Dead Weight: Pay attention to your body's signals


 
 

A.J. Heightman, MPA, EMT-P | From the January 2009 Issue | Monday, January 5, 2009


It's a cold winter morning; a foot of fresh snow fell overnight and you're dispatched to a local health club for a "man down." On arrival, you find the club's driveway and parking lot haven't been plowed yet, forcing you to leave your ambulance in the street and carry your monitor, suction, med kit and oxygen bag through the deep snow and up a steep driveway.

By the time you reach the front door, you're exhausted; your heart is pounding, and you're sweating profusely. You're about 80 lbs. overweight, and the extra tonnage has you breathing like an old race horse.

Once inside, you find a 285-lb. weight lifter down on a mat, removing protective wrapping from his knees and complaining of ankle, lower-back and knee pain. He tells you he tried to dead lift 150 lbs. more than he usually does, heard a snap in his right ankle, and felt pain in his knees and lower back. You start out to your rig to retrieve a backboard, splint and straps, but you find the arriving engine crew walking in with them and your power-assist cot.

You finish your assessment, splint the ankle, secure the patient to a backboard and begin to move to the ambulance. Then you realize that you're going to have to carry the patient and your stretcher 100 yards, because it can't be rolled through the deep snow. The 285-lb. patient, your gear and the 125-lb. stretcher present you with more than a 400 lb. load that will have to be carried to your unit.

By the time your crew reaches the ambulance, the only one breathing normally is your patient. You're sweating profusely and out of breath again, but now your ankles, knees and back ache. The next morning you wake up stiff and feel pain in multiple joints. You normally have pain in your back, hips and knees from the stress of EMS and the extra weight you carry around, but nothing like this.

There are many similarities between the weight lifter trying to lift too much weight, and you. The "symptoms" are all the same. In fact, yours are worse because the weight lifter was in good shape when he began his liftƒyou weren't. You also didn't have the benefit of special support straps to keep your knees from being stressed by the extra weight. Your overweight body reacted by sending important warning signs to you that the additional weight and stress placed on your skeletal support system was traumatizing your body.

We all seem to get by with our extra weight until our body has had enough. However, if we don't pay attention to the warning signs, it begins to fail us in the form of snappedligaments, torn tendons, stress fractures, compressed vertebrae or, worse yet, diabetes, a stroke or a heart attack.

The National Institutes of Health says you're obese if you weigh 20% or more than your ideal body weight. Obesity is also defined by your body mass index (BMI), which evaluates your weight in relation to your height. A person with a BMI score below 18.5 is considered underweight; 18.5Ï24.9 is normal; 25.0Ï29.9 is overweight; and 30.0 and above is classified as obese. People with a BMI of 40 or more, or a BMI of 35 or more with one or more significant co-morbidities, are considered morbidly obese.

We often refer to unconscious patients as being "dead weight." Ironically, the extra weight on our own body could literally cause death. Morbid obesity is the second leading cause of preventable death (after smoking) and is linked to serious and life-threatening diseases, including Type 2 diabetes, high blood pressure, high cholesterol, heart disease, obstructive sleep apnea, clinical depression, acid reflux, cancer, osteoarthritis, joint pain, stress, urinary incontinence, cancer and reproductive health problems.

I understand these issues, because I'm well over the recommended weight for my height. I added 60 lbs. onto my already overweight frame after knee surgery and the months of rehab that followed. During recovery, I ate, got lazy and did little to burn off the extra calories. The additional pounds began to give me all the classic symptoms and problems associated with being overweight, beginning with sleep apnea.

So, I finally bit the bullet and went to a weight-management clinic. Their evaluation and counseling has convinced me of the seriousness of my situation. I'm currently preparing for gastric bypass surgery to assist me in correcting my condition (and to save your back if you ever have to carry me through the snow).

If you're over the recommended weight for your height, you need to get it under control ASAP. To help you maintain a healthy weight, we're premiering "Check Your Vitals" (p. 38), a column that will help you improve your health and fitness.

We've also established a special weight-management group on JEMS Connect, our social networking site, where we can all meet and help each other, lose (or gain) weight and stay healthy (www.jemsconnect.com).

Join me in my effort to get in shape. Remember, you'll have trouble helping your patients if you don't help yourself. --JEMS

References

  1. National Institutes of Health: "Learn About Body Mass Index." www.nhlbi.nih.gov/health/public/heart/obesity/wecan/learn-it/bmi-chart.htm
     
  2. Realize:www.realizeband.com/dtcf/pages/obesity-health.htm



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Related Topics: Health And Safety, Provider Wellness and Safety, Jems From the Editor

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A.J. Heightman, MPA, EMT-P

JEMS Editor-in-Chief A.J. Heightman, MPA, EMT-P, has a background as an EMS director and EMS operations director. He specializes in MCI management.

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