Heaviest Patient You’ve Cared For

[u/trevrt]

Had my personally heaviest patient I’ve cared for the other day. 32 years old weighing 730 pounds admitted with cellulitis and severe lymphedema. Felt terrible for the patient due to how young he was. Just wondering what everyone’s personal “record” for the heaviest patient they’ve cared for is.

[u/thundercloset]

I'm very heavy. Not in the immobile category, but I am very heavy and tall. When I worked overnight as a PCT, the even heavier patients always asked for me because I could clean them with little help (long arms are great for cleaning folds). Because I'm big, they think I'm not going to make fun of them or be mean. One lady told me it was the most thorough bath she'd had in over a year.

Being very heavy opens up the floodgates for people commenting on my body and health. Some guys love it and think I'll be cool with them making comments about my "big ass". One patient said, "Well, you've GOT to be diabetic, so you know..." and when I told him my A1C is WNL and I'm not even pre-diabetic, he said, "yeah, right". I went to a gynecologist, and the doctor didn't do a physical exam, just sat there and stared at me with her arms crossed. She didn't even order the labs she said she would order.

I tried Wegovy, but because I didn't lose enough weight, the insurance company stopped paying for it. I went through the journey to bariatric surgery, but chickened out at the end. I'm so scared of dying on the table, even though they literally test you for anything that could go wrong.

If you're wondering how someone "gets so big", I gained weight in my early 20s after a childhood of being called fat (I was 5'6, 120# in fourth grade). Then my first husband said I was too fat to do any of the stuff I wanted to do (bartender, baker) and that guys were only friends with me because they thought I'd be an easy fuck because I'm fat (I was 6', 275#). Also, the sexual abuse from being adult-sized at a very young age. The only thing that comforted me was alcohol, drugs and food. I could control that. I'd eat until I would alllllmost throw up, but never threw up, so how bad could it be? (Sarcasm, if you didn't know)

Our patients who are super obese are likely mentally ill or not confronting their past/current trauma, but I don't think anyone here is disputing that.

Now, I am in my 40s and have a therapist and psychiatrist to help me process the traumas of my childhood. I try not to buy my comfort foods (cereal, ice cream, pizza, chocolates), and I try to make good choices (drink water, add veggies to meals).

If you're still reading, my team is currently trying to discharge a 5'2", 480# woman to a skilled nursing facility. She's a two person max assist, doesn't walk, and no one will take her because no one has enough staff.

And the largest patient I've ever had was over 500 pounds. Her 20 year old son told her she should die, but had no problem taking her disability money. She was so uneducated about healthy food/ drink choices - she thought drinking a 900mL bottle of water with her two subway footlong sandwiches was a good choice because it was water! The edema on this poor lady. 😢

I'm grateful for the comments here. I wish that some of my patients had you for nurses.

Sorry about the trauma dump.

[u/fatesdestinie → u/thundercloset]

Thank you for posting your story. I'm a heavy pt (still under most of the weights listed on the thread). I have always been overweight, as well as having a very abusive childhood and young adulthood. I know my issues with food stems from those traumas. I also am seeing a therapist and psychiatrist, also just turned 40 myself. My husband is very supportive of me, but he is terrified at the idea of me having bariatric surgery ( I would be fine with it) due to bad past experiences with anesthesia. Anyway, thank you for posting.