"It takes a lot of energy to dissect a human body . people do not realize that," said Arden Monroe-Obermeit, RN.
A few years ago, this morgue technician-turned-nurse had a mystery on her hands. Monroe-Obermeit was inexplicably gaining weight. Many things did not add up. She had the highly physical demands of her job. She followed a strict diet and counted calories. Her entire family was of normal height and weight. No matter how hard she tried, she could not explain her weight gain.
To complicate this mystery even further, 40 hours of Monroe-Obermeit's week were spent in front of video cameras. It just so happened that, during this period of her life, she worked as a morgue technician on the popular Discovery Channel reality show, Dr G: Medical Examiner.
Fortunately, Monroe-Obermeit's mystery ended a few years ago. Now, her life has dramatically changed. She has a definitive answer for her inexplicable weight gain. She is no longer on Dr. G: Medical Examiner. She has a nursing degree from University of Central Florida and a job at Winter Park Memorial Hospital. She is on her way to becoming a nurse practitioner.
This radical transformation in Monroe-Obermeit's life came from her Cushing's syndrome diagnosis. That life-changing diagnosis came from a nurse - not a doctor.
Looking at the Big Picture
"Doctors would always look at one specific problem of mine. I could not get one of them in the room long enough to look at the big picture. Most of my doctors would not give me any more than a few minutes; I could not even get part of my history out before they would move on."
The time constrictions placed on Monroe-Obermeit's doctor appointments naturally resulted in multiple misdiagnoses. This caused her progress toward recovery to move at a glacial pace. However, it also did something else - it prompted her to become a nurse.
"A nurse practitioner took the time to sit down with me and look at the whole picture. She was the one who agreed with me that it was Cushing's syndrome. Separate complaints are always intertwined and she noticed that in me. I want to practice like that."
Monroe-Obermeit prefers the holistic nature of the nursing model to that of the medical model. The medical model tends to focus on a particular ailment, whereas the nursing model views the patient and her ailment as a whole. Monroe-Obermeit credits her diagnosis to the nurse who took the time to view her as a whole person. Now a nurse herself, she plans practicing the same way. This drive to practice a more holistic style of healthcare has caused her to focus on a particular component of nursing - teaching.
Monroe-Obermeit's time at the morgue taught her an odd nursing lesson: teaching patients to lead a healthier lifestyle keeps them out of body bags. While working at the morgue, she always felt an overwhelming number of bodies arrived earlier than they should have simply due to a lack of personal health education.
"I saw too many deaths caused by people ignoring their diabetes or their heart conditions. In nursing, I absolutely love teaching patients how to avoid becoming a case at the morgue."
It makes perfect sense Monroe-Obermeit would value the nurses' role as teacher - she had to deal with the struggles of teaching herself about Cushing's syndrome before anyone would diagnose her with it.
A Little Detective Work Paid Off
"A lot of people do not understand Cushing's syndrome. My endocrinologist said I would have to leave Orlando to get anyone to give me a Cushing's syndrome diagnosis. And Orlando is no small city," said Monroe-Obermeit.
With her mysterious weight gain and fatigue, Monroe-Obermeit knew something was wrong. After leaving a number of doctors scratching their heads, she decided to take matters into her own hands.
She had spent 8 years working alongside Jan Garavaglia, MD, (better known as just 'Dr. G'). During that time, Monroe-Obermeit performed more than 3,000 autopsies and some 500 death-scene investigations. In conjunction with her professional experience, she also had extensive formal training to assist her mystery diagnosis efforts; Monroe-Obermeit holds a bachelor's degree in biological anthropology from the University of Florida.
In an ironic reversal, her experience with so many dead bodies saved her own body - Monroe-Obermeit successfully diagnosed herself.
Over time, she became convinced she had some derivation of Cushing's syndrome. The rare disorder causes excessively high levels of the hormone cortisol within the body. The excess of cortisol results in many different symptoms, including weight gain and fatigue.
The persistent Monroe-Obermeit finally met with a nurse practitioner who ordered radiological tests. The outcome of those tests was just as Monroe-Obermeit expected-they confirmed her Cushing's syndrome diagnosis. Armed with the empirical data, she was able to have surgery performed in which a tumor was removed from her pituitary gland. To validate her self-diagnosis even more, Monroe-Obermeit quickly lost 80 pounds in the months following her surgery.
Patient feedback can be a blessing or a curse for a nurse. Some days, it seems every patient is overly eager to give feedback about everything - the uncomfortable bed, the lukewarm food, the excessive length of his stay,and so on. Other times, patient feedback provides crucial information to the nurse.
Influenced by her time at the morgue and the nurse who took the time to listen to her, Monroe-Obermeit now loves patient feedback. "Dead people cannot give you feedback. Nurses actually get patient feedback. That is huge!"
With her new nursing position at Winter Park Memorial Hospital, Monroe-Obermeit is committed to listening to her patients.
"Obesity is frequently a result of a lifestyle decision and, as a result, it is easier for people to judge you than it is for them to actually listen to you. It is easy not to listen to a patient . but nurses have to. Obesity can be a symptom of something else, just as it was for me."
After spending all those years in the silence of the morgue, Monroe-Obermeit is ready to listen-all because a nurse listened to her.
To read about another patient's experience with Cushing's syndrome, from frustration and confusion to pituitary gland removal and drastic improvement, click here.
A. Trevor Sutton is a frequent contributor to ADVANCE.