600-pound man needs specialist’s care

Dear Dr. Gott: My 38-year-old son is 6-foot 6-inches tall and weighs about 600 pounds. His blood pressure ranges around 125/75 and his cholesterol around 120. He has at least five severely damaged discs in his back, and four years ago he had a severe infection of the panniculus. Since then, the area has filled with fluid and sags near his knees. Aside from being extremely uncomfortable, infection occurs or threatens constantly, necessitating vigilant care. We’ve made inquiries regarding help with the obesity, but the local diet clinic doesn’t take anyone weighing over 500 pounds, and the cost is too prohibitive anyway. You represent our last resort.

Dear Reader: Although your son is tall, he suffers from massive (morbid) obesity. In particular, the collection of fat over his abdomen (called a panniculus) has become a source of continuing infection. Fortunately, his blood pressure and cholesterol levels are normal; nonetheless, this amount of weight is certainly dangerous because of stress on the cardiovascular system.

In my view, your son needs to be under the care of metabolic specialists. If he does not qualify for admission to the diet clinic at your local hospital, ask your family doctor to refer you to a teaching center.

I am especially concerned about your son’s panniculus infection. To rid him of this dangerous complication, plastic surgeons may have to perform liposuction to reduce or remove the panniculus, along with an operation to get rid of the sagging skin. Such considerations should be part and parcel of his evaluation in a medical center.

Because your son’s treatment will eventually include a diet, I am sending you a copy of my Health Report “Losing Weight,” which includes my no-flour, no-sugar diet. Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: I’m 60 and asthmatic. Each time I catch a cold, it turns into bronchitis. Is there anything I can do to prevent colds and bronchitis? I get an annual flu injection and take 2,000 units of vitamin C daily. This isn’t enough.

Dear Reader: Unfortunately, patients with asthma are more prone to serious upper respiratory infections such as bronchitis, which may trigger an asthma attack or inhibit breathing. Asthma is caused by over-reactive airways (breathing passages) that are especially susceptible to irritation in the form of infection (colds and so forth) or inhaled irritants (pollen, smoke and the like).

Your best bet is, in my opinion, to use antibiotics for even trivial respiratory infections. In this way, you may be able to head off more serious trouble. I’ve been told that doctors in England routinely prescribe low doses of antibiotics throughout the winter months to their patients with asthma who tend to suffer repeated bouts of bronchitis. The strategy appears to work.

Ask your doctor to suggest a plan for you. He may buy the antibiotic approach, or he may simply recommend that you use inhaled medicine (Proventil and others) when your breathing is compromised.