John weighed about 370 pounds when we found him barely conscious in his bedroom, which was filled with empty bags of Oreos, Ding Dongs and Ho-Hos.  There was an empty pizza box on the floor.  In front of the bed was a big screen TV.  John was wearing an Adidas XXXL warm-up suit and was in pain.  He could barely fit on our stretcher.  Once in the rescue truck we were on the way to the emergency department which was about seven minutes away.  Obese people like John have an enlarged heart from years of their left ventricle pumping like a jack hammer.  This causes fluid to back up in the lungs from heart failure. 

With each of John’s exhalations, I could hear he was struggling to breath and becoming cyanotic, a blue color tinging his skin from lack of oxygen.  I tried putting an oxygen mask on John and he ripped it off.  He wanted air… he was starving for air as he was drowning in his own fluid and becoming frantic like a caged animal.  I took a plastic suction tube and tried to clear John’s airway.  John knew he was dying.  He said, “Oh no, not now.  Not this way.”  I was trying to calm him.  “I can’t breathe.  I can’t breathe.”  I turned up the AC and sat John up to relieve the pressure from his lungs.  When he lay flat on his back, it was difficult for him to breathe because of all the fat surrounding his chest and upper body.   Just sitting him up while on the stretcher helped him take a few deep breaths, relieving the anxiety for a few minutes before the surge in adrenaline brought him crashing down again.

We were still three minutes from the ER.  I told my driver, “Bro, step it up! Step it up now!” John’s skin was getting more cyanotic.  I heard the engine rev and the speedometer swept past 55 mph to 75 mph, hauling ass through city streets.  In a split second we could have been cracked by another vehicle coming out of a driveway, not anticipating our speed.  As John tried to talk to me, eyes bulging, he sounded like he was gargling.  Pink-tinged sputum spilled out of the corners of his mouth.  This is what they call pulmonary edema, otherwise known as “the death rattle.”

The cardiac monitor showed a heart rate of over 200 beats per minute.  The beep-beep became one steady, piercing noise.  I looked back at John and knew he’d be gone in minutes.  There was nothing I could do but watch this 370-pound man drown to death in his own body fluid—all because no one ever taught him how to lose bodyfat.  Watching John suffer while having the most advanced life support equipment on the planet in my rescue truck just made me want to vomit.  When I see obese people today I see the crucifixion for them a few years away.

My Turning Point

That was just one of the times I’d witnessed the three-minute rapid onset of congestive heart failure in an obese patient suffocating, drowning in their own body fluid.  It’s a sight that’s etched in my memory forever.

We all have moments frozen in our minds where we said, “WTF am I doing?”  Mine came to me in 1996 as I did my job as a paramedic.  I discovered I’d been lying to myself.  I told myself a bullshit story to justify my existence when I brought a patient back to life who was obese, diabetic, a smoker with heart disease and high blood pressure.  What did I save?  Bake on that for a second.  Did I really save them or extend their poor quality of life?

I just prolonged the inevitable.  I gave a person more years of practicing bad behaviors and a shot at having more obese offspring.  This realization made me want to quit.  What’s the fucking point of saving someone if they don’t change their behavior?  From that moment, working as paramedic lost its allure, the sense of having the Right Stuff.  I actually thought at one time we had a special gift.  I realized that trying to save people who were obese was a curse.

We would get calls to take obese people off the toilet when they got stuck.  That’s right, they barely fit in the shitter.  We would have to take them down flights of stairs in a special harness called a stair chair.  It took six firemen to move one person.  Some became regulars and would get to know me by name because we would make multiple trips a month to their homes. 

I remember one man saying to me, “Russ I’ve tried every fucking diet out there.  I shit you not, bro’, nothing works.  It’s all bullshit, man.  Look in my fucking refrigerator!  Look!  There’s no shit food in there.  It’s all real food, dude, really.  My doctor said I have to go very low fat to get this shit off me once and for all!”

The sad story is, as a kid, the orange juice, milk and cereal spiked his blood glucose and insulin which led to his obesity.  As an adult he never had a shot.  Obese people blame themselves, not knowing the research shows their metabolism works in a different manner than that of a thin person.  Many obese people also have low serotonin and dopamine levels.  These feel-good neurotransmitters spike when we eat simple carbohydrates.  This rise in serotonin and dopamine helps us feel calm and good until the next meal.  Anthropologists have studied the human metabolism for 100 years and learned we are not metabolically designed to eat three meals a day with two snacks.  This habit is a disaster which is killing millions of people worldwide.

Obese people suffer crippling pain because of poor circulation, neuropathy and fatty liver.  How could I help these people?  How could I change their quality of life at 370 pounds?  Asking them to try another diet is like asking them to climb K2 unassisted—it’s just not happening. 

If I wanted to save lives I had to educate these people early before their legs would break open and ooze blood and pus from poor circulation.  I used to rub a small amount of Vicks VapoRub under my nose to cover the smell of gangrene in their feet and lower legs.  It was a sickening stench I’ll never forget.  I used to think, “What does it take for these people to lose weight?  Are they just weak?” 

The Answers for Obesity that Medical Science Ignores

After years of watching obese people die in our rescue truck I came to realize they have been sold misinformation from the medical community about low fat and the importance of the food pyramid.  If they had been taught basic physiology, they would have understood the ketogenic diet could have saved them from years of misery.

I understood food is an addiction and obese people have a different metabolism.  It’s not calories in/calories out.  Trust me, there are a lot of obese marathon runners who train 40 to 50 miles a week and can’t lose one pound of fat.

These are good people that lack knowledge and were doing what their physician, nutritionist and personal trainer told them—and guess what?  All these experts were wrong. What they really need to know is they are severely carbohydrate sensitive.  Yep, a half slice of bread eaten by these people can shut down fat burning for 6 hours.  Think about that… a half a slice of bread can elevate blood glucose for hours!

A true lifesaver would help these people before the heart attack, before the diagnosis of diabetes, before becoming obese, but what would that lifesaver look like?  There was no one in 1996 with that skill set.  Traditional medicine was (and is) broken and controlled by Big Pharma.  The government food pyramid killed more people than all wars combined, and the liquid candy makers are taking us all to the next level of metabolic syndrome.

Realizations like this are what led me to my path and life’s work of 11^th-hour interventionism, research, and the founding of Scala Precision Health.

Obesity and diabetes will break our country if we don’t find ways to help people better understand their own unique metabolism.  I started www.RussScala.com so people could download a free ketogenic diet plan.  Hey, it’s a start!  We also developed an advanced gender-specific weight loss program with great success.  We focus on education first, helping people understand the metabolic pathways involved in fat storage.  We always tell them during the first meeting that fat distribution is genetically determined and hormonally regulated. We help them research this process for themselves along with us, as a team.

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