Life as A Nurse~Part 8


Exceeding The Limit


Our society in general has become obese. It is estimated that nearly one
 
third of all major illness's are directly related to a person's body mass.

These include diabetes, heart failure, renal failure, and just simply
 
poor health. Think of this, if a person weighed in excess of 500 lbs.,
 
how much energy does it take that person's heart to circulate blood
 
throughout that mass? Food for thought I suppose. This is the story of
 
one such individual who exceeded all of our expectations.


Case in Point:


Charlie had been coming to the emergency room as long as I could remember.
 
At first, he would drive himself in with various complaints of
 
difficulty breathing, or problems with his diabetes. At that time he
 
tipped the scale around 350 lbs. It could have been higher, but the
 
scales do not weigh higher then that. After a while, he would have his
 
family drive him in. They would jump out of the car, run to triage and
 
ask for help to get Charlie out of the car. Try to close your eyes and
 
imagine a small late model compact vehicle, and in the front seat is a
 
man that you could only imagine how the hell they got him in there to
 
begin with. At least he was still able to walk at this time and after
 
several minutes of rocking the car back and forth, Charlie would dislodge

himself and sit down into the obesity wheelchair.


His problems were getting worse. His glucose was out of control.
  
He was unable to sleep lying down. The sad part was, Charlie was only
 
40 years old. One day I was standing near the medics radios when I heard
 
the alarm go off. "ER, this is medic 143, we are in route to you with a
 
40 yr old male with difficulty breathing, states he has had it all
 
night, Be advised ER, we will be needing help at the ambulance bay to
 
unload this patient. Now, I hadn't seen Charlie for some time. He was
 
either not coming to our hospital, or just there on my days off. I
 
answered the medics, "10-4 medic 143, how large is this patient?" "ER,
 
be advised patient weighs in excess of 800 lbs., give or take." OK, this
 
could get ugly. Our ER beds have a maximum weight limit of 350 lbs.


We needed to get a regular bed for this patient. Andrew and I located a
  
regular hospital bed and brought it to the ambulance bay and waited.
 
Then the thought came to me. "Andrew ? , What is the weight limit on
 
these hospital beds?" "Oh shit", muttered Andrew and went inside to radio

the maintenance department. The news came fast, Weight limit, 500 lbs. We

were stuck. No where to put Charlie, the bed would have to hold him.
 
Andrew and watched as medic 143 pulled into the ER ambulance bay,
 
The ambulance itself was riding low on all four tires. The back doors
 
swung open and all I could see was skin. About that time, two fire units
 
pulled in behind the ambulance. In total, there were approximately 12
 
strong, able body men there to unload Charlie.

 
There is always going to be a hitch in these situations.

The fire dept. had forgotten to put a pull sheet underneath Charlie
 
prior to loading him in the ambulance. As a matter of fact, I asked one
 
of the guys, How did you get him in there? He was wedged so tight
 
between the medics bench and the outside of the ambulance, it was
 
impossible to get around him. The fireman I asked told me they had just
 
backed the ambulance up to him, he turned around and sort fell inside
 
the unit. With some pushing and shoving, he managed to get himself all
 
the way to the back of the unit and he was lodged just behind the
 
driver's seat.


All I could do was sit back and watch.
 
They had placed the bed sideways and began the hour long unloading of
 
Charlie. Andrew and I stood by and watched, then it hit me again.
 
"Andrew, look at the bed?" The bed was still on its side and at least
 
four men were standing, sitting or kneeling on it, all pulling while
 
other men were in the back of the ambulance pushing. The weight of the
 
firemen alone was causing the hydraulics to moan. About that time I saw
 
what appeared to be legs emerging from the back of the ambulance.
 
"Oh my god, I thought," please don't let them drop him. Inch by inch
 
Charlie made his way onto the bed, the inner workings of the bed moaning
 
under the strain.

 
After one hour and 20 minutes, Charlie was finally unloaded. He was
 
slowly  rolled  to ER 9 and his treatment was started. Charlie was a big
 
boy, and he was a nice guy. This time I told him, "Charlie, this is
 
going to kill you, you know that don't you?" He looked at me and stated,
 
"They said if I gained enough weight, I could have that gastric bypass
 
surgery, so I have been putting on the pounds."  I was in shock, The
 
thought that this poor man would actually risk his life so he could lose
 
his body weight was beyond belief.


As I walked away, I heard Charlie asking one of the nurses when dinner
 
was served. I shook my head and promised to go to the gym the next day!
 
Charlie died later that year without ever receiving his surgery. It
 
seems that no doctor would accept him as his other health problems made 

him a poor surgical risk. I was there when Charlie died, they used a
 
moving crate to unload his lifeless body onto a bed and the entire staff
 
was grateful that the code did not last  long.

 
Ultimately, we had to call a mortuary from more than forty miles away
 
to take  Charlie away. He had once requested to be cremated never
 
knowing that the local crematoriums had a weight limit. We finally found
 
one that could take up to 1000 lbs. I think of Charlie at times,
 
his image  pushes me just a bit harder every time I go work out.
  
As I do my last set of stomach crunches I sometimes wonder if all
 
this pain is worth it. When this happens, all I have to do is think of
 
Charlie and my willpower is renewed.