As a leading member of the orthopedic surgeon Tampa community, I see many patients every year that hurt themselves through sports injuries or workplace accidents. I can accept that these injuries are inevitable and am happy to treat them. But I have to admit, I get my share of patients who experience orthopedic problems due to their grossly excessive weight. The morbidly obese are likely to break a leg or tear soft tissue just by the heavy load they place on their lower bodies, or by clumsy tripping. These patients are a nightmare to treat. First of all, they are usually sedentary, to the point where they remain in bed most of day or can only move around in a wheel chair. Their muscles and bones atrophy for lack of exercise, setting themselves up for many types of injuries and disorders.
Operating on a very obese patient is complicated by all the layers of extra fat that must be bypassed to get to the surgical site. Often, I work with plastic surgeons to help me create a path to the injured bone or joint. It makes you a little queasy, I have to admit. Then, there is the poor anesthesiologist – these patients are notorious for complications in this area. As soon as I finish setting the bone or fixing the ligament, I let my surgical student close up the patient: it’s like a marathon runner practicing barefoot on the beach – if he can handle this, he can handle anything.
Post-operative diets initially stress easily digestible foods and plenty of fluids. It is not uncommon for patients to lose their appetites for several weeks after surgery, though that is NOT the case for the morbidly obese, who somehow can’t wait to chow down as soon as they regain consciousness. None of us can understand it, since post-operative nausea and vomiting are common. We let them eat melted, sugar-free ice cream – it seems to do the trick.
Over time, patients should adopt a nutritious and sensible diet and drink plenty of water to help the body heal. Also, you will be instructed to take an iron supplement to prevent anemia. Blood loss causes anemia, and a lot of blood is lost when replacing a joint, especially when the patient weighs over 400 pounds. Your diet should center on low-fat dairy, whole grains, fruits and vegetables, lean meats and plenty of fish. Since you may have limited mobility, stock up on healthy frozen meals, and try not to consume four or five of them at one sitting!