Wednesday, March 27, 2013

The New Epidemic

Every generation of physicians has a prototypical disease, the one that wreaks havoc with almost all the organs. Learned professors of medicine would say, “You can learn all of medicine by studying disease X.” For my father’s generation it was syphilis. For my generation it was alcoholism. For the current generation it would be obesity, hands down. It affected every organ. (Dr. Manheimer, 12 Patients)

Given this current epidemic, it is not uncommon for our hospital to have multiple patients who suffer from obesity. The largest patient I took care of this year was 582 pounds. Generally over 50% of our population is 200 pounds or more. This not only affects the patient but it takes a toll on the caregivers. I spend a large chunk of time in each room setting it up to ensure my health and safety. The last thing I want is to be out on “administrative duty” because I hurt my back. I also don’t want my back to limit how I spend my free and, trust me, Zumba is not easy on it but it sure is fun!

The most common mistake nurse aides make is not raising the bed. This seems so simple but I walk into multiple rooms each day and watch aides totally bent over doing a task as simple as putting lotion on someone’s legs. You can ask all my co-workers that my first response when I witness that is, “I’m sorry, but I won’t do that. Wait until I raise the bed.” I sometimes come off as Ms. Bossy Pants, but the extra time it takes to properly position a patient is the key to health especially as our patients are tipping the scales.

As you read each obese patient’s case file you see that obesity is never the number 1 complaint or diagnosis however it effects every part of their disease and recovery. The sad thing is that many of these patients don’t understand that. If I have a 150 pound man come in because of a below knee amputation, I can almost assure that he’ll be leaving about 3 weeks almost completely independent. You add even 50 pounds onto that man and we’re talking severe limitations. One day I walked into a woman’s room, who was recovering from heart surgery. She had an easy 300 pounds on her 5’2” frame. She was lamenting to me about her current health state saying, “I just don’t know why I keep having health problems.” It didn’t even occur to her that her weight was the underlying problem. It’s frustrating but at the same time it is the reality the health care system has to deal with. I find it absurd when we run out of bariatric equipment (bariatric is the medical word for overweight). I’m always scheming with my co-workers about creating bariatric rehabilitation centers that deal not only with the current health problem but the true reason for them. Who knows what will happen in the future, but I’m sure it won’t be any lighter.

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