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
a 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!

2.) No place to inject the Lovenox

For 1 week post-op,
one must self-administer anticoagulant injections into the
subcutaneous 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!

3.) Food post-surgery

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.

4.) Weight loss

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