any consistent medical care, my hair became and remains dramatically thinner than during childhood and early adolescence and I have a number of health issues that I don’t recall having before I lost the weight. End rant.
I lost my ovary because of my weight. When I was in college, I was walking to class with my friend, (and carrying about 60+ pounds worth of art supplies), and I felt a hard and painful *pop* in my lower abdomen. I dropped to the ground and was rushed to the campus urgent care, where they told me it was probably a hernia and needed to see my doctor. Now, I’m not exactly skinny. I’m 4'11 and over 160 pounds. Besides fibromyalgia, physically I’m relatively healthy. I went to my physician, a little beanpole of a woman, who, to my every complaint replied “it’s constipation. You need to lose weight and you’ll be more regular.” Well, for two years I kept getting the same response. The same pain, in the same place. Finally one day at work it got so bad that I collapsed on the floor crying in the middle of a breakfast rush. I had to actually get angry and raise my voice before my doctor would send me for scans, and she said “maybe it’s appendicitis.” After getting an MRI, it was discovered that I had a tumor in my ovary that had been there since I was born but started growing when I reached adulthood. In the past two years it had been growing and destroying my ovary. If it had been dealt with when it first presented, They would have been able to save my ovary and since the tumor wouldn’t have been so huge, the surgery wouldn’t have been so invasive and my recovery would have been much shorter and much less painful. But since I was overweight, my doctor just assumed that it could be solved with exercise and a better diet. (Which I had already been working on.) TL:DR because I’m fat, my doctor ignored my unrelated health problems so now I’m less likely to have children.
I was refused birth control by my doctor because of my weight. She essentially told me that she wouldn’t trust me to take the pills on a regular schedule unless I lost a significant amount of weight and proved to her that I had the discipline for it.
When I had my gallbladder problems which I lived with undiagnosed for 5 months, (mix of genetics and the Yasmin I was taking. The Yasmin just sped things along) I had an attack that left me weak and unable to breathe properly. So I was rushed to the hospital. Not only was I asked with serious lack of caring if I was in labour.. When I said no, she took her sweet time checking me in and then handed me that god awful heartburn shit that they give people. I nearly puked it up.
When I finally got to see the ER doctor she was more interested with taking a phone call from another hospital then treating me. When she finally did take a moment to “treat” me it was two slaps on the back declared I didn’t have a kidney infection, and that it was acid reflux and my back injury I got from a 40lbs box of chickens falling on me at an old job. With a thinly veiled comment to lose weight my problems would go away.
Saw my GP the next day and he could feel something poking through my ribs and set me up for an emergency ultrasound.
On the way home I had another attack and my mom just thought I was hungry, since I hadn’t eaten in days. Are two grapes puked them back up pretty much right then and there. She called the doctor office and they told her to take me in and that they were phoning to let the hospital know I was coming. When I finally saw the second doctor (7ish hours after I arrived at the ER) he did lab work and found I had a failing liver.
I had an ultra sound the next day and found out that I had gallstones, pancreatitis that was days away from going septic and because of that a failing liver.
Lucky me got surgery four days after everything was said and done, but that first doctor in the ER could have killed me. I’m glad I didn’t believe her that my problem was weight related.
Doctors blaming all my issues on my weight instead of checking and treating my (turns out) severe autoimmune hypothyroidism (which, wow, was contributing to my weight) meant that I had to have a complete thyroidectomy and follow-up radiation treatment because the damage and hypertrophy in my thyroid had turned into a massive blob of thyroid cancer that was compressing my trachea.
Now I may or may not have lymphoma and will have to be on daily medication and a kidney-pummeling amount of calcium for the rest of my life! Thanks, medical establishment.
Thanks to my old Dr, it was 5 years before I was diagnosed with my autoimmune disease! Everything was because I was fat! Broke a toe stubbing it on a wooden stair, it’s because of my fat. The constant chronic pain/inflammation all due to my weight My depression, anxiety and compulsive behaviors are all due to my fat as well Migraines? Fat Insomnia? Fatty fat Anxiety? FAT Every cold or bout of pneumonia FAT Gynecological pain? WAY TOO FAT
Thankfully I have a new Dr and he *listens* to me. I have Fibromyalgia. I have Akylosing Spondylitis I have a rheumatologist I have a pain management specialist I have a gynecologist I have a urologist A fantastic Dr who listens to me, right away.
Me: Both my legs hurt. I can’t walk normally.
Doctor: Ok but you have diabetes because fat
Me: I don’t have diabetes. I don’t even have pre-diabetes. Look, here’s my bloodwork. My a1c is so normal it could ski the Bell Curve.
Doctor: Ok but diabetes.
Me: No.
Doctor: Ok but you should lose weight because your big fat ass is causing mechanical issues in your legs.
Me: … that seems fake, but okay. I’ll do what you say.
Me: Hey doc, I can’t lose weight because I CANNOT WALK OR EXERCISE AT ALL. It’s been 2 years. I can’t go to the bathroom on my own anymore.
Doc: How about I do another MRI on your ankles?
@adhocavenger: Fuck this asshole. Let’s go to another doctor.
Doctor Kate: … this is nerve pain. Maybe you have a compressed disc pressing on your spine. Let’s MRI your spine.
Me: Ok.
Doctor Kate: … uhhhhhh, you have a tumor the size of a large grape inside your spine; it’s compressing your spinal cord and that’s why your everything hurts. Good thing we caught it before it destroyed your spine and left you paralyzed entirely.
Me: … so it isn’t because I’m fat?
Doctor Kate: … fat doesn’t make tumors inside your spine. That doctor is stupid and I will call him and tell his office to never call you again, because he is a jerk. But not being able to move probably caused you to not be able to lose weight like he demanded.
