Irony is NOT a RDA.

[kyburg]

For those of you who voted 'kitty' yesterday, this fluff's for you:



For the rest, color me amazed. NOBODY said no. Not one.

Hooookay, then.

*kid gloves taken off, burned and ashes scattered*

I'm going to start this off then, with some caveats. The only thing that's going to look like a cut is a link to the original stories. And this is going to be a long one - if that upsets you, hit the scroll button now.

If I'm going to talk about this - I'm not going to hide it. If dealing with the concept of weight/body image bothers you to the point of despair? I don't know that you're going to enjoy this.

Just talking about it mind. A post cadhla did some years ago comes to mind - and gives me a bit of pause before plowing ahead. This one. I'd go check it first, you have any qualms about whether or not I've been handed 24K clues on the subject or not.

Now I'm going ask you to put that to the side. Because -

THIS IS NOT ABOUT THE PRETTY.

Thought you'd wonder. At first blush? Sure looks like it.

...Then on November 29 of last year, a few weeks ago, he suffered chest pains. Wanting to live and knowing what to do, he called emergency services. The operator stayed on the phone with him as he waited for the ambulance to arrive. He collapsed and the operater listened to every sound hoping to hear his door open and help arrive. Well, she did hear everything, and what she heard astonished her.

The two ambulance attendants saw this big, fat, disabled guy, living in a messy home. They stood talking about him and decided that he wasn't worth saving. So they stood there and let him die, deciding to tell everyone that he was dead when they arrived. One more cripple out of the way, one more unnecessary life done away with. One more of us gone.

The operator immediately handed in the tape. Charges and investigations ... blah, blah, blah ...

Fact Checked - and damning in the bargain.

Fat, a poor housekeeper...and a gimp. Oh, and unmarried and childless in the bargain. Didn't even have parents to grieve his loss anymore.

*looks at pictures* I could have put that right in a couple of hours, mind. I've mentioned being 'proud' is pretty expensive, right? And he was social - he wasn't a shut-in, or housebound. But nobody deserves the fate he received - let's be clear on that. He had some reasonable expectations of the culture around him - and it failed him. Why?

Let's talk about burnout for a moment. No, really. I'm pretty sure some care providers are gonna go to jail for this - and really, losing their jobs is going to do them a favor. That's clear as a busted nose to me - these guys have seen so many of him they've lost it completely. It's burnout - in a form nobody would accept.

This is where it's gone beyond an occupational hazard and killed someone - and left everyone aghast about how it could happen.

I'm going to try - and I can only try - to give you a perspective on what it is to be the person tasked with saving your life...and can't. Because you weight more than 400 pounds.

And in particular, I'll talk from recent experience - and that's listening to the rad techs. And the rad tech students.

There isn't a story much more heartbreaking than the one about a nineteen year old that could have lost her leg after tripping over a laundry basket, and likely will have years of recovery ahead of her - it was a very near thing. Bad fall? No. She fell, sure, but wedged herself between the wall and the dryer...and it took 45 minutes to extricate her by the fire department, (after someone found her, mind) because she weighed over 380 pounds. She had dislocated her knee so badly the arteries and veins were pinched shut. She was so top heavy she couldn't free herself.

Forty five minutes - you can't free yourself - and according to Jim, she was on as much morphine as it was safe to give, and it wasn't touching the pain she was in.

Please lose the weight.

And she was one of the small ones.

Type II diabetics (and I've heard the term 'metabolic disease' as well) are a complete package - and the social Darwinists like to point out that in some populations (most of them of color), this is an evolutionary change to survive famine, and hence a normal process to weed out those that won't survive our current way of life. Adapt or die. (I'd wish these people sex, but why.)

They gain weight easily - scary easily. And getting it off again? Nearly impossible...and once they're on medication to either max out what insulin production they do have, or insulin replacement entirely? Even more so - losing weight being entirely insulin-dependent is something not for the faint of heart. You'll see the inside of an ER often, either in shock or acidosis. Promise. But the alternative is even worse.

When these people end up inpatient over 500 pounds, they are the sickest people you ever saw. They're losing limbs to amputations, having heart attacks and losing their minds having strokes. They're on dialysis. Their joints are shot, they're in constant pain and maybe even addicted to prescription medications. Physically? Decades older than their healthy peers. They die by small increments, huge leaps and in pieces.

The worst part is that every year, they get bigger - and the technology can't keep up. Most of them are bed-bound. Most of the beds are rated for about 300 pounds. (Check your bathroom scale, you haven't seen this yet. You'd think nothing was more than 300 pounds.) Up to recently, the only scale I ever saw that could measure more than that was one you rolled a wheelchair onto. That probably should have tipped me off.

You've heard the recent upgrade to "It's A Small World" at Disneyland was to deepen the tracks so the boats would stop bottoming out, right? Jim works less than 15 minutes away.

We're not talking about people who carry more than 50 pounds more. Or even 150 pounds more. Those folks get just as sick - for the same reasons - but two people can move them, if they can't move themselves. Diagnostics can be done. The bigger ones?

They break beds. They can't be moved without extreme measures. They suffocate under their own weight. X-ray machines shut down, overheating when they try to do exams on them - and the films aren't usable. Anything more would be dangerous to them - and what can be used? Doesn't work.

And they are often surrounded by family members, desperate to do anything they can for them - dearly loved - and all of them are as large or larger. Everyone of them a client at some point, of the facility. To them, and it's easy to imagine why - big is inevitable. Why fight it?

Please lose the weight.

This stuff doesn't roll off. They stay with you.

When the students graduate, if I get a chance to talk to them...I congratulate them on gaining their majority with an education, their clinical and their dedication to caring for their patients.

And then I ask them to consider what it is going to take to stay in the business of caring for others, not just to enter it. Because they don't tell you the patients are going to break your heart, infuriate you and be absolutely deaf to your fears for them. There are no classes on how to deal with burnout.

Or even how to recognize it.

You'll blow off steam with your colleagues. You'll have to - and somewhere in the mix, you all come to consensus that the really big ones can't be helped. Consciously or unconsciously...and even the patients seem to agree with you. They come in complaining of ailments, want you to help them - and it's plain as plain it's their own fault!

One day, you suggest they lose the weight, they take it wrong and report you. You can't insult patients, after all. You stop caring, after passing that warning point of getting overly involved in your patients problems - burnout is here, and you might not even notice it.

Then you start blaming them for being an inconvenience and taking up valuable time that could be spent on patients that will recover because they aren't so damn FAT.

Patients start getting labelled 'noncompliant' even before treatment begins.

And there are so many, they start to blur. You stop seeing faces.

It's so easy. Just lose the weight. Anyone can do it. It would be so easy.

And then it's all their fault.

I'm not going to go into the character assissination that already goes on towards people of size. You want a really good clue, go to YouTube, search up 'Fat Rant' and let the lady tell you all about it.

I'm not even going to say THAT'S what happened here.

We need to grieve for others besides Barry Baker. And know that the grief exists and not sublimate it.

And then I run into this thing:



Welcome to the world of confirming you're okay in the world. I speak of feeling your affluence.

Right around the waist.

I looked at that - step by step instructions and all, and thought about it. As a party food for more than twenty people? Pretty spiffy - I'm thinking of slicing that bad boy and serving it with slices of sourdough bread. Some beer to go with.

About 1/4" slice per.

Who thought that having the whole thing to yourself would be better? Or even more appropriate?

I mean, every ad I've seen for fast food is BIGGER, CHEAPER and YUMMMMMMMMMIER lately. (There's some $1 value menus going right now that are double burgers - 1/2 lb of beef - come on down!)

There's one that would feed both Jim and I for $4 right now. Seriously. And it's marketed as a meal for one person. Any 'reasonable' person would agree. It only has one soda, after all.

*headdesks*

There's been a lot of talk lately about obesity being a disease of poverty. As in - you're too broke to have anything pleasant to do but eat. You can't travel, you can't go outside, who in their right mind would stop watching television, playing games or reading books if they don't have a job? And food is EASY to come by - compared to housing or transportation, those other things that self-determination and employment demand.

I mean - get a 12 pk of soda, pound that and then recycle the cans? There's another burger, fries, and a soda for you - maybe even a couple of deep-fried tacos. There are a bunch of food banks. Not so much a decent place to work or sleep.

And fast food is cheeeeap. You get so many strokes for showing up, it's incredible.

Things aren't so bad. Have a coke and a smile. You DESERVE that cookie. And you really CAN eat the whole thing!

There's a lovely book on my shelf at home called What to Eat by Marion Nestle. It echoes my college nutrition class so eerily, decades after I took it - it's not funny.

Food isn't just big business here. It is - pun intended - HUGE.

It's nothing less than creepy the way our culture adores the people who eat to excess...and then hates them when the predictable outcome occurs.

And then makes money hand over fist selling them diet aids that don't do dick. Books. Relabeled crap that tastes like shit, probably isn't at all good for you - but it doesn't have any carbs/fat/sugar/name it this week!

Food is also one of those things that doesn't keep like - say - gold or artwork. So if you don't sell it quickly, you'll lose money and in a big way.

So we're told to eat fast - and have some more!

Don't forget how social eating is as well. GOOD TIMES.

Just don't gain weight. Well, gain TOO much. Ya gotta eat, after all.

*raises hand* I have a great-grandmother who died in her bed, over 700 lbs. If I am to believe what her daughter told my mother. And my grandmother was paranoid about her size. And no, she wasn't small, either.

Mom did Weight Watchers when I was a teenager. I did it a couple of years ago now and lost a total of 50 lbs from my high point. (I'm a bit up from the holidays, somewhere between 5 and 10 lbs more. I'm back on plan, and it'll come right back off - trust me.)

It's portion control. It's knowing how much is enough, and leaving the table afterward. Yes, that takes a whole system, meetings and support networks. It does.

Please lose the weight.

EAT EAT EAT YAY!

I have a sister who probably is over 250 lbs. I have a niece who could be her and I, put together. Cousins, ditto.

I lost the weight because my doctor threatened me with drugs for the rest of my life. It was never about the pretty - because let's be blunt. I'm not, and being thin won't make me pretty.

It will make me invisible to public scorn, however.

It's cheaper. And not in the grocery bill department. I don't need a lot of medical care, prescription drugs, adaptive equipment...hell, even my furniture doesn't wear out that fast.

I wish we rewarded people as well when they were of normal size. You just don't register on most of the radar.

And I wish we paid more attention to what being so obese does to the culture and systems that provide care around us - attention, not insults and disgust. Not indifference until someones dies of it.

It's not your fault. It's your responsiblity. It's your choice. You didn't know.

The only way out is through.

Please lose the weight.

And don't get fooled again.

Comments

[foogod.livejournal.com]

Be careful of numbers. Particularly numbers like "100 lbs overweight", because among other things, doctors keep revising the definition of "overweight" downward over and over again with little regard to what that actually means for people.

Our very definitions of these markers are completely skewed now, in my opinion, because the medical community has gotten so utterly preoccupied with only one disease (heart disease) that they ignore everything else. There are studies that have shown that people who are currently considered a "healthy" weight by current medical standards actually have a higher morbidity rate than people who are slightly overweight. What does that mean? It means a "healthy" weight is actually less healthy than being overweight. There's something seriously screwed up about that, but if any doctor tries to say anything about it the entire community comes down on them like a load of bricks, because thinner must be better.

So to be honest, from the studies I've seen, saying somebody's "100 lbs overweight" really should be translated to "60-70 lbs overweight", because the current definition of "the right weight" is actually at least 30 lbs underweight for most people. Mind you, even 70 lbs overweight is still bordering on obese, so it's still a problem, but...

[kyburg.livejournal.com]

Well, the highest leading cause for heart disease? Not being overweight - exactly.

It's diabetes.

And what can REALLY lead to diabetes, that can be affected the most by a change in lifestyle? Being overweight.

Being overweight can - note not always, CAN - lead to hypertension (another big vascular killer - I'd rather die of a heart attack than survive a stroke) as well. The numbers follow each other like carts follow horses.

But there's nothing like being diabetic to really fuck things up. It ups the risk exponentially - and since it's proven that in some cases of Type II, you can get rid of it by getting the weight down? It's worth pushing in every case. Every last one of them.

It also doesn't help that most of the studies out of restricted calorie diets support longevity more than just about ANYTHING else. (And of course, there are big $$ research bucks being spend on trying to mimic the effect on the genes artificially, without restricting caloric intake...*facesmacks*)

Study this, study that. So many of the 'studies' are printed to sell soap and never report the important parts - which to me are - are they double-blind (nope), of a reasonable size and breadth (no idea) and over a long period of time? (UH.)

I go back to that really great class I got in 1979. Yup, that long ago.

15 lbs over is too much. And back then, 5'6" was 120-145. It is now, no real change. (15 lbs under? Too little.)

At 183, I was hypertensive, my lipid profile was WHACK and there were other complaints.

At 150, they dissapeared. At 133 (which I *think* is where we put me at goal), I might as well have been 18 again.

People have a lot of company these days - you really can't point at anyone in the room who meets criteria like this all that often - but it doesn't mean it doesn't exist.

(I wonder if I still have that textbook somewhere....)