Getting Ahead of the 8-Ball

Posted On August 19, 2015

Weight Loss Surgery and Lifestyle Changes Bring Success for Many

Text and Photos by Kristine Hartvigsen

 Bariatric surgery at Lexington Medical Center Lexington SC

It’s no secret that women often bond over clothing and fashion. They shop together, borrow from one another, and even swap items in closet-cleanout parties. But the last thing Marlana Coleman wanted was to take the generous wardrobe items offered by a friend who had lost so much weight she could no longer wear the plus-size clothes. “I didn’t want her old clothes,” Marlana said. “I wanted to lose weight, too!”

Like most of the women in her family, Marlana has been a “big girl” all her life. “I have always been overweight, even as a child. I was a size 16-18 by middle school,” she said. “I saw myself not being able to control it. I overate but still didn’t feel full. Then, I got to be 100 pounds overweight. I couldn’t see myself being able to get ahead of the 8-ball.”

After working nights as a nurse in the emergency room at Lexington Medical Center, Marlana would come home long before dawn to be there when her husband and three young children woke up. Her lifestyle was constantly busy − and stressed. And the weight wasn’t helping matters. She developed high blood pressure, was borderline diabetic, and had persistent knee and back pain.

Marlana, 31, and her husband had tried losing weight together on their own through exercise and healthy eating. Progress was slow to nonexistent. Over the years, Marlana had met several people who had achieved life-changing weight loss through bariatric surgery. She kept thinking about her newly slender, friend, who had opted for a procedure called “sleeve gastrectomy.” She decided to look into it. There are many surgical choices, and at first, the prospect can be daunting.

When she started working at Lexington Medical Center, Marlana heard about the South Carolina Obesity Surgery Center right there on the hospital campus. “I was tired of putting it off,” she said. “I knew I couldn’t do it by myself.”

“My weight before surgery was 254, but my highest weight ever was 272 after I graduated nursing school,” she explained. “It is not all about weight loss. It’s about getting healthy. I wanted to do it for my family.”

Most people have heard of gastric bypass, a procedure in which the surgeon reduces the size of the stomach and creates an alternate route for food to travel, bypassing a large portion of the small intestine that absorbs most calories. The smaller stomach pouch makes patients feel full more quickly, so they eat less. The intestinal also causes the patient to absorb fewer calories. There are other choices in bariatric surgery, including adjustable gastric banding, commonly referred to as “lap band,” which places an inflatable band over the upper part of the stomach to create a smaller pouch and, thus, limiting the amount of food a patient can consume at one time.

Another option is the sleeve gastrectomy, the procedure that produced such dramatic results in Marlana’s friend. Sleeve gastrectomy is one of the most effective forms of bariatric surgery and is recommended for patients with a higher body mass index (BMI, a calculation to gauge obesity using a formula that divides weight by height). In this procedure, the doctor creates a smaller stomach pouch roughly the size of a banana. These days, most of these surgeries are performed laparoscopically through a small incision in the abdomen and working with cameras and special tools. Because it is less invasive, laparoscopy generally offers faster recovery time and less pain overall.

After doing her own research and consulting with Dr. Glen Strickland, co-founder of the SC Obesity Surgery Center, Marlana chose sleeve gastrectomy and underwent the surgery in March 2014. She was hospitalized overnight and discharged the next day to continue her recovery at home, with follow-up visits to monitor her progress. Patients receiving this surgery take from two to six weeks to recover before going back to work or their other routines.

“Right after the surgery, there was some pain, gas pain. They encourage you to walk to get rid of that. I could have only clear liquids for a week. Later I could have soft foods like Jell-O and yogurt. One of the hardest things is to get used to the diet. I craved ‘normal’ foods. The stomach is smaller, and the hunger is less, but I think I wanted normal food simply because I couldn’t have it. But they also teach you how to eat,” Marlana said. “I was back at work in four weeks.”

“Medical science tells us that a lot of people who reach a BMI of 30 and are becoming sick because of it, those people need some sort of intervention,” Dr. Strickland explained.

Bill Kneece, who works in environmental services at LMC, knew he had to take action after undergoing a colonoscopy when he weighed 427 pounds, his heaviest. “I learned that I had a BMI of 59!” the congenial 51-year-old said. “My physician, Dr. March Seabrook, basically told me ‘You could die any time now.’ That scared me. I didn’t want to die of obesity.”

A born performer who used to play piano and trumpet, act, and sing in community theater, Bill hadn’t set foot on a stage in 10 years. He last performed in a 2005 Town Theatre production of Beauty and the Beast.

“I was uncomfortable because I kept thinking that I could be better. I could be healthier than this,” he said. “I love theater, and I love God, but I have been so self-conscious. I was so embarrassed to go to church and to the theater. I didn’t like the way I looked.”

Despite his self-imposed hiatus from the stage, Bill was persuaded to perform in the hospital’s award-winning 2011 Pink Glove Dance breast cancer prevention video. His father had passed away from breast cancer, and he just couldn’t say no to that.

“All I did was dance with a mop,” he said. “I miss that. It was wonderful … I really would like to return to the stage.”

Although he has never smoked or used drugs, Bill began comforting himself with food shortly after high school, following the suicide of a close friend and later the death of a beloved pet. He said he supposed food was his drug.

Like Marlana, Bill chose sleeve gastrectomy. He weighed 409 pounds when he had the operation on March 23, 2015. Within 75 days, he had lost 80 pounds. He was so stunned he had to ask his surgeon, Dr. S. Gray Hughes, if that was normal. He was assured it was.

“Throughout my whole adult life, I was eating very badly, and I enjoyed it. I didn’t care. I am real big on sweets,” Bill admitted. “I don’t miss the overeating, but I do miss those types of foods. Something like chocolate cake might look so good, but at the same time I ask myself, do I need it? It’s mind over matter.” He hopes to reach a goal weight of 200 by continuing to eat well and power walk.

In the year since her surgery, Marlana has lost 107 pounds and weighs a svelte 147, her goal weight. “I don’t deprive myself of anything,” she said. “I will allow myself a couple of bites of a donut, for example. I watch what I eat the rest of the time.”

Anyone considering weight loss surgery needs to understand that it is not a free pass or magic bullet. “It is a life-changer, and you have to commit to it,” Dr. Strickland explained. “People need to understand what they are getting into.” The Center requires prospective patients to attend a 90-minute seminar before making their first appointment. Once accepted as a surgery candidate, patients must complete an education program that can last up to six months. They attend classes, meet with dieticians, and talk with patients who have undergone the surgery. “This is a big deal. We want them to do well. They are our patients for life.”

Indeed. Every Christmas, the Center has a party to reunite patients. It also sponsors monthly meet-and-greets for old and new patients. In addition, a support group meets regularly to help patients be accountable and stay on track.

Costs for bariatric surgery can range from $15,000 to $30,000 or even higher. Because surgery can mitigate costly conditions related to obesity, such as diabetes, hypertension, and sleep apnea, some health insurance companies and will cover it. If a patient does not have insurance or their company will not cover the procedure, there are financing options.

“Insurance companies mandate what we can and cannot do,” Dr. Strickland said. “The FDA (Food and Drug Administration) approved the gastric band for BMIs of 30, but insurance won’t pay for it.” To be a candidate for bariatric surgery, general guidelines state that patients should have a BMI of at least 40, or a BMI of 35 accompanied by one or two “co-morbidities” (related conditions).

“I don’t want to go back. I have worked too hard to get to where I am now,” Marlana said. “One of the best compliments I get is that I don’t look like I used to be a big girl. I want to be that success story.”