800lbs plus man

chadash · Apr 5, 2006

I remember a young woman I had as a patient back in the 70's. She weighed almost 700 pounds, with a fatty tumor that weighed almost 100 pounds. She had been of normal weight until she reached 18 when she began to put on weight. And she stated she never over ate. She was put on a 700 calorie a day diet and gained weight. She was a patient for several months until finally be diagnosed with a rae endocrine disorder. Once treated she lost the weight. But I can remember my peers making crude comments about her. And I can remember how angry I got.
I just watched a program on Prader Willi Syndrome. Another sad genetic disease.
Grannynurse:balloons:

I wonder if my patient had something like that (prader willi). Is there any remedy for that?

Marie_LPN, RN, LPN, RN · Apr 5, 2006

The reason I asked what the point of this is, was because the link came from an entertainment site of some kind, which immediately raised my hackles because I can't think of anything LESS entertaining than the struggles of the super-obese.
And yes, I'll state this for the record: I am seriously overweight (although nowhere near the neighborhood of the folks discussed here) and yes, I'm a bit sensitive when the subject of obesity is raised---again---because a) it's been done to death, and b) inevitably somebody will throw in a post that's hostile and judgmental towards the overweight. It hasn't happened yet on this particular thread, and if it doesn't, it will be the first time........so please, carry on and enjoy the discussion, in the meantime I will excuse myself and go find a less, um, heavy thread to read.

I never saw anything entertaining about someone who is 800 lbs or who used to be 800 lbs. That link may have been from an entertainment site, however, i found 4 different news site that contained the same subject matter about the same person. And this IS a problem where i work, it cannot be sugar-coated or ignored for the sake of protecting someone's feelings, when their safety is threatened, when you don't have the equipment you need for a particular pt. because it's already being used for someone else.

There are certain subjects i'm very sensitive to that get posted here, however, i also realized that none of it was about me, though.

Trauma Columnist · Apr 5, 2006

Obesity is an epidemic in the US unfortunately. It is a reflection on our society versus an individual. I too am 50# overweight and I'm no spring chicken as the saying goes. I was recently on the No-Lift team at our hospital in order to make us a no-lift facility. It was demoralizing (to borrow someone else's word) to do site visits and realize that all this equipment exists. In our ER, we now have a bari-bed and bari-cart right at the doorway for our patients that weigh more than 350# because that is all our carts are rated for. We have many, many super obese patients.

BTW - did anyone know that being super obese is a disability under the American's with Disabilities Act?

Prader-Willi syndrome is extremely sad to see. It means constant monitoring by the parents or caregiver and it is a life-time situation. Usually Prader-Willi kids are very physically healthy (few URI's, few viral illnesses, etc). These kids have a normal life-span but it is a life fraught with many weight issues.

Marie_LPN, RN, LPN, RN · Apr 5, 2006

I don't want to get into trouble or anything, but why was the link edited?
I thought this was a very good story as well as an appropriate topic for a nursing board.

The link had some "adult content" on the page that had nothing to do with the story.

chadash · Apr 5, 2006

Obesity is an epidemic in the US unfortunately. It is a reflection on our society versus an individual. I too am 50# overweight and I'm no spring chicken as the saying goes. I was recently on the No-Lift team at our hospital in order to make us a no-lift facility. It was demoralizing (to borrow someone else's word) to do site visits and realize that all this equipment exists. In our ER, we now have a bari-bed and bari-cart right at the doorway for our patients that weigh more than 350# because that is all our carts are rated for. We have many, many super obese patients.
BTW - did anyone know that being super obese is a disability under the American's with Disabilities Act?
Prader-Willi syndrome is extremely sad to see. It means constant monitoring by the parents or caregiver and it is a life-time situation. Usually Prader-Willi kids are very physically healthy (few URI's, few viral illnesses, etc). These kids have a normal life-span but it is a life fraught with many weight issues.

Thanks for the explaining Prader willi. She was generally healthy, her speech was a bit impaired, and she did not eat all that much. Sometimes she would cry because some of the assistants complained about rolling her. It was a joy to get her out of bed for a bath, she just felt great afterwards. It was like she was trapped, you know what I mean?

Antikigirl, ASN, RN · Apr 5, 2006

My husband, who is a paramedic, gets many bariatric patients in his rig...sadly most often he gets an earful from them about how horrid the conditions are for them in the ambulance, and yell at my hubby (who is overweight too!).

He is really cool with them, very understanding...however he will let them know that ambulances are typically of one size and so are the gurneys...with the exception of the very rare 500lb ones...which are not made for someone over that weight. That he will try to make the trip as easy going and quickly as possible, but to please bear with the limitations of emergency transport.

I too have gotten a yell or two about conditions not providing comfort for the obese...and I just explain that typically due to the circumstances of admit, they were taken to this hospital which doesn't provide more than 2 bariatric beds and that I will get them one as soon as one is available.

It is a fine line trying to comfort patients who are a bit more complaining in nature (certainly not limited to the obese!), yet dealing with the reality that one size doesn't fit all. I mean, I guess the hospital I work in is lucky to have 2 beds for bariatrics...most have none!

I hope that bariatric equipment will become the norm for all facilities...but I can also see that if you get two...you will need three...have three...you will need four. Wonder what facilities will use as a guide to how many they need vs the expense???

As far as ambulances...well I just don't see much around that...they are only so big for safety on the road reasons, and you still need room for the acting paramedic to tend to the patient back there. That one is a toughie!

Marie_LPN, RN, LPN, RN · Apr 5, 2006

I hope that bariatric equipment will become the norm for all facilities...but I can also see that if you get two...you will need three...have three...you will need four. Wonder what facilities will use as a guide to how many they need vs the expense???

Expense is just one of our issues, everytime we order anything like this, it's on backorder.

chadash · Apr 5, 2006

My husband, who is a paramedic, gets many bariatric patients in his rig...sadly most often he gets an earful from them about how horrid the conditions are for them in the ambulance, and yell at my hubby (who is overweight too!).
He is really cool with them, very understanding...however he will let them know that ambulances are typically of one size and so are the gurneys...with the exception of the very rare 500lb ones...which are not made for someone over that weight. That he will try to make the trip as easy going and quickly as possible, but to please bear with the limitations of emergency transport.
I too have gotten a yell or two about conditions not providing comfort for the obese...and I just explain that typically due to the circumstances of admit, they were taken to this hospital which doesn't provide more than 2 bariatric beds and that I will get them one as soon as one is available.
It is a fine line trying to comfort patients who are a bit more complaining in nature (certainly not limited to the obese!), yet dealing with the reality that one size doesn't fit all. I mean, I guess the hospital I work in is lucky to have 2 beds for bariatrics...most have none!
I hope that bariatric equipment will become the norm for all facilities...but I can also see that if you get two...you will need three...have three...you will need four. Wonder what facilities will use as a guide to how many they need vs the expense???
As far as ambulances...well I just don't see much around that...they are only so big for safety on the road reasons, and you still need room for the acting paramedic to tend to the patient back there. That one is a toughie!

Yeah, it may not be as easy as it sounds. I still don't trust those plastic bath beds! seem a little rickety and woggity.

Antikigirl, ASN, RN · Apr 5, 2006

Oh totally! The facility I was working in (ALF) had ordered 5 sit/stand lifts for our patients and it took over 5 months to get them!!! Back order...uhgggggg!

And even those sit/stand lifts were only able to take on a total weight of 500lbs! But there was nobody over 300 lbs at the facility at the time...yet...

The hospital that I am currently doing most of my agency work in is just now ordering sit/stand lifts...wonder how long that wait will be??? They were needed years ago!

chadash · Apr 5, 2006

Is a sit stand lift like a standing frame used for paralysed folk to retain bone mass etc?

'cuse my spelling..

Antikigirl, ASN, RN · Apr 5, 2006

I don't think that will work because the patient needs to be weight bearing. Typically it is just a lift for folks to go from a dangle to a standing position for ease of transfer or to help with ADL's. Can't tell you how wonderful it is for people needing to go to the bedside commode all the time, or in/out of wheelchairs. It is a snap! No lifting on the helpers part, the only physical demands are getting the harness under them, and pushing the lift to where they need to go...and the lifts are easy to push! (carpet a little harder but still very easy).

The only probelm I see with these are limitations in hospitals or small roomed facilities where the lift can barely get in or move...but they are smaller than your typical hoyer.

azerrn · Apr 5, 2006

Re obese patients...My experience in both the ICU and the ER with obese patients has not been positive. There always are the exceptions that are sweet or funny. Most have been rude and demanding, aggressive not assertive.

In some respects, obese patients are the new AIDS patient. It doesn't matter how they got obese, what matters is that they are. And, like universal precautions that started to protect nurses from AIDS, nurses need to have obesity precautions that protect them from the dangers posed by obese patients...in particular, chronic back pain and herniated disc's.