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Lipodystrophy and WastingLipodystrophy and Wasting
           
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Umbilical Hernia surgery, thin abdomenal wall was an issue
Apr 6, 2003

I have been on Zerit, Fortovase, Viracept, Videx for many years. Lipitor was added to bring down my colesterol, plus Androgel which I apply to my buffalo hump. I have lost a medium amount of weight in my buttocks, and gained a lot of weight and size in my abdomen. I've been somewhat overweight (225 lbs) for my height (5 11) and age (48) for many years, but with exersize and better eating habits over the last 8 months, I've dropped to 210 lbs, gained some muscle, my buttocks remained the same, my buffalo hump decreased in size slightly (more on one side than the other, seems odd) and my belly pulled in a little. I recently had surgery on my umbilical hernia, with the approval of my infectious disease doctor. The general surgeon (not experienced with HIV patients to my knowledge) said the operation took 2 hours instead of the 45 minutes that he had expected because my abdominal wall muscles were very thin, and he had to add a fairly large mesh. Is it common to have thin abdomen muscles with belly lypodystrophy? Did I take more of a chance than I was aware of by having the surgery? Is the thin abdomen a result of HIV, meds, years of excessive stomach size (lifestyle and lypodystrophy), all the above? When I can return to exercise (probably 6 or 8 weeks, tbd in 4), should I emphasize or avoid abdomenal specific exercises? Is there anything specific I should be doing right now as I recover from the surgery conducted 6 days ago (drain and stiches removed yesterday)? Thank you all so very much for this service, a big welcome to you doctor Moyle, and a huge thank you to you Dr Fields-Gardner for all your help to others. You all just don't know how much this web-site has meant to me. God Bless you all.

Response from Dr. Moyle

Most likely the weak muscles are from years of central (visceral) fat accumulation inside you abdomen caused by being a little over weight and the lipodystrophy. This should not have increased the risk of the operation; a surgeon would never do an operation like this if there was any significant risk. This visceral fat is hard to get rid of so you have done a good job with diet and exercise. Usually after an operation you should get back to your usual routine slowly bu steadily, you body will soon tell you if you are overdoing it! Generally 6 weeks is about right to start gym work. The way to a flatter stomach is general 'cardio' exercise, don't focus much on specific abodominal exercises.

Best Wishes

Graeme Moyle


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