BHR risks of the very thin patient

July 13, 2008

Aside from the challenges of being skinny, my surgery and recovery have been very successful. The X-rays at 6 weeks looked fabulous, the doctor team has been accessible by telephone, and at 8 weeks I am swimming, riding bike, and walking nearly free of a limp.

I’m a very skinny person.  My body fat is in the less than 2% range, so hard to measure exactly.  I know many people envy such a condition but it is just the way I was born.  For the benefit of other thin people anticipating BHR, I’d like you to know there are potential complications.

1.) Damage from surgical clamps

One day post-op, after the epidural was removed, I noticed the skin on the anterior thigh was numb.  The surgeon and his assistant speculated that the clamps normally used to stabilize the pelvis during surgery don’t have much padding.  Since I had so little padding, they probably damaged the subcutaneous femoral nerve.  Two days later the numbness had vanished, so no big deal.  But if I were a thin patient I would advise the surgeon to add some padding to that clamp for me!

For 1 week post-op, one must self-administer anticoagulant injections into thesubcutaneous fat, usually in one’s “love handles” on the side of the abdomen.  The drug is absorbed into the fatty tissues.  With only a millimeter of subcutaneous fat, I struggled to get the full injection under the skin.  It would usually produce a bulge under the skin that would subsequently disperse over a period of about 20 minutes.  I don’t know of a solution for this, but be prepared for the challenge!

Because one must fast for 12 hours before surgery, and the hospital will likely offer little or no food for 12 hours post surgery, a thin person can feel pretty famished.  I recommend you bring snack foods to the hospital and put them in easy reach so you can eat whenever you need to.  The nursing staff at Stanford Hospital had only milk and apple juice on hand.  I think it is bad to be hungry at any time during recovery.

I lost 5 pounds following surgery, and today, six weeks post-op, I’m still trying to gain it back.  I suppose most of the weight loss is muscle atrophy, and I know I will gain it eventually.  I just want to stress it is so important to have lots of good food on hand and easily had, especially if you are largely on your own after returning home from hospital. Smoothies always taste good, and are easy to make if you have the stuff on hand. Sometimes it is tough to cook when you are hungry and tired and doped up, too.

Brian R-BHR 6/28/08 Dr. John Lannin