http://news.yahoo.com/s/nm/20060725...0BHNlYwN 0bWE-

By Maggie Fox, Health and Science Correspondent
Tue Jul 25, 4:14 PM ET

WASHINGTON (Reuters) - More and more obese people are unable to get full medical care because they are either too big to fit into scanners, or their fat is too dense for X-rays or sound waves to penetrate, radiologists reported on Tuesday.

With 64 percent of the U.S. population either overweight or obese, the problem is worsening, but it represents a business opportunity for equipment makers and hospitals, said Dr. Raul Uppot, a radiologist at Massachusetts General Hospital.

"We noticed over the past couple of years that obesity was playing a role in our ability to see these images clearly," Uppot said in a telephone interview.

Radiologists have their own term for it when writing up reports: "These images are limited due to body habitus."

Uppot's team looked for this phrase in radiology reports from 1989 to 2003. These included standard X-rays, computer assisted X-rays known as CT scans, magnetic resonance imaging (MRI) and positron emission tomography (PET).

These scans are used to look for tumors, blood clots, broken limbs and other injuries and diseased organs.

"Overall, 7,778 or 0.15 percent of 5,253,014 reports were habitus limited," they wrote in the August issue of the journal Radiology.

"It essentially doubled over the last 15 years," Uppot said.

The researchers looked more closely at the records of 200 of the patients, who weighed, on average, 239 pounds (108 kg).

"It is a major issue because ... the patient may still have a tumor, the patient may have appendicitis, the patient may have other inflammatory processes," Uppot said.

"This is affecting radiologists all over the country."

NOTHING BUT STATIC

Ultrasounds are most affected, Uppot said.

"In an obese person because the ultrasound beam does not get to the organs or get to them adequately enough we cannot get a picture. It looks like a snowstorm -- I don't know if you have seen those televisions where it is just whiteout? It looks like that."

An MRI can get a good picture if the patient can fit into the tube or get onto the table, Uppot said. Some manufacturers have started to make MRI machines with larger bore holes, but with the cost in the millions of dollars per machine, only large groups or institutions can afford them.

Siemens Medical Solutions of Siemens AG has seen the market potential. "Increase Your Physician Referral Base with 1.5 Tesla MRI for Obese and Claustrophobic Patients" the company says on its Internet website http://www.medical.siemens.com.

"It is a market out there. People who are taking advantage of it are making money," Uppot said. "We are in the process of buying and installing three of these machines."

One problem is with gastric bypass surgery, where the patients are by definition obese, Uppot said.

"If there is some complication -- abdominal pain or and infection or fever -- they are invariably at higher risk of not being able to be imaged with a CT or MRI," Uppot said.

"For the surgeon, he doesn't want to take the patient back to surgery to explore to see what the problem is," he added.

"For the patient, not knowing what is going on is a big issue. If you tell a patient 'I am sorry -- we just can't sit you on our CAT scanner', that is devastating to hear."

Sad I read a similar article not long ago, but it had to do with the size of the hospital beds, wheelchairs, stretchers and even the operating tables, in addition to the MRI, CT scan equipment, etc. One hospital had over 300 patients that weighed 350 pounds or more in ONE year! They had several over 750 pounds. The fix for this was to make all the stuff bigger and stronger. Not one word was mentioned about trying to help these people lose weight.

If they just keep making everything bigger to accommodate the morbidly obese, where will it stop? I think the money should be spent to help get these people thinner and more active--whatever it takes.

This is not the exact article I mentioned above, but it contains some of the same info. This one does not talk about the surgery patient that could not be strapped securely to a surgery table that had to be placed in a vertical position at some point in the operation. He fell off and burned out the table's lift motor.

Saturday, April 01, 2006

Hospitals Overwhelmed with Morbidly Obese Patients

Note: Edited out the first part...read whole article here> http://improveyoureq.blogspot.com/2...h-morbidly.html

Following in the wake of Southwest, other service providers are having to get their heads up out of the sand. A what's called "morbidly obese person" in a hospital - - or ambulance - - is not going to be a fluke any more. It's becoming ... frequent.

Las Vegas ambulance companies have had to redesign the ambulances, including installing hoists and bigger beds.

Last year a patient care director in a St. Louis hospital was seeing things she could no longer ignore, so she ran the numbers. That day about 1/3 of their 900 patients weighed 350 lbs. or more. She decided to go back and see it that was a fluke. Nope. Some days half the patients were obeses, and 500 lbs. wasn't unusual.

Now, I don't see a lot of people weighing 500 lbs. In fact I may never have. And the fact that hospitals do says what it says (I'm coming to WELLNESS next). Obese people usually have a myriad of health problems -- that's why your doctor wants you to lose -- and they probably visit the hospital more often.

Now this hospital has formed a Bariatric Care Team to take the mountain to Muhammed. (Perhaps not the best analogy to use, either way.)

Now think for a moment of life in a hospital for a patient, and then picture this patient weighing 500 lbs. Normal supplies, equipment, training and personnel must be adjusted.

++The union says healthcare personnel are getting sprains and strains trying to lift obese patients.
++Do the gowns fit? Slippers? Blood pressure cuffs?
++Can they fit through the doors, in the chairs and on the bed?
++Can the ordinary stethoscope handle the layers of adipose tissue around the heart and lungs? Nope. New ones are being designed.
++What about the stretchers and wheelchairs?
++Longer needles for butt shots?
++Can a 500 lb. person go through the average CT scanner or MRI? Of course not.

The nurses' union which operates in 18 states (ATF Healthcare) is demanding new laws to force hospitals to buy equipment like portable hoists.

This hits home with me. My dad's mother was quite obese - over 300 lbs. and when, at the age of 89, she had a heartattack in her bed at home, the ER techs had to call for a hoist, such as they lift cattle with, to get her out of the bed and downstairs into the ambulance. The hospital had to order one too, and then the retirement home.

There are things you wouldn't think of, too. One hospital has installed lights at floor level, because a grossly obese body casts a shadow and they can't see the floor.

Grandmother had to have someone put her snow boots on for her, and had to use a long pair of cooking tongs to pick things up off the floor.

Beds are now going to accommodate 500, not 350. A nurse manager at Barnes-Jewish hospital said they'd had some -- SOME -- 650 pounders on the ward.
36" standard doors are going to become 48" or 52". Comodes must be anchored to the floor so they don't get ripped out of the wall. The longest syringes (4 1/2") are going to become longer.
The suppliers are working to meet the demand. Novation, LLC saw the trend start about 4-5 years ago and they now supply over 1000 items to hospitals for obese patients. (What about towels, and blankets??)

But there are things still not made ... like a body bag. It's the law it has to be leak-proof, and some patients were so large in one hospital, they wouldn't fit in the body bag.

You don't see people who weight 500 lbs because at that weight, you no longer are mobile. You are confined to your bed. So at home and at the hospital are probably the only place they get to go.

When I sold surgical equipment, I had a customer in Ohio whose practice was known (affectionately I'm sure) as 'The 700 Club.'
This surgeon was the only one willing to take the risk of operating on these patients. (He wasn't doing gastric bypass)

At the fattest I ever was, about 350 pounds, I had to be sent to a special facility (the only one in my metro area) to take a bone density scan. Humiliating.

When I was huge my doctor tried to take a chest x-ray and said he could see all the fat pushing on my internal organs

My aunt by marriage is 500+. Lately, everytime I turn around, I hear she's in the hospital.

My other aunt, by blood, was 300+. She ended up drinking herself to death. Neither one got out much.

My 500 aunt has sisters who bring her candy that my uncle tries to keep out of the house.. When she got out one of the last times, she told my uncle she wanted Pepsi and KFC. I would say the KFC probably wasn't SO bad, but I'm sure she wanted the baked beans, mashed potatoes, macaroni & cheese along with those "extra" biscuits you can get...

When my boyfriend's dad had to go to the hospital (heart attack scare) they had to use an open MRI cause he couldn't fit in the regular machine.

I see a lot of people who are getting very close. They're in wheelchairs at the grocery store. It seems the area I live in now has a lot of overweight people. One would think that with all the brats, meat and cheese meals people eat here that people would be thing--not a chance. The brats have sugar and corn startch and I'm sure an extra bun or two. Of course when a gourmet meal consists of a piece of toast with cheese whiz topped with crushed potato chips you begin to wonder. That is what is served at weddings here. I didn't grow up here so it's all foreign to me.

I wish I could take some of these people aside and explain to them what really works. Then I'd have their unsuccessful dr. all over me.

No kidding, theladyboo. When I worked in pharmacy as a tech, we had one guy come in all the time to pick up his diabetes medications- all 6 of them, not including his insulin and other meds. He probably weighed about 300+ pound and was shorter than me. He would complain about the costs of his medication (a common lament in that business, to be sure) and would then plunck down- I sh*t you not- at least 7 king sized Snickers and Butterfingers. I just wanted to tell him...SO BAD...what he could do to help himself...but it would actually (technically) have been aganist the law for me to conseul him (cause I'm not a pharmacist).

I really had to restrain myself at those times.

Interestingly enough, whenever a female patient had a question about PCOS, both the pharmacists knew that I had done a lot of research on that particular subject, and encouraged me to educate the patient about it!

Of course, I had (have) it too, so I could relate to them.

Could you have said, "I'm not a doctor or pharmacist but this stuff will kill you sooner or later".

Seems to me that if you don't present yourself as offering professional advice, it shouldn't be a problem. Mind you, I'm not a layer so .....

He probably wouldn't have listened. I have a friend who is doing low fat and makes remarks about my Atkins. We started at about the same time. I lost about 20 pounds and went off then went back on and lost 40 more when I stopped going off the WOL. She's lost about 7 pounds in the same amount of time and always getting food cravings where I get none. Yet still, she refuses to believe that what I'm doing is right.

Is this for real? That is once of the most appalling sounding "dish" I have ever heard of. And that is served at weddings? Incredible. And what's a brats?

I read and seen a couple of stories about very heavy people and there is always a weight where their legs will no longer support them. Guess that must vary. And there comes a point where they can't get out of bed, or even roll over. I simply can not understand how anyone can get there. My only explanation is that somehow food must have become a drug to these people, and to stop eating is like asking a drug addict to stop heroine.

You are probably right. But you never know, when someone is ready to listen. Maybe something like...if you stop eating all this sugar you probably wouldn't have to buy as much medication...would appeal to his wallet if nothing else.

And bet your friend thought virtuously to herself " Maybe she lost weight but she'll drop dead of a heart attack soon enough ..."