Highest BMI you have seen?

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sella.turcica

sella.turcica

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Talking about obesity in the other thread, what is the highest BMI you guys have seen and what did the patient come for?
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I want to say to say there was a peds patient in med school who had a BMI of 99, but now I can't remember if that was legit.

Recently had one with 69.5, MVA.
 
GF had someone with BMI 92 for some type of Ob/Gyn surgical procedure
 
Haven't gotten to rotations yet, but back when scribing I saw someone with BMI 60. I imagine I will see someone larger in a year or two.
 
I've seen > 100. Patient had to be weighed on the hospital's freight scale as he was over 800 lb. This patient was still able to ambulate, believe it or not. I didn't have to operate on him, but one of my prior partners did (and inappropriately so).
 
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109. Guy was over 700 pounds. Was being transported for bariatric surgery (after spending 3+ years trying to find someone to actually perform it) when he became severely hypoxic in the ambulance and ended up in our hospital. Was in that hospital for 90+ days trying to find a company willing to transport him to have the surgery done. Guy had a good chance of not making through the surgery, but was likely going to die in the near future if he didn't get it anyway. Dangerous case, but I respect the surgeon willing to at least try for this guy, as the pt had spent 10+ years trying to lose enough weight for people to perform the surgery and just kept gaining.
 
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Stagg737 said:
109. Guy was over 700 pounds. Was being transported for bariatric surgery (after spending 3+ years trying to find someone to actually perform it) when he became severely hypoxic in the ambulance and ended up in our hospital. Was in that hospital for 90+ days trying to find a company willing to transport him to have the surgery done. Guy had a good chance of not making through the surgery, but was likely going to die in the near future if he didn't get it anyway. Dangerous case, but I respect the surgeon willing to at least try for this guy, as the pt had spent 10+ years trying to lose enough weight for people to perform the surgery and just kept gaining.
Click to expand...

What happened to him? Do you know?


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Stagg737 said:
109. Guy was over 700 pounds. Was being transported for bariatric surgery (after spending 3+ years trying to find someone to actually perform it) when he became severely hypoxic in the ambulance and ended up in our hospital. Was in that hospital for 90+ days trying to find a company willing to transport him to have the surgery done. Guy had a good chance of not making through the surgery, but was likely going to die in the near future if he didn't get it anyway. Dangerous case, but I respect the surgeon willing to at least try for this guy, as the pt had spent 10+ years trying to lose enough weight for people to perform the surgery and just kept gaining.
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???
Maybe he should stop eating?
 
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107. Guy was on a ventilator in the ICU due to obesity hypoventilation syndrome. The ventilator could not ventilate his chest -- he was too heavy. We called the local zoo to try to get a ventilator for larger animals like bison, but the patient expired before this could be obtained.
 
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DrSnips said:
107. Guy was on a ventilator in the ICU due to obesity hypoventilation syndrome. The ventilator could not ventilate his chest -- he was too heavy. We called the local zoo to try to get a ventilator for larger animals like bison, but the patient expired before this could be obtained.
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Holy ****


Saw a 100 one time, don’t recall details
 
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High 140s. Dude was approx 1100 lbs and 6 feet tall.
Cut out of his home by multiple fire dpts and brought to us. We (anesthesia) arrived at the code in the ER to find him already dead.
I have never seen anything like that before or since. It’s amazing that weight is even compatible with life at all.
 
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For those students who haven't yet encountered this, extremely large patients who don't fit in hospital scanners can be sent to get scanned at the zoo. It doesn't go over well to tell patients this, as you can imagine.
 
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Stagg737 said:
109. Guy was over 700 pounds. Was being transported for bariatric surgery (after spending 3+ years trying to find someone to actually perform it) when he became severely hypoxic in the ambulance and ended up in our hospital. Was in that hospital for 90+ days trying to find a company willing to transport him to have the surgery done. Guy had a good chance of not making through the surgery, but was likely going to die in the near future if he didn't get it anyway. Dangerous case, but I respect the surgeon willing to at least try for this guy, as the pt had spent 10+ years trying to lose enough weight for people to perform the surgery and just kept gaining.
Click to expand...

DrSnips said:
107. Guy was on a ventilator in the ICU due to obesity hypoventilation syndrome. The ventilator could not ventilate his chest -- he was too heavy. We called the local zoo to try to get a ventilator for larger animals like bison, but the patient expired before this could be obtained.
Click to expand...

Man o War said:
High 140s. Dude was approx 1100 lbs and 6 feet tall.
Cut out of his home by multiple fire dpts and brought to us. We (anesthesia) arrived at the code in the ER to find him already dead.
I have never seen anything like that before or since. It’s amazing that weight is even compatible with life at all.
Click to expand...
While personal responsibility is an absolute necessity in most cases of morbid obesity, at some point you gotta point the finger at the enablers in these peoples' lives. When these patients get to the point where they can't get out of their beds, who's bringing them the absurdly large amounts of food to maintain that amount of weight??? We'd be mortified and appalled at people injecting heroin into a patient with opiate addiction, but somehow we don't have that level of disgust with family members bringing heaping hoards of food to these bed-bound folks. I totally understand food = love, but in these cases the patients are literally being killed with kindness. **getting off soapbox now**
 
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Stagg737 said:
109. Guy was over 700 pounds. Was being transported for bariatric surgery (after spending 3+ years trying to find someone to actually perform it) when he became severely hypoxic in the ambulance and ended up in our hospital. Was in that hospital for 90+ days trying to find a company willing to transport him to have the surgery done. Guy had a good chance of not making through the surgery, but was likely going to die in the near future if he didn't get it anyway. Dangerous case, but I respect the surgeon willing to at least try for this guy, as the pt had spent 10+ years trying to lose enough weight for people to perform the surgery and just kept gaining.
Click to expand...

Did he end up with Dr. Now in TX?
 
curbsideconsult said:
While personal responsibility is an absolute necessity in most cases of morbid obesity, at some point you gotta point the finger at the enablers in these peoples' lives. When these patients get to the point where they can't get out of their beds, who's bringing them the absurdly large amounts of food to maintain that amount of weight??? We'd be mortified and appalled at people injecting heroin into a patient with opiate addiction, but somehow we don't have that level of disgust with family members bringing heaping hoards of food to these bed-bound folks. I totally understand food = love, but in these cases the patients are literally being killed with kindness. **getting off soapbox now**
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probably just need money and a cellphone to get food delivered to your bed these days.
https://www.digitaltrends.com/home/best-food-delivery-apps/
 
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74. A relative who wanted me to review medical records. They wanted a second opinion on knee replacement.
 
Smurfette said:
For those students who haven't yet encountered this, extremely large patients who don't fit in hospital scanners can be sent to get scanned at the zoo. It doesn't go over well to tell patients this, as you can imagine.
Click to expand...

Curious on how this works cost wise. A full body CT at my school for a dog is ~$750 (not sure on MRI). What do zoos charge for these human scans?
 
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batsenecal said:
Curious on how this works cost wise. A full body CT at my school for a dog is ~$750 (not sure on MRI). What do zoos charge for these human scans?
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A traditional full body CT for a normal sized (i.e. <350lbs) person is ~$1000 so I imagine the cost of the CT scan for a 1000lb person at the zoo isn't drastically above a CT scan at a hospital. Transporting someone to/from a zoo CT scanner on the other hand is a huge cost bump I imagine.
 
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batsenecal said:
Curious on how this works cost wise. A full body CT at my school for a dog is ~$750 (not sure on MRI). What do zoos charge for these human scans?
Click to expand...

I have no idea. I think the hospital charges for it (and subsequently it gets billed to the patient's insurance) but reimburses the zoo, rather than the zoo charging the patient separately. Guessing the hospital loses money in the deal. But as stated above, transportation to and from the zoo is probably a bigger cost and would get billed to the patient/insurer.
 
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102

Who said that they lose weight in the past year too
 
MSTPlease said:
A traditional full body CT for a normal sized (i.e. <350lbs) person is ~$1000 so I imagine the cost of the CT scan for a 1000lb person at the zoo isn't drastically above a CT scan at a hospital. Transporting someone to/from a zoo CT scanner on the other hand is a huge cost bump I imagine.
Click to expand...

Smurfette said:
I have no idea. I think the hospital charges for it (and subsequently it gets billed to the patient's insurance) but reimburses the zoo, rather than the zoo charging the patient separately. Guessing the hospital loses money in the deal. But as stated above, transportation to and from the zoo is probably a bigger cost and would get billed to the patient/insurer.
Click to expand...

Thanks!
 
Smurfette said:
For those students who haven't yet encountered this, extremely large patients who don't fit in hospital scanners can be sent to get scanned at the zoo. It doesn't go over well to tell patients this, as you can imagine.
Click to expand...

We did that once in med school, the patient was excited though haha
 
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We had a stroke alert on a BMI of 75. Too heavy for the scanner. Neuro did something they called “tPA and pray”.

Apparently that’s a thing, or just a lawsuit waiting to happen.
 
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batsenecal said:
Curious on how this works cost wise. A full body CT at my school for a dog is ~$750 (not sure on MRI). What do zoos charge for these human scans?
Click to expand...
MSTPlease said:
A traditional full body CT for a normal sized (i.e. <350lbs) person is ~$1000 so I imagine the cost of the CT scan for a 1000lb person at the zoo isn't drastically above a CT scan at a hospital. Transporting someone to/from a zoo CT scanner on the other hand is a huge cost bump I imagine.
Click to expand...

Good to see an intersection between vet med and human med :thumbup:
 
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Lawper said:
Good to see an intersection between vet med and human med :thumbup:
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Human med is just very specialized veterinary medicine for a specific primate, amirite? :D
 
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My record, on an ICU rotation as a resident, was BMI 103. He was intubated for a CHF exacerbation, I think after diuresing him he was down to a BMI in the low 90s. After extubation, he told the nurse that if we didn't let him eat immediately (we were waiting for speech therapy to evaluate him before giving him a diet) that he would sign himself out AMA and go to Hometown Buffet.

You can't make this stuff up.
 
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114, vented patient. Did not make it.

Turning the person was super scary; once the wave of tissue goes near the edge of the bed it can start a tidal wave of flesh that even 2 staff members on the other side can’t contain.

Does Houston still have the only bariatric hospital?
 
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49 so far but I’m only in first year. I’m sure I’ll see larger!!
 
OK, I technically broke the record today, but it was cheating.

Patient s/p b/l AKA and wasn't too tall to start with, so they recorded her height <3 feet. EMR calculated BMI 138.
 
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Raryn said:
OK, I technically broke the record today, but it was cheating.

Patient s/p b/l AKA and wasn't too tall to start with, so they recorded her height <3 feet. EMR calculated BMI 138.
Click to expand...

Counts, you win
 
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