Another reason we have to have WLS!

As a person who still suffers with knee and hip problems, I found this upsetting to read: More orthopedic surgeons refusing to operate on obese patients 02/28/2006 A growing number of orthopedic surgeons are refusing to perform hip and knee replacements on obese patients or will perform the procedures only after patients lose a "significant" amount of weight, the Wall Street Journal reports. Although no major studies have quantified how often obese patients are turned away by orthopedic surgeons, the American Association of Hip and Knee Surgeons says refusal to operate on obese patients is a "growing phenomenon" and plans to consider whether to issue "special physician guidelines" for the treatment of obese patients at a board meeting in March. Orthopedic surgeons *****fuse to treat obese patients say such patients often require multiple layers of stitches, take longer to heal because of decreased blood supply to the incision area, and are more likely to develop post-surgical pneumonia or suffer from bed sores. In a study published in the August 2004 Journal of Bone & Joint Surgery, researchers found that the success rate of knee replacements approximately six years after surgery was 88% among obese patients, compared with 99% among normal-weight patients. A separate study found that patients with body mass indices over 35 were three times as likely to require an "additional stay at a rehabilitation facility" and were more than twice as likely to suffer a health-related complication while at the rehabilitative facility. In addition, obese patients are more difficult to diagnose using conventional ultrasound technology because the modality cannot penetrate excess layers of fatty tissue, and IV insertion and injection administration are more complicated in obese patients because "the fat hides the veins." Orthopedic surgeons say operating on obese patients is "far more physically demanding" than operating on normal-weight patients; surgeons often have to use special medical equipment or two operating tables to accommodate larger patients, and health care personnel run the risk of being injured when moving obese patients. However, demand for hip and knee replacements among obese patients remains high because of the pressure excess weight applies to the hip and knee joints; the number of hip replacements performed in the United States nearly doubled from 124,000 in 1993 to 213,000 in 2003, and the number of knee replacements more than doubled from 172,000 to 402,000 during the same time period. The Journal notes that the decision about how many medical resources--and insurance dollars--should be allocated for knee and hip surgery among the obese given the potential complications and need for repeat procedures "raises an increasingly common ethical dilemma" (Naik, 2/28).

Lori, thank you for sharing this article. It is such a vicious cycle for those with hip and knee problems and so difficult to have the prognosis so blik for the obese. I agree it is another good reason for wls. I have such compassion for those who suffer with hip and knee pain. Take good care of yourself. Hugs Aunt Pam

Lori, Thanks for posting this. I know I've mentioned that I worked for doctors for 32 years, and this does go on. It is my firm belief this attitude is the major reason my back deteriorated so badly after my back surgery ... I had more complicated issues (spinally) than my particular surgeon was aware of going in and than he was willing to deal with because of my obesity. As a result, he did only the minimal he *HAD* to do (ie. removed a disc) and told me I had other discs that were bad but "hopefully, those will *resolve themselves*" (direct quote from my followup with him). Translation: "You're fat, and I don't want the added headache." I said this to my PCP a year or two after my back surgery and, for once, instead of hiding behind the "white-coat loyalty" thing doctors do, he agreed. However, he did so while subtly placing the blame on me ... if I hadn't been so fat I wouldn't have found myself in that situation ... you get the drift and I'm sure all of us have gotten that at one time or another in our obese lives. The trouble was, I bought into it, and suffered as a result. I'm sure we'll start seeing this as the next medical $ maker ... Ortho Centers for the Obese, with added costs for accomodation, special facilities and the added overhead malpractice insurance will place on the provider, passed down to the patient, of course. It's a shame. ((hugs)) Myra