From: Bev (anonymous@medispecialty.com)
Fri, 8 Feb 2002 12:08:09 -0600 (CST)

This is in reply to:
Re: Fat Girls Under The Knife cathy:- 

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Weight & Smoking in Relationship to Medical Intervention and a Laporoscopy 

Telling a patient that their weight is the reason for lack of success of a medical treatment, especially to treat an infection, is a poor excuse for a Dr. to use. It is equally unprofessional to discuss such a thing with that patient when other people were visiting in that room! It tells me that this was a very unprofessional and uncompassionate Dr.

A systemic infection can be treated by IV antibiotics and/or oral antibiotics. If there is difficulty placing an IV into a vein, they can do a cut down into a vein, or a thoracic infusion, (they place a shunt into the vein in the chest) they can also shunt the carotid neck vein to give an antibiotic. Different % of adipose tissue can be located in different areas of the body, so there is usually a place to introduce an IV if needed.

Weight can offer problems in a laporoscopic procedure as the insult of gasses placed in the abdominal cavity has to be increased to lift the extra weight in order for the physician to have adequate working space. The more gas needed to create that working space also places pressure on the heart and diaphragm, and can cause the patient to become unstable..the anesthesiologist is monitoring the vital signs and will tell the surgeon to back off on gas as they see it creating pressure on the lungs and heart. Of course this reduces the amount of space to work in and at times a surgeon may have to resort to a laporotomy as the possibility of perforating an organ is increased. Laporoscopic surgery CAN and IS done all the time on “ overweight” pateints, IF the surgeon is skilled enough to perform it that is!

Increased adipose tissue can also decrease the healing of wounds as infection can get into the adipose tissue and create a very serious condition called, " cellulites" and is difficult to treat to the point of healing. It can be done though!

Many people are overweight by 50lbs or more, and many patients are still able to go through a laproscopic procedure. People who smoke can also go through a laporoscopic procedure, but that too increases the potential for problems. Lung capacity is decreased, the O2 levels in the blood compromise healing and they may have a difficult time converting CO2 in the lungs and rid it from their body. 

People can lose weight and they can stop smoking, but it is a difficult thing to do when your battling a chronic physical condition that leaves one with emotional, psychological needs that are mostly the result of poor medical intervention! When it is painful such to sit up in a chair for 5 minutes, who is going to start walking a mile a day, or swim, or ride bike or pump up at the local gym? I do have to agree that IF an ARD sufferer is able to do that, then MAYBE they should before their ARD symptoms get worse as when ARD symptoms escalate to the point of decreasing activity due to excruciating pain levels, it is near to impossible to do anything remotely associated with exercise! forget using protein drinks too try to lose weight as they cause constipation, and an ARD sufferer knows what THAT causes! (For non ARD persons, this is not much different then a good marriage, simply meaning to have and to hold for a very long time!)

I also know ARD sufferers who were underweight and never smoked in their lives, and some of them did not survive an adhesiolysis! 

I think I know what you were trying to say here, Sally, but it sounds a bit harsh to say you have a relative who is overweight but you still love her (referring to a posting by Sally) Of course you love her, who wouldn't love someone just because of how they are built, or their appearance?

I have siblings who are: heavy in girth, thin as a rail, tall as a telephone pole, redheads, brunettes, blonds, short, loud, smoke, drink, (and not just H2O), and some of my brothers are balding and I love them all exactly as they are! I am overweight by statistics 50lbs or more..I am considered morbidly obese by all standards. My cholesterol is high. I do not smoke, never have. I enjoy a wine now and then. I am agile, I am fast in my movements. I can touch my toes without bending my knees. I go strong and steady from 6PM - 10 pm, I bowl once a week, I walk short distances, I hike when we are on our camping trips.. and yet to look at me one would think I sit an eat " bon bons" all day. ( Actually, I wish I could at time) I predominantly live on rice and scrambled eggs. I CANNOT eat salads or most vegetables. I cannot eat meat, I seldom eat bread products..I eat NO gravies or sauces at all, I love the thought and taste of Chinese foods, but my body doesn't! I do indulge in it now and then, but only at home. I have no social life such as going out to a restaurant! I have no hair on my arms and legs, , and I am losing hair all the time, my gums bleed when I brush my teeth, and not from any periodontal disease. I suffer nausea much of the time due to NOT eating nutritional foods, or not eating all day or even for two days sometimes!

You might say that I posses the ability, knowledge and responsibility to change my eating habits and ultimately increase my nutritional status. Yup, Dr.s tell me to TRY to eat better and lose weight, and they DO know the reasons why I cannot accomplish that task. I wish I could as the symptoms that linger from my years of suffering ARD have taken their toll on my body and those symptoms I live with will never be compromised through any medical intervention. I live with the residual damage of so many surgeries for adhesions! 

What type of medical condition would not allow for a balanced meal that could lead to weight loss? Try this: Urinary and bowel incontinency and gastroesophogeal reflux disease! A slice or bread, or dinner roll can cause such burning and pain in your chest very shortly after ingesting it! Sauces, gravy anything with a spice in it..well, doesn't take a rocket scientists to figure out what that feels like as it travels down an excoriated ( raw) esophagus! Raw or cooked vegetables, salads, legumes, oleo, oatmeal, cereal, soups, potatoes.FRUIT..aaagghhh! These things create lose stools, increase your fiber content to assist with evacuations...add that on an already nonfunctioning bowel and guess what you have...a diapered 50 year old lady who throws up spontaneously due to reflux!! LOL! Think that getting gas from raw vegetables or beans is tough, think about the results of those foods creating a VERY fast reaction as it goes in one end and directly " shoots " through your system on it's way out the other end..and yes, just as painful as when you have gas! 

Try to take a long walk when you have this " symptom" from a non functioning intestine. Forget swimming or exercising! I stopped attending social dinner engagements after I spontaneously regurgitated my food during a dinner party at a very nice restaurant where we went to entertain clients of my husbands! I tried to say no, but I gave into the prodding of everyone wanting me there..they all said that nothing could stop them from wanting me there..well guess what? I do NOT go out to eat socially..and that is why I enjoy my Chinese meals at home..nice and close to my bud, " John!" 

Oh, if your thinking that a SURGERY might help my intestines and urinary bladder problems, then you not as educated about ARD as you might think you are! I will live with these LITTLE inconveniences in my life verses the pain of adhesions I had for to many years! These things are real, but I have accepted them in my life and have made concessions to live with it ..to have my pain decreased by 95% from my adhesiolysis with Dr. Reich and Dr. Vadali is worth every minute of life as I have to live it, no matter how I have to live! 

Life offers me NO problems, if someone doesn't like how I look, don't look at me, if you don't like what I have to say, don't listen to me, if you don't live what I live then don't tell me how I SHOULD live it! And if I cannot be offered high quality medical intervention because of my weight then I guess I am doomed to die, so be it! IF I needed to secure a high quality surgery in my future, then I am sure that the surgeon who I elect to perform it will be skilled enough to do it, weight or no weight! 

Oh, I almost forgot! I WAS this same weight when I presented to Dr. Reich for my life saving adhesiolysis he performed on me in April 1999!!! Go figure!