Hey all you EMS peeps!!!

[beanbean]

What happened to everyone? This forum has been so slow!

So any new stories? Gossip? Questions? Accomplishments?

Anything?

I'm bored.

Deirdre

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[DSM]

We could have our own EMS gossip thread.

I was busy with Hurricane Ivan last week. My 2 central A/C's were knocked out unrelated to Ivan...makes for a hot time this far South I have one working now.

And I have been working on my secondaries.

No really interesting EMS stories to tell, just that one of my patients during Ivan was a 500 pound man who could not understand why he had chest pain after eating. He only took 2 or 3 puffs off his cigarette and then his chest started screaming. Why, his pork chop was grilled even though he loves them fried? So why would his chest hurt?

The man was so big our straps would not fit around him

And he wonders why

 

[SMW83]

We could have our own EMS gossip thread.

I was busy with Hurricane Ivan last week. My 2 central A/C's were knocked out unrelated to Ivan...makes for a hot time this far South I have one working now.

And I have been working on my secondaries.

No really interesting EMS stories to tell, just that one of my patients during Ivan was a 500 pound man who could not understand why he had chest pain after eating. He only took 2 or 3 puffs off his cigarette and then his chest started screaming. Why, his pork chop was grilled even though he loves them fried? So why would his chest hurt?

The man was so big our straps would not fit around him

And he wonders why

thats when you call the FireFighters for an EMS assist!

500lbs?!?!?! how the hell could someone let themselves get that LARGE?!?!?!?!?

 

[DSM]

thats when you call the FireFighters for an EMS assist!

500lbs?!?!?! how the hell could someone let themselves get that LARGE?!?!?!?!?

They were there right behind us....first responders actually.

You get that large from a sedantary lifestyle accompanied by eating a LOT of fattening unhealthy foods which this man obviously did. He is 45....I doubt he makes it to 50.

 

[DSM]

I watched a man on a motorcycle crash into an older model camaro in a huge parking lot on his crotch rocket. The man went skipping across the parking lot like a stone on water. His motorcycle was in about 6 pieces and there was a huge dent in the front fender of the old camaro.

His story was that he was revving up the engine and put the motorcycle in the wrong gear and it shot out across the parking lot hitting the ONLY car there!!!

We drove over there and checked on him but he refused our help. I later saw him in the ER!!!

 

[SMW83]

I watched a man on a motorcycle crash into an older model camaro in a huge parking lot on his crotch rocket. The man went skipping across the parking lot like a stone on water. His motorcycle was in about 6 pieces and there was a huge dent in the front fender of the old camaro.

His story was that he was revving up the engine and put the motorcycle in the wrong gear and it shot out across the parking lot hitting the ONLY car there!!!

We drove over there and checked on him but he refused our help. I later saw him in the ER!!!

Like I say.....if it weren't for stupid people doing stupid things, then EMS, FIRE, and POLICE would all be out of a job!!!

 

[beanbean]

Only car in the parking lot!! What luck (or lack there of)!

Its amazing what some people walk away from.

 

[DSM]

Only car in the parking lot!! What luck (or lack there of)!

Its amazing what some people walk away from.

Cross my heart! Only one in sight! Unfortunately for him it was an older model before they started using fiberglass!!

 

[beanbean]

EMS gossip:

Midlife crisis + EMS bonding over calls = mess:

Know a guy on my service who is about 45, has two daughters 16 and 19. Left his wife for a 19 yo female member of the same EMS service. Denied up and down anything was going on with her - even though they signed up for every shift together and she would "sleep over on the couch" at his house. Wrong on so many levels I can't begin to describe how nasty it is.

Makes no sense. He has no money (hell, he works as an EMT full time!) a big gut and a poor attitude. She must have major issues. She's not a ten (who really is), but how low is your self-esteem if you are 19 and hooking up with a guy like this.

 

[BaylorHopeful]

Thanks beanbean........I guess I now know what this 20yo with a big gut who is doing his best to pay his way through school as an EMT has in store for him

Anyway.....I once responded to a poor middle aged lady who syncoped on a treadmill at a gym. She bashed her head up pretty well, lost a few teeth, and when we arrived her baseline BP was something around 80/30 Fun times......

And oh yeah !!!!! Guess what Guess what --> I had my first patient to puke on me today. At least I was wearing my old shoes and long pants and she only hit the toes of em.....

Oh well.....you gotta love that feeling when you see someone who was in pretty shutty shape when you treated em walk outta the hospital with their kids all smiling and such

 

[DSM]

EMS gossip:

Midlife crisis + EMS bonding over calls = mess:

Know a guy on my service who is about 45, has two daughters 16 and 19. Left his wife for a 19 yo female member of the same EMS service. Denied up and down anything was going on with her - even though they signed up for every shift together and she would "sleep over on the couch" at his house. Wrong on so many levels I can't begin to describe how nasty it is.

Makes no sense. He has no money (hell, he works as an EMT full time!) a big gut and a poor attitude. She must have major issues. She's not a ten (who really is), but how low is your self-esteem if you are 19 and hooking up with a guy like this.

Yeah one of our pilots left his wife for a 27 year old...he had kids nearly her age too. He denied it but we busted them.....people, don't forget...ambulances go everywhere!!! Anyway, they married and divorced after a couple of years. Sad to throw away your life like that .

 

[beanbean]

I haven't had an interesting call in a long time. Not much time to ride now with 3 kids and med school.

I am doing an EM elective right now which is cool.. Interesting diadatic sessions and I get to go play in the ED. Yesterday things weren't too exciting, but I always learn something. I plan to do a few hours at our Level I center tomorrow. Its weird being in the trauma room waiting for the patient to be wheeled in. I'm used to doing the wheeling in.

My husband and I are going to the 3rd Annual UCONN Wilderness EM Symposium Friday and Saturday. Camping Friday night, classes and practical play on Saturday. This will be my first time camping. I have traveled the globe from Namibia to Borneo but have never slept in a tent or on the ground.

Sorry for the random postings. I am supposed to be working on my research project - I have a meeting with the EM doc I am working on the study with tomorrow. I am completely unmotivated to read reference articles right now. Related to the research --> DSM - did your service where you flew as a flight medic use Nomex gloves?

 

[DSM]

I haven't had an interesting call in a long time. Not much time to ride now with 3 kids and med school.

I am doing an EM elective right now which is cool.. Interesting diadatic sessions and I get to go play in the ED. Yesterday things weren't too exciting, but I always learn something. I plan to do a few hours at our Level I center tomorrow. Its weird being in the trauma room waiting for the patient to be wheeled in. I'm used to doing the wheeling in.

My husband and I are going to the 3rd Annual UCONN Wilderness EM Symposium Friday and Saturday. Camping Friday night, classes and practical play on Saturday. This will be my first time camping. I have traveled the globe from Namibia to Borneo but have never slept in a tent or on the ground.

Sorry for the random postings. I am supposed to be working on my research project - I have a meeting with the EM doc I am working on the study with tomorrow. I am completely unmotivated to read reference articles right now. Related to the research --> DSM - did your service where you flew as a flight medic use Nomex gloves?

No on the Nomex! Just regular latex gloves....

 

[PluckyDuk8]

Other than the who was going out with who gossip one of the big things going on with one of the EMT's back when I was working (a single mother of two) was that her 12 year old daughter got pregnant and decided to keep the baby. I had a long interesting discussion with that EMT about it and her problems with her children, it opened my eyes quite a bit. Overall, I'm happy that my EMT experience has exposed me to different types of people and cultures that I'm not usually around- has broadened me as a person and can only help with future diverse patient populations.

 

[lytesnsyrens]

nothing too interesting happening in my neck of the woods except for the fact that we seem to be seeing quite a bit more psych patients around here. It's not even the holiday season yet and every night we see a few. Can't wait for thanksgiving to get here, should multiply even more.

 

[leviathan]

They were there right behind us....first responders actually.

You get that large from a sedantary lifestyle accompanied by eating a LOT of fattening unhealthy foods which this man obviously did. He is 45....I doubt he makes it to 50.

Those would be the contributing factors to an innate genetic disorder that causes them to get that large. I don't care how lazy you are and how much you eat, it is nearly impossible to get THAT heavy without an underlying condition.

 

[DSM]

Those would be the contributing factors to an innate genetic disorder that causes them to get that large. I don't care how lazy you are and how much you eat, it is nearly impossible to get THAT heavy without an underlying condition.

I disagree with that. If he wanted, he could lose the weight by changing his habits not his genetics. He got to be that fat all on his own. I have seen too many just like him to think any different.

 

[Febrifuge]

Its weird being in the trauma room waiting for the patient to be wheeled in. I'm used to doing the wheeling in.

That would be weird indeed.

I learned that when the patient is wheeled in, everyone standing around in gowns looks similar enough that if you happen to be the first one to say "hey" to the incoming EMTs, they might start giving you report. I made sure the receiving nurse and the MD could hear too, and when the EMT took a breath I said, "thanks. This is Dr. H; this is F, and she's the nurse for this case."

Sort of embarrassing, for me and the EMT, but also sort of cool. I'm old enough to be a resident, and I guess I have "the look" too.

 

[DOrk]

Those would be the contributing factors to an innate genetic disorder that causes them to get that large. I don't care how lazy you are and how much you eat, it is nearly impossible to get THAT heavy without an underlying condition.

While it's true that many 500 pounders have hypothyroidism, it is more likely an effect of their obesity rather than a cause. That being said, however, I think there is a small number of people who have a legitimate disorder that causes them to become obese. I guess my point is that many more people claim that their obesity is genetic than actually have a genetic defect. It's more about people not wanting to take responsibility for their own health. Those of you who are pre-meds will soon find out that 75% or more of your patients expect you to cure them of all of their ills. Sorry, a month in the ER has made me cynical....

By the way, 250 lbs is equivalent to one Pittsburgh unit (a unit of measure devised by a group of residents at Pitt) Therefore, said 500 pounder above would weigh two Pittsburgh units.

 

[DSM]

While it's true that many 500 pounders have hypothyroidism, it is more likely an effect of their obesity rather than a cause. That being said, however, I think there is a small number of people who have a legitimate disorder that causes them to become obese. I guess my point is that many more people claim that their obesity is genetic than actually have a genetic defect. It's more about people not wanting to take responsibility for their own health. Those of you who are pre-meds will soon find out that 75% or more of your patients expect you to cure them of all of their ills. Sorry, a month in the ER has made me cynical....

By the way, 250 lbs is equivalent to one Pittsburgh unit (a unit of measure devised by a group of residents at Pitt) Therefore, said 500 pounder above would weigh two Pittsburgh units.

I agree completely. There are some legitimate claims of health related or genetic predispostion to obesity but those are rare. Now the people claiming that those are the cause of their obesity...well that is a different number all together. I see these people in their homes. I know what they eat, I watch them smoke and you can tell from the way they talk that they do not exercise. At some point America has to take responsibility for its obesity. The responsibility starts with the individual person.

 

[leviathan]

I disagree with that. If he wanted, he could lose the weight by changing his habits not his genetics. He got to be that fat all on his own. I have seen too many just like him to think any different.

OK, so you have seen too many 500 pounders to think any different, or just overweight people? I'm not basing this on any fact, but I just don't see how they could get THAT overweight. I know many people whose exercise for the day is walking from the couch to the fridge, and maybe the bathroom, eat tons of food, but are maybe only 50-100 pounds overweight, which is still very obese.

In my humble (and again, not based on fact) opinion, there just isn't enough time to eat enough food to maintain a weight of 500 pounds without some sort of disorder in your metabolism. There are a lot of other things that could go wrong besides hypothyroidism, and I don't think hypothyroidism would even cause weight gain to that propensity. However, maybe it has to do with lipid metabolism or something like that. Could you maybe point me to some evidence that says otherwise?

Thanks.

 

[DSM]

OK, so you have seen too many 500 pounders to think any different, or just overweight people? I'm not basing this on any fact, but I just don't see how they could get THAT overweight. I know many people whose exercise for the day is walking from the couch to the fridge, and maybe the bathroom, eat tons of food, but are maybe only 50-100 pounds overweight, which is still very obese.

In my humble (and again, not based on fact) opinion, there just isn't enough time to eat enough food to maintain a weight of 500 pounds without some sort of disorder in your metabolism. There are a lot of other things that could go wrong besides hypothyroidism, and I don't think hypothyroidism would even cause weight gain to that propensity. However, maybe it has to do with lipid metabolism or something like that. Could you maybe point me to some evidence that says otherwise?

Thanks.

Well, when you see evidence of the lifestyle before you and people actually do lose weight when they change this lifestyle and lose all or most of those pounds then I can say there is your proof.

I have been doing this for quite a while and transported my fair share of 500 pounders. I do have a pretty fair idea of what I am talking about. When you walk into their house and you see the evidence of the junk food lying around, you take their history, you see how they live. I actually go into the homes and see the evidence. I am sorry but you can eat yourself into 500 pounds. Very few people can blame that on metabolism or genetics. If that is the case, then why are there so many 500 pounders in modern society? I am sorry. I just don't believe it is genetics the majority of the time.

When I put on that 10 pounds.....it is because I ate too much and did not exercise enough....If I keep up that trend, I will continue to gain. You don't top out, there is no maximum limit.

I used to work with a 450 pound guy as my partner. He ate bread by the loaves with packages of luncheon meat and potato chips by the full size bag. He constantly drank sodas and ate junk food continously. Now let us talk about what he would have for lunch. He could eat a whole large pizza with the works and still be hungry. Lunch at McDonalds consisted of supersized everything and burgers x 2 and then he would be eating 2 hours later.

In fact I have had 2 such partners of that size over the years. Now tell me that is genetics.

 

[deleted6669]

ditto above...I too have transported several of these folks using salvage tarps and ramps to get them into the ambulance because they didn't fit on a gurney.....

 

[leviathan]

Well, when you see evidence of the lifestyle before you and people actually do lose weight when they change this lifestyle and lose all or most of those pounds then I can say there is your proof.

I have been doing this for quite a while and transported my fair share of 500 pounders. I do have a pretty fair idea of what I am talking about. When you walk into their house and you see the evidence of the junk food lying around, you take their history, you see how they live. I actually go into the homes and see the evidence. I am sorry but you can eat yourself into 500 pounds. Very few people can blame that on metabolism or genetics. If that is the case, then why are there so many 500 pounders in modern society? I am sorry. I just don't believe it is genetics the majority of the time.

I wasn't aware that there were many 500 pounders in society. I think by just estimation, I've seen about 10 people who looked like they weighed that much in my lifetime. Maybe it's an American thing?

When I put on that 10 pounds.....it is because I ate too much and did not exercise enough....If I keep up that trend, I will continue to gain. You don't top out, there is no maximum limit.

My reasoning was that there just isn't enough time to eat and maintain a 500 pound stature. Think about the number of calories that someone needs to consume in order to maintain a weight that high.

I used to work with a 450 pound guy as my partner. He ate bread by the loaves with packages of luncheon meat and potato chips by the full size bag. He constantly drank sodas and ate junk food continously. Now let us talk about what he would have for lunch. He could eat a whole large pizza with the works and still be hungry. Lunch at McDonalds consisted of supersized everything and burgers x 2 and then he would be eating 2 hours later.

Ouch. I can actually eat a large pizza on my own, but after I'm almost throwing up from being so full. Or for example, last night I went to Mcdonalds and got a double quarter pounder meal, supersized everything, and then went back and got a 2nd burger. Still was feeling like eating after. By the way, I'm only about 155 pounds, 5'10". Besides that, I'm still young and very active so I have a high high metabolism so it's irrelevant. I'm just trying to show that it isn't always about the amount of food you eat.

In fact I have had 2 such partners of that size over the years. Now tell me that is genetics.

Are you sure they were 500 pounds? Maybe you don't realize how astronomically large that weight is. Anyways, I'm not going to tell you its genetics because I don't have any proof, I was just going off intuition.

 

[DSM]

I wasn't aware that there were many 500 pounders in society. I think by just estimation, I've seen about 10 people who looked like they weighed that much in my lifetime. Maybe it's an American thing?


My reasoning was that there just isn't enough time to eat and maintain a 500 pound stature. Think about the number of calories that someone needs to consume in order to maintain a weight that high.


Ouch. I can actually eat a large pizza on my own, but after I'm almost throwing up from being so full. Or for example, last night I went to Mcdonalds and got a double quarter pounder meal, supersized everything, and then went back and got a 2nd burger. Still was feeling like eating after. By the way, I'm only about 155 pounds, 5'10". Besides that, I'm still young and very active so I have a high high metabolism so it's irrelevant. I'm just trying to show that it isn't always about the amount of food you eat.

Are you sure they were 500 pounds? Maybe you don't realize how astronomically large that weight is. Anyways, I'm not going to tell you its genetics because I don't have any proof, I was just going off intuition.

But you don't constantly eat like this day in and day out. I realize that young guys have a high metabolism and can eat a lot of food but obviously you did not calculate in all the junk food my friends were eating. They ate constantly and that is just what I saw them eat while they were at work. Do you eat loaves of bread at one sitting with a pack of luncheon meat and slathered with mayonaise and then eat the whole pizza? Yes these guys did weigh that much. I saw them and you did not. What I am trying to tell you is that maybe you just have not be exposed to that side of society yet. I have been in the medical field for 15 years and I am in contact more with these 500 + pounders because they have more health problems then the normal person.

I once transported a 500 pound woman who had not been out of her trailer in 6 months because she had gotten so fat that she could not negotiate THREE steps coming off her deck. We nearly killed ourselves getting her off the deck, myself and 2 large strapping muscle bound gentlemen. We were all huffing and puffing by the time we got her down these 3 steps and we could not raise the stretcher up over half way because of her weight. Our stretchers are rated for 500 pounds and when they creak and pop because of the weight and we cannot get our supersized straps around their bulk .....then I am well aware of how much these folks weigh.

And BTW, I did ask her how much she weighed because we were all laughing by the time we got her loaded in the ambulance even her. I told her I did not normally ask such a question. (but since I almost lost a knee over her I figured I had a right to ask) but I did ask her weight. She said the last time she weighed over a year or two ago she was 500 pounds. I venture to say she had gained a few.

I have had all I am going to say on the subject. I do know what I am talking about and any paramedic or EMT who works full time in this business for any great length of time has the same war stories as I do. I just don't think you have had the exposure like I have...I am gathering that from your own words. Maybe you will just have to trust someone who has been in the trenches.

One more thing, if it is genetics then why do the patients lose weight when they get their stomachs stapled? Because they can no longer eat the massive amounts of food that have been sustaining their bulky body and the weight literally falls off.
It is time for people to take responsibilty for their own bodies and what they put in it.

 

[SMW83]

But you don't constantly eat like this day in and day out. I realize that young guys have a high metabolism and can eat a lot of food but obviously you did not calculate in all the junk food my friends were eating. They ate constantly and that is just what I saw them eat while they were at work. Do you eat loaves of bread at one sitting with a pack of luncheon meat and slathered with mayonaise and then eat the whole pizza? Yes these guys did weigh that much. I saw them and you did not. What I am trying to tell you is that maybe you just have not be exposed to that side of society yet. I have been in the medical field for 15 years and I am in contact more with these 500 + pounders because they have more health problems then the normal person.

I once transported a 500 pound woman who had not been out of her trailer in 6 months because she had gotten so fat that she could not negotiate THREE steps coming off her deck. We nearly killed ourselves getting her off the deck, myself and 2 large strapping muscle bound gentlemen. We were all huffing and puffing by the time we got her down these 3 steps and we could not raise the stretcher up over half way because of her weight. Our stretchers are rated for 500 pounds and when they creak and pop because of the weight and we cannot get our supersized straps around their bulk .....then I am well aware of how much these folks weigh.

And BTW, I did ask her how much she weighed because we were all laughing by the time we got her loaded in the ambulance even her. I told her I did not normally ask such a question. (but since I almost lost a knee over her I figured I had a right to ask) but I did ask her weight. She said the last time she weighed over a year or two ago she was 500 pounds. I venture to say she had gained a few.

I have had all I am going to say on the subject. I do know what I am talking about and any paramedic or EMT who works full time in this business for any great length of time has the same war stories as I do. I just don't think you have had the exposure like I have...I am gathering that from your own words. Maybe you will just have to trust someone who has been in the trenches.

One more thing, if it is genetics then why do the patients lose weight when they get their stomachs stapled? Because they can no longer eat the massive amounts of food that have been sustaining their bulky body and the weight literally falls off.
It is time for people to take responsibilty for their own bodies and what they put in it.

And they LET people that weigh that much into EMS?!?!?!?!

THATS A DISGRACE TO THE PROFESSION!!!

 

[leviathan]

But you don't constantly eat like this day in and day out. I realize that young guys have a high metabolism and can eat a lot of food but obviously you did not calculate in all the junk food my friends were eating. They ate constantly and that is just what I saw them eat while they were at work. Do you eat loaves of bread at one sitting with a pack of luncheon meat and slathered with mayonaise and then eat the whole pizza? Yes these guys did weigh that much. I saw them and you did not. What I am trying to tell you is that maybe you just have not be exposed to that side of society yet. I have been in the medical field for 15 years and I am in contact more with these 500 + pounders because they have more health problems then the normal person.

Fair enough. I am not trying to argue with you, DSM, I'm just expressing my level of shock that there are so many people that can get that big. Yes, before speaking with you, I did think it *must* be genetics, but I agree with you that I have only some medical experience as of yet, so I'll definitely take your word for it.

Maybe you will just have to trust someone who has been in the trenches.

Again, I do trust your opinion.

One more thing, if it is genetics then why do the patients lose weight when they get their stomachs stapled? Because they can no longer eat the massive amounts of food that have been sustaining their bulky body and the weight literally falls off.
It is time for people to take responsibilty for their own bodies and what they put in it.

That's a very good point. Also, there are MANY people out there who are extremely obese like that, and once they start watching their diet they lose the weight so quick that they are left with all that disgusting extra loose skin.

 

[SMW83]

Fair enough. I am not trying to argue with you, DSM, I'm just expressing my level of shock that there are so many people that can get that big. Yes, before speaking with you, I did think it *must* be genetics, but I agree with you that I have only some medical experience as of yet, so I'll definitely take your word for it.


Again, I do trust your opinion.


That's a very good point. Also, there are MANY people out there who are extremely obese like that, and once they start watching their diet they lose the weight so quick that they are left with all that disgusting extra loose skin.

Thats when you let them be a guest on Extreme Makeover!!!!!