Wednesday, December 30, 2009

I Always Knew They Were Up To Something.

Fat. Stupid. Fat. Unwilling to put forth any effort to improve their health except to blame the nearest health care professional when they do not get any better. After they cancel several consecutive appointments that is. Mouth breathing, drool dropping, dimwitted simpletons who, given a choice between inhaling a box of ho-hos and taking a walk to the mailbox, will choose the mailbox every time. After they eat the ho-hos. And as long as "walking to the mailbox" means "riding the lawnmower they never actually use to mow the lawn to the mailbox"

Did I mention fat?

All stereotypes of the typical diabetic I am aware, but anyone in the professions will tell you they're ones that don't come out of nowhere. Now I'm not talking about the type I's here. I really think it's time we come up with another name for type I diabetes, as it is completely unfair to associate them with the type II's, which used to be called adult onset diabetes, until the epidemic of fat-ass kids swept through our nation not so long ago.

Before you say I'm being too hard on the diabetic, if you work in a drugstore, a doctors office, or a food establishment that offers unlimited soda refills,  I want you to make a list of your biggest pain in the ass customers. I have little fear in saying you'll be making a list of predominately diabetics. The diabetic has been a living mockery of the notion that people are capable of making the choices necessary to take care of themselves for decades now, but it's not just about them anymore. From yesterday's New York Times we learn this about new high-tech full body scanners, which are being installed in airports and most likely would have prevented the attempted Christmas Day terror attack on a Detroit bound airliner:

body imaging technology has its limits — the machines cannot, for example, detect objects stowed in bodily orifices or concealed within the folds of an obese person’s flesh.

Concealed within the folds of an obese persons flesh. My God. Every pharmacist reading this has a customer with the potential to smuggle enough explosives onto an airplane to set the entire atmosphere on fire. If they ever become smart enough to act in unison the diabetics could cripple the entire world economy with the possible exception of the high-fructose corn syrup industry. I don't want to live in a world built on corn sweetener and pills that guarantee you'll lose 15lbs while you sleep. We must stop coddling the diabetics before it's too late and they destroy us all.

We should also continue to keep an eye on the Germans.

18 comments:

Unknown said...

Years ago, working as an aide-I was bathing an obese patient. No lie- I found a chicken bone under the folds of her breast. She said "oh, I was wondering where that went". Morbidly obese typeII diabetic. Had to be weighed on a scale in the loading dock. Had to be brought to hospital laying down in the back of a station wagon.

Antigonos said...

Well, I'm a fat type 2 diabetic. And so far, NO ONE, neither doctor or dietician, has figured out a way for me to lose weight AND balance my medications so that I don't have severe hypoglycemic attacks 5 or 6 times a day [including when driving, which is really dangerous]. Also, my day begins at 6 a.m. and finishes at midnight or later, so I don't have time for all those "lifestyle changes" like dedicated time for exercise diabetics are constantly being urged to do. Neither do I have the luxury of being able to eat on a regular schedule, or to eat "healthy" meals, since I must eat at my desk between patients [I'm a CNM] and lunch can take several hours on a busy day.

Yes, there are a lot of fat slobs out there who can control their diabetes but don't bother. But not all of us, believe me. It's easy to be judgemental.

The Redheaded Pharmacist said...

Obesity is the single biggest drain on the healthcare system in the United States. And its only getting worse and worse every year. Think of all the complications, disease states, problems, and resulting treatments that are required for people simply because they are overweight.

If you wanted to look at an area of healthcare where outcomes could be dramatically improved and expenditures greatly reduced just find a way for people to eat healthier and lose weight. Bring back physical education in schools. Have health insurance carriers give members free health club memberships. Create a working enviornment where it is actually possible to take a few minutes and sit down and eat. Educate the public on healthy eating choices and easy quick meals to make that are still nutritious. There is so much that can be done.

America is drowning in a sea of fat! No healthcare reform bill will solve any of those problems. It will just mean that we all have to pay for it. Get people to lose weight and keep it off and you will see a dramatic change for the better.

Tyler said...

Dear Antigonos,
It took quite a while for me to stop laughing after reading your post. Of course no doctor or dietician will be able to figure out a way for you to lose weight since you openly admit that you don't exercise and don't "eat healthy." Losing weight is no secret, if calories taken in exceed calories expended you will gain weight. As long as you continue to shovel the unhealthy food in and not do a damn bit of regular exercise you are doomed to continue being the fat "poor is me, no one can figure out how I can lose weight" diabetic. If you changed your diet (it's not that hard to eat healthier while on the go) and got a little more exercise you could take less meds for your diabetes. From the sounds of it, you're either on insulin or sulfonylureas, which is causing your hypoglycemic episodes because you are using these and not eating properly afterwards which is a must because your blood sugar will drop without a doubt if you use these and don't eat a proper meal afterwards. With better eating and exercise you may be able to get on only metformin to treat your diabetes and this does not cause the hypoglycemic episodes since it doesn't involve increased insulin output.

Anonymous said...

Thank you Tyler, You were so much more polite than I was going to be. Anyone can make excuses, it takes effort to actually look for a solution. I bet Antigonos parks in the closest parking spot and thinks it's easier to eat crap than pack a healthy lunch. There are probably a few cases of people who can't lose weight but you don't sound like one of them.

And if you really cared about your health--you'd find a new career so you could take care of yourself. Enough with the excuses....use WAG's slogan (because it is irrelevant for them) "There is a way"

Unknown said...

Wow, jeez I think we touched a nerve.

Anonymous said...

"...if you work in...a food establishment that offers unlimited soda refills, I want you to make a list of your biggest pain in the ass customers. I have little fear in saying you'll be making a list of predominately diabetics."

And you would know that how? Even doctors only know about their own patients' health conditions. Restaurant workers don't know their customers' health status. Stop propagating stereotypes.

Also, read Antigonos' comment again: Antigonos works all day, no meal breaks, and sleeps less than six hours a night. That's not laziness, that's overwork. Sleep deprivation is well known to mess up food metabolism. So lay off Antigonos unless you're willing to pay them to quit their job and exercise all day.

Anonymous said...

"While many may be incredulous, the largest body of evidence has found that fatness is not a risk factor for heart disease or premature death, even controlling for the effects of smoking. Ancel Keys and colleagues confirmed this nearly half a century ago upon examining 16 prospective studies in seven countries, as well as actual angiographic and autopsy examinations of 23,000 sets of coronary arteries which found no relationship between body fatness and the degree or progression of atherosclerotic build-up. And the most careful studies ever since have continued to support these findings.

Dr. Paul Ernsberger, of Case Western Reserve School of Medicine in Cleveland, Ohio, led a review of nearly 400 studies that was published in the Journal of Obesity and Weight Regulation in 1987 which corroborated these results. “The idea that fat strains the heart has no scientific basis,” he said. “As far as I can tell, the idea comes from diet books, not scientific books. Unfortunately, some doctors read diet books.”"

Anonymous said...

Well, this post stirred up a few different kinds of comments, and all relevant, to be sure.

As a previously overworked pharmacist (7 nights on, 7 off), plus inherently 'fat' (genetic component, fat baby, fat food childhood, and when a body is fat due to inertia from long-term illness it's more than 2x as difficult than a non-obese person to get back in shape for various reasons), whenever my physicians have had time to express interest in healthy lifestyles, I've really attempted to show some reduction in weight between visits--not blaming anything, just saying that intellectual approaches do help.

Now, I'm down to part-time work, have joined a health club and exercise in the club 3-5 times a week--which seems a bit silly given that the hour I spend there each session is taken away from time I could be spending on contribution to family life, mental health sessions, cleaning my house, CE, etc. but my present MD expressed encouragement in writing and voice with weight loss associated with improved exercise programs, so am going for it.

Tuesday, however, was a major problem that I forgave myself for as 'end of the year transgression' when I woke at 5:20 AM to leave home at 5:50 to get to out-of-town job at 7:15 because I was going to get started looking at pt charts early, but when I got there door was locked, and there were immediately several problems that only the pharmacist could intervene, plus all throughout the day patient histories kept getting faxed to me with data from where the job was now handling a new clinical program, and no one let us know in advance that we'd get five consults plus three new patients, so I ended up calling each patient 1-4 times to let them know the results of their blood draw and what we were going to do about it, etc. There was the regular work, plus several admits, and prompt discharges. I brought my own fresh fruits and fat-free yogurt, but needed something about 7 PM when the vending food machine wouldn't accept my money (choosing between chimichangas and burritos--y'know there's going to be a lot of carbs and fat, but gotta get something to last through next few hours before finishing up), so went with the fat-free animal crackers.

I mean, from my insight, I look at those with just a little overweight and say to myself, 'if those folks could only lose those last stubborn Kg and get themselves to 'skinny' it's a heckalot easier than massively obese. My impression is there are different stages of obesity and if get to the quite overweight, it's a downward spiral with surgery the only resolution because one actually doesn't need to eat much after a certain weight to either NOT lose weight or keep adding.

Plus, that and the relatives that don't want to be seen with the fattie in public.

And, we can all laugh at a piece of fried chicken in a fat fold, but Naomi Cohen died from heart failure due to fat infiltration of heart muscle, but she gave this world some pretty music.

midwest woman said...

define fatness :)...also one study done 23 years ago doesn't exactly scream evidence based medcine. and even if I concede your cardiac arguement, it stilll doesn't address type 11 DM which tend to disappear with a weight reduction program. and remember diabetes IS ultimately a cardiovascular disease with the damage it does to your cirulatory system. I know it's tough to be in Antigono's position but unfortuanetely you gotta deal with the cards dealt to you.

Anonymous said...

I know a medical resident who, swear to Zod, found a muffin in the fat folds of one of his patients.

I thought things like that were just urban legends and jokes from bad comedy shows. But no, they exist. A god damned muffin in his pannus.

Anonymous said...

How about "fatabetic" ?

Just a little snarky said...

My dad had 3 sisters, all fat, all diabetic, all lazy. 2 of them had to die of "complications of fatness" before the third would even put a good effort into losing weight. The third sister lost 50 lbs, at least it's a start.

It's odd, in my mom's family no one is overweight.

Ex-fat type II DM patient said...

You don't have to make massive lifestyle changes to loose weight. Go on a healthy low fat diet (pack meals and snacks), and fit in any exercise you can (take the stairs, park at the end of the carpark, walk &talk on the phone) - it all adds up. Do some serious exercise on the weekend (two one-hour sessions each day, eg a walk and a swim).
I lost a lot of weight doing this while working 15&16 hour days. You have to be persistant (it took me 18 months to loose the 60kgs I needed to) but it is possible, and it is worth it.

'I can't loose weight' usually means 'I won't try.'

Anonymous said...

My dad's a diabetic and never eats sweet things. He can't stand them. He's a diabetic because he eats too MUCH of everything and can't exercise properly due to an injury that limits his movement. So he "exercises" but it's useless, not nearly enough to exercise the strong muscles he has underneath the fat or enough to get his heart going, since all cardio in gyms requires movements he cannot do.

He follows a strict diabetic diet, but doesn't seem to understand that his sugar will spike just as much from eating 3 oranges in one sitting as from eating some candy. Because he's eaten this way for years, when he reduces his intake he feels like he's STARVING even though he's eating full meals and he is left so cranky that he is unable to properly work at his job.

I'm hopeful once he retires he'll be able to take a few months and get to a normal portion size, then maybe lose weight and control the diabetes. But the truth is, some diabetics simply are not in a job or other situation that allows them to lose weight or control their food intake well.

In an ideal world, anyone who was so obese they had resulting health problems would be able to take paid medical leave from work, check into an appropriate weight-loss center, stay for as long as it took to get the weight manageable and get into a routine they could do, then return to work slowly to integrate the weight-loss routine into their schedule. Of course, that's ridiculous, but it's what is needed to help individuals in jobs that aren't easily merged with a new healthy routine.

Heather said...

There will always be excuses. Let me give you mine:

I have PCOS- which is known to be tied to Syndrome X or metabolic syndrome or whatever. (I was diagnosed as a skinny teenager- it was not caused by weight. It has, however, lead do some of my weight.) And I *have to* take Seroquel, which is tied to diabetes/weight gain. (Not as much so as Zyprexa, but it's still there for sure.) To add insult to injury- I can't consume any of the fake sugars. Sorbitol makes me sicker than a dog, splenda/aspertame/nutrasweet all give me crippling migraines. So I have huge sugar cravings from the seroquel, and can only hit those cravings with real sugar. Awesome.

I'm also a full time student and I work multiple jobs to get by. I am *busy* and I'm *broke.*

But you know what? I'm still capable of putting apples and bananas in my cart instead of Snickers. And I can take 15 minutes once a week and hard boil a bunch of eggs for easy, on the go protein. String cheese, nut butters, whole grains, fresh fruits and veggies- all of these things are well within my reach. (And replacing a soda can with a water bottle is better for me, my wallet and the environment.)

It's not easy. It's not always "fun" and yeah, sometimes I'd rather kick back with a pan of brownies and say that it's not my fault and there's nothing I can do about it and it's TOO HARD (waaaaah!) But by making little changes that stick, I have not only stopped the predictable 10 pounds or so a year weight gain, but I have slowly started reversing it. Do I lose weight slower than others? Yes, I do. Do I fail sometimes? Yup. Do I kind of hate the skinny people of the world- especially those who can eat and drink whatever they want? Yes, I do. But I want to have a healthy body, and no one is going to do that for me. When the research proves that dropping as little as 10% of body weight can drastically improve many aspects of my health, and that this can be obtained through small life style and diet choices, I have little sympathy for most who claim they "can't" do it. Sure you can, you just don't WANT TO. You don't want to sacrifice your daily binge. You don't want to get up off the couch and miss an inspirational episode of America's Fattest Fatties by going for a walk.

The problem with obesity is that it kills you so slowly. If we had to see immediate consequences from a can of soda, things would be different I think. But we live in a culture that refuses to believe that ANYTHING is our fault. So we sit there and shovel our mouths full of sugar and fat and wash it down with more sugar and fat and then sit in our doctor's office, baffled, crying about how we can't lose weight. WTF ever.

No one is responsible for my weight except for me. I can't control everything- but I will control what I can. And being in the position that I'm in leads me to call bullshit on a lot of the above comments that want to defend or excuse away lazy, ignorant and selfish behavior.

Tyler said...

Kathmandu,

There is definitely a relationship between being overweight and having high blood pressure. High blood pressure is a huge strain on the entire cardiovascular system. There is also a relationship between diet and plaque build up in the arteries. There is also a relationship between diet and being overweight. You can find a lot of studies and a lot of doctors that say a lot of things, but that doesn't make them right. One or two studies or one or two doctors saying something doesn't make it correct

Corrinne said...

Did someone just say people should get paid medical leave because they are obese?? If it is a life or death (as in, the immediate future) then yeah. But JUST to lose weight? Are you kidding? I am busy as fuck, broke as hell, and could lose 15 pounds. But that's my own damn fault. I don't have much time to exercise but I also give in and chill out instead of exercising at times. But guess, what, I hold myself accountable for that. You can still eat healthy when you are busy and broke. I have two jobs and go to college full time.

Also, it's proven that losing those last stubborn pounds is harder than losing the first 100 pounds, or what not. The heavier you are the more calories you burn from doing simple things.