Today we had a morbidly obese 20 y/o female come into the ER via ambulance c/o severe lower abdominal pain, bloody diarrhea 20x/day for 2 days. She was stable (140/90, 100, 20, 99.0).
Come to find out she was giving herself enemas 2 days ago alternating with Rum and Isopropyl alcohol. She read in a "homeopathic" book that this was a good method of weight loss. She was under the impression that in order to cleanse her liver and "rid herself of toxins" that it required multiple enemas with various types of alcohol. I'm not really sure if the book actually suggested alcohol enemas or if that is what she understood it to mean by "cleansing".
At this point it was shift change so I don't know what the diagnostics showed.
It bothers me that someone would go to such drastic measures to lose weight. While I fully understand the desire to lose weight, I don't understand the desperate measures.
I've seen people come in after trying to cut out their own fat, I've seen them almost die from the effects of water intoxication, I've seen women who attempted to do their own breast reduction because they couldn't afford to have the procedure done, I've seen too much.
Couple of questions... I've been in nursing for 20+ years. Mostly ER, Trauma, ICU/CCU. I'm not sure I want to keep doing this. Most times I can deal with it through dark humor or sometimes a bubble bath, a glass of wine, and a little time does the trick. But I go through these times where nothing makes me feel better about these people. These are intelligent, reasonable people that are simply desperate.
How do others deal with this?
And this girl has me bugged. What happens with someone who for 12 hours repeated Rum/Isopropyl alcohol enemas? I've heard of wine enemas, but never Rum and Isopropyl alcohol for 12 hours.
I've heard being overweight is a combination of genetics and learned eating habits. One is not exclusive of the other. I do believe that being overweight is at least partly a choice. And some people are more predisposed to it than others.
My views.
Edit: I also think that *continuing* to be obese can be a choice, once the detrimental effects of lifestyle choices has been consciously realized. Remember that I said I also think that genetics plays a role, so it's not totally a choice to be obese. Also, I think if your hormones are in an unusual state, such as when you're pregnant, you can gain weight and keep it for a while even after the baby is born. I'm sure there are also other reasons outside that people have obesity other than it just being a choice.
Obesity is certainly a complex issue.
From my point of view, those are minor issues. I'm referring to the emotional side of all this. It just isn't as easy as "quit eating." If it was there wouldn't be an obese person on this planet.
Have you [anyone] ever been trapped in an elevator long enough to pea in the corner? Been in an abusive relationship, fearful for the lives of your children, yourself, yet having nowhere to go nor even the means to leave? That it may be outside of our experience (even outside our [rational?] comprehension) makes it no less real. No less tragic. No less desperate.
I wasn't saying that I don't understand it as much as I don't relate to it. I've never been in such a position. But I certainly have empathy for those who do.
I wish there were more understanding, too. Some of the comments I hear from people who are supposed to be healthcare providers are truly depressing. I can't imagine the desperation this woman must have been feeling, let alone how humiliated she was to have to explain what happened. I find it hard to believe she went to such extremes just because she was looking for a quick fix to her weight issues. It sounds ot me like there was a lot more going on there.
While I hate to write so many posts in a row I had to comment on this one.
You are soooo correct! I agree with this so much. It was shift change within 10 minutes of this gal's arrival and already the jokes started flying. No doubt it was humiliating to have to explain what she did.
And yes, h/c pro's should be much more understanding.
Just to put in another point of view... I am 75kgs, therefore medically on the upper level of a healthy weight, however, my diet is approx 1500cals a day, 500cals less than the UK approved for me. BUT, until recently I didn't realise that I have an underactive thyroid controlling my weight and therefore stopping me from losing weight when even on a healthy diet.
I know you are speaking of obese patients and clearly I do not fit in that category, but I just thought I'd remind you than not everyone who is overweight does it by choice
:chuckle Why, thank you!
I've heard being overweight is a combination of genetics and learned eating habits. One is not exclusive of the other. I do believe that being overweight is at least partly a choice. And some people are more predisposed to it than others.
Just to put in another point of view... I am 75kgs, therefore medically on the upper level of a healthy weight, however, my diet is approx 1500cals a day, 500cals less than the UK approved for me. BUT, until recently I didn't realise that I have an underactive thyroid controlling my weight and therefore stopping me from losing weight when even on a healthy diet.
I know you are speaking of obese patients and clearly I do not fit in that category, but I just thought I'd remind you than not everyone who is overweight does it by choice
Ditto... JFTR, I finally found my answer to Hashi's and weight gain. Cytomel. Not sure what brand is in the UK but generic is Liothyronine Sodium. Great stuff!
Specializes in med/surg, telemetry, IV therapy, mgmt.
Sounds like you need to change your job or change to another area of nursing. One of the biggest problems of working in a hospital, and I think, particularly, in the ER is that you get an unusually skewed view of people and their illnesses. There are many nurses who work in jobs where they would never have seen what you have. Perhaps a change to a regular medical unit or ICU or even to the ER of a specialty hospital (such as a cancer center) would give you a much needed change. 20 years is a long time to spend in one place.
Bipley
845 Posts
From my point of view, those are minor issues. I'm referring to the emotional side of all this. It just isn't as easy as "quit eating." If it was there wouldn't be an obese person on this planet.