Nikki Lee <[log in to unmask]> wrote:

> People of that size are often too out of shape to assist in their own
> movement. They must be carried and turned regularly and have deep breathing
> assistance because   their chest wall can be too heavy for them to expand
> their lungs enough. When their lungs can't expand enough, they don't get
> enough oxygen and can be irritable as a result of air hunger, or have an
> easier time developing pneumonia.
>
> Personal hygiene can be another challenge; nothing like finding yeast or
> mold or other nasty things in folds and crevices. One has a personal
> reaction to a sudden blast of noxious smell; pretty difficult to avoid
> although one learns to breathe through one's mouth all the time, to honor
> the client.

> There are always more than two sides to story.
> 
> Then, if the obese woman has a ceserean section, everything is intensified.
> She's more likely to have the wound break open, or get pnuemonia or a
> bladder infection. She's in too much pain to be very helpful with her baby.
> She has to be physically lifted from stretcher to OR table, and back again,
> and thence to recovery room.


Nikki, you seem to have read the word "obese", and imagined only people
over 250 or 300 kg. Women have their files marked "obese" on the ward/in
the clinic as soon as they hit a BMI of 30, which is around 86 kg (190
pounds) for a five foot six woman. When I was at that weight (and a fair
bit heavier) I was winning State medals in my sport, working a very
heavy shift work schedule, travelling around the world alone ... nothing
at all like you describe! At a BMI of 40, which doctors so dolefully
proclaim "morbid obesity", I climbed onto the OR table quite happily by
myself for my C section, thankyou, for an indication unrelated to
weight. At two weeks I was doing the grocery shopping with baby in a
sling, at three weeks we were going out as a family for day tours in the
Swan Valley, and at around six weeks I was cycling again. I'm sure that
many here have similar stories.

The vast majority of obese women you will see in practice have BMIs
between 30 and 45, and don't experience any of the things you describe.
We are talking about completely different groups of people. 

Lara Hopkins

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