Health Care Thoughts: I really shouldn’t write this…..
by Tom aka Rusty Rustbelt
Health Care Thoughts: I really shouldn’t write this…..
This will, if Dan publishes the piece, offend someone for certain.
I have a libertarian do-your-own-thing streak, but something recently really struck me as a tragic image.
So I am in the grocery store, and coming around the aisle hear the beep-beep of a back up alarm on a power cart. I often try to help power cart shoppers reach items on higher shelves, especially the little old ladies and men wearing veteran caps.
The fellow on the cart I would estimate to be about 5′ 9″ and at least 450 pounds. And I was going to offer to help but then I saw him struggling to put three cartons of ice cream in his basket. I decided to mind my own business but the image really bothers me.
Mrs. Rustbelt and me have become sort of go to experts on issues related to the morbidly obese, her clinical and me on equipment and safety, so I know what lies ahead. My sweetheart has a rep for managing difficult diabetes cases.
The future. Chances of diabetes near 100%, congestive heart failure near 100%, extremity pain near 100%, below knee amputation/s near 100%, early death near 100%.
The gentlemen cannot be cared for safely in about 95% of the hospital rooms and about 95% of the nursing homes in the country. He will not fit well in a conventional ambulance and will be a danger to the paramedics and firefighters who would have to transport him.
Even a minor surgery carries a very high risk and moving him onto a surgical table is a dangerous maneuver. “Routine” anesthesia could kill him.
There is a high likelihood one or more health care workers will be injured someday while caring for him (which reminds me, Mrs. R needs me to pick up her prescriptions, work related injury).
So, am I a SOB? I don’t know his history. Should I have helped him? Should I mind my own business? Should I think about the safety of health care workers? Should I think about costs to the government? Should he think about buying some carrots? Is he responsible for his own health?
Fire away.
Rusty
I looked for something to be offended about. Best I could come up with is , first, we ALL have a libertarian streak. The differences among us come down to just where we realize that it is IMPOSSIBLE to do without “government.”
second, you and i don’t know why this guy is “morbidly obese,” but I think it is unlikely it is just a matter of carrots and will power.
third, sorta, most of the people i see are at least a little bit obese. a little will power might help them, but probably not much or for long. a life where calories were a little harder to come by and exercise was a little harder to avoid would help enormously, but that is not a matter of will power.
As for the safety of health care workers, that is in their own hands… or should be if they can confront management and demand safer working conditions.
There are.limited, ways you can protect yourself trying to move heavy objects.
there are mechanical aids to moving heavy objects.
and more hands make lighter work…
if health care workers are hurting themselves moving obese patients, someone is being stupid.
Coberly:
Mrs. Rustbelt has a comment.
“Tell your friend that even with excellent staff, excellent training and the best equipment available a morbidly obese patient has a higher risk of injury and the staff has an elevated risk of injury. The human body was not meant to function in that condition. He doesn’t understand health care work, clearly. Tell him we are used to being disrespected, whatever.”
She is a little grumpy, Friday the family of one of her patients stuffed him full of carbs and sweets, he went into a diabetic coma, and it took four paramedics to get him to the hospital. He lived, probably due to swift action by Mrs. R. Her reward? Two hours of extra paperwork.
Would you hand a suicidal man a loaded gun?
str, only you know where your heart lies in this case. But I think the guy doesn’t care about your help. If he were truly waiting around for the charity of others, he wouldn’t be in that rolly-cart trying to do his own shopping.
Maybe the ice cream was for a party at work and maybe he used to weigh 550 and has lost and is losing more weight than you could imagine. I think it is hard for most people to weigh that much. Or maybe not and you are right. You should ask him next time and tell him you will help him if his purchase is for someone other than himself.
How do you feel about unfortunate Predar Willi children who let themselves get too fat. If anything shows that weight AND hunger are complex and genetic, this one disease does it. I’m not saying people like him have the same abnormality, I am saying that extreme abnormalities give credence to the vast range of human traits including regulation of hunger and weight.
Rusty,
Say thank you to Mrs Rustbelt for what she does, the former mrs ilsm is a long serving ER nurse.
I get a kick out of showers in hotels with their bowed out curtain rods!
“Do not judge by appearances; a rich heart may be under a poor coat” Scottish proverb.
That guy on the indoor golfcart is my ideal lbertarian, living freely as he/she does.
I imagine he rode his cart out the door to his Harley………
I think ‘morbidly obese’ people have as much right to 3 packages of ice cream as anyone in the US to own an AR 15 and hundreds of rounds of NATO ball 5.56mm (the 30000 annaul firearm suicides only use 1 round). Grocers should facilitate them like gun dealers and the NRA.
Scottis proverb or one of Dipchak Chapra’s law: Practice Non Judgement!
I miss m’da, but that’s how he died. Didn’t have to be that way.
rusty, no offense…that you’re even thinking about his future makes you a lot more compassionate than i would be…
Rusty
give my sincere kind regards to Mrs Rusty. And try to find a way to say nicely to her what I am not smart enough to say nicely.
No one was disrespecting her. Not I certainly.
Yes injuries among health care workers are higher than they ought to be. That is why I offered three modest suggestions. Nothing in her answer suggests that she understands that “there are ways to reduce risk.”
I certainly don’t understand nursing. I do understand something about the common human characteristic of being offended and persisting in self harming behavior.
STR:
No need to sweat the small stuff. In time he will remove his offensive self from your view by his own actions and you will be able to carry on as if he never existed.Life is harsh.
We are in trouble when people equate ice cream with an AR-15.
I think both the impulse to help and the decision to not help him get 3 cartons of ice cream were very decent of you. It’s a hard issue. I’m pretty sure nothing much gained by not helping him with the ice cream (and nothing would be gained by giving a lecture on obesity and health). But it is a good general rule to not help people hurt themselves.
I am ignorant, but I would tend to guess that the only way to treat such obesity that works is surgery (illiectomy or latex band around the stomach or both), I tend to hope that with Obamacare more people who really need such extreme measures have access to them.
The trouble is that Rusty’s response to the fat man was NOT “this is tragic.”
It was, “here is a criminally irresponsible person who is going to put my wife in danger.”
You and I don’t know how much “self control” would cost this person. Does hunger hurt him worse than it does me? Or does he know he only has six months to live whatever he does, so he says “what the hell?” Or maybe he was buying it for his kid’s birthday party.
The good that Rusty might have done, if only for himself, would have been to help the guy reach the ice cream, say something nice, and go on about his own business.
As for Mrs Rusty I have two thoughts, which may be offensive.
I have a dog of a strong, stupid breed. It pulls on the leash no matter what. If it is tangled around him, me, or the innocent bystander. I am aware that I am at some risk of harm when i take him out on the leash. But I would be a fool to blame him.
Or, I can imagine some army medic complaining about his patients running around where people are shooting guns. I mean, the nurse could get hurt.
If I were a real Republican, I’d say that if the job is too dangerous for you, maybe you need to look into another line of work.
And yes, he says, I know that all this will do is create hate and misunderstanding. Curt Doolittle was telling me just the other day about “conservatives” and their religious values. I could suggest what I think “Jesus would do,” but they crucified him.
I spend quite a lot of time in hospitals and doctors’ reception areas. I see interesting things there. One day when I was waiting to see my cardiologist, I noticed two young women sitting a few seats over. One was slender and petite, maybe early 20’s. Her companion was also fairly short,and about the same age. But, young lady number 2 weighed at least 450 pounds. At least that much, probably more.
In a short while, the two young ladies were called to go into the examination room area. I was sitting in the row of chairs that lined the aisle to the exam rooms. That put me a few feet from the patients walking toward the exam rooms. Young lady number 2 had a hard time walking. Her friend held her arm and tried to support her. But number 2 stumbled and lurched to the right.
I noticed that there was something wrong with number 2’s hip. It looked like her hip had dislocated. By the time I turned my attention back to number 2, she was down on the floor,flat on her back, unresponsive. The nurses in the office called the cardiologist and attempted to resuscitate number 2. Another nurse ushered the rest of us into another smaller waiting room. The office manager started rescheduled our appts. But some people said they’d wait for an email.
One of the other patients asked me what would happen to number 2. I said “they” would try to resuscitate the unfortunate young lady. I lied of course since number two had died right in front of us all just a few minutes ago. No matter how she reached such great weight, number 2 succombed to the combined effects of her obesity and her heart condition (most likely congestive heart failure.) That much is clear.
Rusty’s wife does routinely what it takes three grown men to do. In my husband’s case, when he was admitted to the ER the men were available. Otherwise, the nurses and CNA’s on duty would have had to haul all 350 plus pounds of him onto the exam table. I honestly couldn’t believe at the time that was possible. Later, nurses in ICU proved it was.
I conclude from my experiences with modern medicine that anyone who says that people fake disabilities caused by heavy lifting and hard labor needs to think again. Especially if the disabled person was a nurse or nurse assistant caring for obese or immobile patients. NancyO
I knew a very smart engineer who was director of an applied engineering program at a major private university. This guy was well over 500 pounds, and not surprisingly he ultimately died of complications resulting from his morbid obesity. But he had gone to various serious obesity control programs and tried to lose weight. It was dismaying to realize that even very smart people who have ready access to the best possible health care programs may, in some cases, be unable to lose weight. I guess all I am saying is that it is too easy to pass judgement on people who have problems that are different than yours.
Nancy, That is interesting. It amazed me that we can lift 500lb objects with the right equipment but not people so I Googled. The first website I opened had lifts with up to 800 lb capacity. Admittedly, the person would need to get into the harnesses in the first place. There is a lot I don’t understand about the lives of these people but, as a cripple, I do understand the difficulty of maintaining weight when exercise is limited by a disability. I think that may be why such people can only lose weight in a medical facility. They are too unhealthy for surgery. Does insurance cover surgical procedures for people headed for trouble but still in good enough health to undergo an operation?
The proper equipment exists. But, my local hospital doesn’t employ it in the ER. Chairs, beds, exam and operation tables have to specially constructed for use with obese people or those with mobility problems. This type of bariatric equipment is generally used in nursing homes but not assisted living facilities. EMT’s don’t have lifts in their ambulances. To get a patient with a broken hip onto a gurney requires a lift of dead weight up from the floor to the gurney. You do the lift by sheer muscle power. I don’t know about insurance coverage for lap band and other similar surgery. It probably depends on the insurance polcy. The investment in new bariatric equipment is beyond the means of many small rural hospitals. NancyO
Nancy O
I wasn’t claiming that reports of injuries to nurses were fake.
I was mostly saying that telling yourself you are morally superior to someone else is not putting yourself on the path to truth or self knowledge.
i also offered a few suggestions for other thoughts to think when tempted to despise someone for their irresponsible obesity.
I note that you say. “the proper equipment exists but the local hospital doesn’t employ it…”
that was one of my points.
point two is that you are likely to get hurt trying to lift a heavy weight, especially a human who might move suddenly, or whose body does not have the internal structure that allows you to move fairly easily if you are careful a refrigerator for example. you can protect yourself.
me, i am not such a humanitarian that i am going to throw myself in the path of a falling 400 lb person. but i also know a trick or two for moving heavy people-like objects that will work sometimes, and generally even if i can’t move them, i can avoid hurting myself.
maybe not always. but, like i said, if that is your business you are better off studying how to do what you can without getting hurt than going around complaining about the moral irresponsibility of the people you are paid to take care of.
i also know that going around giving people good advice can get you hurt.