Those who have bariatric surgery know the timing needs to be right. Then it’s a matter of finding a program and a surgeon that provide the necessary support and expertise, making a commitment and setting reasonable goals. Kathleen Rondeau did all that. A year after her surgery, she is healthy and active — just as she hoped. “Now I have the opportunity to live the life I want to live,” she says.
By early 2015, Ms. Rondeau had given a lot of thought to having bariatric surgery. Weighing 282 pounds and with her 48th birthday approaching, she began thinking about how she wanted to spend the rest of her life. “I was an emotional eater,” says the Chelmsford resident. “I worked with a nutritionist and lost 70 pounds at one point, but regained it. Nothing worked.”
Then she attended an Emerson Hospital Center for Weight Loss information session. “I asked Dr. Lautz lots of questions, and he answered them all,” says Ms. Rondeau of David Lautz, MD, bariatric surgeon and the center’s medical director. “By the time I left the info session, my name was on the clinic sign-up sheet.”
Things moved quickly, which is what she wanted. “All of a sudden, it was surgery day!” she says. “I know other people who had bariatric surgery at other programs, and the process was drawn out.”
Ms. Rondeau decided not to broadcast her upcoming surgery. “It was a personal journey for me,” she says. “I wanted to be mentally ready. Because I didn’t tell many people beforehand, the staff at Emerson became my support throughout the process. From day one, every single person there made me believe I could do this.”
Before surgery, concerns about diet
A year earlier, Ms. Rondeau was diagnosed with eosinophilic esophagitis, an inflammatory condition of the esophagus that made her allergic to eggs, dairy, peanuts and wheat. “The dietitian at the center was absolutely wonderful,” she says. “She did research and found food alternatives for me.”
“We help our patients make the post-surgery diet work,” says Dr. Lautz. “It’s something a lot of people worry about. They sometimes assume they will be eating baby food and missing steak and pasta. After surgery, they find out they can be satisfied with a small amount of food, in part because of changes in the hunger hormones. Food becomes less important.”
Ms. Rondeau and Dr. Lautz discussed which of the surgical options would be best for her. “I decided to have the sleeve gastrectomy because I wanted a sense of normalcy,” she says. “Also, I felt it would make me a little more accountable.” The sleeve gastrectomy permanently removes two-thirds of the stomach and is associated with somewhat less weight loss than the gastric bypass, which creates a smaller stomach pouch and bypasses part of the small intestine to restrict food intake.
“Nationally, the sleeve gastrectomy has become the most popular procedure for weight loss,” Dr. Lautz notes. “Some patients tell me it seems more normal to them, and that the gastric bypass is ‘too much surgery’ for what they want. However, others decide to have the procedure that leads to the most weight loss, which is a bypass. Surgically speaking, the sleeve procedure is a simpler, more straightforward operation. Regardless of which surgery someone chooses, we change the anatomy and physiology, as well as behavior.”
After surgery, “the happiest ever”
It didn’t take long for Ms. Rondeau to see evidence that the changes made in the operating room that day would change her life. “I had no discomfort after surgery,” she recalls of the operation, which Dr. Lautz performed in July 2015. “It didn’t seem like I had anything done.” She stayed two nights at Emerson and went home prepared to carefully track her progress.
“I didn’t have a weight loss goal as much as I wanted to be healthy,” she says. “I was a size 22, and I wanted to get to size 10. Within a month, I was losing weight and thought: this is really happening.”
Something else was happening. The health consequences of carrying so much extra weight started to disappear. “I was on medication for high blood pressure, depression and anxiety,” says Ms. Rondeau. “In less than a year after my surgery, I was able to come off all of them. I suffered daily from plantar fasciitis in my feet, and my knees, hips and lower back were painful. Those aches and pains are all gone.”
With the pounds dropping and her energy increasing, Ms. Rondeau proceeded to undertake several physical feats. “I’m turning 49 next year, and I made a bucket list of things I want to do,” she explains. “I climbed Mount Monadnock with my daughter, completed a 5K mud run that had me running — and crawling — through an obstacle course, rode on a zipline and am next scheduled to skydive.”
She attends a gym where she works out regularly and intensely. “I want to push myself,” she says. “This is the me that always lived inside that body. I’m surrounding myself with positive things, and I’m the happiest I ever remember being in my life.”
Ms. Rondeau learned a few things along the way. “You may go into the surgery with a goal, but you can’t overwhelm yourself with that goal,” she says. “At one point, I decided I should only weigh myself once a week. And I celebrated when I achieved small goals, like the first time I bent over to tie my shoes, and it wasn’t a struggle.”
Then there is the gratitude that she feels and eagerly expresses. “I can’t say enough about the Emerson program. Dr. Lautz is incredible, and the entire staff, who are so proud of me, had an effect on my progress. I’ll always have a special place in my heart for all of them.”
Obesity can be tough on joints, feet
The most notable change in Kathleen Rondeau’s life after bariatric surgery is that she got moving again. It’s hard to exercise when you are in pain.
According to John McInnis, MD, an Emerson orthopedic surgeon, the amount of excess weight someone is carrying, as well as the duration of being overweight, cause degeneration of the joints. “People who have been overweight for 20 years are likely to have degenerated, painful knees or hips,” he says.
“Some patients want to have joint replacement surgery. I urge them to lose weight first, because they will do better in terms of the surgery itself and the rehabilitation afterward. When I send someone to Dr. Lautz, I know they will lose the weight.”
It’s a challenge to exercise when you are obese and have joint pain. “I suggest low-impact activities, such as cycling, using the elliptical and walking in the water,” Dr. McInnis says. “Someone who loses just ten pounds will see an improvement in their knee pain.”
Gregory Catalano, DPM, an Emerson podiatrist, sees many adults with overuse injuries that affect their feet. “Young, active people develop plantar fasciitis, Achilles tendonitis or stress fractures,” he says. “When I diagnose someone with plantar fasciitis, they often tell me that they stand a lot at work, and they have added exercise. It’s too much for their feet.”
Dr. Catalano emphasizes that overuse injuries come in all sizes and shapes of people. “Someone who is 100 pounds overweight can develop these problems because of the amount of force exerted on their feet. If you’re heavier than you should be, it will contribute to the development of foot problems.”