NL·Critical Condition

Too big for breast reduction? Why this woman was refused the surgery she needs

A woman from Mount Pearl says she desperately needs a breast reduction, but is being refused because of her weight.

One thing stands in the way of the procedure this Mt. Pearl woman desperately wants

Tanya Field has trouble finding bras that fit. She just purchased this one, but says after wearing it for an hour it causes the skin on her back to go numb. (Paula Gale/CBC)

Tanya Field's breasts developed early in life, and she was being teased about their size by Grade 7.

"I had a lot of nicknames in high school and junior high," Field said.

Today at the age of 42, her bra size ranges from 40 DDD to 42 G.

It's not nicknames that bother her now. The married mother from Mount Pearl, NL, said her overly large breasts prevent her from running around with her nine-year-old child.

"I can't run or jog … I can't exercise like normal people. I just can't," Field said.

A decade of pain

Field has been suffering with neck and back pain for more than a decade. She's undergone both neck and back surgery but her symptoms continue, due in part to her large breasts.

"Leaning down and bending over ... it puts a lot (of strain) on your back and on your neck."

The list of issues is long. She has trouble finding clothes and bras that fit. She gets rashes, and has trouble sleeping.

A photo of Tanya Field, taken while on vacation. (Submitted by Tanya Field)

"You know just getting comfortable, I can't sleep on my stomach. I always have to shift around."

Having such a heavy chest just adds to the problems, she said.

"It's not the cause of all the issues, but it doesn't help the situation."

Weight/breast reduction connection

It appears that Field would be a good candidate for a breast reduction, a common surgery in the province. Last year, 580 women in Newfoundland and Labrador had the procedure done, and it was covered by the provincial health plan.

For the surgery to be covered, the breast tissue has to be a certain weight and the woman must be experiencing health problems, said Dr. Joy Cluett.

But Field said two plastic surgeons in St. John's have refused to do the surgery because of her weight, even when Field asked about doing it fee-for-service. They want Field to lower her BMI or body mass index from a 34 down to a 27.

Field said her current weight is about 185 lbs so that means losing about 40 pounds in order to have the surgery.

She's been struggling for years to lose that weight through dieting and lifestyle changes. Her most recent diet didn't help much.

"For four straight months I cut out soft drinks and sweets and I think I probably lost two pounds," she said.

She also had to cancel her gym membership due to her neck and back problems.

Doctors decide

But it's not MCP that makes weight part of the criteria. In a written statement to CBC News, the Department of Health and Community Services said the approval is up to the doctor.

"When determined medically necessary by a physician, breast reduction surgery is covered by MCP. Approval for surgery is not required by the department," the statement reads.

"Like any elective operation, the appropriate time for surgery is decided by the surgeon, and health indicators or conditions may be a factor in their decision."

Tanya Field looks at family photos in her home. (Paula Gale/CBC)

In Nova Scotia, the provincial health department explicitly states it will only pay for the surgery if the woman has a BMI of 27 or less, but women there are fighting to have that changed, saying the decision should be made on a case-by-case basis.

Field has even travelled to Nova Scotia for a consultation with a private plastic surgeon in Halifax. "He said, 'You are a perfect candidate, especially with your medical history, you really should have it done.'"

But the surgery costs $10,000. Field said that's just not affordable for her family right now, but she's started to put money away for the procedure.

Field said her husband has been very supportive of her mission to get the procedure. She says he worries about her health as she ages.

"He said, 'You know when you're 50 and 60 years old, the extra weight — like you're going to be hunched over — your back is going to get worse, your neck is going to get worse,'" she said.

"It really annoys me that doctors can hold this standard. I can understand if I was 600 pounds."

ABOUT THE AUTHOR

Paula Gale is the host of The Broadcast on CBC Radio One, based in St. John's. She's been a journalist in Newfoundland and Labrador for more than 20 years. Her email is paula.gale@cbc.ca