Clinical Assessment
Saturday, September 24, 2011
Today’s post is another excerpt from “Best Weight: A Practical Guide to Office-Based Weight Management“, recently published by the Canadian Obesity Network.
This guide is meant for health professionals dealing with obese clients and is NOT a self-management tool or weight-loss program. However, I assume that even general readers may find some of this material of interest.
CLINICAL ASSESSMENT
Obesity affects virtually every organ system, and a comprehensive history and physical exam is an essential first step to treatment. Chapter 1 outlined the prerequisites for office set-up, for putting obese patients at ease during the clinical encounter. Body size can make physical examination difficult, reducing the clinical sensitivity of palpation, percussion, and auscultation. Severely obese patients may take longer to undress and may need assistance putting their clothes and shoes back on. Excessive sweating and limited physical hygiene due to difficulty in reaching all parts of the body may pose further embarrassment. Simple requests such as providing a urine or stool sample may be physically impossible for patients who cannot access their private parts. Clinical assessment includes determining the patient’s degree of obesity, which affects their risk of co-morbidities. A number of tools can be used in combination to avoid some of the shortcomings each method has on its own.
© Copyright 2010 by Dr. Arya M. Sharma and Dr. Yoni Freedhoff. All rights reserved.
The opinions in this book are those of the authors and do not represent those of the Canadian Obesity Network.
Members of the Canadian Obesity Network can download Best Weight for free.
Best Weight is also available at Amazon and Barnes & Nobles (part of the proceeds from all sales go to support the Canadian Obesity Network)
If you have already read Best Weight, please take a few minutes to leave a review on the Amazon or Barnes & Nobles website.
Saturday, September 24, 2011
I hope many physicians and other health care givers read this book. Providing a size-friendly office space would make it so much easier for those of us who are obese – from having to squeeze into the chairs in the waiting rooms, all of which have arms, to trying to get on to and off of the narrow examinations tables. I avoided getting a pap test for many years because it was so difficult to get into the proper position, especially to “move down just a little bit more” to get my feet in the stirrups. And those little paper gowns – what can I say. I even bought my own blood pressure taking equipment which I take to the office because their cuffs are too small. My physician is understanding and sympathic but the office space could be more size-friendly.