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Dr. Charogat
Dr. Charogat, Doctor
Category: Medical
Satisfied Customers: 1803
Experience:  Licensed in both NYS and NJ with experience in surgery and medicine.
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My 67 year old husband who is very obese (30st) he has several

Customer Question

My 67 year old husband who is very obese (30st) he has several problems, arthritis in knee's hip's back etc; He was told he needed a new hip 7 years ago but at that time was told by the GP who dealing with his case that although she could refer him to a surgeon the outcome of the meeting would ultimately be for him to try to reduce his weight significantly so it would be up to him to diet. The downside of that was he was not big eater and did not eat a lot of fatty foods. His weight problem stemmed from alcohol for several years. He gave up drinking 15 years ago and has not touched a drop since....he just did not feel like drinking again from that time. He did go on to eat a lot of crisps and fizzy drinks and is possibly the reason he can't shift the pounds easily. Since then he now is house bound, has problems with his bowels (loose stools) and often has been unable to get to the toilet in time, also he often cant make it the toilet to empty his bladder. He has medication to help him from needing to pass urine frequently. He uses a Zimmer frame all the time, I have to wash him and help him dress and stop him from laying on his back, has a C-pap machine. I feel I had to give you as much information to his background health issues. Two day's ago 08/11/2014 he bled from his navel. I want him to phone his doctor to let them know as I feel it may be due to his weight as you can't even see his nave as it is so deep set. There is some sign of blood in his stools and has been invited to a Endoscopy but he at the time phoned to explain that due to arthritic complaints and significant weight it would be impossible for him to even get onto the table and he would be embarrassed if there were not any gowns to cover his dignity. He is very disabled now. Could you give me any reason for him not contact his GP as to why he is bleeding from his navel? I feel he must. And could you tell me what may be the reasons why he is?
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. Charogat replied 2 years ago.
Dr.Customer:

Hi, and thank you for coming to JustAnswer.com with your question.

Dr.Customer:

First. When someone is morbidly obese then it is harder for them to lose weight that for a person who is closer to a normal weight. Their metabolism shifts somehow to a lower gear. This means that even if he isn't eating that much, it will still take a while for the weight to go down.

Dr.Customer:

As the doctor said, the first thing he has to do is lose weight.

Dr.Customer:

It sounds to me like he might need to go to a clinic (for inpatient treatment) that specifically deals with morbid obesity.

Dr.Customer:

This is a copy/paste from the US National Library of Medicine / National Institutes of Health

Dr.Customer:
Gastroenterol Clin North Am. 1987 Sep;16(3):443-9.

Treatment of morbid obesity by nonsurgical means: diet, drugs, behavior modification, exercise.



Abstract



Treatment of morbid obesity requires that the patient should achieve a negative energy balance of at least 350,000 kcal. Dietary treatment under metabolic ward control in time achieves any desired weight loss, but few morbidly obese patients can maintain dietary restriction for long enough as outpatients. The objective of both surgical and nonsurgical treatments is, in effect, to encourage (or force) the patient to diet. Drug treatment and exercise are ineffective in long-term massive obesity, but behavior therapy or jaw-wiring followed by the fitting of a waist cord can achieve worthwhile weight loss maintained for 3 years of follow-up.




PMID:
3325425
[PubMed - indexed for MEDLINE]
Dr. Charogat and 2 other Medical Specialists are ready to help you
Expert:  Dr. Charogat replied 2 years ago.

As far as the bleeding from your husband's navel. I think at his present weight it is not possible to see exactly where the bleeding is coming from. Even if you can find the area of the naval it would be hard to determine what it is coming from.

The most worrisome thing about this is if he has an open wound (however small) that is causing this bleeding. He would have a very high chance of getting celulitis
- an infection of the skin - which would be hard to treat at his weight. It is important for him to see his doctor and/or a doctor specializing in obesity in order to figure out what exactly is going on.

Please let me know if you have further questions.

G-d Bless

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Customer: replied 2 years ago.

He already has cellulitis on both of his legs and are very swollen and has been treated for weeping on his legs from infection. I thank you for your input and will try to persuade him to talk to his GP. This will be my last time on this site. Again I thank you.

Expert:  Dr. Charogat replied 2 years ago.

Please know that you can come back at any time to ask questions. There are no additional charges (I see you've already paid the fee) for continuing to ask questions about this.

Wishing you all the best.

G-d Bless