Friday, December 20, 2013

specially designed

Reece is one of the few people who’ve been on the bariatric training course, so he knows how to handle the chair. He unclips it from the charger, makes some adjustments, unfolds the seat, then quickly runs through some of the features. It’s an amazing piece of engineering. Tough, adaptable. It even has a mechanism for propelling the chair backwards up stairs.
‘What do you think?’
In fact, the last piece of kit that impressed me quite as much was the robotic forklift suit Sigourney Weaver operated in Aliens.
But it needs to be. The patient we’ve come to transport weighs thirty stone.

There are four of us. Reece and his crew-mate had fetched the bariatric truck and driven across two counties to rendezvous with us here. We went in together with the special chair, leaving the bariatric trolley set up down in the lobby because the lift was only big enough for six people.

Sheila’s door swings aside automatically. Everything about the place is super-sized, the furniture, the cushions and grab rails, even the WWF wrestlers on the plasma screen, parading and flexing their steroidal figures, roaring in hyper-coloured violence as the door closes behind us and we walk in.

Sheila is opposite the screen, contained by a gigantic chair, catheterised, padded, remote controlled, sweet jarred and diet coked, everything to hand.  
‘I don’t know how you’re going to move me,’ she wheezes, muting the wrestlers.
In all honestly, neither do we.

But after some initial discussion and exploratory examinations, clambering around her like drones around a queen, we set to work. Using Sheila’s gigantic zimmer frame and the tilt mechanism on her armchair, we help her to stand and turn just enough to get the chair in position. Every movement is slow and teetering, everything at its limit – bones, organs, spot-welded aluminium. And suddenly the chair doesn’t seem quite so all-conquering. The seatbelt that had looked so generous downstairs strains to go round Sheila’s belly; the straps to keep her legs in place are half a metre short. We address these problems as best we can, working round the vast folds of her corrupted flesh, cellulitic, multi-coloured green, brown and red, crusted, scabbed like the skin on a diseased whale.
In all honesty, the ocean is the only place Sheila could be comfortable now. Instead of the hospital we should be taking her for surgery at the aquarium, where they could fashion a blow-hole then float her out to sea for rehab. Because here in this room, landed like this, undiluted gravity is just too heavy.
‘Give – me – a – minute. Wait – a minute.’
All we can do is stand close-by at four points and stop her from falling.

Down in the lobby it’s the same problem. But even though Sheila is very unwell, she manages to do the minimum to rise from the chair, turn, and roll back onto the trolley. Once she’s on, we lower the back, slide her into a better position, wrap her up.  It takes all four of us to tow her out to the truck.

* * *

There’s a team of nurses waiting for us at the hospital, gathered round a special bed-cum-chair, with bars and grab-rails and automated plates to make the transfer easier.
Once she’s safely over, we take our kit and head back to the truck.

‘She was big,’ says Reece, putting the chair back on charge. ‘But anyway – hey? – what d’you think?’
‘Amazing,’ I tell him. ‘Brilliant bit of kit.’


Cassandra said...

I feel sorry for Sheila. Life like that cannot be pleasant. I wonder how she got to that place? You know it doesn't just happen overnight... but what started it? Thyroid problems? Some other disease? Curious. And now there she is, analogized as a diseased whale. Poor woman. (I'm glad no one got hurt moving her! It could easily have gone bad, I'm sure.)

Spence Kennedy said...

Hi Cassandra

I must admit I hesitated before using the whale analogy, but in the end I used it because I thought it would get across the shock of seeing someone in that condition. It's truly appalling, the long-term trauma that Sheila's weight problem has put her body through. And then there are all the practical problems her size creates for everyone else, not just the ambulance crews, but the carers, nurses, doctors.

You're right - the problem must have developed over many years. My understanding is that although thyroid problems are sometimes a factor in weight gain, morbid obesity is still more associated with diet & lack of exercise - and of course, the heavier you get, the less you want or can exericse, so there's an exponential increase over time. Certainly in Sheila's case, there were large jars of sweets placed around the chair, so I doubt her calorie intact was well-controlled.

I wish she'd managed to get help with her weight before it came to this - a situation that must be torture for her.

I don't want to come across as uncaring. I certainly wish things were better for her.

PS My next post better be more Christmassy or I'm in trouble! :)

TomVee said...

Don't worry about your posts being appropriate for the season Spence! After all, in your job the calls make no such allowances either do they?

To the contrary, I am happy and grateful that you keep posting over the holidays as opposed to many blogs going into christmas hibernation.

I think the whale analogy, while risky in that it could easily be misunderstood as condescending, was apt. You are not alone in being reminded of helpless animals out of their element when confronted with obesity.

As for thyroid trouble, I have just over a month ago been diagnosed with hypothyroidosis. I hardly got to gain ten punds before the fatigue, the intestinal trouble and of course the inexplicable weight gain made me go to see a doctor, who took some blood samples. I am since on hormone replacement therapy, whch will stay with me for life, but it is merely a single pill every day. My point is, hypothyroidosis is too easily caught and too easily treated to allow for such uncontrolled weight gain.

jacksofbuxton said...

This would be a good place for you to use the previous blog's other wordly spirits to help shift Sheila.

Spence Kennedy said...

Thanks, Tom. Sorry to hear about your hypothyroidosis, but I'm glad it's all been caught & treated early. I think you make a good point about it being readily diagnosed & treated, so it's frustrating that if it's implicated in Sheila's case, it wasn't addressed years ago.

I must admit I regret using the whale analogy, but that's the hazard of blogs - publish in haste & repent at leisure. A lot of the time I find it difficult to get across the shock of some of these jobs without feeling like I'm revelling in the dreadful descriptions. With Sheila, she was so heavy & her skin so ravaged by the side effects of her immobility, being supported & cleansed by the sea would be a good thing. But it is a dangerous analogy, and maybe I should've gone down some other avenue.

Hey Jack - We had a joke at the time about Reece being in the next Avengers Assemble movie. But then when they ran through the cast in the trailer, introducing all the characters & their special skills - Iron Man with his suit, Thor with his hammer, Hulk with his muskles and so on - maybe Reece & his bariatric chair would be a bit off-putting. :/

Anonymous said...

I weigh as much as Shiela, Spence..and that whale analogy would apply to me. Luckily for me I am still mobile, but I wish I had a blow hole so I could float..please don't feel bad..the truth is still the truth, regardless how cruel it sounds. Happy Christmas and cheers from Rockford, IL. Corina H.

Spence Kennedy said...

Hi Corina

Well - I feel even worse now! Thanks for being so nice about it all.

I hope you're as well set up with accommodation & equipment as Sheila was. Access to the flat was good (even if the lift was undersized), and her chair was amazing.

Happy Christmas, Corina. I hope you have a great holiday. :)

Anonymous said...

Don't feel bad Spence..truth is truth, and it does bother me to be so big, precisely because of the reasons you mentioned, like if God forbid, I have to go to hospital again, i don't want to be the cause of someone getting hurt. Luckily, I can still get around and work etc. Have a good one, and thanks for your blog! I love reading it! HUG Spence!
Corina H.

Spence Kennedy said...

Cheers, Corina. Big hug back - and thanks for reading! :) x

Anonymous said...

I found the whale analogy very discriptive, and I agree with previous commenter who pointed out that a simple case of hypothyroidism is unlikely to be the root cause of such massive weight gain. But to say morbid obesity is associated with 'over eating and not enough exercise' while true, does not explain anything. Obesity in adults is associated with a poor childhood, particularly neglect, iirc. And of course there are all kinds of metabolic problems, Prader-Willi syndrome etc, etc.

Anyway, just my thoughts. I very much enjoy your writing Spence.


Spence Kennedy said...

Thanks very much, Anon. You make a good point about the background to these cases. It stands to reason that a significant weight problem wouldn't happen overnight, and it's interesting that lately there have been cases of child neglect based on over-feeding. I haven't heard of Prader-Willis syndrome, so I'll take a look at that, too.

Thanks for the comment, Anon. Very interesting. Glad you didn't think the whale analogy was overdone (although I still wince a bit when I read it back..).

Cassandra said...

Don't worry, Spence. I didn't read it as uncaring. Hope my comment didn't come across as critical! It was sadness for her… sadness that she COULD be portrayed as a whale (and a diseased one at that) and it be accurate. I agree with you on the morbid obesity thing… and you're probably right about the calorie intake. :\ Just… poor lady. What a life.

Spence Kennedy said...

I don't mind criticism, Cass (honest!). I often get a bit carried away with some of these descriptions and I need reminding it's people I'm talking about! Funnily enough (or not so funny) I had an almost identical case just a few days later, but I didn't write about it because it was all just too awful. I wish things didn't get to that state, because it happens over a long period of time. You'd think that something could be done to pre-empt the horror (and I think in these extreme cases, it is a kind of horror). I really appreciate all your comments, Cass. Don't worry how they sound or anything - just put it out there! :) (And Happy New Year - did I say that already?)

Anonymous said...

H commenting on a comment on a comment...

There are lots of studies that link obesity in adults with maltreatment in childhood (for example, the study outlined here:

Childhood obesity may arise from poor parenting (or it may not), but adult obesity - especially extreme cases such as Shiela described here - often come from an unhappy background. Overeating may be one way of trying to fend off the overwhelming grief of having neglectful parents. Anyway, sympathies to Shiela, I hope she gets some help.

Keep up the good work Spence.

Spence Kennedy said...

Thanks very much, Anon - and for the link to the article.

It'd be great if these problems of obesity could be addressed in childhood, but I can only imagine how difficult effective family interventions would be in many cases, short of taking children into protective custody. Education is important, as is a proper balance of taxation between good & harmful foods. No easy answers, but it should be given as much focus & funding as smoking and other areas of public health, as the cost to the NHS is significant.

Cheers Anon!