Sad story 480-pound woman dies after six years on couch

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From Palm Beach Post

480-pound woman dies after six years on couch

By Pat Moore

Thursday, August 12, 2004

She lived in filth, so large she couldn't move from her sofa, even to use the bathroom.

Early Wednesday, still fused to the couch, Gayle Laverne Grinds died following a six-hour effort by rescue workers who struggled to lift the 480-pound woman and get her to a Martin County hospital.

Unable to separate the skin of the 39-year-old woman from her sofa, 12 Martin County Fire-Rescue workers slid both onto a trailer and hauled her behind a pickup to Martin Memorial Hospital South. She died a short time later.

Sheriff's investigators questioned how Grinds lived in such conditions without more help from family or authorities.

"We're not treating her death as suspicious at this point, but we do have an investigation started because the circumstances surrounding her death are so unusual," Martin Sheriff's Sgt. Jenell Atlas said.

The Treasure Coast medical examiner performed an autopsy of the 4-foot-10 woman and listed her cause of death as "morbid obesity," officials said. Results of toxicology tests will take several weeks.

"I tried to take care of her the best I could," said 54-year-old Herman Thomas, who lived with Grinds in the duplex apartment in Golden Gate, south of Stuart. "I tried to get her to get up, but it wouldn't do no good."

He said the woman that he called his wife hadn't been off the couch for six years. No record of their marriage could be found.

"I wish I could have pulled her off the couch, but she wouldn't let me," he said, covering his face and sobbing.

Inside the home, the floor and walls were matted with feces, and trash was strewn across the floors, some which were bare concrete. Furniture was toppled, and pictures were knocked off walls.

Atlas said sheriff's detectives will look for potential "negligence issues" related to her care and death.

"We want to know what happened to her, how she ended up this way, and is she supposed to have been receiving any care," she said.

Rescue workers were called to the home at 8:44 p.m. Tuesday by Grinds' brother and his girlfriend, who reported the woman had trouble breathing and "emphysema problems." The crew initially tried to remove her from the couch, but the pain was too excruciating.

Workers wore protective clothing and installed large air handling hoses to ventilate the horrendous odor emitting from the home while trying to figure out how to get the woman and her couch to the hospital.

The street in front of the row of duplex apartments turned into a makeshift construction site as rescue crews used hammers and chain saws to build a large wooden stretcher with handles cut around the perimeter so firefighters could lift the woman and the couch, Martin County Fire-Rescue District Chief Jim Loffredo said.

After several failed attempts, including building one plywood plank that was too small to hold her, workers removed sliding glass patio doors at the back of the home, leaving a 6-foot opening large enough to get her out.

They slid the couch with her on it onto the larger wooden plank supported by 2-by-4 boards, which were slid onto a utility trailer.

"We couldn't get her in the ambulance," Loffredo said.

The trailer was hooked to the back of a pickup, leaving the scene sometime after 2 a.m., witnesses said. Grinds died at 3:12 a.m., still attached to the couch, officials said.

Neighbors who watched the lengthy rescue effort said they had never seen Grinds out of the home.

Jerry Thomas, who lives across the street for six years, said he has seen young girls at the home on occasion but never knew Grinds was inside.

"All we knew was the old man lived there," Thomas said. "I had no idea a woman ever lived in that house. Apparently she'd been on that couch a long time."

Unidentified relatives expressed anger at the scene.

"Family members are upset.... It's a difficult position," Martin County Fire-Rescue specialist Chris Wisniewski said.

Clifford Grinds, who is believed to be Gayle Grinds' brother, refused comment and slammed a door when contacted by a reporter at his Hobe Sound home Wednesday afternoon.

Court records show Gayle Grinds cared for a young niece and nephew after the death of her sister in 1992. Those children are now 19 and 15, but their whereabouts were unclear Wednesday.

"We are used to going to people's houses when things are at their worst... and that's fine, we're trained for it," Atlas said. "But there is no warning for something like this."

Atlas said a community policing deputy who worked the neighborhood a few years ago knew of Grinds but never had any dealings with her, and no deputy had ever been called inside the home.

In June 2003, 911 dispatchers received a call from the home for medical assistance, but Martin County Fire Chief Tom Billington said he could not reveal the nature of that call, citing federal medical privacy laws and the ongoing investigation.

The Department of Children and Families can intervene to help adults who are unable to care for themselves, but DCF officials said Wednesday they did not know about Grinds.

Christine Demetriades, agency spokeswoman for the Treasure Coast, said DCF has no record of calls to the abuse hot line or reports before she died.

(link no longer works) www.palmbeachpost.com/localnews/content/martin_stlucie/epaper/2004/08/12/m1a_mcbody_0812.html

there's a ton of evidence to suggest that it is NOT a myth. i'll dig up some stuff later, as I don't have time right now...

but you're not even taking into account different metabolic disorders that cause people to gain weight. and it is commonly supported that when food is in short supply (ie: dieting or starvation) then metabolism actually slows down, leading to a "yo yo" in weight when the person goes back up to a regular (not excessive) calorie intake.

btw, 1988 is 16 years ago. i would NOT say it is recent!

Here is a more recent study (2000).

Weinsier R.L, et al. "Do adaptive changes in metabolic rate favor weight regain in weight-reduced individuals? An examination of the set-point theory." American Journal of Clinical Nutrition, 2000 Nov; 72 (5), pp. 1088-94.

"BACKGROUND: Obese persons generally regain lost weight, suggesting that adaptive metabolic changes favor return to a preset weight. "

"OBJECTIVE: Our objective was to determine whether adaptive changes in resting metabolic rate (RMR) and thyroid hormones occur in weight-reduced persons, predisposing them to long-term weight gain."

"CONCLUSIONS: "Failure to establish energy balance [i.e. not continuing to restrict caloric intake] after weight loss gives the misleading impression that weight-reduced persons are energy conservative and predisposed to weight regain. Our findings do not provide evidence in support of adaptive metabolic changes as an explanation for the tendency of weight-reduced persons to regain weight

aren't we way off topic here?????

point taken, all right already.

Specializes in Oncology/Haemetology/HIV.
I have a problem with this bit of your post. There was obvious neglect here, dysfunctional circumstances, shame, depression, hopelessness. Sometimes obese people just give up feeling that there is nothing or no one who can help them and really don't have the capability of caring for themselves or even calling someone for help. This is a very tragic situation but stating that you have a problem with people destroying their lives and expecting someone else to pick up the pieces and make them whole......????? You're a student nurse. I hope you learn some compassion for others and not be so judgmental about those in situations like this.

I am an experienced nurse, and have a bit of a problem with your attitude towards Teresa.

The obese patient neglected herself. Yes, there are dysfunctional issues here, but it does not change the fact that the person ultimately responsible for her condition is herself. No one can change without the will within themselves. And if that is not present, the family/friends/SOs can beat there head against a wall until its bloody, and it will not help the patient. The patient has to pick up that phone, and if she does not, then there will be little hope of recovery.

I have known COPDers threaten or beat people for hiding their cigarettes. I have known alcoholics to still cold medication and drink it for the alcohol. And there are plenty of junkies out there to prostitute themselves or kill/rob for that next fix. Yes, life was unkind to them, and they may have plenty of reasons for feeling bad. But that does not alter the fact that THEY must seek the change.

Please do not blame the family for the dismal situation that this woman got herself into. Barring them putting a funnel down her throat, pouring down ensure and tying her to the couch, it was her choice to do this to herself and not seek help, somewhere along the line.

And please ldon't let the poster get what s/he wants, a p^&*ing match between dieters/dietees

Specializes in Pediatrics, Nursing Education.
aren't we way off topic here?????

point taken, all right already.

yeah, we are. anyway... i'm debating if i should even answer, as it looks like someone wants to get into a pissing match. but, since she is awaiting my reply, here goes.

title: adaptive reduction in basal metabolic rate in response to food deprivation in humans: a role for feedback signals from fat stores

author: dulloo ag, jacquet j.

department of physiology, faculty of medicine, university of geneva, switzerland

american journal of clinical nutrition

abstract: we assessed the importance of lean and fat tissue depletion as determinants of the adaptive reduction in basal metabolic rate (bmr) in response to food deprivation by reanalyzing the data on bmr and body composition for the 32 men participating in the classic minnesota experiment of semi-starvation and refeeding. we used individual data on bmr, body fat, and fat-free mass (ffm) assessed during the control (prestarvation) period, at weeks 12 and 24 of semistarvation (s12 and s24), and week 12 of restricted refeeding (r 12) to calculate an index of the reduction in thermogenesis at s12, s24, and r12, defined as the change in bmr adjusted for changes in ffm and fat mass, and an index of the state of depletion of the fat mass and ffm compartments at these times, defined as the deviation in fat mass or ffm relative to control values. the results indicated a positive relation between the reduction in thermogenesis and the degree of fat mass depletion (but not ffm depletion) during weight loss as well as during weight recovery (r = 0.5, p

title: adaptiation to low calorie intake in obese mice: contribution of a metabolic component to diminished energy expenditures during and after weight loss

authors: dulloo ag; colakatisa r

department of physiology, unversity of geneva, switzerland

international journal of obesity

abstract: adaptive changes in energy expenditure (ee) in response to low calorie intake were assessed quantitatively in obese mice using techniques that measure ee chronically over weeks (by the comparative carcass method), and also over 24 h (by indirect calorimetry). grossly obese mice were slimmed (by restricting food to 50 per cent of normal intake) until their body weight reached that of the lean. they were subsequently either maintained in the post-obese state by continued food restriction at 25 per cent below the obese controls, or refed at the same calorie intake as controls. total ee (assessed over 3 week periods) fell by 30 per cent during weight loss (obese controls 1356 kj vs obese-slimmed 966 kj, p less than 0.001), by 25 per cent during maintenance of the post-obese weight (obese control 1443 kj vs post-obese 1062 kj, p less than 0.001), and remained diminished by 17 per cent during weight regain upon refeeding (obese control 1443 kj vs slimmed/refed 1176 kj, p less than 0.001). similar reductions in daily oxygen consumption were also obtained by indirect calorimetry, and as a function of lean body mass, 24 h vo2 were lower than controls by 17 per cent, 9 per cent and 10 per cent respectively (p less than 0.01 at least), and remained so under conditions of locomotory restraint. it is calculated that in these obese mice, a metabolic component (unassociated with changes in lean body mass and activity) comprised nearly two-thirds of the adaptive fall in ee during weight loss, and one-half of the change in ee during both phases of post-obese weight maintenance and during weight regain. these studies therefore support the notion that in response to low calorie intake, adaptive changes in the efficiency of cellular energy utilization are of considerable quantitative importance in the resistance to weight loss and in the ease with which the obese condition is rapidly regained after slimming.

Specializes in Critical Care / Psychiatry.
yeah, we are. anyway... i'm debating if i should even answer, as it looks like someone wants to get into a pissing match. but, since she is awaiting my reply, here goes.

And heeere we go again... :rolleyes:

Does anyone else come here to learn some stuff instead of fight with folks?

Let's all be nice, eh?

Shel

Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Peeing is for the toilet (or the woods if you're out camping).

Specializes in Home Health.

The obese patient neglected herself. Yes, there are dysfunctional issues here, but it does not change the fact that the person ultimately responsible for her condition is herself. No one can change without the will within themselves. And if that is not present, the family/friends/SOs can beat there head against a wall until its bloody, and it will not help the patient. The patient has to pick up that phone, and if she does not, then there will be little hope of recovery.[/Quote]

Just so I understand. If it was your mother, you would not take the intiative to pick up the phone yourself and call adult protective services? You would not event try to help her?

I have known COPDers threaten or beat people for hiding their cigarettes. I have known alcoholics to still cold medication and drink it for the alcohol. And there are plenty of junkies out there to prostitute themselves or kill/rob for that next fix. Yes, life was unkind to them, and they may have plenty of reasons for feeling bad. But that does not alter the fact that THEY must seek the change.

Please do not blame the family for the dismal situation that this woman got herself into. Barring them putting a funnel down her throat, pouring down ensure and tying her to the couch, it was her choice to do this to herself and not seek help, somewhere along the line.

So, since she couldn't get up off the couch, it is her fault that the foods selected were not salads, cottage cheese, and lean meats? The best thing they could have done for her was to not come home, let her figure out how to fend for herself. They most certainly did play a role in this. While I do not feel they are entirely to blame, they certainly played a big part in enabling her addictive and dangerous behavior. Just like those fat babies on the talk shows. They aren't driving themselves to McDonalds and getting thier own Big Macs!

And please ldon't let the poster get what s/he wants, a p^&*ing match between dieters/dietees

I'll agree with you there.

yeah, we are. anyway... i'm debating if i should even answer, as it looks like someone wants to get into a pissing match. but, since she is awaiting my reply, here goes.

As you first responded to my post, and called me incorrect, I am puzzled on why you would think that it is I who wants a 'pissing match'.

In any case, rather than a 'pissing match,' I would like to correct ignorance, either on my part or on others, without insults. As someone else said, let's all be nice, okay?

Thanks for supplying the references. A few comments.

For the first study:

1. The correlation reported (0.5) between thermogenesis and amount of fat depletion is significant but not particularly strong. However, as a correlation can only measure a linear relationship, it may be that most or even all of the subjects experienced a decreased thermogenic rate with increased fat depletion, but at some nonlinear rate. However, as this information isn't available from the abstract, this would be an unwarranted assumption. An alternative for the relatively weak correlation is that, some had a decrease in BMR, some had an increase in BMR, and some had no change in BMR.

2. The confidence level for the results (p=0.01) is also quite weak. Scientific studies that are considered strongest have P=0.001, an order of magnitude higher. That is, there is a reasonable possibility that results here are due to chance.

3. Most importantly. In the abstract, there is no indication of the magnitude of the alternation of BMR. This could be within 100%, 10%, or 1%. That is, there may very well be a reasonable correlation between rate of thermogenesis and fat depletion, but the differences may not be practically significant, which is consistent with what that studies that I've read indicate. For example, if a starvation diet causes a BMR decrease of 3%, this would have little significant effect on the ability to maintain weight loss.

I am interested in this result, and I'll get a copy of this paper (if the journal is in our university library) to check these questions.

For the second study:

Differences in adjusted BMR between 9-17% are reported in rats. These are significant changes, but are really not that large. There is also no indication as the variability of the findings (i.e. no correlation coefficient or r value reported), a significant shortcoming. Nevertheless, I agree that these differences are large enough to contradict the findings of the (human) studies that I have read, which indicate no real differences. However, as the second study concerns rats and not humans, for that reason alone results can be disregarded, as they may or may not have relevance to human physiological response.

Overall, the evidence for changes in human 'efficiency' seems weak at best based on what was presented here. This is particularly so because a number of other studies (including the two that I cited, but I have seen more) have found no differences. In general, if results cannot be confirmed by other studies, which is what science requires before acceptance, there is a strong indication that a false positive occurred. This could be by chance or experimental error.

I am somewhat puzzled that you only gave one human study. I would think that if indeed the evidence is large, as you say, positive result studies should be easy to find. Do you know of any other studies by different (i.e. independent) researchers that confirm the results of this one? I searched on Medline for this (using keywords obesity and metabolic rate) an got quite a few but none that were positive. If you know of any more, or of more appropriate keywords to search, I would be very interested in seeing them.

Thanks.

Specializes in LTC,Hospice/palliative care,acute care.
The obese patient neglected herself. Yes, there are dysfunctional issues here, but it does not change the fact that the person ultimately responsible for her condition is herself. No one can change without the will within themselves. And if that is not present, the family/friends/SOs can beat there head against a wall until its bloody, and it will not help the patient. The patient has to pick up that phone, and if she does not, then there will be little hope of recovery.

That's exactly right...the fastest way to burn-out is thinking you can FIX all of your patients...THey are responsible..Wecan deliver the care they need and educate them but we can't take their non-compliance personally....We have to realize that we can not control them .....I am sure we have all seen patients come from appalling conditions-it's not up to us to decide where and how they should live.....I truly hope thatI die right here in my own home :) --I pray that I am left alone by the go-gooders----left alone to die in my dirty house full of cats....crawling to the kitchen and taking sponge baths in the downstairs powder room......I can order everything I'll need and have it delivered......I'll just wake up dead somedayand no one will know until the neighbors start to complain about the stink......no oneyyyyy

I just wanted to add that there are people who are not capable of taking care of themselves or understand that actions have concequeces. Lots of people with mental illness/addiction problems or borderline developmental disabilities fall just outside of the system enough to be invisible. If the family was incapable of cleaning feces off the floors and walls, they probably were also incapable of calling for help, or understanding really what was going on, even if they were capable of taking their magic food stamp card to the grocery store to get food. A very sad story. Still, If its good to remind people that if someone is refusing care, especially a family member, such that they are developing sores or are a real danger to themselves, theres always adult protective services. At least I hope there is.

No one knows the exact circumstances of this situation, so some of the replies are without knowing the whole story. :clown:

I work with a grossly obese CNA and from my own personal experience, I get really drained from being around her. Her life revolves around food! Every Wednesday morning she grabs the newspaper for all the grocery store sales. If something happens at work and she has to move very fast, I'm afraid I'm going to have to deal with HER and the patient.

Everybody feels sorry for her because she's fat, but after working with her for 4 years I get tired of it. Sorry if that offends, I'm just being honest based on my own personal experience. She laughs about her lazy life....food addict...TV addict...I try not to be judgemental, I have my own issues. But I mostly see her doing this to herself. She now has sleep apnea which causes her to have seizures in her sleep, and her GYN told her the weight is causing female problems!? WTF? She will not quit eatting and she will not get help?

In what little I know about this situation, I don't feel too sorry for this lady, except she died. I feel worse for her husband? family? because ppl seem to look at them judgementally. Do you think he shoved the food down her throat? Do you think he isn't embarrassed by all of this, and possibly blamed.It's nobody's fault.

There is another nurse I work with who is grossly obese. She just had knee replacement. Another CNA I work with who is obese, is now on pain medication and physical therapy because of her weight and her back.

Geez.

Specializes in Public Health, DEI.

LOL... well, I also grab the newspapers for all the food sales on Wednesday, but I just like to save money on my groceries. I do have to say though, that for someone who claims to try not to be judgmental, your post does sound awfully judgmental.

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