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 :(

Eeeek this is getting nasty

But like I said before if we cant be honest with ourselves about obesity (and other self inflicted health conditions) now, during a global health pandemic, when can we be?

Now isnt the time to be peddling misinformation under the guise of 'body positivity'. In fact in the current circumstances it is downright dangerous. And maybe if obesity had been confronted when it started becoming a problem, the OP wouldn't be in the position she is in now which is clearly scaring her.

I do not have it in for overweight people, I think society makes it very hard for them to address the issue of their weight with constant reaffirmtions that they dont have a problem. Same as functioning alcoholics that cant cope without their nightly 'wine o clock', it is dressed up as being socially acceptable. If it didnt cause any health issues I doubt anybody would care.

But I think the time has come in the current circumstances to start addressing obesity in the cold light of day.

I can't help but feel if I came on her and explained I had a horrific childhood and became an alcoholic and I'm worried that I won't be treated because of that I would have a lot my sympathy

Both are addictions.

My childhood was horrendous and it messed up my eating habits and mind. And I'm not over it still in my 30s.

But in a way I'm glad my addiction is food. It could have been much worse.

I may be fat but I'm a good and present mother. If I turned to alcohol or drugs I may not even have my family and children now.

I've lost weight SO SO many times, a stone or 2 and it's gone back on because I can't break the mental cycle, even with therapy. And the drugs make it so much worse.

I guess I just have to see what fate has in store for me.

I was around 14 stone for years and since my new drugs I'm now 17 in the last year. But they help my brain.

Hi. Do not be worried. Most guidelines are based on clinical scoring using a frailty index and BMI is not on it. So, you will be treated.

BMI of 40 is not too big a deal nowadays for intubation as significant proportion of people are plus sized, but would be better to be a bit lesser.😀

I think we're all looking at our lifestyle choices right now, not just BMI but other stuff. Few of us are perfect, we're all human with an individual story to tell. We should all try our very best right now to ease the burden on services whether that is losing weight, eating healthier food, stopping smoking etc. And could we offer support and encouragement rather than judgement: that's more humane but also more effective. OP well done on your efforts so far. Keep going

I’m BMI 39 so on the border of morbidly obese I guess.

Can I ask why high BMI makes intubation more difficult?

@CherryPavlova

Please quote something that I have said personally which is nasty

OP I'm in no doubt you are a good person and a good mother, your weight has absolutely no bearing on that whatsoever.

However I really hope you find your fighting spirit, it would be a real shame to let your childhood issues cause you very serious health problems later down the line.

I think given the current pandemic, what used to be a personal health issue is now a societal one as it could have a direct impact on somebody else's life by way of using up medical resources.

I'm sure every overweight person has their reasons from comfort eating, to depression, to not having enough time to prepare more nutritious meals. However if they all just accepted it and considered it justified, nothing will change for them or for our health system.

OP please try not to go down the road of IFs IFs IFs, the worrying will make you feel awful.
You don't currently have Coronavirus. You may never get it. If you did, you may have it mildly. If you had it severely you may need some extra treatment. If you were very poorly then you may need breathing intervention and if you still needed further treatment then you may need intubation and ventilation. And only then would a clinical decision based on many many factors be made. Please don't focus on this, you are not helping yourself x

And more generally I wanted to address the doom mongers on this thread and the others where people are winding themselves into a frenzy. I am not stupid, I am really scared of this virus too and I'm doing all I can to avoid it and make sure everyone is as safe as possible. I'm not being flippant but the truth is that ventilation is not an automatic and inevitable consequence of getting CV-19. It is the most severely affected patients who represent a smaller but very varied group of people and it is not a guarantee of live or die either. Did you know you can actually get a chest infection from being on a vent? The clinical realities of this pandemic are far more complex than who gets a ventilator and who doesn't. It's still up to the persons body to fight the virus so the most sensible and proactive thing anyone can do is try to be as healthy as possible. Wash your hands properly. Social distance. Eat as healthily as possible under the circumstances. Exercise as you can. And let's be kind to one another and gentle with ourselves, this is hard enough without the mudslinging.

@CherryPavlova

It is grossly unprofessional and very sad to use your gossip to intimidate some poor young mother

WTF are you on about? I was stating the FACTS about who would be more likely to be chosen according to best outcome.

I haven't made it personal at all. Decisions will be made according to the patient's fitness and likelihood of getting weened off a vent.

I stated FACT that apple shaped people are harder to prone then pear shaped.

But you know what, I'll change what l have said

Don't worry everyone...there are thousanda of ventilators and ITU trained staff to look after you all. They will ventilate everyone no matter what co-morbidities they have and as we have so many vents, tough decisions won't need to be made

Doctors aren't trained to make emotionally based decisions depending on how nice, thoughtful or loving individual patients are. They are trained to make clinical decisions which is exactly how it should be. And yes, I have friends and family who are doctors and have worked in the health service too.

@Lougle. I never at any time said OP would not be selected for ventilation. I said she would but was less likely to survive regardless because of her morbid obesity. Im sure enough beds will be available if the peak is depressed enough

"I said she would but was less likely to survive regardless because of her morbid obesity."

But why would you say that? Just because you know something, that doesn't mean you have to volunteer it when it serves no good purpose. That aside, it's only a statistical probability. I used to do audit in our ICU and every month we'd have "stunning survivors" (patients with >50% mortality prediction who went on to survive). Every month we'd review the cases of patients who died despite having incredibly low mortality predictions. It's not straight forward.

Op whilst it is true that doctors will chose who gets treated based on best likely outcome you still have a very small chance of becoming seriously ill from this virus. Please don’t panic. Practice social distancing and good hygiene. Even in the over 80s, the highest risk group, about 80% will recover. We are taking it so seriously because no one has immunity, making it a big public health crisis if a large % of the population becomes infected but the risk to individuals remains very low.

Bless you op

Ignore the hate.

Stay home and stay safe with your dc.

Try not to worry.

FWIW I have a complex history with thyroid and have experienced the extremes of low and high thyroid hormones in my body. From these experiences alone I am so humble as the human body is so unique and so susceptible to small hormonal changes that can create huge changes in appetite and weight.

For me alone I have had rapid weight gain and loss and sudden onset of extreme increase of appetite. These experiences can only really be understood if lived so people should not judge.

For all those trying to lose weight, I wish you good luck. It's not easy, but it can be done and I think all this wll be a wake up call for many (fingers crossed this includes my best friend)

As someone who has lost 7 stone in the last 5 years, I would say just take each meal at a time. Don't get overwhelmed by the amount of time and effort needed. Every time you make a healthy choice and at the end of each day you stay within your calories brings you one day closer

@Goatymcgoaty people with higher BMI also have more fat in the soft tissues of the jaw/neck, which can affect the position of the larynx/trachea, making it harder to get a tube in. They also desaturate (drop oxygen levels) much quicker so if you're struggling to get the tube in things get critical quickly.

But it doesn't end with getting the tube in. People with a higher BMI are then harder to ventilate - the weight of fat on their abdomen and chest means you have to use higher pressures to get adequate volumes of gas into the lungs, and high pressure ventilation is not good for the lungs. They're also harder to get IV/arterial lines into, including sometimes central lines (big ones in the jugular/subclavian/femoral veins). And higher risk of other complications like pressure sores despite nursing staff's best efforts.

However, in normal circumstances, this wouldn't stop us admitting someone with a high BMI to ICU, or ventilating them. We'd still give them as good a chance as we could. What we don't take into consideration is how many kids someone has.

I got bored of people being nasty to you by page 2 so sorry of this question is over/ has been answered.

You walk miles every day, you run a household, you are young, your medications are for MH reasons (not for multiple serious medical problems)
These are all positives. You wouldn't be stopped from being vented because of your weight alone. Makes it trickier but far from something that outright stops you from getting your foot in the ITU door!

From what I read half the people on here were humble bragging or telling you to diet. Just pointless and cruel.

I wouldn’t think being a parent has anything to do with the choices they make.

It is about how likely you are to recover. You could have all the kids in the world and still be a waste of resources.

@dreamALittleDreamofMe - 'A waste of resources'?! What a nasty thing to say!

Remember - just because you have a high BMI does not mean you will necessarily need hospitalisation, and not all who are hospitalised need ventilators. xx

OP, but here is the thing: you don't need people's sympathy or understanding at all.

It's irrelevant whether they have it in them or not. It's completely irrelevant what they think and you need to stop looking for validation.

What you need is to focus on yourself and do the right thing for you. This depends entirely on you and you need to find the strenght to do it.

The reality is no matter how big or small you are, there will always be people who won't be supportive or understanding of your past. I had PTSD before after an assault, been through baby loss and a fair share of shit too, but the thing is if you're unhealthy weight because of the stress past events have caused you then you are the only person who can change this. It really does not depend on anyone else.

I'd like to reiterate my point from earlier that our nation does care about our high risk people, so much so that we are all taking unprecedented steps to protect them. Our government places that amount of value on vulnerable people and is trying to support them to stay healthy. I do not believe either that medics make triage decisions 'coldly' if these decisions must be made its the last thing they would want to do. They want to to save their patients and they believe every one counts that is why they work so hard and put themselves at risk.

So I hope the OP knows that the nation stands with her in her struggle to stay well and take care of herself. Even though many of us are self isolating right now we are actually all working together more than we have before, and that is the reality of this situation.

It's just how it is, op. I have severe asthma, I won't find a bed at ICU either. Having kids won't swing the balance for me nor for you. It's not personal or malicious. It's just how it goes.