My BMI is 40 are they less likely to ventilate me?

[FuckADuckie]

If I did get it because I'm on the list of secondary issues?

I just read this somewhere and am terrified now :(

It's hard not to take it personally but IF medical professionals have to prioritise who to intubate it will not be based on moral judgments but on medical ones. Hopefully if we can slow the spread down then they will not have to make those choices and so can continue as usual, but IF they have to Prioritise it will be based on how likely interventions will take and how long they will take to work. So if someone with BMI 23 and someone with BMI 41 both need interventions, they might well work for both patients, but the person with a BMI of 23 could well need less intervention and for less time as they recover quickly and less likely to get secondary issues. Therefore they would be prioritised. It's not "fair" in the sense we have come to believe healthcare should be (every patient treated equally, every patient treated regardless of cost or time) but it is "fairer" to treat two or three patients at a lower BMI instead of one patient at a higher BMI because more people are being treated. It's the greater good for the greatest number (utilitarianism). And yes it's shit. But hopefully it will not come to that

It's important to understand that if you have to be ventilated then you are very, very, very ill. If you need ECMO then it really is last chance saloon and not very likely to save you.

Ventilation is NOT a sure fire cure for the complications caused by COVID-19.

For many very ill people with underlying risk factors, the ventilator will not help them. Whatever is attempted they will die and comfort care only may be clinically most appropriate.

Even in times where there are enough ventilators to go round a doctor would have to have the difficult conversation with the patient/relative regarding whether ventilation was appropriate for them if they had severe underlying conditions.

In times of equipment shortage, they will prioritize those most likely to be helped by that equipment - it is NOT a judgement on the VALUE of the person.

I've pm'ed you FuckADuckie.

The poor dr's have the horrendous responsibility of applying criteria for who gets an ICU bed based on how likely the patient is to survive. You are less likely to survive than others. There are people in their 20s, 30s and 40s with no underlining health conditions fighting for their lives in ICU wards in London. There simply aren't enough beds or ventilators. Really important you stay at home and no one enters or leaves until it's all over. Good luck.

This is very worrying indeed. Where do you get your information, do you have a reliable link for that?

@FuckADuckie
I feel the same, I have gained 6 stone since February 2019 due to a mix of Antipsychotics and Antidepressants.
It always seems to be for me the best psychiatric medication for me are the high risk of weight gain ones.
One half of me thinks stop taking it and get the weight off, the cholesterol and blood sugars normal again, but the other half of me thinks I really need this to stay sane.

If I hear one more morbidly obese person say they are healthy I will scream. Sadly the strain on the heart and lungs, as well as the joints, blood pressure and diabetes risk, does not qualify for 'healthy'.
You can be a normal weight or underweight and not be remotely healthy too. You can be skinny and have high cholesterol and atherosclerosis and ischaemic heart disease.

Your blood pressure might be higher than your own norm if you put on weight but that doesn't necessarily mean it would be over the norm for the population as a whole.

Other factors besides weight need to be considered to determine good health.

There are people in their 20s, 30s and 40s with no underlining health conditions fighting for their lives in ICU wards in London.
Really? Can you tell us the source of this information? That is quite shocking.

Other factors besides weight need to be considered to determine good health

Of course this is true. However, I work in health and have been told by oncologists and other specialists that the two main lifestyle factors that increase risk of most illnesses are: obesity and smoking. So whilst anyone can be unhealthy, these two factors are major lifestyle risks for all diseases.

"How will they know what your BMI is? Surely if you are ill enough to need to be ventilated they won't weigh you."

ICU beds have built in scales and a tape measure is used to measure the height. ICU patients are weighed every day because it gives very valuable information about fluid load, nutrition, etc. Some ICU drugs (such as noradrenaline) are given based on actual body weight. Other treatments (such as ventilation volumes) are given based on ideal/expected body weight. You can cause as much damage by over ventilating a patient as by under ventilating them, so it is necessary to be accurate.

I think the key here is to remember that doctors (in this case anaesthetists, as nearly all ICU consultants are actually anaesthetists with specialist training in intensive care medicine) are trained and expert in making these difficult decisions. For example, there are many times when an older person breaks their hip and a decision has to be made about whether to operate. Generally, that comes down to a balancing act and the patient/relatives are told 'If we operate, Harold has a high chance of dying. If we don't operate, Harold will die.' Some patients accept that the odds are against them and refuse surgery, knowing they will die. Others will say 'let's give it a go...'

All treatment is based on the premise of 'doing least harm'. Intensive care is barbaric. It is invasive, causes suffering and can cause psychological damage. It is only justified if there is the prospect of potential recovery. Otherwise, we are just denying a patient a peaceful death. These decisions can be made hour by hour, or even minute by minute. It can be the case that a treatment is justified at 8.30 am and not justified at 11.00 am. That's why there are always twice a day ward rounds in ICU (mandated) and treatment plans are modified as needed.

I really don't think that BMI is something to ponder at this moment. It is what it is and nobody can safely bring themselves from a BMI of 40+ to a BMI of

'It's important to understand that if you have to be ventilated then you are very, very, very ill. If you need ECMO then it really is last chance saloon and not very likely to save you.

Ventilation is NOT a sure fire cure for the complications caused by COVID-19. '

This is an important point. The doctor on the sky news report in the Italian hospital said that they hadn't been able to save anyone who had been treated for covid 19 in intensive care.

Just focus on eating well and shielding yourself OP.

I have a BMI of 26 but I do honestly wish it were considered and realised just how many medications really do cause weight gain because quite a few do but the weight gain is seen as no big deal, particularly with regards to particular drugs used to treat mental health conditions and no steps are taken to counteract them, it's seen as unimportant, an acceptable side effect. I actually refused to take a particular anti-depressant because weight gain is a well known side effect.

Please no nasty comments. My BMI is in the 30s, covid19 has been a wake up call and I am now on healthy eating regime. Although I have no underlying health conditions I know myself that I get out of breath from mild exercise. I have 3x dc so want to be in the best possible condition for them.

Good luck to everyone in the same boat xx

There are people in their 20s, 30s and 40s with no underlining health conditions fighting for their lives in ICU wards in London.

Really? Can you tell us the source of this information? That is quite shocking

I too would like to see a source for that. The last information I read from Italian fatalities indicated that only 0.8% of those who have died due to COVID-19 had no underlying conditions.

www.google.co.uk/amp/s/www.bloomberg.com/amp/news/articles/2020-03-18/99-of-those-who-died-from-virus-had-other-illness-italy-says

@PotsofChoc good for you, I wish you every success 💐

In italy there is people of the ages 30 and 40s fighting for their lifes so it wouldn't suprise me if its happening here
They aren't mentioning ages of death now so im guessing only what that means!!

The There are people in their 20s, 30s and 40s with no underlining health conditions fighting for their lives in ICU wards in London.
seems to be teacher, so they would definitely know the importance of quoting good sources.

I'm sure they will be along shortly,

@DitheringDoris Thanks, that actually means a lot. One horrible man that I work with has spent the week spouting out about Chinese immigrants and Syrians refugees being a virus themselves and causing this. He is similar to some in this thread and then had loads of digs about me being fat and being last in the queue! I went home and cried xx

Yes, normally the morbidly obese (bmi over 40) are less likely to be intubated as their bodies can’t handle it. In a pandemic it’s even less likely.

thank you so much lougle for your clear compassionate and constructive posts about ITU.

OP - I'm in a similar position and was wondering about this too, thanks for starting this thread.

@ScarlettBlaize
I know she's morbidly obese and doesn't think that should affect her treatment, which is what is being discussed here

She is asking if it will affect her treatment, so she is naturally worried. And people are responding in the main by advising that her treatment is determined by how successful the outcome will likely be. Not by being unnecessarily cruel in their responses.

I am overweight. Since all this started I’ve had a wake up call and I am trying to get my body as fit as I can and have already lost 5lb. Get fit, get active and ensure you’re ready for this virus. Don’t loll on sofa, don’t sit about eating snacks.

From what I know they will incubate people that have the greatest chance of survival so if it comes to a toss up between someone who isn’t as likely to and someone who is then unfortunately you will lose out. That’s the way it is unfortunately. They won’t take a chance of two people not making it when one can be saved and to be honest it’s not going to be a decision based on one of two if this gets worse. It could be one in twenty and they have to choose which one to try to save.

From what I know they will incubate people that have the greatest chance of survival so if it comes to a toss up between someone who isn’t as likely to and someone who is then unfortunately you will lose out.

I disagree. It won’t necessarily be based on survival it will be based on who is most likely to recover. That may mean rejecting a 20 yo with a 40 BMI for a fit 50 yo.

It makes me so angry when people get all judgy about people being overweight.

It is was as simple as 'eat less move more' then there would be no overweight people at all. Obesity is a very complex psychological and hormonal condition. Sneering at overweight people just makes you look stupid.

Op I know you must feel really scared

If you get the virus your chances of getting seriously ill are still very low. Try to focus on that. No one knows what could happen if they get to the point of needing intensive intervention but most people who are ill enough to need a ventilator won't sadly survive anyway.

If you can take small steps to being healthier that might make you feel more in control if nothing else.