My first day back after vacationing was a rude re-awakening. I never realise how much you simply “forget” when you are away just thinking about what is for dinner and whether to order Chianti Classico or Nebiollo. I forgot how sad and pathetic our obesity epidemic is in this country. Today I had a patient who came in (at least he drove instead of calling EMS) for a fall out of a chair the night before where he injured his knee. He was morbidly obese and was nearly 400 big ones. He apparently was napping in the chair when he simply slid out and landed on his already arthritic left knee. No fracture on X-ray so I was hopeful to discharge him. Alas, it was not to be. He tried to take one step with a wooden cane we gave him and “CRACK”! We thought for a second he snapped his fibula but nope - the cane just broke in half under his weight! He fell again to the floor was was too weak to get up himself. It took 5 of us to lift him and that was that. Admitted. Once you get that fat, you really are almost helpless after a relatively minor injury like a bruised knee. I almost wanted to call for a bariatric surgery consult!
Canadian Pharmacy
We had a large woman who came in after her office chair at work broke underneath the weight of her enormous body and now her back was hurting. She filed it as a worker’s comp claim. I’m betting it wasn’t the chair’s fault it broke.
We once had a super morbidly obese patient who self-transported to the ED but couldn’t actually walk in. Anyway, the tech and I managed to squeeze the patient into a big boy wheelchair (~650 lb capacity). The tech’s trying to push the chair to triage but it won’t budge. Why? Because the patient was so fat that he caused the front wheels on the big boy to collapse inward. The funniest part was the tech’s total obliviousness to the situation. “Are the brakes on? Is there something in the way?” No, no, no. There were patients and staff everywhere, trying not to laugh as I silently attempted to point out that the patient was too fat for the fat-person wheelchair.
Last 900+lber we had was a frequent flier, nice guy ‘tho, ended up coding & dying because the dr couldn’t intubate or trach the guy because…he was too fat.
As a nurse, and as a formerly morbidly obese person who HAD gastric bypass, I’m rather horrified at the tone of this post. Making fun of the fat people doesn’t really help. I’ve lost a whole person (117 lbs), and am now a normal size, but my empathy is still intact. Do you honestly think obese people get that way on purpose? I’m saddened by the attitude here.
More overweight people should be more proactive about there health. This post isn’t poking fun. It is merely sharing a true story that actually happened. There are just as many funny stories about people who aren’t overweight floating around the internet……
Well Nurse Exec, I impressed with your weight loss and I hope others who are morbidly obese some day confront their problem and grab the bull by the horns like you did. Obesity is such a factor in heathcare these days and we see things like described in my post regularly. The patient himself by the way, had a good laugh when he broke the cane.
NurseExec, glad to hear you lost some weight.
Its a shame that people get so big that they cannot even sit up in bed by themselves. They cannot move from the ambulence stretcher to the hospital stretcher, and they don’t even fit on that stretcher so you have to get them a hospital bed.
The workers in the ER have to move the obese people, and YES, the do injure themselves doing it. Why shouldnt people have a little chip on there shoulder and vent about it here. If fat people don’t like it, then loose some weight or read blogs by fat people.
Do you like to see your friends and coworkers in pain for merely trying to help someone who cannot help themselves?
Maybe they should put the fork down and lift some weights or get on the treadmill every day for the rest of their lives, eat a low calorie diet, and yes go hungry and skip some meals occasionally. Stop eating by the clock but rather by the body hunger. If your not hungry, then don’t eat. Don’t eat between meals. ETC, ETC, ETC. And yes, if all else fails, get a lap band to help. You Cannot afford not to do it.
Yesterday we had a 560 pound man who could not even move because “everything hurt.” Everyone was afraid to move him. We have seen too many people herniate disks, strain muscles, etc, to be moving these “human whales”, which may be the largest people on earth.
The advanced lifing equipment is not even rated to handle these mammouth individuals.
I wonder if these people ever say to themselves “what am I doing to myself” and get help like Nurse Exec did.
I am sure that if you read every blog, that each blog could offended someone. I am sure this blog did not set out to offend anyone, but may emphasize a dislike to treating severely obese patients. If your fat enought to just break a cane by just leaning on it, then you need to address the underlying issue- your obesity. I have seen that on cartoons, but never in person.
I get some obese patients that come in with knee and ankle pain….. Hmmm, could it be that your body is not designed to carry an extra 300 pounds around every day of your life… I am not paid to be nice or sugar coat the issue, and believe its my job to tell them its time to loose the weight. Your body cannot handle it, and it will only get worse.
I crap you naught, today at lunch I was sitting with 100% staff, yes 100% (like 4 people) who’d had some variation of a gastric bypass and they were giving their opinion on which was best to the overweight secretary.
Sorry, but listening to all these tales of obesity and surgical complications while eating made me rather repulsed. How can you get so fat as to need surgery to make you stop eating? I don’t get it, I guess.
NurseExec, unless you’re strapped to a wall being force-fed, it IS your fault you got big. You’re putting the food in your mouth; you’re the one not exercising enough. Between alcoholism and obesity, the # of people who blame their own behaviors on others is obnoxious.
Nurse Exec., I just looked at your weight loss progress on your blog. What a difference your weight loss has made. You look great. But, yes I did notice that the people here are still criticizing you for the weight you USE to be, rather than congratulating you for what you have done.
“Stop eating by the clock but rather by the body hunger.”
Ummm, I think that’s a PROBLEM with a lot of overweight people. Your stomach expands. You’re hungry all the time. (Often with a psychological component.) When I was refeeding from my anorexia, I was told that it would take months for my body to adjust back to normal hunger/fullness cues and even longer for me to mentally be able to process those cues because I had been so out of touch with my body for so long. I imagine that it’s much the same for overweight people.
I found these comments very interesting, and I appreciate the folks who actually went to my blog. Yeah, I ate my way to that weight, Nurse K. I’m not disputing that. My point was that as health care professionals, a little empathy seems more appropriate than denigration, humiliation, or laughter. Again, thanks for the great comments–they gave me a lot to think about about how *I* think about obesity these days–both mine, and others.
I dunno, I never say “congratulations” when you lose weight due to surgery. I find that strange. It’s like “congratulations your newly-altered anatomy borne of high cost, possibility of multiple complications, long-term sequelae, and risk finally prevented you from eating too much. Congratulations on the deterrent effects of dumping syndrome to your ice cream habit….”
I’m more like “do you feel better?” –Yes I do. “I’m glad you feel better.” or “I’m glad your blood pressure is better and your diabetes is gone.” As a Type I diabetic, the idea that people will eat themselves into a version of my disease and not care about it enough to lose weight to make it go away (when someone like me can do no such thing) is bizarre. People have been trying to cure juvenile diabetes for decades, but all you have to do to cure yours is stop eating so much and exercise. If only it were so easy…
I’m not a medic, and I came across this page while looking for something totally different (yes really) but I would just like to add a comment or two, if I may :
As Nurse K said, “unless you’re strapped to a wall being force-fed, it IS your fault you got big.” Now, people don’t put on 200 lbs overnight - they SEE themselves getting bigger every time they look in a mirror. Don’t they have any self-respect ? Do they LIKE what they see ?
After 40 years at between 155-160 lbs, I put on 20 lbs in the past couple of years - and when I look at myself in the bathroom mirror it disgusts me, so what am I doing ? I’m dieting (carefully) and taking more exercise …and I’m going to lose those 20 lbs.
It is rather scary to read what healthcare professionals say about the obese. I would hope that you do not let your attitude prevent you from giving us the care we deserve. We are still people and deserve respect, or is all you see our weight and not us?
Actually, getting people to take responsibility for their own actions vs. excusing and denying is healthy. How are your going to change the behavior that is causing your obesity if you can’t even acknowledge that you’re the one killing yourself slowly with a cheeseburger and shake?
I take care of anyone and everyone and can stick IVs in 400-pounders on the first try. I will, however, let a guy do the chest compressions when they code though. It’s quite painful on the wrists to try to compress someone that large and almost can’t be done safely.
Quit worrying about what we think and start worrying about ventricular hypertrophy, CHF, htn, heart disease, and diabetes.
Yes they fucking do that on purpose. Not getting fat is simplest thing in the world - eat less. Many obese ppl are “nice”- just because they have nothing else going for them
Given that I was obese from the time I was, oh, seven, I’m not addressing a lot of the hate I’m seeing here. I did have gastric bypass 6 years ago, and headed off a lot of the typical weight-related problems (that my mother and, to a lesser degree my father, are dealing with in their 50s).
While I do enjoy the “Oh my God!” reaction from people who haven’t seen me since before surgery–my 10 year high school reunion was fun!–I don’t usually enjoy hearing how “good” I look. That’s not why I had surgery. I make it a huge priority if someone is actively losing weight, regardless of how they’re doing it, to ask how they feel. I much rather would talk about how much better I’m feeling than how much better I look. There’s a huge implied insult there–”Wow! You look great! That’s really good, because you were a big, ugly, hideous fatass before.” is essentially what you’re saying.
Max, while it’s not true for many overweight people, you do realize that there are other reasons for weight problems other than “put the fork down!” I realize it’s probably not within your cognitive abilities to step outside your narrow box, but there are other reasons–diseases, medications, etc.–that people gain weight, even large amounts thereof, that they have little to no control over. Prior to my surgery, I had a hell of a lot more going for me than being “nice”. And it is attitudes like yours that lead me to, at 130 lbs, still feel very insecure about my body, not believe that I’m in any way attractive, and similar. So thanks for that, to all of you that feel that fat people need to be insulted because they don’t feel bad enough about being fat to make you happy. I hope that somehow my (and anyone like me’s) insecurities somehow give you the warm fuzzies you’re clearly lacking.
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but there are other reasons–diseases, medications, etc.–that people gain weight, even large amounts thereof, that they have little to no control over.
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There is no disease or medication that will make you gain weight if you do not consume excess caloric intake. EAT LESS - THAT SIMPLE. You dont need exercise (though it is recommended for many other health benefits) or do anything at all -all you need is eat less.
Max, an example of a medical condition or medication that will cause weight gain in virtually all cases would be steroid dependent conditions. Chronic long term glucocorticoids cause fluid retention and weight gain (trunk and face) to some degree in most patients - no matter what they eat (unless they essentially starved themselves and became malnourished). This is a minority of people - the main problem I think is that many, many obese people have simmering psychiatric conditions (not that they are “crazy”, just self-esteem/depression issues)which makes it very hard for them to “put the fork down”. Another situation is that in certain ethnic groups (and socio-economic classes), being obese carries no stigma - and may be DESIRABLE, so there is no incentive to not get big until one develops severe medical problems.
I believe that most 7 year old children are fat due the way they are brought up and the food that is being served to them by their parents. Its interesting that Beth’s’ parents are heavy, especially the mother. Is that nature or nurture? Was it the food her mother fed her father all those years what has caused him to be obese, overeating at every meal a little, or was he just destined to be fat? Did they eat a lot of high calorie cheap fast food with non diet soda? It tastes great but is horrible for your waist line.
I think Beth has learned to overcome some of the problems that caused her mother to be heavy such as eating better, more healthy alternatives. I hope she has passed this on to her family as well so they don’t have the stigma of being obese. Remember a minute on lips, a lifetime on the hips. Is that food really worth it? Say no thank you.
I see children all the time in the ER. Fat children have fat parents. They sit in the ER and eat out of the vending machines and drink regular soda. The most ridiculous patients are in the ER for chest pain and keep disappearing to go smoke or are eating McDonalds (brought in by their supportive lovely family members) when you enter the room to discuss the case.
A small number of obese people suffer from physical Disease that causes obesity, but rather have disease due to obesity.
Who do you people think your are? Just remember you
can keep your mouths closed as easy as we can put a fork down, didn’t your parents raise YOU right? With a little respect towards other people? OR did they teach you that it was ok to say things out of rudeness? Must be your upbringing!!
YOU KNOW OVER WEIGHT PEOPLE HAVE FEELINGS TOO. JUST BECAUSE WE ARE FAT DOESN’T GIVE YOU THE RIGHT TO MAKE FUN OF US. WOULD YOU MAKE FUN IF IT WAS ONE OF YOUR FAMILY MEMBERS? I DON’T THINK SO. BECAUSE IF YOU DID YOU ARE A PIECE OF CRAP. AND MAYBE IT MIGHT BE YOU ONE DAY IN THIS SPOT WE ARE IN.
YOU KNOW OVER WEIGHT PEOPLE HAVE FEELINGS TOO. JUST BECAUSE WE ARE FAT DOESN’T GIVE YOU THE RIGHT TO MAKE FUN OF US. WOULD YOU MAKE FUN IF IT WAS ONE OF YOUR FAMILY MEMBERS? I DON’T THINK SO. BECAUSE IF YOU DID YOU ARE A PIECE OF CRAP.
“There is no disease or medication that will make you gain weight if you do not consume excess caloric intake. EAT LESS - THAT SIMPLE. You dont need exercise (though it is recommended for many other health benefits) or do anything at all -all you need is eat less.” Max
I’m joining a little late here, but - have any of you heard of endocrine problems? It’s attitudes like this that make it so hard to get a diagnosis, the doctor sees “fat” and nothing else. I watched my son grow to almost 300 lbs by the time he was 16, my daughter gained almost 100 lbs in one school year.
It’s truly sickening to see the medical community dismiss fat as just fat. Interestingly, one doctor who told my son that his only problem was his weight, was the same size as my son!! He didn’t seem to be sick though, so why did he tell my son that was his problem? Oh, because he was to lazy to actually investigate.
Reading this blog, and the comments here, just reinforces what I had suspected. Most health care professionals are ignorant and biased and don’t see the “person” part of “fat person”, they just see the fat.
There are medical conditions that cause obesity. And sometimes obesity is caused by meds, mental problems, depression, etc. But regardless of how a person became obese, they may also still be sick and in pain and require treatment and (hopefully) compassion. Think about if one thin and one heavy patient came into the ER. They both have fallen on the ice and broken an ankle. Does the thin patient get all the compassion while the overweight one gets the lecture on being too fat? Considering the source here, I am going to say yes. Regardless of what an overweight person is seen for, you people will jump to the conclusion that their obesity is the cause.
Toothache? Too fat. Brain tumor? Too fat.
Believe it or not, people do not do this to themselves on purpose. Do you know anyone who sets out to be the fat guy as a goal in life? Because I don’t.
Help them, and stop being so smug and judgemental!
Let me find out what hospital you work in, and I will copy all of these threads and send them to your Chief of Staff.
You are the most unprofessional, ignorant and arrogant Doctor I have ever heard.
I am truly disgusted by your comments.
Perhaps you should take a permanent vacation from medicine and sip your Chianti to a slow and painless existence.
Quote: My first day back after vacationing was a rude re-awakening. I never realise how much you simply “forget” when you are away just thinking about what is for dinner and whether to order Chianti Classico or Nebiollo. I forgot how sad and pathetic our obesity epidemic is in this country.
Unquote.
Thanks—but I don’t want a doctor who has “memory” problems. What else did you forget?
Have you seen anyone about the “big-head” you have?
It’s really very unbecoming. In fact—it makes me want to puke.
Well, actually, the obesity epidemic is sad and pathetic. Our country is pathetic is ways. People don’t walk enough - they just drive. People sit at desks all day. People eat terrible food. Our diabetes and HTN rate are disgusting. Much of this is avoidable which in my opinion is reprehensible. I don’t just blame people themselves - I also blame the food industry and the car/suburban cul-de-sac culture that has helped create it. They start advertising to kids and bad life-long habits are imbued. Patients often don’t have or can’t afford healthy food choices. Doctors need to intervene early to help patients get back on track and once diagnosed, need to really work with patients to control their disease and hopefully change these habits. More dietitian referrals need to be made. I am not saying Europe is perfect, but they do walk more, they do (still) eat healthier and they are thinner. And Shellraiser, you have some serious anger management issues to work through.
Fat people should be executed. Don’t give me that ‘they cant help it’ bullshit, they absolutely can. In fact, they’re the only ones to blame for their own obesity.
“Believe it or not, people do not do this to themselves on purpose. Do you know anyone who sets out to be the fat guy as a goal in life? Because I don’t.”
Knowing you’re overweight and choosing not to do anything about it IS doing it on purpose. You’re making a conscious decision to remain overweight. Your choices are (A) Do something about it, or (B) Don’t do anything. If you choose not to do anything, that’s fine, but being angry at someone else for your decision isn’t exactly fair.
“If you choose not to do anything, that’s fine, but being angry at someone else for your decision isn’t exactly fair.”
It seems to me that obese people field more anger from other people than they direct toward other people. I’ve only been awake for an hour, and have already read so many intolerant posts (on various subjects), I’m ready to turn off my computer for the day. Maybe that’s not such a bad idea.
my 2 cents
I think some are forgetting the main purpose of many blogs is to vent about the authors life which usually is work related. SO the thought and comments here are what the posted thinks not what they actually say to the overweight in the flesh.
At least I hope the medical professionals here have a better bedside manner -its one think to practice tough love and point out what needs to be done to lose those pounds.
I think you need to realize anyone over 300 lbs has an addiction like problem. You do not just fix it immediately nor easily. Exercise is far from easy if you have gotten to the point you have joint problems. I have a bad knee and exercise with only that problem is far from easy as it is very difficult to not over do it.
I suggest you direct some of your antimosity and lobbying to the food producers –>reduced portions/healthier options in restaurants and processed foods so full of chemicalized ingredients the stuff is plan toxic to the eater.
Hello, I had the opportunity to work at the U of M with a professor of food science & nutrition for 6 years. He wrote an interesting treatise about the obesity epidemic in America while I was working with him. He defined obesity as “a state of malnutrition created by the American food industry”. Food companies add sugar, salt, and fat to food as a cheap way to maximize flavor; they also substitute more expensive natural ingredients with chemically derived formulas. This technique is called, “Value Added”, the goal being to to maximize their profit and keep the stock holders happy. Add to that the typical American’s sedentary lifestyle–sitting at a computer at work, driving everywhere, watching television, etc.–and you have an epidemic of obesity.
Nobody chooses to be obese. They are, simply enough, victims of a terribly dysfunctional culture.
Oh yes. While we’re on this line of thought, might I add that eating a healthy, natural diet has recently become more expensive than buying highly processed, shelf stable foods, probably because of fuel prices in combination with the highly perishable nature of natural food. This is really sad. It costs more to make it yourself than it does to buy it in a box!
Everyone in my family is overweight…except me. I worked hard to do something about my weight because I recognized that it was unhealthy. My sits smoking and eating fried chicken and brownies and talking about how much her legs and back hurt. I got some antidepressants, a gym membership (I go 5-6 days/wk) and a fridge full of HEALTHY food. I researched calories and fat and fiber and portion sizes. Hate to break it to you, folks, but sometimes things take EFFORT. Also, my mom has diabetes, CHF, COPD and will probably not live to see 55 as she’s already almost died several times and is still in her 40’s. You are where you are because you want to be. (With the obvious exception of those FEW with a valid medical excuse that they literally can do nothing about.)
u ppl r a disgrace to mankind, is this the way u speak of ppl that r too blak, or too white, or too gay or too jewish, get the fuk out of here, i am humiliated to even think that i share a country with ppl who r so closeminded, i hope one day…”nurse k”…that u have a child that is overweight, lets see how u feel when they come home from school in tears bc sumone like urself made fun of them…and if ur soo fukin smart try to look up hereditary things…like being over weight, do u think that ppl who r born with cancer or any other disease or abnormailty chose to live with that…no…….go fukin kill urself…..or maybe one day ull piss off the wrong “fat”bitch
Most things that are worthwhile aren’t easy. I am on steroids for colitis. I do end up with the moonface, but I maintain a healthy weight. How? I focus on healthy diet. Plenty of veggies and fruits even if I have to boil them so that my digestive system tolerates them. I get out and go for a run even if I have to carry toilet paper and run in the woods. It’s a matter of being proactive and doing what it takes to be a healthy. It’s not just about the weight, but also good physical and mental habits.
Well goody-goody for “cl.” I am one of those poor bastards that has every flippin’ card stacked against them for being obese & thanks to high doses of steroids, we’re talking decadron baby, the elephant gun of glucocorticoids, I have gained 110 lbs., which came off of me in months when the immnuosuppressant were working for me, so if you are lucky enough not to have gained immense weight to match your moon face, good for you (mumbles under breath: you shallow tool!). We have genetics, we have endocrine disease, & after being on steroids for 5 years, I am DOOMED to always being a big ol’ fatty! I’ll NEVER weigh 130 lbs. unless I am dying! I am literally carrying approximately 60 lbs. of water weight at this very moment. My legs have swollen up & all I can do for it is to double up my dose of HCTZ & pray I don’t piss myself! It is sad that there are a few of us fatsos out there that are not eating McLardos or other fat & calorie laden foods & the only exercise is either to lift a fork, click the remote, & wobble off to the fridge, but guess what: we, the lonely few of the group that may get a little slack from some, we are often treated to the love (sic) of those around us. I will not ever be a candidate for bariatric surgery of any sort thanks to auto-immune disease, a really nasty one at that. Let me weigh in (hardee har har) here about bariatric surgery, & I’ve seen 2 of my friends die from the roux-en-Y procedure, due to malnutrion & stupid doctors! Yes, stupid doctors. Just like the rest of our society, there are bound to be stupid docs out there, just be smart enough to move on when you feel that you have one. Physicians are a sort of commodity, they are “selling” a service & you, as a consumer, can “return” them & look for one who is better suited to care for you. I have had to do so & even though some of my docs can be less than friendly & chipper, but damn, they know how to treat me & keep me alive! I may be flippin’ huge for most people’s tastes, but I am not trying to appease the masses, I’m simply trying to stay alive, whether I am fat or acceptably thin enough to be amongst the “beautiful people” (but keep in mind beauty does not = smart), I AM ALIVE! That in itself is a miracle of sorts as I have had 3 of my docs tell me that they are truly flying blind when it comes to my care. I’d also like to lay myself out, so to speak, before I got sick, I was judgmental of others by the way they’d look too. Thanks to the way things seem to go for A-holes of that sort, let me tell you that I first got fat, then had to have my teeth pulled, all of them, because I had constant infections, even a nasty bout with endocarditis, & my docs & I figured that it may be a wise & prudent step to make sure that it wasn’t coming from my teeth (as they were prone to all sorts of problems & decay), so there I was; fat & toothless, now just to really make things funny for some, & a true kick in the arse for me, my beautiful light brown, curly hair, which is long & oh so thick, will probably be the next to go, as the next step in trying to rein in my wild immune system is chemo! Ha ha! So, just to stay alive, I’ll have to suffer being a fat, toothless, bald bitch! The lesson I’m hoping some of you shallow folk can take from my experiences: don’t judge by looks! Instead of worrying about your body size, why not try to broaden your education by investing in reading more, talking to others you judge as “too fat, too ugly, too thin, etc.” & see if you can’t learn a thing or two that you didn’t know? One of my favorite things is to read while I waste time on the stationary bike at the gym (the only piece of equipment I have gotten the green light to use by my docs & the gym’s trainer for the time being) & I also love to learn new languages. Broaden your horizons in a mental way.
As for all of the detractors & those I suspect of having mad cow disease who read this doc’s blog: go screw! Working in an ER is the most stressful, trying, horrendous, & at times, most rewarding job there is. Whenever you are having to care for the lives & mishaps of the public, some who are liars, cheats, nasty to the core, sick as hell & basically “time wasters,” you need an outlet to vent. This doc is not writing to upset people, he’s letting out the blackness & trying to be humane. I’d rather he let out what’s getting to him, & doing it with humour, than being a provebial closed ear prick to his patients & the staff around him. I’ve seen those sort, have had the misfortune of being in their care & it because of that that I wish it was mandatory for all health care workers would use blogging instead of drugs & alcohol, are just out & out meanness to vent their woes. Keep making me laugh doc, as they say, laughter is the best medicine & golly, you’re a funny one & a veritable “good read!”