TLC continues to produce shows with titles that I am not a big fan of. Previously we reacted to Family By The Ton featuring Casey, ...

the-grim-reality-of-life-at-800-pounds

The Grim Reality Of Life At 800+ Pounds

my 600 lb life I'm curious how it compares to the other show that we've watched family by the ton hate the names of these shows but let's see what it's got one two 1 two 3 repositioning is of utmost importance especially when you're uh overweight to this degree because you start putting pressure on certain areas of your skin your muscles your bones you could develop pressure ulcers those can get infected becomes very very complicated to treat I have no life my legs can't even hold my weight anymore that's why it's so important when we talk about someone being obese or being overweight we talk about their quality of life being equally as important at the as their state of health and their risks that they face my weight has condemned me to this bed I can't do anything I can't even bathe myself it's really important that you clean within the skin folds as well cuz bacteria can get trapped there it's a dark moist environment most of the time and as as a result fungi thrive in that type of environment so not only do you have to wash it well but you have to dry it well as well I have arthritis gout lymphadema diabetes I wouldn't be surprised if this is all a result of metabolic syndrome which can develop uh from being overweight to this degree you know a lot of people when I even talked about bariatric surgery on some of my past videos were quite critical of me for saying that that bariatric surgery can be an option for somebody but for somebody like this who is struggling to move around because of arthritis because of legit imate medical conditions she's unable to take care of herself on her own so yes bariatric surgery can be a lifechanger a life saer in many cases while I don't think it's appropriate in all cases far from all cases I think you need to be open-minded that in medicine the selection for the treatment depends on the individual patient in front of you and this patient for now at least it makes sense as a kid I was never [Music] overweight it wasn't until my early 20s that my weight started to be a problem I tried to break up with my boyfriend at the time he lost it and he took me hostage he held me a gun point and I thought I was going to die a lot of folks rush to judge people many feel like fat shaming is appropriate because they view someone who who uh is obese as lazy people have true problems medically related and psychologically related this person dealt with a traumatic situation and perhaps that is the cause of the start of this condition so to judge someone unfairly just by simply reading them off as lazy is unfair and that's why we're against fat shaming on this channel I was too scared to leave the house and I lived in constant fear and I just ate I'm a Junk Food Junkie A lot of times when you eat those types of food FS they can increase temporarily some neurotransmitters in your brain that help you feel good so it almost becomes a type of self-medication when you start binging foods like that especially the junk Foods she don't lose the weight I'm afraid then she'll pass it's a very reasonable concern to have when someone is of that size cuz you're putting tremendous strain on your every organ in your body and it's an unnatural straight as well we're expecting arrival of Marlo M from what I understand and she may be close to 800 lb if she's that big and she should have used bariatric Ambulance with medical care to go with her she should not have come to East on her own she should have waited for a safer option yeah I agree but at the same time that safer option may be unaffordable to most people that's why as a doctor you can't just make recommendations you have to make recommendations with the patient in mind do they want to do this can they afford to do this is this service even available to them I can already see that she is in one of the worst condition hand FES I ever seen for a prolonged trip like that with lack of Mobility her chance of developing a blood clot goes through the roof and why is that dangerous because a blood clot is more likely to happen in the lower extremities than if that clot travels in the circulation back to the heart and then to the lungs and gets stuck there you develop a pulmonary embolism which cuts off blood supply to the lung and essentially that part of the lung starts dying you could see how that could quickly become fatal I can't move my leg your leg H look I got a little bit swelling huh well that swelling could be as a result of the DVT that clot we just talked about or it could be her lymphadema acting up we're going to run some test to find out what may be going on with you the test that they're usually running in these situations would be a Doppler ultrasound of the low extremities which is an ultrasound to check for blood flow in the lower extremities to see if everything's opened if all the blood vessels are open and then also a dher test and sometimes if they suspect that the P the cloud has already traveled to the lungs we can do a special type of cat scan okay so that could potentially mean that one obviously the pulmonary that we just talked about but also um a lot of stress on her heart something could have happened there congestive heart failure wise but also patients that are of her size do develop sleep apnea where they stop breathing for periods of time but usually it's not to the point where their heart stops as well she put her body to the limit for years and the car right down was just too much for her to handle we need to get her to surgery immediately to put a filter in here so what he's talking about here is an IVC filter which is an inferior vein a Cava filter which is meant to be put into the vein in order to catch and act like a net for clots that could potentially leave the lower body and come up to the lungs so prevents them from reaching the lungs now usually we do this only as a secondary Resort because in patients who have blood cloths we usually put them on blood thinning agents unless there is a true contraindication for starting the blood thinners or that they scan her legs and they see so many clots there that they don't even think that they can dissolve them in this case I'm not sure why they decided to go with the IVC filter instead of blood thing agents but they could be doing both at the same time uh that that's also been done in the past as well and I'm currently placing the filed in the v this is a delicate operation so we have to do this very carefully but will have same moned life it's important to point out cuz I don't think Dr na is making this very clear this isn't the treatment to save her life this is a treatment to prevent another clot from happening and dislodging again going to the lungs and also it's not 100% [Music] effective that's a very aggressive diet I don't know if she needed that aggressive of a diet right off the bat even eating 2,000 calories a day would cause weight loss I don't think you needed it to be so extreme outside I have to adjust to a controlled diet they've been trying to get me up to walk I feel like they're pushing me to hurt so one of the orders that we almost always put in for patients that are hospitalized for extended period of time is ambulate with assistance ambulate at least from out of bed to chair because that allows the patient to decrease the likelihood of developing clots it helps facilitate the recovery starts working the cardiovascular system because a patient who's so deconditioned meaning not used to moving around needs to gradually work their way up in order to return to be able to have some level of Independence hi when someone become immobile they get used to others doing everything for them all right are you ready that can be a tough Dynamic to change okay you ready yeah okay I'm bring this one first but we're going to do what we can to try all right the rest will be up Tom Marlo P fall please it's okay we got if Mar won't get up then we can't treat her yeah being able to move and carry your own body weight is very important in order for to have success of any surgery because again you need to have your heart strong enough to be able to do that part of my risk stratification for pre-operative screening is finding out what a patient's activity levels are like what are they able to do for example if a patient actively exercises they automatically a lower risk versus a patient who sedentary doesn't exercise gets winded just by walking a block that patient automatically becomes higher risk when I say higher risk I mean higher risk for their heart stopping like that's the risk I'm talking about I'm going to go ahead and perform weight loss surgery because outside of this she has no hope gastric bypass surgery will reduce SS of stomach and also bypass part of intestine the stomach is big as a watermelon but this is how pression we're going to as aaku is has a small orange this sounds and looks barbaric because it is but it's an extreme measure to potentially save a person's life this is why we don't recommend bariatric surgery from someone who's only somewhat overweight every treatment has risks in fact if a treatment doesn't have risks it likely in the beginning never had any potential benefit anyway Marla is demonstrating very poor attitude and very poor response this is in very dysfunctional Behavior she's stubborn like that and she act like a kid you Trigg her like a kid it's a very controversial way to be a physician I find that I've had success with other motivational techniques making a healthier connection with your patient using motivational interviewing techniques granted it doesn't work all the time patient needs to know there's consequences for their actions you could tell the doctor now is getting a little bit offended getting a little irritated pulling yourself out of that situation is probably ideal because now while you're using this old school like Harden type of mentality it doesn't work for all people and can actually have the patient turn against you I'm hoping that Senor home will be a wake up [Music] call I wonder why they need Dr now for this Dr now is not a rehabilitation specialist maybe getting her in with a mental health specialist would have probably been the best thing here and while Dr now could be a great bariatric surgeon he's clearly not a mental health specialist he's clearly not a rehab specialist and while all of his advice medically Mak sense he's clearly not being effective in communicating that message and getting the patient to take care of her best interest getting another team member here would go a long way and helping her perhaps find her inner motivation to want to stand up here we go all right keep keep pushing you w okay all right good job Marlo yeah I didn't think I could get up you want to try it again yeah this is the time and tested true method time tested true true time tested method of motivation doesn't come first it's doing the action and then the motivation follows like her saying I want to do it again keep going keep going keep going keep going you're almost there keep going you're almost there all right there you go wow wow that's a great good job I'm so proud of myself makes me feel like I can do anything about 300 lb less huh can you tell the difference yeah breathing is probably easier for her because your lungs cannot fully expand against all of that excess skin weight and as a result parts of your lungs actually die off through a process called atelectasis so when can I get Skin Surgery from what I can tell you're not making much of for to get better that's your opinion I don't think I have a very good um understanding with you and you don't have one with me I think that's a very fair assessment he's jumping to conclusions it seems like all the time as a doctor you need to be doing this as as a team like a collaborative approach not just with you and the patient but you the patient the physical therapist you have to be getting the reports if the reports were coming in from the physical therapist that patient's not interested in doing this that's one thing but my suspicion is he's making assumptions based on her weight or lack of progress now you need to be investigating this lack of progress where it's coming from you can't just make assumptions in 5,000 patient in past 40 years I don't remember I've seen anybody 6 month after surgery that haven't been able to walk you're putting me in my opinion is BAS a you can't put me with nobody else you got a bad attitude why do you have a bad attitude time out doctor now separate yourself you can have this same exact conversation same theme same message that he's trying to get across without ever getting mad you are literally doing the opposite of deescalate the situation I feel you don't treat me fair or I can't do anymore for you okay see your primary doctor ask him tomorrow to find an a surgeon because we are dismissing you from our care the patient makes a statement I feel you don't treat me fair or right you need to explore that as a physician what do you mean by that patient will say I want this Skin Surgery and you're not giving this to me I can then say to the patient I would love to give you the Skin Surgery but I know that if we do it before you start walking ultimately it's going to harm you my goal here is to treat you not to treat your skin it's to make you as healthy as a person as possible and not put you into negative situations or danger situation isn't that what you want for yourself as well you see how we just all got on the same page that might not work the first time that might have to take multiple things but that's why you got to be patient you got to be patient with your patience I finally found a clinic here in Ashville to help me keep making progress with my weight loss I hope I made it below 400 lb 364 and she's standing miss m how you doing nice to see you well you have made astounding progress and if you can lose that next 100 lb then you can have all the extra skin taken off if you do the Skin Surgery also too early you then still lose more weight you'll need more surgery means more scars more complications you also have to be understanding that Having excess skin makes it challenging to mobilize and move around be understanding and say I understand that this is terrible but we're going to have to keep moving through this so what ways can I help you maybe you can get them outfit recommendations compression stockings whatever it is to try and help your patient achieve their goals once I get this skin off of me and nothing's holding me back anymore I'm going to travel and see the world genuinely her life has changed her opportunities have expanded greatly and I'm not talking about her opportunities to travel the world that's cool but her ability to move to the kitchen her ability to prepare food for herself that if one of her kids gets sick she could still care for her daily needs imagine that if one of her kids can't come she would have to not be able to shower and potentially get infections then get hospitalized it's not a quality of life that is reasonable so that's why bariatric surgery absolutely needs to exist at least for now we need to be openminded finded to its risks and be aware of its risks and not overuse it as a treatment we can't wait to show you how she looks now please welcome Miss Mara mccan wow you're not alone you can overcome your struggles and fears you can overcome you can do it I did it you can do it post-traumatic growth right there someone went through a terrible situation both initially with her partner but now also a traumatic situation with her weight and now she's a role model for people she's using that trauma to to grow from to help others grow yay I'm team Marlo actually not too long ago I was accused of being fat phobic on Reddit click here for that video where I sort of explained my stance I think it's a worthwhile watch as always stay happy and healthy [Music]

Dr.

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