Knee replacement dangerous @ my weight, dr suggested VSG.

Hello. VSGers - I am new (to this site and to posting).  My knees are bone on bone (painful) and my Dr says it is too dangerous to do replacements at my weight (60 year old, female, 5'6", 280. )  I carry much of my weight in my legs and achieving a dry area for surgery is hard with fat legs.  (He didn't say fat,..I did). anyway....he suggested VSG (had it himself a year ago).  I am at that space where I think "I SHOULD be able to do this myself."  But I haven't been able to keep weight off in the past.  Have lost weight so many times in the past and always gained it back and more.   Could surgery help with that?  Is it any easier to lose the weight post surgery?  I guess I don't mean EASIER, I actually mean POSSIBLE!  Is it truly possible?  And if so...in your opinion, what made it possible if it wasn't before?  Thanks, in advance, for your honesty and help.  Thx! Cheryl

Not only is the surgery more dangerous while overweight, but your knee replacements won't last as long.  Extra weight puts more strain on the replacements, so they may only last about 10 years, instead of 15-20.  

I had both of my knees replaced when I weighed about 220.  They felt much better than before the surgery, as I was also bone on bone.  Now that I have had VSG and have lost 70 pounds, my knees feel AMAZING.  I walk several miles a day, at least 5, and can't tell you how happy I am.  My doctor warned me that my replacements wouldn't last too long at 220, but I tried to lose weight and couldn't keep it off.  In fact I got heavier, up to 239.9.  Now that I've had VSG I think I will be able to keep it off as long as I use the tool properly.  Meaning, eat properly, get exercise and always keep in mind that I was miserable at 239 pounds and feel so much better now that I'm under 170.  I have about 35 more pounds to go and will just feel better and better and better!

Thanks Neesie- I had not thought about the knees not lasting as long.  I cannot even imagine being under 170.... But I am trying to imagine it!  I long for the ability to walk for more than 10 steps without pain.  Can't imagine that either!  Thanks for your quick and honest response.  I have my seminar (1st meeting) on Thursday so I am committed to hearing the details and making the decision then.  Thanks again! Cheryl

You're so welcome!  I'm happy to help in any way I can.  

Hi Cheryl, welcome!

I was 60 when I had my surgery five years ago.  High weight was close to yours, 268, although surgery weight was 240-something.  It took me a little over a year to lose my weight, and I have kept it off for four years. Like you, I had lost weight several times (never this much, I usually got to about the 170s-180s), but I always put it back on, plus more.  I do have knee issues, which have improved since losing weight.  Looking at replacement surgery eventually I suppose.  I walk about 4 miles a day now, something that was not feasible before.

You ask a really good question, why has it been possible to keep the weight off, this time? And I have to say, I don't really know, other than to say that surgery was "the last house on the block" for me. They didn't operate on my head, but sometimes it seems that something switched up there while I was under anesthesia, LOL.  I endured a lifetime of shame and humiliation around my weight issues, all of which is gone, and I think the memory of that keeps me on track; I never want to go back to that horrible place again. 

The surgery alone won't do the trick for any length of time, although most people can lose weight in the immediate aftermath.  Also for me, in the long term, willpower alone has never been sufficient to keep me on any kind of food plan, there had to be an internal commitment, a decision that the surgery is the first step in a lifetime journey.  And that decision, in turn, drives my food choices.  "Decision" sounds simple, but that seems to be what it was for me.  And the decision was this, also pretty simple: I will eat this way for the rest of my life.  I never went on a maintenance food plan, i.e., adding carbs to stop weight loss, which would have been a slippery slope.  The basic food plan that worked during weight loss is the plan I follow about 99% today, sort of a "paleo with dairy" thing. No refined grains (and damn little whole grains), no sugar.  There are a few events where I allow myself exceptions, but very few.  It's that lifetime decision, or commitment, or whatever you want to call it.

So yes, it is absolutely possible.  Whether it's something each person can do is up to them. 

Thanks, Kathy, I appreciate your story....and the honesty of your response.  DECISION....great choice of words! To cut off all other choices. It feels like by the time I reached the realization that I needed to commit to a life change....the task just seemed too gigantic.  I need to lose 140 lbs!  That's half my weight...so I had pretty much accepted that I would always be that way....giving up more and more activity until I died.  Then my knees started hurting and I knew I had to do something (knee replacement) but I can't until I lose weight....and it felt so hopeless.  Right now, this minute, I feel hope (for the first time in a very long time!). So thank you!  Yeah... I do not want to add sugars etc back in....that is the road to perdition for me.  The one thing that has always sucked me back in....my version of crack!  so I am actually longing for the freedom from that!  Thanks for sharing your "after" journey and also your age.  It feels like I have accepted a half-life for sooooo long!  Dare I dream for something better?!  Yes,  I think yes!  ð?¤" thx! C

Cheryl,

     January 2015, when I started this process I was bone on bone on my right knee and not much better in the left, 59, and 271. My Ortho said I needed a total knee replacement, but the outcome was not looking promising. I used a cane most days, just to get around where I had to. Fast forward to today... I'm down 118 pounds, swimming a mile three times a week, and walking my dog a mile at a clip.My range of motion has improved some, and the increased  activity helps the osteoarthritis some. I'll eventually need the replacement, but the quality of my life is 100 times better now... not eager to be sidelined by surgery right away. My sleeve made it all possible.

Thank you, Ocean!  I am so encouraged by your story!  I pray that I can do it, too! It sounds awesome....like you have a REAL life!  I would love that!  Thanks!  Cheryl

Hi Cheryl,

I read your post and I see myself in your description.  I lost weight many times only to gain it back and more.  I kept hoping I could do it on my own, but never could sustain it. 

I had the surgery 2.5 years ago.  I lost 225 pounds and I now weigh 160 pounds.  I went from a BMI of 60 to a BMI of 24. 

And I've been maintaining for close to a year.  The surgery makes it possible.

I don't want to give you the impression that it is easy.  Its not.  It takes determination and a commitment to watch your calories and carbs for the rest of your life.  But it tips the balance to make it possible.  I could never have done it without the surgery.

Best of luck on your weight loss journey.

Carol

Hi Cheryl,  as an orthopedic nurse I care for post-op patients with knee replacements every work day.  Excess weight is a huge barrier for an uneventful recovery.  Your doctor's advice is right on.  Every pound of weight  is equal to four pounds of pressure on our joints,  so when you do the math the numbers are staggering!  I have early OA myself in my knees and am hoping for VSG by the summer before it gets away on me.  Good luck in your journey with WLS and a knee replacement,  if you do them in that order you will eventually be dancing in the streets!