Sunday, August 24, 2008

Another Reason to Lose Weight - YIKES!

Like many of you, I read a tremendous volume of online medical journals trying to keep abreast of the latest advances and atrocities in heart medicine. In yet another classic, "I don't know whether to laugh or cry" moment I stumbled across this report:

Extremely obese a cath lab problem: Some turned away because of weight restrictions on tables

In what has to be the one of the most incredulous statements ever uttered by a doctor, lead investigator Dr. Thomas Vanhecke (William Beaumont Hospital, Royal Oak, MI) offered, "It is a paradox. New research is showing us that patients are dying younger with more cardiovascular disease, and yet there are no cath lab guidelines for how to treat those who are morbidly or massively obese."

Is the good doctor worried about people getting fat and having heart attacks at an alarming rate at progressively earlier ages? No, he dithers over the fact there are no guidelines on how to treat morbidly obese patients. Hell, wouldn't want to smush any of that shiny new cath lab equipment or have the guy topple over on you! Where was the good doctor when these folks were shoving their faces full of cream pie? Here's a paradox for you doc, if not utter irony. Can you imagine being so overweight that when the inevitable angina or heart attack comes the hospital might turn you away because they fear you will break the cath lab table?!

Vanhecke also said that when faced with obese patients they are typically told to exercise and diet before they can undergo the procedure. Huh?! I'm having a heart attack and you want me to go exercise for six months then come back? Yowza!

Now, I hate to go off the deep end (not really) but if you link to the actual article you will see the quotes I lifted are not radically out of context. I've had my fun at the doctor's expense over some (ahem) rather dubious statements and it is time to get serious. These types of pronouncements speak loudly about the mindset of traditional medicine whose position appears to be "let people get morbidly ill while we invest in better "guidelines" and technologies to fix them." This might give you an inkling as to why medicine is becoming so expensive.

At the risk of being accused of using bad puns, what ever happened to the old axiom, "an ounce of prevention is worth a pound of cure?" Perhaps 500 pounds in some cases.

Excuse me while I finish my Diet Coke!



Thomas Vanhecke said...

The state of obesity is insane. The more obese, the higher the risk of acute coronary events and emergent angiography, however, cardiac catheterization is allowed under a certain weight threshold. THis is the paradox that I refer to. (I am not worried about a paradox about not having guidelines as taken out of context here)
I applaud you for your response, as my intention with this research was to bring awareness to "how bad it has become" with obesity, and the incur astonishment that patients are actually rejected for medical care because of these reasons.
I respectively disagree, it is not the role of cardiologist to be there for "when these folks were shoving their faces full of cream pie...."
We tell our patients to lose weight, to stop smoking, to take their meds, but this obesity problem is at a societal level, and we have our hands full right now treating patients who are full of existing disease.
The mindset of traditional medicine is far from "let people get morbidly ill..." Other than taking food out of people's mouths as you suggest, If it was up to them, I believe most physicians would make cigarettes illegal, tax fast food, and institute mandatory intervention for "at risk" children and adolescents, we could also charge parents of obese kids with child abuse (and put lipitor in the water ...:)

Again, I can stomach the theme of your article. Your title "another reason to lose weight" was the main purpose of this brief report.

Thomas E. Vanhecke, MD

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