Tuesday, September 01, 2009

Oh my God I am so tired.

Jeebus grits, people. I am the conjugation of exhausted.

Six--count 'em--six patients last week, all of whom had neuromuscular disorders (myasthenia gravis, CIDP, MS) and all of whom, every single last one, was well north of three hundred pounds.

In fact, the lightest patient we had in the group was 166 kilos (365 pounds, more or less) at four foot eleven inches tall. She was Pickwickian to the point of near-sphericality.

Now, then: I am not of the opinion that "fat" automatically equals "unhealthy". I'm much more concerned with your mobility, your lab values, your ability to manage your daily activities, and what it is you eat. A skinny person who eats nothing but the value menu from McDonald's is going to be a much bigger pain in my ass, medically speaking, than a 300-lb guy who takes good care of himself and simply has fat genes.

However. When you're my height (five-two on a tall day, with an inch of MBTs underneath) and weigh enough that you literally cannot walk across the room without getting winded, something is very, very wrong. Add a demyelinating disorder to whatever it is that's wrong, and things will go from very, very wrong to severely jacked up in short order.

And when things do go to severely jacked up, and you're unable to move at all, the person who's going to be lifting--or, more accurately, helping to lift--you is me.

Which means, at the end of a four-day run, that I will be tireder than I can even express. Attila came over this morning and I panted through a workout, unable to curl 20 pounds more than about eighteen times. That barbell was so. damn. heavy.

Then I ate some eggs, fell over into bed, and slept until 1530. I have bean tostadas in the oven now, and plan to fall over and sleep some more after I apply them to my face. No, I have not showered. Yes, I have brushed my teeth. I think.

We have one Hoyer for the entire hospital, so every lift we did last week was a dead-man, six person affair with doubled drawsheets. The only person who got the Hoyer was the dude who weighed 800 lbs, and he only got that when it was time for him to go to the unit because his FVC was dropping fast.

Reader, I am going back to bed.


gorochan said...

what the hell, we have two hoyers on just our floor (ok well we do have the SCI peeps who need it, but we have TWO and like 45 beds). We also have the air transfer assist thingies, aka air pal. Also floating around on our floor are the Stedy Stand and your basic sara lift. The other floors have their own stuff. Maybe talk to your hospital's employee health and point out how so much heavy lifting (especially with bariatric Pts) can cause employee health issues over time and get them to advocate for more lifting devices. It sounds like the air pal would really have helped out, or even the one that's a slick polyester sheet you can leave under the Pt that reduces a lot of friction when pulling them up.

little d, S.N. said...

God...that's depressing. And of COURSE they mandate "safe lifting practices" and not lifting more than 45 pounds, right? :-p

Anonymous said...

I can sympathize - I am working as a health coach for an ins co - talking to people who weigh over 300# who tell me they a) eat a healthy diet b) dont eat much c) dont know why they are heavy....
or d) it is their medication/glands/family to blame. NO it isnt!!! Put the fork down, people!!!

Slatsette said...

Aaaand... THAT is why I had to quit being a CNA. Every lift was a dead weight lift, because we did not have enough hoyers. My back simply couldn't take it and I had to go to physical therapy. And I was only 24 at the time. I have so much respect for people who are able to work under those conditions (let alone the fact that it's... illegal or something for employers to make you do that)

Moose said...

Have you ever noticed the most clueless people make their comments anonymously?

As someone who is 5'2" and weighs over 400 lbs, let me tell you -- a) I didn't get to be over 300 lbs until I injured my spine and developed lupus, 2] exercise for the disabled fat person can be a challenge. I can deadlift over 100 lbs with just my arms and upper back, because I can't do any weight-bearing exercise, so my upper body is very strong, 3. The myth that fat people eat more than thin people is one that's been disproven time after time after time, yet still manages to hold on. Some fat people do overeat. So do some thin people.

Lastly, some days I can't walk across the room without getting winded. Some days I can walk across the room just fine. It all depends on how badly my joints and spine ache that day. I'm sure I"m not the only one in this situation. Especially for people with neuromuscular problems, maybe the "winded" part comes from struggling with the health issues and not so much with the fat.