Saturday, 9 November 2013

Problems with obesity

I know the topic isn't an easy target and many strong emotions rise when bringing it up. For those who feel offended I'm not in top shape myself and I've been bullied at school for this very same reason. But still it's worth writing for. Just to see a glimpse from doctor's point of view.

Currently I'm working at anesthesiology and to see heavily overweight patients makes me sigh because I know there's trouble ahead.

I'm writing this just to tell obese people view why physicians are so obsessed about their patient's weight. It's not about appearance, trust me. It makes our job extremely difficult in some cases and the cost of that just might be.. Well you know.

With obesity one is more likely to suffer from high blood pressure, lower limb osteoarthritis, sleep apnea etc. Making just about any diagnosis can be challenging. Listening to hear murmurs through a thick subcutaneous layer with your stethoscope, trying to locate a painful spot around the stomach, examining a chubby knee and realizing your muscles aren't big enough to lift it.

Then again we have all sorts of tests we can do, right? Lab results are rather reliable if one takes into account the size of the patient. In some cases the plasma is carrying too much lipids which can alter some results. X-rays are hard to read because the fat layer impairs the quality. Same goes for ultrasound. With CT or MRI scans the staff has to take into consideration whether or not the patient fits the cylinder.

Surgery and later physiotherapy repeat all these challenges from their own point of view.

So why does an over weight patient make my blood pressure rise? When putting patients to sleep for an operation you need to take care of their breathing. Usually this means intubation. Just because there isn't much space inside the throat this is difficult. Always. Then again there's extra weight above the lungs pulling them down. Ventilation machines are always fighting back when I make my adjustments. Heavy obesity also affects drug doses, blood pressure stabilizing, recovery and so on.

Westerns society is suffering from obesity. And the answer to the problem is not alone in the hands of medical doctors, but we do have our share. Information is one part of it.

For any overweight reader. I don't wish to overbear you. I'm sure obesity in your case is not a simple thing. I don't think it ever is. But you could be healthier and you could feel better. Sometimes the first step is like a baby step. How about turning to your physician? We don't know everything but we do know a lot. And we can help.