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BMI 40+: No joy?

Discussion in 'Knee Replacement Pre-Op Area' started by Marketask, Jun 1, 2017.

  1. Marketask

    Marketask
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    I am told by my Osteo doc that a BMI over 40 excludes me from having knee surgery. I have painful spurs, losing use of leg muscles, poor balance, frequently falling. Is it true that super obese folks get no relief? I still want to walk. Anyone else working to reduce BMI for a chance at surgery? Any supersized folk actually had KR?
     
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  2. Celle

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  3. sooz58

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    I am way above that # and having surgery the 13th!
     
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  4. earlgrey

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    Hello
    I have a BMI 45 and had a hard time too. I was shot down by five OS before a very nice lady from Nashville told me about a doctor close to where I live. I have a date of June 19th if every thing works out. Don't give up. Call every surgeon and ask if they have a BMI limit. I paid for three surgeons (will pay someday) before finding one. I almost gave up and the next day God gave me hope again. Never give up!
     
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  5. keefsmom

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    BMI at 40, day 9 post op and doing quite well, thank you! I would never let any doc who sees me as nothing more complicated than a math calculation lay a hand on me and neither should you.
     
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  6. Gone again

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    I had a Surgeon tell me at a BMI of 36 he would only do posterior THR. If I wanted an anterior I would have to loose 60 pounds. I found another another surgeon.
     
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  7. Josephine

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    I get so cross when I hear about this because there are many surgeons out there who are much more accommodating and sympathetic than this.

    I had a BMI of 43 (254lbs) when I had my right knee done and 46 (297lbs) for the left (5 years apart). But my surgeon is a darling! I nursed one of his patients who had her knee done with a BMI of 63 (400lbs) and she did terribly well.
     
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  8. PolarBear60

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    Find another surgeon (challenging to do without significant travel in your area, but it will be worth it). My BMI is 43. I had both knees replaced at that same BMI. The left was two years ago, and the right was a year ago. Both knees and I are doing well.

    With my increased ease of movement, I would have hoped to have been able to drop some of my weight by now, but, for whatever reason, that has not happened. I am, however, able to move much more easily and have very little knee pain (negligible and shrinking) at this point. I love my new knees, and my surgeon had zero problems accommodating my weight (averaged around 280-285 for both surgeries). He acknowledged there were some increased risks, but he didn't consider them to be show stoppers. He understood the long-term benefits of being able to move without excruciating pain.

    Keep looking. There's nothing wrong with working to achieve a healthier weight for your body, but it shouldn't be the only factor in determining your canidacy for knee replacement. You could have other health matters that might complicate matters, but if the only reason you were given was BMI, that's rubbish.
     
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  9. Ruby9297

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    I was told the same. I have actually lost count of how may OS told me my BMI was too high. So 5 years ago I had Bariatric surgery and got my BMI down to 33. I went back to the doctor, who then told me that I was too young! I am now 53, with a BMI of 36, and was asked to lose more weight before the surgery, while I was also told, "this is not the time to go on a diet, your body needs all the nutrients it can get." Talk about mixed messages! I am finally scheduled for July 13th. I have suffered for probably 15-20 years, I have actually lost count, except that I know when we bought the house we live in now (14 years ago) one of deciding factors was that this is a one story house because it hurt my knees too much to go up and down stairs, and I'd been dealing with that pain for quite a number of years by then.


    Sent from my iPad using BoneSmart Forum
     
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  10. GingerP

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    @Marketask . I am sorry that you were told the same thing that I was told.

    When I first visited the surgeon that did my LTKR in December, he said get your BMI under 50 and get some of the fluid off your legs (edema problem ) and then we can talk about surgery. Well, I did all I could to lose 30+ pounds and when my appointment came around I was 49.9. So he says you just made it, so we can schedule the TKR.

    I ended up with my leg tissue not healing probably for lots of reasons, but he was then quick to throw it back to me that he "took a chance on me". Relating it that I was too heavy. He then did another surgery to fix the problem and only moved it down the incision line and I'm still on a wound vac.

    Now he has left the clinic I go to, so the other surgeon is young and he draws a very hard line and says NO to anyone over 40BMI, thus, I won't be able to even talk with him about having my right knee done.

    In the meantime, I have called two other area surgeon's offices and asked them directly if they would consult with me about knee surgery and told them up front that I am now about 48 BMI. I was told by both that their Dr sometimes goes up to 42. I met with one of the surgeons and he and I talked about what I have been through and what I am needing for my right knee. I told him what I weigh, yet not once did he say he wouldn't do surgery on me.

    I am doing all I can to try to lose maybe another 20-25 lbs in the next 4 months. I know it's a hefty goal, when I pretty much can't do any exercise. I see this surgeon again at the end of August and we will see what he has to say.

    I was also told that anesthesia has issues with people who are overweight. Please, let me tell you, my TKR was done well and I have no issues whatsoever with the joint replacement at a 49.9. My leg tissue is needed to heal only.

    There are surgeons but it is getting more and more difficult to find them. I was told by the new surgeon I saw that the university hospital will reject referrals if they are over BMI numbers, sight unseen.

    It's a form of discrimination based on weight - what are we to do to be able to live a decent pain free life? Keep looking.

    I'm trying to lose what I can to show I'm serious about helping myself. I do know that it is better for the joint and our recovery to weigh less, but when we are hurting how can we do anything to make it that way? Wishing you the best of luck. I know this is terribly disappointing. I have been there too.
     
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  11. Giggles10

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    Thank you so much for responding. I am so sorry for all that you are going through. I met with a general surgeon last week and he thinks the mesh didnt hold from the hernia surgery he did 7 years ago, so i will probably have to have that repaired in my abdomen before doing a knee replacement. He has scheduled me for tests this week. I was so sure i was going to get my tkr scheduled at that last OS appointment that i signed up for my first cruise with several of my friends for March 2018. So now i am working against the clock to get everything done and time to heal. There is no way i can go on a cruise in my condition now.
     
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  12. bashbago

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    I hope you were able to find another OS to do your surgery. I think I had a BMI of 45 for my RTKR. I had no problems with the surgery or healing. After nine years the replacement looks good. I know the towns are far apart in ND, so finding a different surgeon may not be easy. I wish you the best.
     
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  13. froggymom

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    I totally understand the trouble with the dr and bmi. It took me ten years alot of pain and tears to find the dr thats done three implants for me both hips and one knee. There is hope the right dr is out there amd im sure your perfect dr will come along soon. Good luck take care and have a blessed night.:hi::flwrysmile::flwrysmile::angel:
     
  14. Jajakio

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    The difficulty of finding a surgeon willing to operate at 40 plus BMi depends a lot on where you live. I'm in US. Tennessee to be exact. A lot of world class Nashville hospitals. But it isn't just the surgeon. Two hospitals I looked into won't allow elective surgeries (like knee replacement) on over 40 BMI and I found the fine print on my Obamacare insurance policy will also not approve over 40 BMI knee replacements without extenuating circumstances ( insurance rep told me this meant like a broken bones or something not just severity of osteo).

    All this happened within the last 12 months. Long story short I lost 40 pounds since January 2017 and had my total knee replacement surgery July 7th at 39 BMI. I'm 10 days out and doing great. Prior to surgery I had spent the last 6 months doing hot tub exercises recommend by physical therapist. I could barely stand for 5 minutes without pain so walking was kind of out but I found I could bicycle sitting down in hot tub. Therapist devised 20 minute program of bicycling, leg lifts, etc and I exercised in the hot tub 20 minutes twice a day nearly everyday. Even before surgery it helped with the pain and I really miss not being able to get in now.

    Any way at 10 days post surgery I am doing well. Pain was rough but is slowly getting better. Physical therapist says I'm ahead of where I need to be with 98 ROM at one week. I worried about effect of higher BMI but so far, so good. I tried to lose weight for years without success but I was forced to figure it out by total lack of other choices.
     
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  15. Giggles10

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    I am so happy you are doing well and thank you for responding! My BMI changes every couple of days, but it is back up to 41.0 today. You would think I could lose 10 lbs easily enough but it just won't happen. I saw my general surgeon last week who gave me test results of a hietal hernia in the lower esophagus and ulcer. But, at least he didn't say bleeding ulcer or something requiring surgery. I talked to him about not being able to lose weight and he is referring me to a Non-surgical bariatric doctor to help me figure it out. Then he referred me to a new Orthopedic surgeon....who turns out to be....WAIT FOR IT...the SON of the Orthopedic Surgeon that I had been seeing that keeps turning me down and telling me I am too young. They are even in the same clinic! Well, I guess I will roll with it and see what happens. Neither office has called to schedule an appointment yet.

    Continue to do well and thrive!
     
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  16. Iloved3

    Iloved3

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    My BMI is 40 and I had LTKR June 14. I have done extremely well and my surgeon said I am his star patient! I reached 130 degrees of flexation and 0 degrees of extension before week six of recovery! I was terrified I would be a failure at recovery because of my weight.

    Keep looking for a surgeon who believe in you and show them how it is done!!!
     
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