My sister has CHF!

[minkydog]

I just found out that my sister was sent to the doctor with severe pitting edema, shortness of breath and BP 168/105! They did a cardiac workup and most of her stuff was okay--cholesteral/trig are suprisingly low, cardiac enzymes normal. Still waiting on the echo results. Chest xray reveals an enlarged heart and she says "some test" should have come back <100, but its 189. She's only 51. But she is terribly obese. Now I'm not skinny girl myself, but she weighs over 130-lbs more than I do Like, well over 350-lbs

This summer we had the opportunity to talk frankly about her weight, the fact that her feet and knees are so painful she has to sit down every 50 yards and she's so tired and out of breath all the time, and I strongly suggested that she consider weight loss surgery. She had a million excuses--she can't take time off from school, "there's not a doctor in Mississippi who does it"(which I don't believe), she's got a vacation coming up, her daughter has a golf tournament, she'll go to a nutritionist, blah blah blah. She says her weight doesn't bother her, that she is very healthy just "big." Whoa, sista! You passed "big" about 200-lbs ago! DSis is in total denial and it's about to kill her! Her husband matches her pound for pound, too. And her 11yo daughter out-weighs my DD16(no wonder, all the kid eats are chicken nuggets and french fries. Nothing else. Except candy, soda, and ice cream.)

I am just worried to death about my sister. I dont think she will listen to me. You know what her response to the doctor was? "That's what happens when you hit 50." Uh, no it's not. Its what happens when you abuse your body to ridiculous extremes. Don't act surprised when you body fails you. Part of me is scared for her and part of me is mad at her. I wish I could just shake some sense into her!

[teacups]

I dont know how you can convince her to see it your way. It seems like one of those things that the person has to see or be ready to see on their own. I dont know... have you checkd out any sites where the actual obese people chat... and maybe ask them for advice? I'm sure they'd be more than willing to give you some advice. Who better?
I know this must scare you.

[Namsupak]

Unfortunately Mississippi and our state of WV have some of the highest rates of obesity. The lab test you are mentioning in your post is BNP (Brain Natriuretic Peptide). And yes 189 is too high. From your description of her response to the doctor as well as the family situation it also seems like your sister would be a non-compliant patient. It is extremely difficult to try and get the super obese to make the lifestyle changes that are necessary or to even understand that something drastic needs to be done. When people get to such a huge positive weight the prospect of losing weight or doing activity seems so daunting. I am not sure of her medical history or her BMI but from your post I would guess she is already at the point of maintaining and gaining weight, she would need both diet and exercise to put her in a negative calorie balance. The best thing for you to do is to be persistent with her. You could try and start an activity or diet regimen for yourself and then try to include her in it. Besides that I always tell these patients that they need to be in charge of their health and that they need to think of family and friends they would like to enjoy life with. Bariatric surgery is certainly an option however if she is not willing to put an work into it then it won't be a great solution for her. Some people think it is like a magic bullet but we follow these patients for years and they will also issues that they need to deal with after the surgery. Best of luck but you are doing the right thing by being concerned, keep at her even though she doesn't want to hear it.

[minkydog]

Originally Posted by Namsupak

Unfortunately Mississippi and our state of WV have some of the highest rates of obesity. The lab test you are mentioning in your post is BNP (Brain Natriuretic Peptide). And yes 189 is too high. From your description of her response to the doctor as well as the family situation it also seems like your sister would be a non-compliant patient. It is extremely difficult to try and get the super obese to make the lifestyle changes that are necessary or to even understand that something drastic needs to be done. When people get to such a huge positive weight the prospect of losing weight or doing activity seems so daunting. I am not sure of her medical history or her BMI but from your post I would guess she is already at the point of maintaining and gaining weight, she would need both diet and exercise to put her in a negative calorie balance. The best thing for you to do is to be persistent with her. You could try and start an activity or diet regimen for yourself and then try to include her in it. Besides that I always tell these patients that they need to be in charge of their health and that they need to think of family and friends they would like to enjoy life with. Bariatric surgery is certainly an option however if she is not willing to put an work into it then it won't be a great solution for her. Some people think it is like a magic bullet but we follow these patients for years and they will also issues that they need to deal with after the surgery. Best of luck but you are doing the right thing by being concerned, keep at her even though she doesn't want to hear it.

Thanks for the info on BNP. I wasn't sure what that was. I''m afraid you're right about her willingness to change. She's so heavy now that even when she does diet and exercise it doesn't last long before she gets discouraged. And let's face it, when you weigh over 300-lbs, losing 20 is a drop in the bucket. She'd have to lose at least 50-lbs so you'd even notice it. She is definitely maintaining and gaining, and seems to have no control at all over her eating.

*sigh* DSis has many health problems, although to hear her tell it she is very healthy. She totally pooh-poohs the significance of her severe sleep apnea, degenerative arthritis in her knees, hips, and neck, depression, plantar faciitis in both feet, and now CHF. She thinks she's "healthy enough" because she doesn't have diabetes*(yet!) Diabetes type1 and type2 are very prevalent in our family and she had gestational diabetes. So it's probably only a matter of time.

GAh! She's only 51.

[Eeyore'sthebest]

If you have any questions about weight loss surgery please do not hesitate to ask me. It was a life saver to me and my only regret was not doing it 3 years earlier. I am almost 2 years out and while I'm not "skinny", I can shop in any store now. And I can participate with my DD in any activity and I can walk every Disney park without having to rest or use an ECV.

And yes, MS does have WL surgeons.

[booger73]

Untreated CHF has a 5 year mortality of almost 50%..

just sayin'.

[minkydog]

Originally Posted by booger73

Untreated CHF has a 5 year mortality of almost 50%..

just sayin'.

I read that just last night when I was looking up some stuff! That's horrifying! DSis is pretty computer savvy so I'm sure she is surfing the web. She did tell me a little bit ago that she intends to seek out a bariatric surgeon, but then she went on to say she can't do it until next summer at the earliest. So I got pretty blunt with her--this is a life-threatening situation. Waiting until summer is not adviseable!