Obesity: The Post Mortem Page #5

---

Its not a nice feeling at all.

It makes you feel really low, sad, alone.

[Vinette] The next block of organs

to be removed

are the organs of the digestive system

called the coeliac block.

What I'm trying to do here is make sure

that I've got the stomach

and the lower bowel and the liver and

the spleen all together in one block

for Mike to take a look at,

and not to damage the kidneys,

but at this point, I dont think I am

going to be able to damage them anyway

because they are so surrounded

by such a large envelope of fat.

So we have got some faecal matter,

we have got some bile,

and then obviously a lot of blood.

The blood is mixed in with the fat

which is yellow, so that is giving us

some orangey fluids.

It is a multi-sensory rainbow

at the moment.

Every single thing that is in each of

these blocks is incredibly important,

and, you know, does amazing jobs

for our body.

Its just a case of... It's not very

pleasant once they have stopped working

and they have started to decompose

a little bit.

[Vinette] To completely free the organs,

Carla needs to cut through

the fibrous membrane

that holds them to the spine

at the back of the body.

So this is a huge coeliac block.

It is incredibly heavy and the liver,

as you can see, is taking up most of it.

You can just see the spleen there

and also the stomach

and a bit of the small bowel

is attached as well.

When I first encountered

a deceased person,

I think what really struck me

was just the stillness and the cold

because, of course, I had never,

at that point, felt flesh

that was so cold and it gave me

a real kind of sensation

of kind of dipping my toe

into very cold water.

And then once I had done it,

that feeling had never quite left.

It was like this other subterranean world.

[Vinette] In the next stage

of the post-mortem,

will we find any evidence of fat damage

in the organs of our donors

digestive system?

This is the organs that include the liver,

the spleen, the stomach and the pancreas.

Now this is much heavier than I would

expect it to be in a smaller individual.

Largely because the liver is so big.

[Vinette] First, Mike is going

to take a look at the organ

that most people associate with obesity.

This is the stomach.

Basically, just like a bag that holds the

food before the food goes through

into the bowel

where it is actually digested

and there are actually many

of the treatments associated

with obesity deal with the stomach

and what they try and do is reduce

the size of the stomach

so that people have a feeling

of being satisfied

from eating without eating so much.

There is a whole variety, gastric bands

fit around the stomach,

there is various bypass operations

and so forth.

The stomach is very good at dilating,

so if this lady had had

a very large meal before she died

and had not had opportunity to digest it,

the stomach would be much more obvious.

But this is a fairly typical

sized stomach.

[Vinette] Next Mike

will dissect the liver,

the organ he discovered showing

such dramatic change

when he saw it in the open body.

But what will it reveal to us

about the consequences of fat

building up where it shouldnt?

The first thing I saw

when we opened the abdomen

was the size of this liver and the fact

that this liver showed marked

fatty change.

I am going to make some slices

through the liver

just so I can see what the cut surface

of the liver looks like.

I am using a sponge so I dont cut myself.

So I have made some cuts across the liver

there, and you can see

that the surface of the liver

is this sort of pinky colour.

That is very characteristic of fatty liver

change. It is very soft.

It almost feels like pate in consistency.

Normal liver is quite soft,

but not as soft as this

and it has a much meatier,

much redder, bloody colour, dark red.

The lightness in this is caused

by the fat within the liver

and the fat is deposited

within the hepatocytes,

which are the liver cells,

and this fat would obviously

be pale in colour and the liver cells

themselves are

dark so the combination of the two gives

you this light sort of pink colour.

That's much, much lighter colour than

you would expect a normal liver to be.

That is a classic sign of fatty liver

disease and is becoming a major problem

and is one of the major reasons

for a liver transplant in the world.

The most common cause of fatty liver

at the moment is alcohol-related

fatty liver, but we know that this lady

drunk almost nothing,

so it is very unlikely that this change

is due to alcohol consumption.

It is almost certainly

an obesity-related change.

Fatty liver causes damage to the liver.

It can lead on to cirrhosis,

it can actually lead on to cancer as well.

But even if people do not develop

cancer or,

it can lead to liver failure, so there is

multiple ways it can lead to the death

of a patient. It didnt lead

to the death of this lady

really because her heart was

itself so bad,

but this is very dramatic change

within this liver.

[Vinette] Before the post-mortem,

we could never have known how dramatically

damaged our donors liver would be,

or that she'd be carrying a

second life-threatening disease.

But excess internal fat

doesnt have to be a death sentence.

The good news is the fight to beat the

dangerous invisible fat can be won.

It is a daily struggle,

but the prize is big.

Now I am trying to lose weight. I have

actually lost three and a half stone.

I am in a weight management clinic,

I get support from a dietician.

I get support through weekly weigh-in's

and I get support from a counsellor

which is really, really handy

to help with your mental frame

of mind as well.

So what I have been doing to lose weight

is cutting out the chocolate,

cutting out the biscuits,

cutting out the crisps,

all that sort stuff.

I am not perfect.

I still have the take aways,

I still have cheeky bar of chocolate,

but, you know, I have also been

exercising a lot more

and really pushing myself to exercise,

really pushing myself to get to the gym.

[Ben] Tons of activity. I struggle.

I try and get in an hour of walking a day,

but I dont always manage it.

Just walking around the park half a dozen

times doesnt really do it for me.

You know, I dont like running and

I have a problem with my knees.

To start jogging around a park is not only

just a physically difficult thing,

but it is an emotionally

difficult thing to do.

To get out there in running gear

for all the world to see

some parts of your body jiggling

that you just dont want

them to see sadly.

I have had gym memberships up the wazoo.

Ive done detoxes for 22 days,

just drinking lemon juice, cayenne pepper,

water and a bit of maple syrup.

Its disgusting, I can tell you.

I have tried a lot and I will

probably end up trying more,

but I think slowly getting better

and making better choices

is really where it is all about.

Rate this script:0.0 / 0 votes