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BMI Too High

Discussion in 'Knee Replacement Pre-Op Area' started by Inagaony, Apr 5, 2017.

  1. Inagaony

    Inagaony New Member
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    Member Since:
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    Location:
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    Hi,
    I'm almost 47 years old and have a BMI of 38. I have chronic osteoarthritis in my right knee with significant deterioration of cartilage resulting in bone on bone grinding. I was told 5 years ago that the only option would be for me to have a total knee replacement but I was far too young so would not be considered. 5 years down the line the pain is unbearable. It is ruining my life. I can only walk short distances, it interferes with my sleep and my job and my social life is non-existent. I have been told by the CCG that I am too overweight to have the operation and have to lose weight, no help offered. My doctor applied for individual funding which was turned down immediately without any consultation with me. Please help! I am so frustrated.
     
  2. Jaycey

    Jaycey Moderator

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    @Inagaony Welcome to BoneSmart! Sounds like you are a victim of the postcode lottery that is becoming far too frequent here in the UK. I live in East Riding and do know that healthcare here is way underfunded. They are looking for any reason refuse treatment.

    How much weight are you supposed to lose? Surely there is no chance to do that when you are having mobility issues due to pain. And BTW - age has nothing to do with TKR. We have teenagers on this site who have had the surgery.

    Tough call fighting a CCG. I'm going to tag @Josephine who is also in the UK for her input. If it were me I would be writing letters and demanding my rights as a patient!
     
  3. KarriB

    KarriB Forum Advisor

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    I don't know much about the U.K. health system. Can you look for another OS who would be willing to take you on? I can tell you that I am overweight, but my OS went ahead and did the TKR. He understood that with a sedentary lifestyle I wouldn't be able to lose weight. I'm currently trying to take off weight so my left TKR will be an easier recovery.
     
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  4. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    @Inagaony whereabouts are you in Yorkshire? Because the surgeon who did my knees has no issues about BMI.
    I had a BMI of 43 (254lbs) when I had both my knees done (5 years apart)
    I also nursed a lady who had her knee done and had a BMI of 63 (400lbs) and she did terribly well.

    If you're prepared to come over to Sunderland, you could get yours done by him.
    Just read this NHS choice: Patient's Charter and your right to choose.
     
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  5. newlybionic

    newlybionic Forum Advisor

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    That's terrible! I'm so sorry for you. My BMI is just a bit less than yours and my OS didn't even mention it at all. It's impossible to get fit when you are in pain. I hope you can be able to find a way to get your surgery soon.
     
  6. Inagaony

    Inagaony New Member
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    Hi,thanks for all your replies. I live in Cottingham just outside of Hull. My doctor told me to cut down to 500 calories a day to lose the weight which I tried but it just wasn't sustainable. I didn't lose weight and felt ill. I eat quite a good low carb diet but after an initial 1 stone weight loss have failed to shift any weight for 7 months.
    After I begged my doctor to help me (I was sobbing and pleading) she eventually referred me to see a surgeon. I had been asking for over two years to which I was told I was too young. When she eventually agreed the rules to a BMI of 35 had just come in so they automatically refused me. I appealed and also wrote to my local MP David Davis who in turn wrote to the CCG. They advised that I asked for Individual funding which my doctor did for me, stating in this proposal that I was severely depressed because of the pain, was relying on morphine daily and was often wetting myself as I'm unable to climb the stairs quickly enough to get to the toilet plus a list of other things. Again they refused due to my BMI
     
    Last edited: Apr 6, 2017
  7. Celle

    Celle Forum Advisor

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    @Inagaony - did you see Josephine's offer in Post #4? It's something worth considering, especially as you are in so much pain.
     
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  8. Inagaony

    Inagaony New Member
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    My doctor then sent me to a pain clinic where I have been having acupuncture - I was allowed 6 sessions which proved to be frustrating as I was having to take time off work in my job as a teacher and also ineffective. However, I met the most amazing physio who tried to help. She managed to get me an appointment with a surgeon in North Yorkshire who took new X-rays of my knee (the first for 5 years) and was prepared to operate, even going as far as filling out the forms. This was until he weighed me and rang his manager who then said their policy was a BMI of 30 or under, so he then took back all the forms and threw them in the bin! By this point I was pleading with him but stated that these were the rules and I needed to go back to my gp.
    The physio then managed to get me on an exercise on referral scheme to which I've been attending but the pain when exercising is immense, it's bad enough standing on it, doing my job. My gp does nothing to help. They believe I should lose the weight but offer no help. I wrote back to my MP and received a letter yesterday from him with one enclosed from the CCG stating that overweight people need a second knee a lot sooner than normal weight people and that they take longer to heal, I know this is not true.
    I had ovarian cancer two years ago and had major surgery from which I recovered really quickly and was back at work after 5 weeks. I just want to sleep, walk, work, play with my grand children and live like a normal person without the pain. Also as a concsequence my left knee is now suffering.
     
  9. Inagaony

    Inagaony New Member
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    Location:
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    Josephine thank you. I'll have a read of that document whilst I'm off over Easter. I was about to visit Citizen's Advice over the legality of the CCG' s decision. I would certainly go elsewhere x
     
  10. Josephine

    Josephine NURSE DIRECTOR, BONESMART Administrator

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    Well then, go see your GP and tell him you want to be referred to Mr Shaun O'Brien at the Royal Hospital Sunderland. If your GP prevaricates, you have to be strong and quote the law which is in the article on NHS choices. He cannot refuse you. Let me know how you get on.
     
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  11. Jaycey

    Jaycey Moderator

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    @Inagaony please let us know if you have any problems getting this referral from your GP. You may need to be firm and don't take "no" for an answer. It is your right as a patient to be referred to a physician of your choice.
     
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  12. Inagaony

    Inagaony New Member
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    Thank you, I had no idea I could do that. I shall go next week. She is quite a battle axe but I will be firm! Thanks for your help x
     
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  13. Jaycey

    Jaycey Moderator

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    Be sure and tell your GP you want a referral to the specific surgeon Jo has suggested - not just to the hospital. She may try and tell you that you can't do this. But I did it - twice! It is your right to choose!
     
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  14. earlgrey

    earlgrey New Member

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    Apr 8, 2017
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    Hang in there. I live in Tennessee and I first went to three surgeons who came close to laughing at me. They didn't mind charging me an arm and a leg(I know how that sounds).A very nice lady on Bone smart let me know about a doctor who works thirty miles away that said he would do it if my doctor said I could pass a exam. By the way i'm BMI 45 and had given up on my thought of getting my RTKR replaced. Call everyone you can and ask the nurse if there is a BMI limit. It's not a sure thing yet, but I have hope that I have not had in six months. God answers prayers.
     
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