The news from the doctor isn’t good. After stepping on the scale and seeing a number way above what it should be, the doctor delivers even more bad news, using terms such as “prediabetes,” “prehypertension” and “rising cholesterol.”
But all the popular diets have failed over the years, and to say that the patient is at wit’s end is an understatement.
That was the story of Rachel Swift of Water Valley in Graves County.
“I battled my weight most of my life,” Swift said. “I was an athlete in school, but when I got married, I got comfortable. I gained 70 pounds in no time. Then it went from 70 pounds to 100 pounds. I did everything from Atkins to Weight Watchers, and I got so discouraged.”
Swift said she was “borderline everything” and one year away from going on several medicines to treat what the medical industry calls comorbidities, including diabetes, hypertension and cardiovascular disease. At that time, the only medicine she was taking was several doses of ibuprofen a day to just deal with her body’s aches and pains.
“My breaking point was how I felt,” she said. “I was prediabetic, and diabetes runs real bad on both sides of my family. My grandma died at 62 of a heart attack, and she was very obese. I have three children … I felt horrible, and I didn’t want to cheat them out of life.”
Swift selected Dr. Anthony Davis with Bariatric Care and Weight Loss at Baptist Health Paducah, who presented her with two options: gastric bypass surgery or a gastric sleeve procedure.
Beth Mueth, the bariatric coordinator and dietitian with Baptist Health Paducah, said the goal of both procedures is to limit food intake into the stomach.
“Your stomach can stretch up to the size of a football, and that’s how much food it can hold,” Mueth said. “When Dr. Davis does a bypass, he’s taking the football down to the size of a hard-boiled egg” by creating a small pouch in the upper stomach and rerouting the intestines to attach to that pouch. The food then bypasses the larger part of the stomach and some of the small intestine, creating a faster sense of fullness and preventing fewer calories from being absorbed into the digestive system.
The gastric sleeve is less dramatic in that there is no involvement of organs other than the stomach.
“The sleeve is taking that football and stapling a line going down the center, taking that football down to the size of a banana,” Mueth said. “That extra piece of stomach is removed, and there’s no redirecting and reattaching of intestines. It’s simply restriction by volume only.”
Of the 142 surgeries Davis performed in 2017, 113 patients opted for the gastric sleeve procedure. Swift was one of them.
“I chose the sleeve because I wanted to be as natural as you can get. That way, I would have my own stomach,” she said.
Her surgery was on Nov. 8, 2017. As of the end of June 2018, she had shed 81 pounds.
“It’s changed my life,” Swift said.
She credits her choice with saving her life in more ways than one. Following her surgery, the part of the stomach that was removed was sent for testing, and pathology revealed advanced metaplasia, which eventually would have transformed into stomach cancer.
“I have metaplasia in the part of my stomach [that remains], but it’s very mild. I look at it as a miracle as well,” she said. “If I had not done the surgery or if I had chosen gastric bypass, I wouldn’t have ever known.”
As with most surgical procedures, there’s always a risk of unwanted consequences with weight-loss surgery. These range from weight regain to hernias to leakage from the stomach where it was stapled or sewn to the intestines, depending on the procedure.
The American Society for Metabolic and Bariatric Surgery reports that the chance of a patient dying from weight-loss surgery is 0.1 percent, which is lower than those for gallbladder and hip replacement surgeries. Patients deemed morbidly obese have a 50-100 percent increased risk of premature death, but the surgery reduces that risk of premature death by 30-40 percent.
With three children ages 11, 13 and 14, Swift believed she needed to change her life.
“I felt like I was going to cheat them if I didn’t make it,” she said. “I’m active with them, and they’ve never known me to be active. I can run them places and do things. I feel good. My knees don’t hurt. I used to have to eat Advil every day because my body ached all the time. My body doesn’t hurt anymore.”
Eating habits must change following the surgery. Mueth said patients can eat no more than a half-cup of food at a time, several times a day, and half of that must be protein.
Swift has happily adapted to that regimen.
“I just choose healthy fruits, vegetables and proteins,” she said. “I drink water and unsweet tea. I don’t want to go back. I’m an all-or-nothing person. I don’t want to go back to where I was.”
In addition to healthier eating and reduced caloric intake, activity is a post-procedure must.
“The surgery works very well the first six months to a year, but once you start getting six months to a year out, your body starts adjusting to it. It’s the new normal for it,” Mueth said. “People who keep their weight off are the ones who fit exercise and activity into their day. [The surgery] is a tool, and it works as good as you will let it work.”
Mueth pointed out that another tool for weight-loss success is to build a strong support group that includes not only family and friends but also the Bariatric Care and Weight Loss program, which offers monthly group meetings, educational resources and access to exercise clubs.
“We have built a huge amount of education in our program,” she said. “When they come for monthly visits, it’s not just a weight check. They’re also walking out with some kind of education, whether it’s portion control, recipes or setting goals. There’s always something new each time they come. They have to have a support system to help keep them successful long term.”
Swift uses the knowledge gained from those monthly meetings to make healthy choices and to guide her family in the right direction.
“I wish somebody a long time ago would have sat down with me and just said, ‘Hey, better back off from eating two helpings of something,’ so I talk to my kids all the time about making healthy choices,” she said. “This has helped change our dynamic. My husband drinks more water now. It’s set the tone in our home … and been a great support system.”
As for regaining the weight, the ASMBS reports that as many as 50 percent of patients do, in fact, regain, but it’s only a small amount of weight, and “studies find that most bariatric surgery patients maintain successful weight loss long term … Successful results are determined by the patient, by their perceived improvement in quality of life.”
Mueth agrees, saying it’s not about the numbers. “We’re about getting people their life back.”
Swift happily declares that she has her life back, and it’s a much better one than before.
“Food is an addiction. I feel the surgery broke my addiction cycle, and it’s up to me to make the choices to not go back to that addiction,” she said. “I just want to be able to feel good and be that present mom and be at everything that my kids are doing, and feel good at it and have a smile on my face because I feel good. I just want to have a long, healthy life.”
Is Weight-Loss Surgery for You?
Choosing surgery to help lose weight is a major life decision. So is it right for you?
Most weight-loss programs have strict guidelines and assessment procedures, but here are a few key qualifications for surgery candidates:
• A person’s body mass index (BMI) is 40 or higher.
• A person is more than 100 pounds overweight.
• The BMI is 35 or higher and the person suffers from obesity-related diseases such as Type 2 diabetes, hypertension, heart disease and other ailments and disorders.
• The patient has attempted multiple weight-loss programs with no success.
For more information, visit baptisthealth.com