Vertical Sleeve Surgery (3) Patient Story
The First Day of Your New Life
At 284 pounds, Kelli Beschi couldn’t do a flight of stairs or walk a quarter of a mile without huffing and puffing. Since the excess weight put pressure on her joints, her knees and feet would swell, causing pain. She was on three asthma medications that didn’t help much, had pre-diabetes as well as borderline high blood pressure and cholesterol levels, and had a family history of heart disease and cancer. “My primary care doctor said the thing that will end your life is your weight and that I was spinning the roulette wheel,” recalls Kelli, 47, of Uxbridge.
However, losing weight for Kelli was no easy task; over decades, she had tried numerous diets and exercise programs. When she was eleven years old, Kelli was close to 200 pounds and attending Weight Watchers. “There were times I would drop 50, 60, 70 pounds and then within a year or two I’d gain it all back,” says Kelli. “As I got bigger, between the breathing, the knees, and the feet, it became so uncomfortable. At that size, I didn’t want people to see me working out.”
Thanks to working with the team at the FreshStart program based out of The Center for Weight Loss Surgery at Milford Regional and undergoing laparoscopic vertical sleeve gastrectomy in May 2015, Kelli has lost over 119 pounds and recently completed her sixth 5K race. She has gone from a 26-28 pants size down to size 8-10.
Kelli before surgery
Weight loss surgery, known as bariatric surgery, is an option for individuals with a body mass index (BMI) greater than 40, or 35 if there are accompanying weight-related illnesses such as diabetes, sleep apnea, or arthritis. A BMI of 40 equates to an individual being approximately 100 pounds overweight. “The rate of weight loss varies patient to patient, but our goal at the one to two-year time point after surgery is for the average patient to lose at least 60 percent of their excess body weight,” explains Donald R. Czerniach, MD, Surgical Director of the Bariatric Program. “Bariatric surgery is also very effective in reducing or improving obstructive sleep apnea, Type 2 diabetes, hypertension, high cholesterol, chronic weight bearing joint pain and asthma.”
According to Dr. Czerniach, after undergoing surgery 60-70 percent of patients with Type 2 diabetes will get off all their medications, about 75 percent of sleep apnea cases resolve, and 80 to 90 percent of hypertension cases improve. Dr. Czerniach, along with bariatric surgeon Philip A. Cohen, MD, perform two types of weight loss surgery–vertical sleeve gastrectomy and gastric bypass. Approximately 85 percent of patients undergo the vertical sleeve, in which a large portion of the stomach is removed and a new smaller stomach is created, notes Dr. Czerniach. In gastric bypass surgery, a smaller stomach is created and food bypasses the old stomach and part of the small intestine. Both types of surgery are performed laparoscopically and use about five small incisions. The goal of either operation is a patient who feels full after eating a small volume of food and changes in the body’s metabolism that increase weight loss.
“Patients that may do better with a bypass are those who have a very high body mass index, those with significant reflux disease or daily heartburn, and those with Type 2 diabetes that is difficult to control with medication,” says Dr. Czerniach.
Kelli attended an information session to explore surgical options at the hospital in November of 2014. The presentation convinced her to move forward with Dr. Czerniach and the FreshStart team which includes a coordinator, nurse practitioners, dietitians, behavioral health counselors and physical therapists. The FreshStart approach includes ongoing support through patient post op groups, an exercise program and individual appointments. Most patients go home the day after the surgery. Early on, the weight loss can approach five pounds a week, especially when patients are limited to a liquid diet consisting of non-carbonated sugar-free liquids and a liquid protein supplement, explains Dr. Czerniach.
“During weeks three-to-eight, patients advance to soft, protein-rich foods such as yogurt, cottage cheese, tuna salad and eggs, and they gradually add chicken, turkey, pork, fish and cheese,” he says. “After week eight, they add back roughage such as fruits and vegetables. We recommend a minimum of 60 grams of protein a day. Protein provides the building blocks for tissue healing and it requires the most energy to digest, which stimulates the digestive system to actively burn calories.”
Patients who perform manual labor typically stay out of work for four-to-six weeks, and those with more sedentary jobs can often return after three weeks. Patients follow-up with their surgeons at two weeks, six weeks, six months, a year, eighteen months, two years and then annually after surgery. Dr. Czerniach highly recommends that patients attend the monthly support group meetings, where they can interact with other successful patients like Kelli. She also shares her story at orientation sessions for new patients and visits post-op patients in the hospital on the day of their surgery.
“This is a permanent lifestyle change,” he stresses. “It becomes harder to overeat at one sitting as patients feel restricted by the small stomach left behind, but grazing is a much easier habit to fall into. Successful patients develop a repetitive pattern of successful eating behaviors. Kelli has really embraced the lifestyle and she has become representative of what the program preaches. I had one patient recently who attended an orientation session, heard our wonderful volunteers speak, and said that without that input, she wouldn’t have had the courage to proceed with surgery. That’s what’s special about a small program like Milford. You see the same faces, you engage with the same providers, and that adds accountability as well as a level of comfort not experienced in larger programs.”
Today, Kelli has perfect blood pressure, cholesterol, blood sugar levels and only needs an inhaler for seasonal allergies. Her weight stays at around 165 pounds, and she likes to take walks, hike, bike, and exercise at the gym. While she doesn’t attain the fastest times in her 5K events, it thrills her that she can finish. “To me it’s the satisfaction of being able to do it,” she says. “It’s a confidence booster and keeps me on the right track. I eat to live now, not live to eat.”
Kelli credits the FreshStart program for changing her life and praises the hospital staff for how well they handle bariatric patients when admitted for surgery. “Dr. Czerniach was very welcoming and understanding when I first met him, and is a big cheerleader for me,” she says. “I’ve also gotten to know Dr. Cohen. They’re both excellent doctors. It’s the best decision I ever made in my life. I always tell people the day of the surgery that this is the first day of your new life.”
To make an appointment with Dr. Czerniach, call UMass Memorial General Surgery at Milford at 508-458-4250.
