Obese children...my rant - page 7

by Gently.me

14,615 Views | 80 Comments

Ok so child comes in with laceration to the hand. 12 years old, about 5'5'' and weighs 260lbs. Big boy. The MD who was suturing was not his PCP, just there to take care of the urgent task. As she wassuturing, the child keeps... Read More


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    I had a 12 year old 260lb boy with HTN, high cholesterol, liver failure, and newly diagnosed with diabetes. Pt Mom refused to take him to the exercise and weight loss program the Doctor had recommneded. I could not help but think this was a slow murder of her child. I've dealt with this child twice, once because he developed PNA and the other for ketoacidosis. This kiddo is sicker then many 70 year olds.
    carolmaccas66 likes this.
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    Quote from HappydayRn
    I had a 12 year old 260lb boy with HTN, high cholesterol, liver failure, and newly diagnosed with diabetes. Pt Mom refused to take him to the exercise and weight loss program the Doctor had recommneded. I could not help but think this was a slow murder of her child. I've dealt with this child twice, once because he developed PNA and the other for ketoacidosis. This kiddo is sicker then many 70 year olds.
    To me this is child abuse, or neglect or something to that effect, It should be court ordered in this case.

    This upsets me very very much.
    rubato, CCL RN, leslie :-D, and 1 other like this.
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    I think one of the reasons this upsets us is also because we try to give them the education and advice and many times even the resources to deal with these issues, they don't follow up or make the changes we suggest, and then they come back again asking us for help when the next problem arises. It is so frustrating! We are trying to help but if you're not gonna help yourself then don't keep coming back and expect us to be compassionate.
    carolmaccas66 and anotherone like this.
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    Quote from R!XTER
    I think one of the reasons this upsets us is also because we try to give them the education and advice and many times even the resources to deal with these issues, they don't follow up or make the changes we suggest, and then they come back again asking us for help when the next problem arises. It is so frustrating! We are trying to help but if you're not gonna help yourself then don't keep coming back and expect us to be compassionate.
    With that comes the perception that these kids just get sick out of nowhere. Granted injuries are injuries, but when they're coming in for breathing issues, it's obviously r/t their weight (although not obvious to them). Then you hear "it runs in the family". Why does it run in the family? Because children model their parents behavior. I'm tired of everyone writing off ALL of their medical and weight issues to genetics. The exceptions (actually hereditary issues) are rarer than we all want to believe. Its the behavior that's hereditary.
    R!XTER, carolmaccas66, and leslie :-D like this.
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    Quote from nurse educate
    With that comes the perception that these kids just get sick out of nowhere. Granted injuries are injuries, but when they're coming in for breathing issues, it's obviously r/t their weight (although not obvious to them). Then you hear "it runs in the family". Why does it run in the family? Because children model their parents behavior. I'm tired of everyone writing off ALL of their medical and weight issues to genetics. The exceptions (actually hereditary issues) are rarer than we all want to believe. Its the behavior that's hereditary.
    Every time I hear the quote "it runs in the family" I have to bluntly tell that person it is their choice to break the chain, because dead is dead. When it comes to obesity, they may have to work harder ESPECIALLY at family events, because if they don't they will be in the hospital with health problems (pick an organ) in no time. If is it obesity secondary to hypothyroidism, you have to work 3 times as hard to keep the weight off.

    I am a firm stop the excuses kind of gal. Obesity is a choice, and it is more complicated than "eat less calories than you take in" I do know. The cure to obesity is lifestyle change. It is sad to see people accept that their obesity is just the way it is supposed to be.... let's get them motivated!!

    This is why I LOVE the show "the Biggest Loser". So inspirational to see obese people make lifestyle changes and choices, and to be able to see the results pan out!
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    Quote from R!XTER
    And let's not forget that obese children too often become obese adults. Then they come into our ER's at 600 lbs because they are short of breath. Shocker. And we have to have 3 people holding up their belly fat (while trying not to breathe because the odor is so horrible) while the doc tries to dig around for their penis, which is buried in all of their fat, in order to place a foley. (This just happened the other night). Forgive me, I know I signed up for this job, but I just feel like they are a huge burden on us. I know often it stems from a psych issue, but I cannot help but resent it. There is no way people like this can hold down a job. They cannot even move enough to get around their homes. So it's not that big of a leap to assume they are on food stamps, Welfare, Medicaid, etc. So let's be real people, WE are paying for their horrific lifestyles, as well as the honor of holding up their rolls of fat. This just sickens me to no end. And I apologize if I've offended anyone.
    I am so with you on this. ALL the people we get in the ED/ER who have fallen over have been obese. One doctor actually said a person's weight would not have helped their issues with falling over - once you fall & ur big, u won't be the same again. And they usually displace/break hips & it doesn't seem to bother them one iota.
    We had one lady come in, who kept falling over, they sent her home after examination & she kept falling over (doc thinks she was getting some type of dementia). And she was so fat, she couldn't sit upright in the chair we were using to pee or to go to xray, she was nearly sliding off cos her belly fat was in the way. She ended up having diabetes (which she had denied having & hadn't followed any diets etc), she had high BP & her son said she sat at home all day & just ate. She hardly ever moved out the house, no exercise, did crocheting & someone did her washing/housework. I wonder if this says something about society? Perhaps she felt lonely & isolated, I don't know, as she went up to a ward. Perhaps she should have been made to do some housework to get exercise, but I doubt she would have done it anyway. And the very worse part was she smelled like ripe faeces.
    Then we had another older lady, who was slightly confused, hugely overweight, who had again fallen over. The smell from her nether region was so bad, I don't even know how to describe it - have u ever smelled rotting flesh? Maybe that was it, mixed with rotting fish. This woman was so huge, we couldn't get her on a bedpan. She obviously didn't wash, & I wondered if she hadn't washed herself in years. When I looked at her pubic hair, it was moving. However she knew where she was, the date/day and why she was in the hospital.
    I do think these people take up a lot of time and energy in the health care system. I too blame families, for running after mum & dad as they get older, instead of trying to get them out for exercise & helping them be independent. Have u ever tried to take away an older person's dessert, saying their diabetes is sky high & they can't have it? You will be charged and accused of abuse by the families, who understand nothing about diabetes or how serious obesity is.
    And have u ever noticed when mama gets admitted to hospital with issues to do with weight etc, that when the family come to visit they are all obese as well?
    Gaining weight I think is inevitable as we age, but becoming obese is not inevitable. And because eating is seen as something we HAVE to do to survive, it's not seen as bad, but it's a slow, slow killer eating bad etc. You may get away with not having health issues when ur young and overweight, but you won't get away with it when u get older - I always tell people it WILL catch up with you, you will suffer from it & you will end up in hospital not being able to move. That is why we need to instill good and healthy moving & eating in kids today.
    Obesity is now considered a MAJOR health problem by the WHO, as I've learned. We used to focus on adults getting obese, now it's a major problem for kids.
    Where will it end I wonder & how can we change it?
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    Quote from R!XTER
    I think one of the reasons this upsets us is also because we try to give them the education and advice and many times even the resources to deal with these issues, they don't follow up or make the changes we suggest, and then they come back again asking us for help when the next problem arises. It is so frustrating! We are trying to help but if you're not gonna help yourself then don't keep coming back and expect us to be compassionate.
    Yes, we get this in our ED. It gets extremely wearying.
    I'm dreading it because I have to go back there tonight. I so hope we don't get the family who's mother is end stage COPD, who can't breathe, who is PALLIATIVE & come in begging us to do something about it. Their mother is a CO2 retainer. Why they keep bringing her to the ED I don't know, the doctors tell them repeatedly we can't do anything, we put her on O2 (as a comfort measure), & the family sit there ringing their hands, with the kids milling around & they are sooo bored. People use the ED for us to say: no it's OK you smoked for 40 years & are dying, we will cure/care for you. It's OK you ate yourself stupid for 50 years, that you can't breathe/walk/pee whatever and you say to us you don't have a problem, that's OK.
    Well tonight, I'm going to start saying it is NOT OK and pull the families aside to have a talk with them about mum or dad's lack of independence. Same with the parents of obese kids. I'm tired of babying people & if management don't like it, tough. I think not saying anything or saying something wrong/unhealthy is OK is a BIG part of the problem & we need to change people's thinking. I feel very strongly about all this.
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    Quote from carolmaccas66
    Yes, we get this in our ED. It gets extremely wearying.
    I'm dreading it because I have to go back there tonight. I so hope we don't get the family who's mother is end stage COPD, who can't breathe, who is PALLIATIVE & come in begging us to do something about it. Their mother is a CO2 retainer. Why they keep bringing her to the ED I don't know, the doctors tell them repeatedly we can't do anything, we put her on O2 (as a comfort measure), & the family sit there ringing their hands, with the kids milling around & they are sooo bored. People use the ED for us to say: no it's OK you smoked for 40 years & are dying, we will cure/care for you. It's OK you ate yourself stupid for 50 years, that you can't breathe/walk/pee whatever and you say to us you don't have a problem, that's OK.
    Well tonight, I'm going to start saying it is NOT OK and pull the families aside to have a talk with them about mum or dad's lack of independence. Same with the parents of obese kids. I'm tired of babying people & if management don't like it, tough. I think not saying anything or saying something wrong/unhealthy is OK is a BIG part of the problem & we need to change people's thinking. I feel very strongly about all this.
    Judge much? ED nurses can't pick their patients, they are sick maybe because of what they did, maybe because someone else helped them along to their states. Regardless of the reason, compassion needs to be part of your makeup. Family dynamics make or break people's lives, your commentary will have little effect on them-in fact, if these people are a little "backwards" it might get you hurt!

    You draw more flies with honey, than vinegar.....you cannot change culture, but you can add to it. Are you aware that this country has a 5th grade reading level, if you are teaching or providing healthcare literature it drops to 3rd grade. Small changes over time can= big victories. Blasting someone is like shutting the door, they won't hear you or your message.

    As for the topic, it is all over the news, it is on every talk show, it is in every school and in every fast food establishment. It is a government directive.....UNTIL WE MAKE GOOD FOOD AFFORDABLE AND AVAILABLE TO THOSE WHO NEED IT-THERE WILL BE FAT CHILDREN! Also, acceptance of fat, jelly rolls, muffin tops, by men and women alike has made it very easy for people to "let it all hang out". I would be mortified to have fat hanging out of clothes, yet regardless of age I have seen every age group doing it! While acceptance of people is a good thing, morbid obesity is not.....fat is never beautiful, just a weight to be carried around similar to Silas Marners chains.

    Maybe back to school night should include strategies for healthy living, maybe exposure to fruits, vegetables and salads by local farmers and vendors to kids who may never eat them due to parent dislikes, maybe there should be a lengthened school day to keep kids from going to home to empty houses and no activity, other countries include "real" physical fitness(hikes, cycling, swimming, boating, horseback riding, running, martial arts, etc) not just sports in their curriculum's, keep the kids till 4pm every day and make sure they play and run.

    I know this is a rant, but I must state fat people wear their addiction for all to see....we don't see the nuts, smokers, drug addicts, abusers, sex addicts, child abusers, nasty, evil, mean, etc.....because their "problem" is hidden. Anger at the obese does not help them, in fact, it hurts them because they will avoid you and become the 500lb person who requires total care. Bad for them, bad for us.

    A final note, my kids were always in the 99th%, the doctor would say it and I would ask what their weight had to do with their health? They were wearing the same clothes size as their peers, were tall, but weighed alot (no fat). She could never answer me....as my son grew he was thin, he would eat like crazy....become a fireplug, then grow several inches and be slim again. My daughter was the same way. When they reached their final heights she is 5'10" and he is 6'3" their weight in numbers remained heavy, but both are slim. Their doctors still cannot explaing to me why this is so.....are their bodies so dense? bones so heavy? is it their muscle mass? I don't know....but if you were to see their weights you would assume them being overweight, yet they could both fitness models. So numbers aren't always everything, for those who quoted them....
    M
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    Quote from NICU_babyRN
    You are not alone! I can't stand fast food mostly because in the rare times I go into a fast food establishment I see more than the number one can handle of fat families who LOVE fast food and it's ALL they eat.
    The kicker is when I see kids who can barely walk already eating canned bads and french fries....
    It's so preventable but many fail to accept their wrong-doings. It's NOT that hard to cook homemade meals the are healthy and affordable.
    That's my rant
    Many of those homecooked meals would be much more affordable and healthier. It is more affordable especially for larger families. My husband and I have a larger family and I figured our meals to be on average 70 to 80 cents per person, per meal. I'm talking a meat, 2 vegetables, a starch and the drink. There is no fast food restaurant that is selling a meal for close to that. But many families are not taking the time to cook a real meal. It really isn't that hard at all. Most people waste far more money than what it would take to invest in a decent crock pot. I have known people with the IQ of a plant who can turn out fabulous meals with one of those.

    I have noticed that in poorer neighborhoods it is hard to find stores that sell healthier foods. Those foods can been acquired with some effort, but they are not readily available (heaven forbid people try to grow their own vegetables, but even then some people honestly don't have a yard to grow one).
    MAISY, RN-ER likes this.
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    Quote from R!XTER
    I think one of the reasons this upsets us is also because we try to give them the education and advice and many times even the resources to deal with these issues, they don't follow up or make the changes we suggest, and then they come back again asking us for help when the next problem arises. It is so frustrating! We are trying to help but if you're not gonna help yourself then don't keep coming back and expect us to be compassionate.
    Speak for yourself. I hope I can still be compassionate, particularly if a child is involved. Should I stop being compassionate to lung cancer patients because they smoked? After all, they did it to themselves...

    <sarcasm>
    Last edit by OCNRN63 on Sep 24, '11


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