a very sad patient story

This entry today is more about about a medical patient but it certainly relates to the need for weight loss in those whose health is jeopardized by their weight.

Last nite I made a housecall on a very unfortunate woman, age 57, who 5 years ago had a severe stroke leaving her basically bedridden, unable to communicate at all, no real response to verbal stimuli, inability to eat or drink and reliant on tube feedings and a tracheostomy with a ventilator for air. The family is VERY close, and one of her sons, who is in his 20's, took over daily responsibility for his mother's care., allowing his father and sister to work. The son gave up his work and is at his mother's side the entire day. She has made no progress in 5 years and her neurologists feel that there is a zero% chance of any "meaningful" life.

I have been seeing the woman at her home for about 5 years, treating minor issues that arise, such as a respiratory infection, skin infection etc. The son provides a level of care MUCH better than any hospital or nursing facility would. The only reason she has not died as yet is because of the son's amazing attention to detail.

There was no living will present, and last nite I was called because the family was deciding whether to call Hospice in and perhaps think of withdrawing some of the support such as tube feedings. As a physician, I try to be cognizant of the entire family situation, realizing that it is not just the ill person who is involved, but how this affedcts the entire family. Clearly, in this case, not only is the mother bedridden, but because of the 24/7 attention the son provides, he is basically houseridden. The "quality of life" issue for everyone in the household is an issue in my opinion. At the end of our discussions, the son felt that he would feel too guilty agreeing to withdraw life support.

Purpose of this story for your thoughts: 1-If you do not have a living will now, PLEASE get this done ASAP. Do not leave it to your children or spouse to make decisions for you..the guilt may be too much. I know how I would feel...and that is I would NEVER want my love ones to have to attend to my medical needs if I had no chance of improving to become a functional human being again. If you feel the same, put it in writing. 2- (And this is the relevance to weight loss issues) Sometimes people do things like smoke cigarettes, allow themselves to remain morbidly obese and their attitude is : "Well, if my time comes and I die, so be it..I have lived a good life..." Well, sometimes the "time comes" in a very prolonged and painful way. Whether it be the smoker with COPD who gasps for breath every second of every day or the obese person with diabetes who has a stroke paralyzing them or haveing amputations because of vascular disease, sometimes the sequelae of your decisions can be prolonged and not immediate. Take pause to think about how life would change for you if something like a stoke occurred and you were bedridden for years. Isn't it better to make the choice right now of becoming healthier?

Really sorry for the pretty depressing entry this morning, but my housecall last nite gave me motivation to write this stuff today....but now, to a MUCH better and cheery reminder: PATIENT APPRECIATION DAY TOMORROW, SATURDAY 10AM-2PM.....WE APPRECIATE YOU AND WANT TO SHOW YOU!!!!! FREE STUFF!!!!!! BRING FRIENDS!!!!