Denied SRS for being overweight?

[annahell]

Hi all,

I have been lurking around here forever, but this is my first post! Woo! First off, I really appreciate all of the work and response you all have put into this board. It has been a tremendous resource for me and it's always the first place I check when I have any kind of trans-related questions. Thank you!

A bit about me: I started HRT in June 2008 and started living full time in May 2009. I am scheduled to have surgery with Dr. Brassard in Montreal next week (my surgery date is May 9th).

So, to my question...I have lost A LOT of weight in preparation for surgery (almost 40 pounds), but I am still about ten pounds away from their suggested limit. I should be able to lose at least five more pounds before then, but that is still five pounds over the limit. Other than that, I am in good health and fairly fit (I don't smoke, rarely drink, exercise 4-5 times per week for at least an hour, I'm a vegetarian, etc. )  Have you heard of anyone getting sent home for being over the recommended weight (for Brassard or any other surgeon)? Was anyone here close to the weight limit but still allowed to have surgery? Has this been answered somewhere else on Susan's that I missed?

I know there is wide variation in the requirements and some seem a lot more strict than others. I'm really hoping it works out because I honestly don't know what I would do if I couldn't have surgery that day. I feel like I've worked very hard and jumped through so many hoops just to get here. I know I'm not doing myself any favors by getting all worked about this, but I can't help it. 

Anyway, thanks in advance, everyone- any advice would be appreciated.


-Anna

[Kristyn]

When I had my surgery in Montreal there was a girl there  who was really heavy.  I would guess she was more than 200lbs.  If you're only 5 pounds from the limit, you might be ok but you should be able to lose that extra weight if you really try--it's only 5 lbs.

[annahell]

Thanks, Kristyn! So, the woman you spoke of was allowed to have surgery, right? If she was around 200 pounds, that's well under their current recommendation of 220 pounds...I'm over that. (I only read that figure in an email from Josee - it's not posted anywhere and it isn't mentioned in the packet of information I received from Brassard's office.)

You're right, five pounds won't be hard, but, like I said, I'm closer to ten pounds over right now. It would be very hard for me to lose ten pounds in eight days.

[Kristyn]

Yeah, she had her surgery and I'm pretty sure she was over 200lbs.  She was big and she was taller than me--I'm 5'11" and she was a good two to three inches taller.  I'm pretty sure if you're 5 or 6 pounds over you will be able to have your surgery.  Try real hard but don't starve yourself or you won't lose any weight.  Eat high protein high fiber foods

[annahell]

Thanks for the support! Weird, maybe she had a lower BMI because she was so tall? It's hard to tell when you don't know the specifics, but it's comforting that she was able to go through surgery without any problems. I'm a bit shorter than you, a little over 5'9", but I feel like I carry it well. Then again I could be completely self-deluded.

I'm really going to try to lose the entire amount - I feel more confident about things now than I did this morning and ten pounds seem like it might actually be possible. I'm going to try to stick with mostly raw vegan food with lots of protein and fiber - shouldn't be too difficult!

[luna nyan]

As with all elective surgery (and yes, even though it's an essential part of the process for us, it's _elective_ in the fact that you're not going to die of disease if you don't have it immediately), the doctors will tend to be more conservative on their assessment of whether you're fit for surgery.  In most surgical procedures, risks are increased if the patient is morbidly obese or overweight.  (Higher chances of anaesthetic complications, etc etc)

Annabell, it sounds like you're doing well in losing weight for surgery, keep working at it and you might surprise yourself and hit target! *cheer*

[annahell]

Agreed! I totally get that medical providers have insurance constraints and they want to do all they can to ensure that they have good outcome and survivability statistics. I have no problem with them trying to manage costs that way. And a person should do everything they can to present a healthy body for surgery - it's such a major procedure and you could potentially be under anesthesia for hours. Still, it seems like an arbitrary number and I'd be very surprised if he didn't take other patient information into account when making his decision.

I'm definitely working hard at losing the last little bit! (even tho I'm so sick of dieting by now). The thing that was really bothering me was the rapid weight gain I experienced after stopping a juice cleanse (I did the Master Cleanse for 30 days). I get why it happened, my body wasn't used to regular food and my metabolism had slowed to a crawl, but it was still frustrating to watch. Today was the first day I didn't gain any weight (and I actually lost about a pound) so that's exciting all by itself! I think my metabolism is back to normal now, so I'm going to try to eat high protein/low carb with a lot of raw veggies and I should be ok.

[luna nyan]

Still, it seems like an arbitrary number and I'd be very surprised if he didn't take other patient information into account when making his decision.

I doubt it's arbitrary.  Especially regarding the general anesthetic, complication rates related to patient obesity statistics are pretty well established (see link here.  As far as SRS complication rates are concerned, I would guess that there wouldn't be particularly good statistics established.

[Annah]

i have to agree with luna. The weight number isn't arbitrary. They use your BMI based on your height and come up with the weight thresh hold.

Doctors have this threshold because comorbids can develop to will put you at risk for having surgery overweight. Doctors, naturally, do not want to be sued for complications so when it comes to elective surgery, they will err on the side of caution.

Eat high protein, lower fat, lower carbs. Keep you calories at 1200 a day. You'll lose the weight.

Trust me..its easier losing the 10 pounds than it is worrying up until operation day whether or not the Doctor will commit to your surgery because you are still above his threshold.