Booming business in care for obese

CNN.com – Booming business in caring for obese – Aug 29, 2004

KANSAS CITY, Missouri (AP) — At St. Luke’s Hospital, each of the 14 new neurology intensive care rooms has a feature that’s becoming standard in the health care industry: a patient lift system that can handle 600 pounds.

When people weigh as much as livestock, it makes our jobs in medicine harder. There’s nothing like seeing 8 firefighters haul in a 500+ pound patient and turn her care over to the 110# nurse.

Later in the article, a silly argument appears:

“People would not be doing this if there wasn’t market share to be captured, but the reason there is a market share is that this population has been underserved,” said Walter Lindstrom, founding partner of the San Diego-based Obesity Law and Advocacy Center. “This isn’t just for bariatric surgery. Bariatric patients also need to get their gall bladders taken out or they get cancer.”

The statistics all say this segment of the population is growing exponentially (that’s a better pun than ‘they’ve been overserved, that’s why this has happened’). That there are a lot more manufacturers for this equipment means there’s money to pay for it, not out of some ‘recognition of underservice’.


Comments

  1. The sad reality is that this isn’t a booming “market” except that the numbers of patients that make up the morbidly obese population is increasing. The resources to pay for their care, including fancy ultra-heavy-duty patient lifts, doesn’t rise with their numbers, as many are medically indigent or underinsured.

  2. Last week in the ER, I helped move a 900-1000 lb man who came in for dyspnea. It was damn scary.

    When the paramedics stood him up to get him off the ambulance, he turned blue. I was around when we had to move him from the ER (where he was on a wooden cart) onto a bariatric bed and up to the unit.

    We had an intubation tray and cric tray ready. Our biggest fear was him ending up on the floor (where we would not be able to get him up) and having to code him.

    He did turn blue again when he stood up, but we were able to get him onto the bariatric bed and up to the unit without incident.

  3. Once a person crosses that 900-pound barrier, are there any valid statistics that estimate the remaining life expectancy of such a person?

    It must be fairly easy to find, on the internet, statistical tables of “normal” life expectancy by age. I wonder if there are any tables that add in the second dimension of body weight. There must be nothing “normal” about the remaining life expectancy of a 500 – 1000 pound person. At what point does weight become the dominant factor, rather than age?

  4. Seems amazing that our skin can actually stretch that far….When I have been pregnant it seemed like my skin was stretched about as far as it could go and that was just a 20lb. weight gain.

    How does their skin hold all that in? Probably not a big medical concern in the big (no pun intended) picture of things. But still, how does it?

  5. Cathy,

    If the change over time is slow enough, skin will grow infinitely. Plastic surgeons take advantage of this all the time by placing empty “balloons” (called tissue expanders) underneath the skin and inflating them litle by little to stretch the tissue enough to cover a defect. This is often used in women who have hade mastectomies to make room for permanent breast implants. In terms of a pregnancy the 6 months or so that one “shows” is a pretty quick period to expand that much in one area of the body.

    Bill

  6. Cathy, I immediately thought of the rubber balloon, which attains great expansion of surface area simply by elastic stretching and a thinning of the surface layer material. However, you only get so far with this analogy before you encounter a spontaneous rupture of the surface material (or skin layer). I’ve never heard of this happening in humans, but who knows? My knowledge of the subject is no deeper than a layer of skin.

    One night in the ER I was watching a doctor suture a deep laceration to the knee of a middle age patient. It was amazing clear there that skin is a covering of finite thickness. It reminded me of a cross-section of an orange or of a tennis ball. The layer does thin with age, however, which accounts for the ease of skin tears in the elderly.

    Massive weight gain is no overnight accomplishment. There must be something in our genes that tells the body to add new skin cells in just the right areas.

  7. Toby, I believe I heard the average life expectancy for a morbidly obese person was 33.6 years. I have no clue where I saw that, it’s just a number that has stuck in my mind.

  8. Bill and Toby, thanks for your explanations..It makes a little more sense now. Toby, If a spontaneous rupture of the skin occured in a 900lb. person, I imagine that could be quite dangerous.

  9. Cathy, yes, I’d imagine a spontaneous rupture of the skin of a 900-lb person would be very serious (not that I have the medical backround to know).

    My mind is taking me back to the original “Alien” movie, with Sigourney Weaver. 150 lb ‘mother’ + 750 lb baby = spontaneous skin rupture. Uggghhhh!