Need to lose 9lbs in a week - help!

[Sylver75]

I was scheduled for urgent neck surgery on Feb 29th, got a call 3 days before to say it was cancelled and to ring back in 14 days when I'd lost 14lbs. I decided to cut calories to 600 per day and lost the first few days, then it ground to a halt. I upped calories to 900 hoping it might help but I'm still seeing very little movement on the scales (0.2lbs) this morning, I weigh daily. I'm drinking two litres plus of water, eating mostly protein (eggs, chicken or turkey) but am panicking that I'm running out of time.

I risk being paralysed from the neck down without this surgery. The surgeon fought the anaesthesist to get it done but they wouldn't budge.

I'm 48, BMI is 48.4 and they want it below 47 by next Tuesday. That's 8.5lbs in a week.

I tried my GP, she just talked me into going on Ozempic so I'm on that now too since last week but at 600cals the injection isn't gonna make me wanna eat less than I've been doing already through sheer willpower.

I'm desperate at this point. Not getting this surgery will be potentially catastrophic to the whole rest of my life.

Has anyone got experience of having to do this?

I can't exercise, I've been warned that any jerking of my neck could be disastrous so I'm risking it all just by going to work or doing anything at all. The surgeon said it's the type of injury he'd normally see if someone had been in a car wreck. I've not had any accident but have degenerative issues with my spine, this will be my third surgery, had two on my lower back already and 15 years plus of pain.

The Republic of Ireland health system makes the NHS look well funded and for most people you have to pay for basic medical checks. €50-€65 per person/child per GP visit for example. Doctors are paid better in comparison to the UK but all do private work at consultant level and there are just enough medical staff or beds. Private medical insurance is a necessity really but I'm still surprised if the risk is this severe and imminent that action hasn't been taken.

I meant guidelines should change to allow the choice to lie with the patient, rather than flatout denying essential surgery to someone because of their weight. Nobody would be losing their licence 🙄

Give over. Of course it just can't lie with the patient. Anesthetists should be able to go to work and care for patients, where caring means that they aren't expected to put patients at incredible risk - even if the patient is incredibly desperate happy with that level of risk.

Op if this is a private hospital I’m not sure I’d trust what they’re saying. Can you contact your gp?

Everyone is at risk during surgery. You give informed consent to take those risks. The risks are higher with a high bmi, but why shouldn't an overweight person have the same right to decide if they want to take those risks?

I wonder if you'd feel the same if it was you being denied such important surgery.

Yes, everyone is at risk and great care is made to make that risk as minimal as possible. Some people are at far greater risk than others and I think the people involved in that surgery should have a right to step away from a situation in which the level of risk goes beyond what they are happy with. These are people too.

A dietitian?

Ive heard it all now. OP isnt on weight loss diet in terms of lifestyle, she simply needs to shift a few pounds to meet a BMI level for an operation. She just needs to fast/liquid diet for a week or so

A dietitian is not needed for this, its not a lifestyle change she is making or a long term action

Its not 'unsafe' any more than having an operation is 'unsafe' or having chemo is 'unsafe'. Its a means to achieve an end, thats all.

If you're going to need to do another urine test next time, consider buying some urine sample pots yourself (from the pharmacy or even amazon) and doing your sample at home so you don't have to drink loads of water which will definitely have added weight.

I rang the hospital today to see if I could at least be given an appointment sometime in the next few weeks by which time I will be down to the 47 BMI, I'm at 48 now.

They said the anaesthesists won't even allow an appointment for the future to be made until I get to 47. I'm having worrying symptoms now, numbness and electric shocks in my fingers so I'm kinda freaking out. I can't afford any more delays.

Dietwise, I'm just 6.5lbs off the target. I've cut to under 500cals a day and yesterday had protein for both meals. Today, I had some grilled veg as I'm conscious of getting bunged up too. From tomorrow I guess I'll have to try to do just water for a few days, though I'm not sure how well I'll fare on that, I already feel light headed in the morning after not eating since lunch the previous day and am also still working full time.

The way I'm going I'm just gonna end up paralysed and I won't care then about eating at all.

Poor you, how stressful.

Laxatives, suppositories etc.

Bone broth with loads of chopped spinach in it?

Keep going with your 600 calories a day ( or 800 a day if it’s too difficult)

you can’t lose weight any faster. It’s really tough because you can’t exercise.

i think the weight often comes off in fits and starts, so you might lose enough in a few weeks. If not, they can postpone by a few days.

Just keep going.

It gets worse. They now deny ever telling me I needed to get to a BMI of 47 and instead need to lose 10% of weight. This is the third time they've changed the rules. (BMI under 50, then BMI 47, now this).

That means that instead of having 6.5lbs to lose I have 14lbs to lose. At the 0.5lb a day I seem to be stuck on, that's 28 days. Add on how long after that it would be before surgery and I fear it will all be too little too late.

It's grossly unfair to change the rules like this. I'm starting to believe they have no intention of ever doing the surgery.

This all sounds really hard OP I really feel for you. Do you have a GP you can speak to for some support about what the actual overall plan is for the management if you’re condition? It sounds very confusing for you.

I recently had weightloss surgery and had to do an LRD for 2 weeks before surgery. I used meal replacement shakes, stuck to it religiously, I was having about 1000 calories a day, I lost 14lbs in 2 weeks, could this be an option for you?

If I'm not losing that much on 500 calories, how would I lose more on double that? That's confusing. I'd try anything at this point.

I'm confused.

If 10% of your body weight is 14lbs, then you weigh 140lbs, so how do you have a BMI of 47?

140lbs is a healthy body weight for most women.

Sorry if I've misunderstood something.

10% of my weight when I was last at the hospital was 28lbs. I've lost 14lbs in 13 days so half gone leaving 14lbs to go.

Have you tried intermittent fasting? The fastest amount of weight I lost was cutting to a 3 hour eating window and staying around 600 cals and pounding water. I took plenty of vitamins etc but it was the fastest way. Hope you get surgery soon ❤️

Cambridge diet.
Because it uses up all your glycogen stores you get a lot of water loss.
I tried it once when I was about 12 stone and I lost about 9 lbs in the first week then lost about 2lbs a week after that (which was the max I could lose at that weight).
Then get a colonic.

But more importantly get all this correspondence from the hospital via email if they keep changing the weight goal so you can hold them to task.

OP I think you have done brilliantly so far. But as far as weight loss goes, I'm not sure that there's anything more that you can realistically do.

What I would be doing is going back to your surgeon and explaining to him that you've been doing your best to meet an ever changing target. Say that you really don't understand why the criteria keep changing and ask him to clarify with the anesthetist exactly what it is they're worried about. Is it overall weight? Is it BMI? Is it a particular body shape? Or what? It may be that they have a well founded fear of something specific happening, but rather than go into that level of detail with you they're just telling you to lower your BMI/lose weight/ whatever because they know that lowers the risk, and it's easier for them just to say 'them's the rules' than to explain everything. They may be more open to talking to a fellow professional and if you can find out exactly what they're concerned about you stand a much better chance of being able to address it.

Think PPs have the weightloss side covered, so instead, thinking of the bizarre behaviour over how much weight it is you’ve to lose: I know everyone’s focused on the referendum on Friday, but is this something where one of your TDs might be able to help? They tend to take an interest in their local hospitals & this is a wee bit more than the standard long wait issue. (Which is obviously an important issue, but ykwim.)

If I were you I’d request my records from the Hospital (as it’s private you’ve to use either the Data Protection Act or your contract with them rather than going through the HSE) to see what they’ve said about how much weight you need to lose. I’d also email them with a summary of things so there’s a paper trail of the timeline established; & of what they’ve denied saying.

If you deteriorate suddenly are you able to get to a public hospital?

If the operation is so urgent you should look into getting an urgent referral to a public hospital, with more anaesthesists who may not have this rule of loss of 10% weight, which does sound a bit arbitrary.

You may be able to do this with the same consultant, as many seem to have a public and a private clinic, so if you're in the Blackrock clinic your consultant may be also working in Vincent's.

Your consultant's secretary can give you this info, and may well have come across patients who've been in the same position as you, and may be able to advise on the best way to get the operation as quickly as possible.

As others have advised, you should put your concerns about shifting advice on weight loss, and the urgency of the operation, to your consultant in writing. If this doesn't get you clear guidance, I'd put a subject access request too - useful to get the info on your file, useful for them to know you have it.

Also check if there's a complaints unit - I had to make a complaint about a relatives treatment in a public hospital and the complaints office was fantastic and got things changed.

Good luck with it all.

I'm 40 miles from any kind of hospital. If I deteriorate, I'm done for.

It's awful what they're doing to you, @Sylver75. I really hope you can get someone to advocate for you. As well as the things @RosaMayBillinghurst suggested, are you able to tell your consultant what's happening and how frightened you are?

If it's this urgent surely the public hospital will step in and do this? Can you go back to your GP and explain the situation?

Are they arse covering because they're private whereas public hospital will see that the need for the op outweighs the risk?

(I'm not at all medical just also overweight and curious about the thread)