my 600 pound life i'm curious how it
compares to the other show that we've
watched family by the time hate the
names of these shows but let's see what
it's got huge thank you to ziprecruiter
for sponsoring this video
one
two
one
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 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 because bacteria can get
trapped there it's a dark moist
environment most of the time and 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
lymphedema diabetes i wouldn't be
surprised if this is all a result of
metabolic syndrome which can develop
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 legitimate medical conditions she's
unable to take care of herself on her
own so yes bariatric surgery can be a
life changer a lifesaver 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 overweight
[Music]
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 helped me at gunpoint
and i thought i was gonna die a lot of
folks rush to judge people many
feel like fat shaming is appropriate
because they view someone who
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 writing 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
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 foods 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
this shall pass it's a very reasonable
concern to have when someone is of that
size because you're putting tremendous
strain on you every organ in your body
and it's an unnatural strain as well
we're expecting arrival of marlon
mccants
from what i understand she may be close
to 800 pounds
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 eastern she
said i 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
headquarters 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 then 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 lungs
starts dying you could see how that
could quickly become fatal okay
your leg hurt
[Music]
look at that 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 lymphedema
acting up we're gonna run some tests 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 lower 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
d-dimer test and sometimes if they
suspect that the pul the clot has
already traveled to the lungs we can do
a special type of cat scan back to the
show in just a second but first i want
to talk to you about ziprecruiter the
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remember doctor is spelled out all right
let's get back to the show
so that
could potentially mean that one
obviously the pulmonariums that we just
talked about but also 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 pushed her
body to the limit for years
and the car ride 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 vena
cava filter which is meant to be put
into the vein in order to catch and act
like a net four clots that could
potentially leave the lower body and
come up to the lungs so it prevents them
from reaching the lungs now usually we
do this only as a secondary resort
because in patients who have blood clots
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
that that's also been done in the past
as well and i'm currently placing the
filters in the vena cava this is a
delicate operation so we have to do this
very carefully
but it will have the same monolith line
it's important to point out because i
don't think dr now 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 effective
[Music]
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 of having to adjust to a
controlled diet
they've been trying to get me up to walk
i feel like they're pushing me too hard
so one of the orders that we almost
always put in for patients that are
hospitalized for extended periods 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
when someone becomes immobile they get
used to others doing everything for them
all right are we ready
that can be a tough dynamic to change
okay you ready yeah okay let me bring
this one first
but we're going to do what we can to try
you ready
all right the rest will be up tomorrow
push
please
if marlod won't get up
then we can't trade here 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're
automatically a lower risk versus a
patient whose 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 their stomach and also bypass
part of intestine
the stomach is as big as a watermelon
but this operation we're going to use as
a stomach it 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 him very
dysfunctional behavior she's stubborn
like that if she act like a kid you
trick 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
hardened type of mentality it doesn't
work for all people and can actually
have the patient turn against you i'm
hoping that sending your home will be a
wake-up call
[Music]
i wonder why they need doctor now for
this doctor 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 makes sense he's clearly not
being effective in communicating that
message and getting the patient to take
care of her best interests getting
another team member here would go a long
way in helping her perhaps find her
inner motivation to want to stand
up here we go
all right
keep keep pushing your weight down wow
oh okay
all right okay good job marlon yeah
i didn't think i could get up you want
to try it again yeah we can 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 you're
almost there keep going you're almost
there all right
there you go
wow
wow that's great
i'm so proud of myself
makes me feel like i can do anything
about 300 pounds 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 sin
surgery from what i can tell you're not
making much effort 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
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 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
patients in past 40 years i don't
remember i've seen anybody six months
after surgery that hadn't been able to
walk
you're putting me in my opinion is your
base and my agreement okay put me with
nobody else got the bad attitude
and why do i have a bad headache 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
de-escalating the situation i feel you
don't treat me
fair or marlo i can't do any more for
you okay see your primary doctor ask him
tomorrow to find another surgeon because
we are dismissing you from our care the
patient makes a statement i feel you
don't treat me
fair or marlo 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 a negative situation or
dangerous 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 patients i finally
found the clinic here in asheville to
help me keep making progress with my
weight loss
i hope i made it below
400. wow
364. and she's standing ms mccann
nice to see you
well you have made astounding progress
and if you can lose that next hundred
pounds 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 gonna 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
gonna 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 can
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
open-minded 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 marla
mccann
[Applause]
you're not alone you can overcome your
struggles and fears you can overcome you
can do it i did it and 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 marla
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 and again huge thank you to
ziprecruiter for sponsoring this video
as always stay happy and healthy
[Music]
you