I am sitting in the nail salon and in walks this woman who is like 350 pounds, she is short of breath on exertion has an increased respiratory rate and is pursed lip breathing, huffing and puffing, trying to get into the pedicure chair but needs help as she can not lift one of her legs that high without assistance. My immediate reaction is to go to her, but realize that I am not at work and I better let the pedicurist help her out. She settled down pretty good though and her respiratory rate when back down to normal and my anxiety went away. It returned though because she kept complaining that her big toe hurt and I just wanted to go and look it at (I did not though). I at least wanted to tell the pedicurist that this person probably has diabetes, her legs are as big as trucks and she probably has poor circulation and I would not cut those toe nails without the person signing a consent and waiver of liability. Seriously. I have nothing personal against the obese population. It is just such a risk factor that leads to so many health problems, ie: coronary heart disease, Diabetes, sleep apnea. I am not even going to mention the emotional and practical problems such as self care deficits and altered body images etc…
My first loss of a patient was an obese male over 350 pounds. That was a code blue this new nurse will never forget and now the fear of the obese patient circling the drain will never go away. The intubation was hard, the chest compressions (ahhhh) the 2 inch backboard seemed useless, central line insertion in the groin nearly impossible. I was only 2 weeks off of orientation, I remember the family wailing in the background, the intensivist asking me questions, and the patient turning a greyer shade of blue every single minute till the end…ashen. It was over and everyone left except me and the aide, to extubate and clean up the body and the floor and the bed and all the empty vials of epinephrine and sodium bicarbonate. Wow…the implications of obesity go beyond the risk for diseases, the obese patient is harder to treat and any treatment carries increased risk.
So yeah..that is where my mind was while the manicurist polished my nails to a high shine metallic blue. Perfect.
So what is your BMI?
See Jane Nurse 
