Doctors Say Medical Imaging Devices Can't Handle a 'Fattening Population'

[bemildred]

Super-size me.

CHICAGO — Obese Americans are overwhelming medical imaging machines that now have a hard time peering inside their bodies, doctors reported Wednesday.

"Hospital radiology departments are increasingly unable to adequately image and assess obese patients because of the limitations in current radiology equipment," said Raul Uppot, a physician at Massachusetts General Hospital in Boston.

LA Times

[KurtNYC]

1. Score another failure for product designers

It must be nice to design products without reality intruding. Each generation is getting taller also (hello airlines).

Maybe they are like designer labels that purposely don't make larger sizes. The machines only fit Calista Flockhart.

[SmokingJacket]

2. There are more and more articles that criticize us for our failure to

conform to the MACHINES.

I agree that obesity is a terrible and increasing health problem, but what's with these articles insisting that humans must adapt to machines?

Not sure if I'm even making a valid point here, but something about this freaks me out.

[Sgent]

3. These are some of the health risks

of being overweight. Due to physics, machines such as an MRI have to be enclosed. Although their are open versions, the imaging is much worse and the chance of missing something is much higher. In addition the larger you make the bore, the more radiation your exposed to, and the less the clarity of the image.

For ultrasound (sonograms, ultrasound, and echo) its even a bigger issue. Due to the law of physics, the signals are distorted by fat. The bigger the person, the less clear the image.

As for health in general, complication rates for surgery of all types, recovery from various diseases, and circulation problems are all inherant with larger size.

Even something simple such as drawing blood or starting an IV can be serious in someone extremely large -- requiring venous cutdowns and surgical insertion at times.

[Dear Maggie]

13. Yes, real concerns

Someone commented once that you don't see any OLD people who are fat. Lean means longevity if that's true.

I also wonder about how much of general overweight might be endocrine disruption as there are so many pesticides used now adays that would causes such. In particular, and not often thought of, there was a study on 'chemical alley' in Louisiana and another in Pittsburg ... (somewhere on the east coast) & there was more obesity in that population

There are some jet fuels labeled as pesticides; so that may prove true also for those who live close to airports www.valdezlink.com/jp4.htm

[Marlena]

11. yeah, but...

Folks with a lot of fat on them are also, for example, much harder to operate on. Imaging isn't the only place where health care becomes more difficult when the patient is morbidly obese.

We gotta do something about the way people tend to eat in this country, and, even more impotantly, WHAT they tend to eat. It's nothing short of appalling, and causes significant problems in a wide variety of areas.

[kslib]

4. A personal note

I was about 50 lbs. overweight in college. I had pneumonia requiring an x-ray, and went to the college health clinic. The doctor gave me this skimpy ass gown to change into, and then instructed me to walk over to x-ray, which involved going from the exam room, then crossing the waiting room (full of students)to get to radiology. I was so embarrassed (well, em "bare-assed")! Then when I got there, she was standing in the room, told me to stand against the machine, then pronounced (to the tech and nurse) that I was probably "too fat" to get a good reading. Probably one of the most emotionally charged doctors visits ever. I reported her that day on my way out. There are good ways to discuss weight and bad ways.

[Sgent]

5. Sorry if I offended

I certainly didn't mean to. What was done to you was horrible.

I myself am about 75lbs overweight, and am suffering health effects from it. Unfortunately, physics doesn't recongize the ADA or the 16th ammendment, so for imaging purposes I can't get as good an image as someone just out of boot camp.

That being said, today's imaging is still much better than that of 20 years ago, and it is constantly improving as is all technology. Things will continue to improve, but I think there is a fine line between accomidations and demanding the impossible.

[kslib]

6. No offense!

Just thought I'd share the "other side" I've since lost the weight, but, in a way, I'm glad I was "obese." I'm a nursing student, and I would never want to put any patient through that! I do agree though, for the morbidly obese, it would be unrealistic to make machines that fit them perfectly. I'm not sure, but that may even mean keeping two machines?

[Sgent]

7. It depends...

For instance, by increasing the bore of a MRI by 50%, you have increase the radiation by 400%. Doing this increases the potential for long term harm to the patient due to cumaltive radiation exposure. It also increases the amount of background noise that needs to be filtered out by a factor of 4. Much like using a zoom lense on a camera, the more you have to zoom, you lose clarity and resolution.

Finally, it would be a very bad idea for someone who didn't need it to use such a device -- meaning that in rural areas you would have to have 2 MRI's for every location (there is 1 MRI machine in a 25 mile radious of me). At 3 million a pop, these aren't exactly cheap machines.

Ultrasound is absorbed by fat. Although not as dangerous as x-ray radiation, you run into the same problems in terms of clarity and resolution when you increase the power (again exponentially). Although ultrasound is not thought ot have long term side effects, no-one really knows what the increased movement will do.

Finally, no matter what the changes, it is unlikely that a Cardiologist will accept items like a diagnostic ultrasound (echocardiogram). They are already wrong 20% of the time in normal people -- and by the time you increase the power, etc, you may not have an effective image. They will want to do an invasive procedure if they believe the person is truley at high risk for a clot, etc.

[Muzzle Tough]

8. The 16th amendment.......

.....is the income tax.

Maybe you were thinking of the 14th amendment?

[FM Arouet666]

9. Too FAT for the CAT Scanner

Obesity is a very real problem. Many Americans seem to have the idea that unrestrained consumption is a good thing. The glutton society, giant SUVs using tons of gas, supersize me, biggy fries and a biggy coke, more More MORE..... Having traveled around the world, I see the disgust other societies have for the fat American, being one myself, I know. I see the looks. Order a bucket of chicken at KFC for two people, in Beijing, and I guarantee you will get some stares.

Patients are getting larger every year. It is not about getting a bigger CAT scanner or MRI, it is about getting Americans in better shape. And don't flame me about how I am attacking the obese, I need to lose about 50 lbs, I know it is difficult.

I have had a string of 400+ pound patients lately, and everyone has been difficult to treat. Don't fit in the scanner, or if they do the picture is not much help. Respiratory or cardiac complications after surgery, can't get them out of bed for physical therapy, can't get an IV in them etc etc etc.....

I have witnessed the end result of years of tobacco abuse on the human body, and now see a trend toward the same kind of destruction with obesity. We don't need to adapt technology to meet the needs of giant Americans, we need giant Americans to adapt a better life style.

[kslib]

10. I agree. Whole-heartedly.

I think it would help a lot if doctors and nurses were trained (in school, or continuing eds) on how to approach the subject of weight loss. I've read that many PCPs don't approach the topic because they don't want to offend someone, or they do approach the topic, but in a condescending manner. This might help the problem, a little bit at least, by getting people to move and to eat right. I also think that making healthy food cost effective would also help. I know that fish is better for me than hamburger, but hamburger is a lot cheaper in my small town grocery store. I'm able to buy the fish, but someone who is living paycheck to paycheck may not be able. Same thing goes for salads/veggies v. ramen/mac & cheese, etc. Also, we are a society of go, go, go, and it is soooo much easier to stop at the drive thru, or boil a pot of mac and cheese than to go home and face an hour of cook time after working a 12 hr. shift. Just my 2 cents.

[WildClarySage]

12. I agree, but on the other hand

I'm disgusted by doctors whose every solution for my every health care situation is "lose weight". I had an ear infection which left some minor and temporary hearing loss a few years ago, and when I was having my hearing checked, the audiologist mentioned I needed to lose weight. WTF does that have to do with my ears????

[FM Arouet666]

14. Your correct

I see patients everyday for a variety of reasons. If you present with appendicitis and happen to be overweight, the two are simply not related. I would consider mentioning a persons weight unrelated to a current evaluation as inappropriate.

Also, you mention you are disgusted by doctors, the audiologist is a technician, not a doctor. Which makes it even more inappropriate.

Being overweight is a problem, but it is not the cause of every malady.


Peace....

[WildClarySage]

15. Sorry I suppose I meant a different term.

It was the doctor who was evaluating the results of the test, not the technician administering it.