Underweight Dr will not clear for all activities

[Eagle92]

I promise this won't be a rant, or even a series of rants

 

I just remembered an autobiography I read back in the day about a WWII Marine Raider, predecessors to Marine Recon and today's spec ops Marines. Anyway this guy did not meet the USMC's H/W guidelines at the recruter's, also being underweight. The recruiter suggested that he come back in an hour or so, after having a very full meal and heavy deserts in order to meet the minimum weight. He followed the recruiter's suggestion, gorged himself, and met the weight minimum.

[Beavah]

Yah, I reckon anyone with sense knew this policy would cause all kinds of problems.

 

Da issues with using BMI are well known in the medical community. It's a sorta approximation for health, and doesn't work for the 5-10% outliers on either end... the young, tall, lean fellows or broad/strong adults.

 

The 30 minutes thing IIRC came from ARC's loose approximation of when wilderness medical protocols should apply rather than in-town ones.

 

So both items, da BMI chart and the 30 minutes thing are rough approximations. Rough approximations are not somethin' that yeh should turn into "policy."

 

That having been said, I think generally speakin' the weight guidelines for most average adult leaders are good ones. I think when we're above da max we really shouldn't be on high adventure trips, and when we're above the recommended we are slowin' down active high school aged boys, and limiting what they can do. But those have to be applied with some measure of judgment and common sense is all.

 

For da kids, I think prep-trips tell yeh more about readiness than the BMI charts (which were designed for adults).

 

Beavah

 

[Engineer61]

I'd tend to side with the physician on this.

 

And I'll agree with some of the other responses that there may be other underlying issues that you don't know about (and won't know about).

 

In the end, if the Dr. signs off and the kids get hurt or dies because of something he decided (or was pressured into) overlook(ing), it's his tail in the malpractice sling. He's culpable because he signed off on it.

 

The ONLY thing I see that the parent can do is find another Dr. I don't see where BSA has any say in the matter.

[jemek]

IN this situation...there is NO other underlying health issues. He is simply a small framed boy...just as my Eagle Scout Son is. That is why my friend asked me for advice as she knew my son was also small frame.

 

Her son has ALWAYS been able to carry his own pack. Just as my son has been able to do. My son is underweight based on the chart. He is 5'6 and 106 lbs.

 

He went on Philmont Trek 2 years ago..he was 6 4 and 95 lbs...well under what the chart gives.

 

The concern is..that with this new chart and the Dr reading it as..in order to do some of these things you need to weigh more...What message is that sending the kids...in a day and age where we worry about obese children....we send a mixed message to small framed children. That your size/weight means you can not be treated equally as your peers..even when you are capable of keeping up with them with no issues.

 

Gonzo...The boy in your situation..I am so sorry his mom doesn't recognize her sons weakness...he might have low muscle tone..which is what my 11 year old daughter has. It is really a shame and I feel for the young man. We are very aware of her limits. Thus the reason she does not go on extended hikes, or back packing trips.

 

 

 

 

[Eagledad]

Doctors are like engineers, they each have different opinions of how to do their job. I had one scout who by the age 15 had been through 4 heart surgeries. His doctor had no problem with Philmont and approved him to go. I was the one who kept questioning the scout and his dad if he was healthy enough for the trek. He had the doctor write me a personal letter, which I sent to Philmont along with all his medical history. I was convinced Philmont would say no, but they had no trouble letting him go.

 

I also have a 5 7 115 lb. son who has done three Philmont treks. The only thing I saw him struggle at because of his size was lifting a canoe out of the water on to his shoulders while at Northern Tier. He had no trouble with the 80lb Duluth packs, but the canoes size was just awkward for his size.

 

I would get another doctors opinion for this young man.

 

Barry

 

[Oak Tree]

The original post asked "IS the Dr interpreting this chart incorrectly?"

 

I think that's exactly what's happening. That is, the doctor is not offering an opinion on whether the boy should be allowed to do the activity, he is just saying - "The boy doesn't meet the BSA's guidelines, so I won't approve him, because the BSA tells me not to."

 

I think that getting a physician from council to explain the form would be the best approach.

 

On the other hand, the form is fairly clear. It may be terrible policy, but that's what's listed. I could easily argue that the BSA doesn't want the underweight boys to be approved, based on that form. I disagree and I think he should be fine - but I can see where the doctor is coming from.

[Eagle92]

Make sure the form is the MOST UP TO DATE VERSION available, one that mentions the Body Fat % and not an older one form a few months ago. I know my form that I had the doc fill out made no mention of the body fat %, but as I read the FAQs, noticed it now mentions a body fat %. As long as he isn't over 295 pounds and is under 21% body fat, he is good to go.

 

[Beavah]

As long as he isn't over 295 pounds and is under 21% body fat, he is good to go.

 

Goin' to have to go look at a new form, but I'm not sure this is right, eh?

 

I think da point of the lower weight limit is that it increases the risk of musculoskeletal injuries. The skinny folks are always goin' to be carrying / lifting a higher percentage of body weight, which on rough terrain means a greater chance of bone/joint injuries in a slip and fall or somethin' like that.

 

Now, my experience has been that most athletic kids are dexterous enough that they solve da problem by just bein' quicker and more limber. But it does apply to underweight adults, eh? And perhaps to underweight lads who aren't as athletic. Seen that occasionally at camp in lads whose parents/family have 'em on vegetarian diets for religious/personal reasons.

 

Beavah

 

[Eagle92]

Beav,

I cut and pasted the Part B info. Bold is to highlight. In rereading it, I think it is poorly written. In the FAQ, which I posted below the med from quote, it sound as if the body fat % is an alternative, but still lists the max weight as 295.

 

Part B

PHYSICAL EXAMINATION

Height_____________ Weight_____________ % body fat____________ Meets height/weight limits Yes No

Blood pressure____________ Pulse_____________

Individuals desiring to participate in any high-adventure activity or event in which emergency evacuation would take longer than 30 minutes by ground transportation will not be permitted to do so if they exceed the height/weight limits as documented in the table at the bottom of this page or if during a physical exam their health care provider determines that body fat percentage is outside the range of 10 to 31 percent for a woman or 2 to 25 percent for a man. Enforcing this limit is strongly encouraged for all other events, but it is not mandatory. (For healthy height/weight guidelines, visit www.cdc.gov.)

 

From FAQs found here: http://www.scouting.org/scoutsource/HealthandSafety/Resources/MedicalFormFAQs.aspx

Q. I believe my body fat percentage will prove that I am fit and able to participate in the events described in the Annual Health and Medical Record requiring the use of the height/weight chart. Can I obtain a body fat test from my physician and use those results?

A. Yes, body fat percentage may be used if your weight is 295 pounds or less. (Acceptable body fat percentage for women is 10 to 31 percent. Acceptable body fat percentage for men is 2 to 25 percent. Verification by a physician is required.)

 

[John-in-KC]

Had a visit with a Scouter physician friend last night.

 

Short version: Unit/family should ask Council surgeon to consult with family doc. In this physicians' professional judgment, this is the simplest path to getting over this hurdle for this Scout.