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Ideal Weight & Tube Feeding
Jun 13, 2002

Dear Dr. Fields-Gardner,

Thank you for your quick response to my last question. In your answer (below), when you say "tube feeding" or "feeding directly into the veins," do you mean via an I.V.? My niece is still not eating properly, and just keeps getting thinner & thinner. (We all believe she is now under 75 lbs.)

When I talked with the doctor's office today, it turns out she is now anemic, and they have ordered two pints of blood for her. At the time she gets the transfusion, they will weigh her, also. However, since she does not have insurance, the office let me know that putting her in the hospital for wasting or on some type of I.V. (either at home or in the hospital) is not an option since she does not have insurance. They said the AIDS Foundation grant will not cover this type of expense.

What is the "ideal" weight for someone with a very tiny bone-frame, 5'3"? (She was 5'4" or 5'5", so I'm being conservative with her height.)

Thank you so much for your quick response.

Sleepless,

Dear Sleepless, Even at 95 pounds, she was pretty light weight. So, in this case, I would say that more aggressive measures might be needed. Talk with her doctor about the possibility of nutrition support... this may mean tube feeding or feeding directly into the veins, depending on how well the gut functions.

The body tends to "shut down" when it reaches around 60-66 of normal weight or, more specifically, when the body cell mass (muscle and organ tissues) reach a low of around 55 of ideal. So, at this point, the problem should be urgently addressed with all the precautions that are normally put into place for such feeding styles.

Response from Ms. Fields-Gardner

Tube feeding is through the gastrointestinal tract and "TPN" is directly into the blood. If your niece does not have private insurance, you can be looking into federal and state funded insurance (Medicare, Medicaid, public aid, others) to cover such therapies as needed. Talk to your niece's case manager/social worker to make some of those things happen immediately.

As for ideal weight, the equation we typically use for women in the U.S. suggests 100 pounds for the first 5 feet of height and 5 pounds for each inch of height over 5 feet. For a small frame, we can subtract up to 10% and for a large frame we might add as much as 10% for expected weight. For your conservative estimate, that makes her ideal body weight 103.5 pounds. You can ask for a referral to a dietitian to make sure that you get the right estimate.

While you are making things happen for your niece, check into some calorie-containing supplements. You can look at simple ones from the grocery store to add calories, like instant breakfast. You can even use "diet" supplements to add needed calories!

Overall, it sounds like this is going to take some work on the part of relatives and friends to make things happen for your niece. Get a good case manager from the doctor's office involved who knows how to get through the confusing system of coverage and resources and be persistent!

Best wishes to you in your upcoming work on behalf of your niece!


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