Obese patients pose weighty problem for German hospitals

April 13th, 2008 - 10:19 am ICT by admin  

By Irena Guettel
Hamburg, April 13 (DPA) Obesity specialist Oliver Mann is used to patients who are so fat that the operating table buckles under their weight. But the woman the surgeon operated on recently at the University Clinic in Hamburg set a record - she tipped the scales at 350 kg. “A few years ago such patients were an exception. This year we’ve had five or six weighing more than 200 kg,” he said.

And Hamburg is not the only city that has to deal with such a weighty problem. “It’s a trend that is causing growing concern in Germany,” said Daniel Wosnitzka, an executive with the Berlin-based Society of German Hospitals.

A glance at the statistics shows just how much of a problem obesity has become. One in two Germans is considered overweight and one in five are obese, according to the Federal Office of Statistics.

Obesity is based on body mass index (BMI) - an individual’s body weight divided by the square of his or her height. People with a BMI of 30 or more are classed as obese, while those with a BMI of 25-29.9 are considered overweight.

One of the worst affected regions is the former communist east of Germany - a fact confirmed by Red Cross paramedics in the state of Saxony Anhalt.

“You have to imagine it like a removal,” sais Dirk Rohra, Red Cross in one of the state’s main cities, Halle. “Some of the patients weigh as much as a piano.”

Often, the paramedics have to call in the fire brigade to help them. In extreme cases, aerial platforms or cranes are used to lift an obese patient into the ambulance.

“The main problem is time,” said Rohra. “Transporting obese patients takes much longer, which can be a critical factor in emergency situations.”

It’s simple things that make life difficult for the medics to provide first aid.

Often, the patients are so fat that the sleeve of the blood pressure measuring device does not fit around their arm. Or they cannot be given an injections because the medics can’t locate their veins.

Once in hospital the doctors usually make small incisions in the patient’s flesh. While two assistants pull the mass of fat apart, the doctor is able to insert a needle into the exposed vein.

For Mann, performing surgery on such patients is hard work - not just physically. “I am usually much tenser, because I always think what might go wrong,” he said.

When operating on the stomach, the layers of fat often impair his view of vital organs and arteries. He has to take immense care to ensure he does not inadvertently damage them.

Computer imaging is not much help. Above a certain girth, the patients won’t fit in the cylinders used for magnetic resonance imaging or CT scans. And regular ultrasound does not go deep enough into the bodily tissue.

To overcome this, the German company Siemens Medical Solutions is developing bigger cylinders for use in scans and ultrasound equipment with a wider range. The company says demand is growing, particularly in the US.

Another German firm, Sizewise Rentals, specializes in providing hospitals with extra-wide and stable beds, walking aids, wheelchairs and pulley systems to lift heavy patients.

Turnover grew 40 percent last year, according to the company’s managing director, Uwe Gabler.

Mann’s clinic in Hamburg had to rent a special bed to accommodate his heavyweight woman patient, although this won’t be necessary in future.

At the end of the year the hospital is moving into a new building in which beds and operating tables will be able to accommodate supersize patients.

The doctor says the operating tables will be able to put up with 350-kg patients without buckling. One can even handle weights up to 500 kg.

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