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Old 03-04-2008, 10:13 AM   #1
Jennifer Conlin
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Obesity is now a bad word!

I don't often have time to talk to much to my patients in the ER. Once in a while I will take or have the time to talk to them about what they are dealing with.
The other day I had a mid 40's white male in DKA. He seems reasonable enough. He was dealing with new onset of diabetes, so it was understandable how he was in DKA. It's really hard to find what works and what does not when it's all new to you. As I was placing his IV doing an doing his EKG and blood sugar I started to talk to him.
He was asking me some questions. I told him not to over simplify but diet and excise need to be your best friends. I explained that in the diabetic community that they struggle with Obesity and low activity levels.
I never said he was obese! I used the term as a medical term.

I went on with my little Infomercial. Telling him that I was once part of a study at WVU where we had diabetics do two 15 minuet sessions of walking and other exercises twice a day for 4 months. That at the end of the four months most of there BP's had decreased and that most of them were using less insulin daily. But that after the study all of them stopped there exercise program....how frustrating!

Ok, just for the record I never said he was obese.( but he is!)
Later I walked passed the room and overheard him saying to his wife. "She really should not use that word Obesity or any form of it." Then he went on to say he was going to write a complaint about me.
Well ****, there I go caring again. I should have just called him what he was and left it at that!

DKA is...
(Diabetic ketoacidosis (DKA) is a life-threatening complication in patients with untreated diabetes mellitus (chronic high blood sugar or hyperglycemia). Near complete deficiency of insulin and elevated levels of certain stress hormones combine to cause DKA. DKA is more common among Type I diabetics, but may also occur in Type II diabetics generally when physiologically stressed, such as during an infection. Patients with new, undiagnosed Type I diabetes frequently present to hospitals with DKA. DKA can also occur in a known diabetic who fails to take prescribed insulin. DKA was a major cause of death in Type I diabetics before insulin injections were available; untreated DKA has a high mortality rate.)
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Last edited by Jennifer Conlin; 03-04-2008 at 10:16 AM..
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Old 03-04-2008, 10:42 AM   #2
Aaron Trent
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Re: Obesity is now a bad word!

He is a serious idiot and you were trying to improve his life. You are right, he is wrong, and if that complaint goes anywhere your hospital needs new management.
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Old 03-04-2008, 01:20 PM   #3
Eugene R. Allen
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Re: Obesity is now a bad word!

Jennifer, I feel your pain. If you say don't be an idiot or stop acting like a fool to a person who is an idiot and/or acting like a fool you are bound to get a complaint...even if you don't actually call them what they are sure you called them. For we cop types who have to deal with lots of fools and idiots we don't have quite as many helping conversations as you were having with your patient, so our complaints are generally a bit different from yours. I second Aaron's evaluation of your standing in that conversation and certainly hope your admin folks recognize your efforts to help the person and not coddle him into thinking his disease is not his fault...which is precisely what the lazy and obese people of the world with horrible diets want to believe. Good health takes effort and they don't want to make that effort. I applaud your efforts to help Mr. WM in his mid 40's who is really going to be in a pickle when he is in his mid 50's unless he listens to you.

Keep it up.
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Old 03-04-2008, 01:25 PM   #4
Leah Turner
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Re: Obesity is now a bad word!

You were certainly not in the wrong, and I agree that if that complaint goes anywhere you have nothing to apologize for (hopefully, and I would think most likely, it won't).
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Old 03-04-2008, 01:30 PM   #5
Susie Rosenberg
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Re: Obesity is now a bad word!

Jen,

That blows.

I've worked ED most of my career, I understand your frustration. You'd figure you get someone in extreme situations, they'd be open to suggestions as to how to improve their lot and stay out of the ER next time.

All I can say is that denial is powerful, and often it's when people are most scared that they are most defended, so don't take it personally. Chalk it up to denial, terror, and maybe the mental status effects of being in DKA and let it go. Of course, it could be the guy's just an *******.

You did the best you could for the guy, and you should be commended for educating your patient.

Don't let it stop you from providing good care, the next one may be the one who hears you and whose life you change.

Susie
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Old 03-04-2008, 01:40 PM   #6
Jason Borzych
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Re: Obesity is now a bad word!

IMO the worst thing that ever happened to obese people are studies that say 10 or 15% of people who are obese cannot help it not matter what they do, because of genetics..... It seems like every obese person feels they are part of that 10-15% and I don't really believe those studies. If that was true those people have solved the energy crisis they can take in 2000 calories burn 2500 calories and still store fat? hmmmmm

On the other hand I have great respect for anyone who realizes that they are the ones who control what goes in their mouth, and do something about their problem.
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Old 03-04-2008, 02:42 PM   #7
Derek Maffett
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Re: Obesity is now a bad word!

I guess we have to come up with a new, more complicated, and almost impossible for anyone to understand term for "fat." Something like "Suprasillyaddicttocarboimia."
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Old 03-04-2008, 03:50 PM   #8
John Seiler
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Re: Obesity is now a bad word!

One of our members is a GP and he goes through the same thing in his practice. I personally feel that not using clinical terminology is tantamount to malpractice. If you're obese and a medical professional tells you otherwise, it untrue and misleading.

Lifelong tanner: "Telling me I have melanoma is hurtful to me as skin cancer has negative implications to my complexion and hence, my self-esteem. I'm filing a complaint."

Let us know what your employer thinks.
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Old 03-04-2008, 10:18 PM   #9
Randy Tarasevich
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Re: Obesity is now a bad word!

There's alot of "bad" words out here nowadays, apparently. I've been finding this out as of late.
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Old 03-05-2008, 07:38 AM   #10
Wade Smith
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Re: Obesity is now a bad word!

No good deed goes unpunished.
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