Month after month, Deanna Isborn
avoided going to the hospital.
Her surgical wounds weren't healing properly and were causing great discomfort, but the memory of her previous ambulance trips so traumatized her that she couldn't bear the thought.
Isborn, 35, weighs more than 600 pounds. She can't walk. Lifting her onto a standard 2-foot-wide stretcher and keeping her from falling off is a monumental task. Two ambulances would be dispatched to her Phoenix home because two crews were needed to hoist her safely in the vehicle. Neighbors would gawk.
"I used to cry and panic and shake," Isborn says. "It was horrible. I had to be medicated one time. The stress of knowing I'm going to get on that little tiny gurney was awful."
Yet by the time Isborn finally decided to see a doctor and called for transportation, Southwest Ambulance had a solution. Two vehicles in the company's Phoenix fleet had been fitted with a winch-and-pulley system in which a wider, stronger gurney is latched to a steel chain and dragged up a retractable metal ramp.
In more evidence that the nation's fast-growing obesity problem is creating practical challenges as well as physical ones, the question of how to transport extremely overweight patients to the hospital is an increasingly pressing concern to ambulance providers.
These "bariatric ambulances," named for the branch of medicine that focuses on obesity, are rare. Southwest Ambulance has them in the Phoenix and Tucson areas, and the nation's largest private ambulance company, American Medical Response, has similarly adapted vehicles so far in Seattle, Denver, Portland, Ore., and Columbia, S.C. Both plan more in other cities.
But that represents a sliver of a nation in which the number of "morbidly obese" - defined as when a person is at least 100 pounds more than his recommended weight for his height - is burgeoning. There are now about 7.5 million morbidly obese adults in the USA, or roughly 5% of adults. That's up from about 4 million, or 3%, in 1990, says the American Obesity Association, an advocacy group.
"Not only are we getting fatter, but we're getting very fat at an increasing rate," says AOA president Richard Atkinson, director of the Medstar Obesity Institute, a research and treatment center in Washington, D.C.
Health problems of the highly obese are only exacerbated if, like Isborn, they don't call because the experience of being transported is so painful, hazardous and humiliating. In many cities, morbidly obese people are placed on the ground on tarps and dragged through their homes or on their driveways before being lifted and slid into ambulances, Southwest Ambulance spokesman Joshua Weiss says.
Another Southwest patient in Phoenix, Edna Thomas, also avoided going to the hospital for several weeks this year until a kidney infection became so acute that her son forced her to do so. That's when Thomas, who weighs more than 400 pounds and is 5-foot-1, found out about the bariatric ambulance, which now ferries her to and from a variety of medical appointments.
"It was fantastic," says Thomas, 53. "It slowly takes you up and puts you in the ambulance, where you don't put that much strain on the (ambulance workers).
"I always felt sorry for them, having to lift a big person like me. Nobody's Hercules."
Accommodating the morbidly obese is a problem hitting more than just ambulance companies.
Atkinson claims the fact that such issues are raised is a reflection of widespread
prejudice against obese people.
