Too fat for a hysterectomy?

[RedDoughnut]

I've had problems with very heavy bleeding for well over a year.
A fibroid was thought to be to blame but that's been vaginally removed and the bleeding/clots is just as bad
The mirena coil came out.
I can only think the next step will be hysterectomy
My womb was described as bulky. I've had c sections years ago.
But my BMI is nearly 40.

Lose weight. It will likely help your symptoms and you may not even need a hysterectomy...

Wow! I hadn't thought of that. Let's hope I don't bleed to death while dieting

Well, not really sure what you want people to say then? general anaesthetic IS way more risky the more overweight you are so it would be a good idea to see if you can lose weight if you want to reduce the risks. Being overweight also increases estrogen levels which is often the cause of fibroids and heavy bleeding/womb thickening so losing weight would help that too.

Loosing weight is something I'm sure you've thought about and if you can't do it alone, can the doctors not help you, with advice or tablets. Sometimes will power isn't enough alone. They now help people give up smoking and help anorexic people and rightly so but people being over weight should also get help if they want it.
How old are you? Have you finished your family?
Good luck.

At that weight your increased risk of death under GA is double as you are classed as morbidly obese. I used to be an assistant in an operating theatre doing general anaesthetics in a day surgery unit.

You are in pain and stressed which is why you have probably been short with the first couple of responses but they are factually correct.

What has been your medical teams actual advice?

Agree. Of course its not "easy" to lose weight (I put on like, 5 stone with my first pregnancy and losing it was really hard but I am glad I did). But, its important if you are going for surgery as the risks are so much higher and some surgeons will tell you that you need to lose 5-10% of your body weight before they will risk it. Have you asked for help regarding losing the weight? there might be medications you can take to help you

I've already lost so much blood I needed a transfusion.
I seriously need something short term.
I have a gynaecology appointment agin next week.
I thought I can't be the only fat person to need surgery.

Absolute load of old guff - we'd be killing a lot more people if that were true!

Well get started on losing weight then. Being that heavy is so damaging to your body & will be affecting your health massively.

@RedDoughnut A dear friend of mine had a hysterectomy, she weighed 23 stone.
Her story was very similar to yours and she recovered very well.

Start keto and start it today.

It completely sorted out my PCOS and fertility issues

if you’re too overweight for anaesthetic there isn’t an alternative available to you and it sounds like you’re really suffering

my aunt desperately needs a hip replacement but can’t have one as she’s too heavy.

Hold days! Do people not realise how difficult losing weight is when you're under stress? Cut her some slack

My BMI was about 37 when I had mine and it wasn't an issue.

Folk telling OP to lose weight - when you're in constant, immobilising pain, it's not easy to lose weight.

Once I was fully recovered, I found it - not 'easy' but 'feasible' to adopt some healthier habits and lose weight.

Have the operation (if your doctors agree) and once you're over it you'll have the headspace to think about losing weight, if that's what you want to do.

Are you sure they won’t operate? You might be fine! You really aren’t the biggest patient to have an hysterectomy. And I imagine your life will be a lot less stressful and your cortisol levels lower which might make losing weight more feasible.

Your life is at risk whatever you do, I’m so sorry. You need to go on some weight loss vaccinations asap.

I'm sure you want any surgery to be as low risk as possible. Can you ask the gyn for a hormonal solution to keep the periods at bay for awhile? Continuous BCP, implant, try another coil?

My mum had breast cancer and needed a mastectomy, her surgeon said to her if she was very overweight (she is just in between healthy and obese, on the cusp) then they can’t do surgery on those people. They said it was handy that she was active and fairly healthy for a 62 YO. It was new news to me that they don’t like to operate on overweight people

This is an over-dramatic response to the OP's situation. No one is denying there are health risks attached to obesity, but it's neither accurate nor helpful to say her 'life is at risk'.

Have another mirena put in. Then lose weight.

@FannyBawz DGM had her hip done with just an epidural due to allergies. Is that an option for your aunt?

I'm sorry to hear about your struggles, ask for an endometrial alblation, I'm assuming you're done having kids, best thing ever, they do it while you're awake in minutes, I had mine at 42 when my periods started flooding, coil wasn't suitable as made me very nauseous. I went in asking for hysterectomy and this was offered. So pleased it worked.

I've tried twice with a Mirena, once last year and once this month. They have come out with big clots.

I think some posters have no idea what it's like to pass clots the size of lemons and have blood running down your leg despite a tampon and pad.

There is nothing i can do about being fat in the short term

I've had all the medication to stop bleeding, tranexamic acid, norethisterobe etc.
Everything has stopped working.

I'm 54. Taking the fibroid out hasn't helped.
I'm not ignoring the weight issue but i need short term help too.

For the love of God, if op is bleeding to the point of needing blood transfusions I would imagine she's feeling quite unwell in herself and probably going to struggle to embark on a healthy eating/exercise regime without significant medical support.

Op how long since the fibroid has been removed? Are recent smears clear etc?

Personally I'd be seeing a gynaecologist and talking about a hysterectomy. I know what I'm talking about - I had one for much the same reasons and my bmi was about the same as yours . I had blood pouring down my legs and I used to pass huge clots. The surgeon didn't hesitate - he told me what my risks were but he didn't say that my weight was a big problem. He did the surgery vaginally so I didn't have an abdominal wound , and I recovered faster than people do with the abdo method. I was back at work within a month.

I know that people on MN will tell you that overweight will cause all sorts of horrendous problems, but honestly, overweight people have surgery all the time , it's not the end of the world. Go for it - honestly it will be the best thing you ever did for yourself. Good luck.

Ablation might be an option, and I think it can be done without a general?