Spring 2013 edition
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Our Staff Makes the Difference ... But Our Patients Tell the Story
All That Jazz: Ralph Peterson Rediscovers his Rhythm after Weight Loss Success
By Linda Trainor, RN, BSN
As a full-time professor of percussion and ensembles at Berklee College of Music, and one of the top three drummers in the renaissance of jazz since the early 1980s, Ralph Peterson walks to the beat of a different drummer — and to a rhythm that’s entirely his own.
In fact, Ralph does not skip a beat when he talks about his career and journey to weight loss and wellness.
"I can distinctly recall why I previously carried an excess of 100 pounds," Ralph says. "I can attribute gaining weight to specific circumstances that greatly affected my life.”
Ralph further explains that years ago he experienced back and ankle injuries, leading to multiple orthopedic surgeries that in turn limited his ability to exercise. He was also battling alcohol and drug addiction.
Making that his first priority, and with the help of a 12-step program, Ralph is now completely alcohol- and drug-free — and has been for the past 17 years. Today, Ralph says he does not take his recovery for granted and keeps working his recovery program one day at a time.
The recovery from drugs and alcohol, however, led to another addiction — food.
"I literally switched my addiction to food, and gained a lot of weight during my recovery from drugs, alcohol and my major orthopedic surgeries," says Ralph. "I felt like I was eating myself to death."
Ralph began to consider weight loss surgery when he found himself tipping the scales at 330 pounds. He also credits his wife, Diane, for recognizing the signs of his dangerously high blood pressure.
"My primary care physician was adamant that I lose weight, since my blood pressure was extremely high and I already had been diagnosed with high cholesterol and type 2 diabetes," he explains. “Being placed on blood pressure medication forced me to seriously reconsider alternative interventions for long-term weight loss."
Since Ralph had tried many contemporary, non-medical weight loss interventions without lasting results, he decided to explore the option of having weight loss surgery.
"I researched other programs in the area, but Beth Israel Deaconess Medical Center (BIDMC) was the right fit for me," says Ralph. "I chose to have the sleeve gastrectomy, because I needed it. The resizing of my stomach made sense to me. Dr. [Robert] Andrews viewed me as someone who was serious about taking this step. He was a big part of my decision to come to BIDMC."
Dr. Andrews performed the operation in June of 2012 at BIDMC’s Weight Loss Surgery Center.
"Dr. Andrews and the staff provided encouragement from the get-go," Ralph says. "By having the surgery, I felt I could realistically achieve the goals I set for myself, which were to not only lose weight, but to improve my health.
"I felt that by having the size of my stomach reduced with the gastric sleeve, my capacity to eat would greatly be reduced, which I definitely needed for portion control, so that my workouts could catch up to my weight loss needs and goals," Ralph adds.
Ralph prepared for his surgery as suggested by the bariatric multidisciplinary team.
"I felt that 10 pounds to lose before weight loss surgery was well within my reach," he says, and did just that by practicing Taekwando, riding his exercise bike, and following a pre-operative diet as directed by the bariatric nutritionists.
Ralph weighed 318 pounds on the date of his surgery; within just a few weeks, he lost 30 pounds and found his hypertension and diabetes to be significantly better — so much so that his doctors took him off all medications.
Ten months later, Ralph has lost a total of 70 pounds … but who’s counting? Ralph says the biggest difference is that his quality of life has tremendously improved, both physically and emotionally.
Ralph now rides 20 miles on his stationary bike five days a week. He has also has earned a third-degree black belt in Taekwondo. While pleased with his exercise program, he likes to think of himself as a “work in progress.”
"I am in much better shape now," Ralph says. "I added strength training to my program, which builds muscle and tones the body. I have a belt that is literally on its second lap around my waist."
Among his other life changes since undergoing bariatric surgery, Ralph has also experienced liberation from reacting to stressful situations.
"Now, I don't let my circumstances or life events dictate my behaviors, because circumstances change all the time,” he says. "I am simply thrilled that I awaken every morning, 70 pounds lighter, drug and alcohol free, breathing better, walking better, and really feeling better.
"Happiness is a decision,” he adds. “It's that simple. You must make the choice, then follow the choice with action. And no matter the circumstances in life, you must hold on to that decision, no matter what."
So life is good for Ralph, and that’s where the music swells — it's easy to see that jazz plays a key role in his happiness. Ralph has built a career as a bandleader and sideman in jazz over the past 30 years. He travels and tours around the world to locales including Europe, Japan and Korea. Ralph has also made more than 100 recordings; the latest two through his own music label, Onyx Productions.
Ralph has spent 28 years as an educator at the college level as well, teaching at Berklee College of Music.
"I feel so blessed to earn a living at what I love doing," he says.
With all that jazz in Ralph's life, he still makes himself available to the community, giving his time as a Taekwondo instructor to children in the Dorchester area.
"I am so grateful at the opportunities that life has presented to me, it is only right that I give back to the community," says Ralph. "However, I don't think I would have been able to keep this current schedule if I was carrying around all that extra weight.”
Even before having weight loss surgery, Ralph was always known for his energetic rhythm.
"But now that I've lost 70 pounds,” he says, “I feel like I am captain to an endless supply of energy."
All photos courtesy of Ralph Peterson
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Bariatric Network Expands to BID-Milton
By Christie Roy, BIDMC staff
Patients who are considering, or have already undergone, weight loss surgery at Beth Israel Deaconess Medical Center (BIDMC) now have more options for where they have their procedure or receive their care — and can do so closer to home.
In yet another example of how BIDMC is offering patients access to our world-class care outside the city of Boston, the Bariatric Surgery Program at Beth Israel Deaconess Hospital-Milton has been re-designed to operate as a seamless branch of the Weight Loss Surgery Center at BIDMC.
“The support services, the clinical pathway, and the nutrition protocol that all patients receive in both Boston and Milton have been unified, making it very easy for patients to transition between programs,” explains Angela Fenton, MA, LMHC, Bariatric Surgery Program Manager and Mental Health Practitioner at BID-Milton.
“Our main goal in Milton is to ensure that we provide the highest quality of care to our bariatric patients in a community setting, a setting that allows us to offer a very personalized approach to weight loss surgery,” she adds.
Making it Convenient
Patients can now choose to have their surgery at BIDMC in Boston yet enjoy the convenience of attending all pre- and post-surgery visits, including information sessions and support groups, at BID-Milton.
Likewise, patients can also opt to have both their procedure and all of their pre- and post-operative care outside of the city at BID-Milton.
And, Fenton says, patients who have had surgery and some of their care at BIDMC are more than welcome to begin seeing the clinicians and attending support groups in Milton.
While BID-Milton, as a hospital, had already been invested in weight loss surgery for some time, the programs in Milton and Boston only became more closely integrated in January of 2013, according to Fenton.
“In a very short time, we’ve been able to do a lot of outreach with local primary care physicians, and they’ve really appreciated having the experience of our Boston-based, Harvard Medical School surgeons here in the community, seeing it as a tremendous benefit to their patients,” she says. “We’ve experienced a lot of positive growth over these first few months, with an increase in word-of-mouth referrals — having patients refer other patients is always a good sign. We know we are doing things right.”
Working Together for Patients
Just like at the multidisciplinary center in Boston, patients who come to the bariatric program at BID-Milton will find all of the clinicians working closely — and working well, Fenton adds — together.
Surgeons Dr. Robert Andrews (the program’s Medical Director) and Dr. Benjamin Schneider lead the team that includes program nurse Deizy Mendes, RN; bariatric dietitian Melissa Packin, MS, RD, LDN; and Fenton, also a licensed mental health practitioner who provides the necessary psychological support for patients.
“We also have a very organized administrative assistant in Maura Bertolino, who helps keep the entire program running smoothly,” Fenton adds.
And, just this month, a new bariatrician joined the BID-Milton team: Dr. Veronica Vedensky is now seeing all pre- and post-operative weight loss surgery patients, helping prepare them for their procedures and supporting them medically through their post-operative experience.
It is clear, Fenton says, that each member of the program’s staff is fully committed to the success of their patients.
“We all genuinely care about the job we do, and the lives of our patients that we transform,” she explains. “We’re able to truly get to know our patients, and our comfortable office setting allows them to share their ‘other’ stories with us — their vacations, hobbies, children getting married. We celebrate our patients’ quality-of-life changes right alongside them.”
Keeping Everyone Involved
It’s no wonder that this team becomes so close with their patients — getting family members involved is a big part of the entire weight loss surgery process at BID-Milton.
“We really encourage family and supporters to be participants in the care here — with the patient’s permission, of course,” Fenton says. “We have brothers, spouses, older children who come to the information sessions and support groups so that they can better understand what their family member is going through.”
Welcoming family members into the program has benefits for everyone.
“When the family is involved — and the patient has the appropriate support at home — we find that the education and understanding of the surgery itself is improved,” says Fenton. “Often, if a patient’s spouse is nervous about the surgery or the life changes afterwards, we’ll have them be involved in the pre- and post-op mental health visits too. This lets us all go through and understand the process together.”
Experienced Care, Unique Support
Most everyone on BID-Milton’s bariatric team has years of experience treating and supporting weight loss surgery patients — a definite plus, according to Fenton. And for some of those team members, the non-medical expertise they have allows them to provide care at an even higher level.
One example is bariatric dietitian Melissa Packin, who has a degree in culinary arts.
“For Melissa to not only be dedicated to bariatrics 24-7, but to also be a trained chef, she’s able to advise patients on how best to cook healthy recipes at home,” Fenton says. “This extra perspective is a big help in educating our patients in nutrition.”
Healthy cooking and healthy eating are frequent topics for BID-Milton’s bariatric support groups. A cooking demonstration is planned for one upcoming session; protein supplement tasting is scheduled for another.
Exercise factors in too — a local health club will present at one session about a medically-supervised fitness program they are developing.
“Developing a fitness plan can be tough for anyone, but especially for a weight loss surgery patient who may have not taken part in a structured exercise program for some time,” says Fenton. “With a program like this that’s supervised by licensed medical professionals in a supportive environment, we hope that the common barriers to exercise will be reduced.”
A Few Extra Benefits
For bariatric patients to have access to this experienced team of clinicians and the personalized care they provide, all in a community locale, is terrific enough — so how could it be even better?
Amid all of the positive feedback BID-Milton’s program has received, Fenton says she has heard the most about one thing that can be a bit difficult, expensive, and time-consuming when traveling to a large medical center in a big city.
“Parking!” Fenton exclaims. “Everyone appreciates that BID-Milton has free and very accessible parking. Patients can park right outside our building — great for those who may have mobility issues. Plus, coming to this ‘tranquil’ hospital setting away from the busy city streets can be a more comforting experience if you have anxiety about deciding to have this kind of surgery.”
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Top Three Reasons to Dine IN
By Kate Otto, RD, LDN
Bariatric Dietitian at BIDMC
1. Save calories.
It is a well-known fact that many restaurant meals contain several hundred more calories than if we had made the same meal ourselves. Have you checked the nutrition facts from any of your favorite restaurants lately? Some chains have made it easier for us by including their calorie information right on the menu, and it can be quite an eye-opener: 900 calories for a turkey sandwich? No, thank you.
2. Save money.
Who couldn’t use a few extra bucks these days? Restaurants are businesses, after all — they need to make a profit too. Fast food meals are rarely even a good value anymore. Save your hard-earned cash for a special occasion that’s worth the financial and caloric cost.
3. Avoid foodborne illness.
Need I say more?
We all have barriers to healthy lifestyle changes, and sometimes dining in can be difficult. Whether you work long hours, have a busy schedule keeping up with or caring for family members, have volunteer commitments, or just plain don’t like to cook, I understand your frustrations. Here’s a few tips to help get you started:
Keep it balanced and keep it simple.
You don’t have to have culinary training to make a delicious, healthy meal you and your family will love. Aim to include a lean protein source, like poultry without the skin, egg whites/egg substitute, seafood, lean beef, or pork loin. Pair it with a good-size portion of non-starchy vegetables, and top it off with a smaller amount of whole grain or low glycemic index carbohydrate sources, like brown rice, quinoa, sweet potato, or beans.
Two words: slow cooker.
If you don’t own one already, I highly suggest considering the investment. And, I would argue that slow cookers are the easiest, lowest maintenance way to cook. With only a few simple preparation steps, just throw in some key ingredients (consider the balance as mentioned above), season as desired and flip the switch. No stirring, no preheating, no waiting for the water to boil. Seriously, sign me up!
Recipes are easy to come by, and ingredient adjustments/substitutions are endless. If your schedule can be unpredictable, consider spending a little more for one that has a self-timer. (Trust me on this one, especially if you live alone.)
Here's one recipe, from my mentor/friend/fellow RD’s blog »
Scared of the stove?
No worries if you're not confident enough to tackle the range — your microwave can be just as effective (and way speedier too)! Stock up on convenience items to use when you are in a time crunch. Healthy frozen meals, frozen or pre-cut raw vegetables and fruits, and pre-grilled protein foods can all save you time and calories.
This is especially helpful if you only have a couple hours per week to prepare food, or if you would prefer to only have to “bite the bullet” once per week. Make several servings at once. Leftovers generally keep in the fridge for five days. However, after five days (or when it starts to smell a little funky, whichever comes first), toss it to avoid foodborne illness.
Do you live alone and/or crave variety in your diet? Invest in some reusable plastic or glass containers and freeze your leftovers. Next time you want a healthy meal and have no time to spare — voilà, a homemade frozen individual meal is within reach.
Or, prepare each meal component individually, and mix and match later. For example, if you have some chicken, veggies, and quinoa, enjoy them together today, add them to some greens in a salad tomorrow, throw them in a wrap for a sandwich the next day.
Plan your grocery list ahead of time.
Organization is the key to maximizing your budget and your time. Check out the weekly circular for sales on convenience items or your general staple foods, clip a few coupons, and plan your menu ahead of time to save your wallet and your precious time later.
Breakfast for dinner.
Why not? Eggs are easy and a great source of protein. Scramble them with some veggies and a sprinkle of low fat cheese, add in a slice of whole wheat toast, English muffin, or bagel thin and you’ve got a balanced meal! Limit your yolks to no more than three per week if you are concerned about your cholesterol levels.
Ask for help.
Delegate tasks when you can; take turns doing the grocery shopping or cooking. If you are new to at-home meal prep, talk to family members or friends about their “go-to” healthy recipes for some ideas. Bonus tip: getting your kids involved in meal prep makes them more apt to try new foods.
Haven’t convinced you yet?
Or, perhaps you are human and realize it’s 100 percent unrealistic to never dine out? I hear you, and completely understand where you are coming from. Let’s be real though: few things compare to a delicious meal out with friends and family that doesn’t require you to lift a finger. Here’s some tips to enjoy a meal out without sabotaging your weight loss efforts:
- Order an appetizer or lunch-sized portion as your entrée.
- Make special requests: substitute calorie-dense side dishes for nutrient-dense ones (think mixed veggies instead of loaded mashed potatoes).
- Split a meal with a friend or family member, or ask for a takeout container to be brought out with your food.
- Keep yourself informed: check out the menu ahead of time online; first to find a meal you can tolerate, and to browse the nutrition facts if they are available. (Even registered dietitians have to do this!)
- Keep your protein sources lean.
- Opt for steamed veggies vs. sautéed.
- Limit your liquid calories. If you’ve undergone a bariatric procedure, remember to separate fluids and solids by 30 minutes to maximize satiety. H20 is the way to go!
- Decide ahead of time between the bread basket, an appetizer, or dessert. Better yet — ask that the bread basket not be brought out.
- Heading out after dinner and can’t take your leftovers with you, but don’t want to be tempted to pick at them while you wait for the bill? Douse your plate with salt, pepper, or anything that will prevent you from mindless munching. Yes, this is a waste. But keep in mind the server will just be dumping it anyway.
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On the Lighter Side
Your Astrological Food & Fitness Forecast
What Do the Stars Have in Store for You This Spring?
By Linda Trainor, RN, BSN
This spring I decided to (briefly) take off my nurse’s cap and gaze into the galaxy, reaching out to the stars with the hope that they can help us all blossom with inspiration as we strive to meet our personal dietary and exercise goals. Find your sign and see what food, fun, and fitness feats are in your future!
Jan 20 - Feb 18
Expect to have fun while enjoying your independence from bad habits that burden your lifestyle. Aquarians not only have a craving for sweets, but a craving for excitement and adventure. This spring promises to provide you with solutions to get the body that is just right for you! Since you are observant by nature, be on the lookout for opportunities to conquer procrastination. Go outside. Breathe in … breathe out … there’s that long-awaited, fresh spring air!
Have fun this spring while exercising your intellect and body with positive thoughts and free spontaneous activities that yield healthy outcomes. Perhaps an unplanned trip to the mountains, an unexpected beach or camping trip with a friend or loved one may bring sweet lasting memories for a lifetime. Don't forget to pack fresh berries, vegetables and fruit for the trip.
Feb 19 - March 20
Your quest to obtain health and fitness is well within your reach this spring. It is easy for you to kick any habit that is preventing you from achieving your fitness goals. Since you enjoy social events and new situations, get your calendar ready to be filled with many fun activities that are simply perfect for the compassionate, nurturing-by-nature Pisces.
Since you often think of others first, remember that this spring is about YOU first! NOW is the time to nourish your palate with tasty fruits, low-fat dips and healthy vegetables. When in doubt, leave it out with any person, place or situation that will not contribute to your optimal peace of mind, health and fitness goals. Seize the opportunities that will only bring out the best in you.
March 21 - April 19
Bask not only in the sunshine this spring, but in the glory of knowing that you will experience the results you are seeking from your health and fitness plan. Your diligence in keeping accurate food records, along with daily exercise, will continue to serve you well. Those born under this star’s sign are naturally optimistic and enthusiastic, and serve as great role models. Others take notice and want to emulate your daily dedication to fitness.
Take heed not to get bored from your daily fitness and food choices. Assure that your exercise includes fun-filled activities that are challenging. Are you ready for Zumba? You may also benefit from taking a cooking class — perhaps a great opportunity this spring to meet new people who share your enthusiasm for vibrant health.
April 20 - May 20
A Taurus is noted for persistence in achieving goals. Your faithfulness to your fitness plans will serve you well this spring. Getting in shape and becoming slim and trim is the primary item on your agenda. Don't forget to let others know that you mean business when it comes to eating healthy and making exercise your daily priority.
Keeping others aware of your goals is crucial to your success, as your generosity fosters caring for others’ needs first rather than your own. Find your strength, be patient, and stay loyal to your fitness goals — this spring is your time to shine.
May 21 - June 20
If at first you don't succeed, Gemini, you are just about normal. This spring is the time to let go of the past and live in the present. Keep your eye on the prize: health and fitness. Even though it may appear to others that you are NOT affected by daily personal and professional demands, internally you might feel like a wound-up spring. Take time to unwind, relax and focus on mindful eating.
Spring is the best time to fit a meaningful exercise plan into your calendar. It may simply be walking five minutes six times daily, or as grand as entering a 5K. Since you cherish your independence, you decide what the best plan is for you. Just know the stars are in alignment for you to succeed.
June 21 - July 22
The crab is associated with Cancer because this creature best describes those born under this zodiac sign. Crabs by nature can aggressively come out of their shells to fight, but they can also secretively skitter away to hide. No time to hide this spring, Cancer! Since you are observant of your environment, adaptable and responsive to people, places and situations, spring will provide many opportunities to come out of your shell and enjoy the sunshine.
There’s no stopping you this year from achieving your health and fitness goals. It’s a great time to lighten up and enjoy the change of season. Even though life’s stressors may tug at your heartstrings, intuition will serve as a guiding light for you to focus on your goals. Health is wealth and you will overcome any shyness or insecurity to cash in and prove there is nothing you cannot accomplish this spring.
July 23 - August 22
A Leo's loyalty to their fitness plan yields significant results this spring. Those born under this zodiac sign give credence to the old saying, "You reap what you sow." Others are attracted to your wit, style, humor and dedication to health and fitness.
You make it appear seemingly effortless to achieve your fitness goals; however, you truly are aware that it requires daily dedication to a plan for success. Since Leos are social butterflies, you may want to share your shapely secrets of keeping accurate food records and being faithful to your exercise routine with family and friends — and you will likely have many opportunities to do so. Keep working your fitness routine; you have plenty of loyal supporters cheering for continued success.
August 23 - September 22
Before a Virgo plunges into any fitness plan, they invariably will analyze all the facts and must know all the details before being willing to make any changes. Winter was a great time to create an exercise routine, but spring is the best time of the year for you to put this plan into action and get into shape.
Don't underestimate how your positive outlook will help you achieve the healthy outcomes that you are seeking. As the weather warms, walking, bike riding, and hiking are fun activities to relieve stress. Practice mindful eating habits too — take small bites of food while chewing slowly. Keep in mind, to analyze is to paralyze. Don't tire yourself by thinking too much. Don't strive for perfection; simply enjoy the fresh air and take comfort in this little saying: "Inch by inch it's a cinch, yard by yard it's hard."
September 23 - October 22
No more sitting on the fence, Libras. Take the leap of faith in knowing that indecisiveness does not serve you well. Spring promises to nurture your graceful, peaceful and hospitable nature. Let go of past failures and forgive yourself for not achieving all of your goals. You have what it takes to succeed this spring. Choose to replace negative, unpleasant thoughts of discouragement with positive words of encouragement. Take the necessary steps to make a list so you’ll only buy healthy foods when marketing. Be sure to incorporate fun exercise into your daily routine, too.
There’s no doubt about it! You are known as the peaceful diplomat of the Zodiac, and spring is the time to be kind and true to yourself. You deserve to be healthy and fit. Let the sun shine on your healthful goals.
October 23 - November 21
No mystery this spring for Scorpios. Those born under this star’s sign are sure to experience a lot of fun while getting fit this spring. It is crystal clear that you are in the driver’s seat and have approached the corner of health and wellness. Gardening, raking, and cleaning your car are a few of the many ways for you to burn extra calories while you enjoy the spring air. Getting the grill out early this year will also prove beneficial to your diet.
Scorpios are especially noted in the Zodiac for their deep intensity and their tremendous ability to survey any situation. These characteristics will serve you well with your spring fitness routine. You will not deviate from your game plan and are certain to champion your health goals.
November 22 - December 21
Count on jumping right over any hurdles to your fitness this spring. There will be plenty of opportunities for you to revitalize your exercise routine. Your sense of humor and friendly personality may attract friends to join you in walking, hiking, bike riding, sightseeing, and sharing healthy meals. Your tolerance to others makes it easy to have you as a workout partner. Having you alongside will make the sun shine brighter for your pals this spring.
Be happy. Wake up daily knowing exactly how you will take action with your fitness plan. Visualize to actualize. Don't deviate from your exercise routine; be confident that your fitness goals will be reached. Your commitment to health will serve you well, as you keep your eyes on your own plate and enjoy the company of workout partners that help you spring into shape.
December 22 - January 19
Pursuing your ambitions towards health and fitness this spring will prove to be fulfilling and rewarding. You have waited a long time to get what you want, and spring is your time to succeed. Use your great organizational skills to design a comprehensive fitness plan that is just right for you! Never underestimate that small changes bring big results. Faithfully follow your exercise plan, and you will achieve your health goals with flying colors.
Since Capricorns are known to like being in control of their surroundings and situations, clear your cupboards of any candy, chips, and unhealthy snacks. Keep the company of like-minded folks who share your appreciation for fitness. Loosen up! Try and relax this spring and be certain that nature will run its due course. Just as seeds that were planted in the fall are destined to blossom in the spring, so shall following your individual wellness plan bring you the desired results that you are seeking.
While the bariatric clinicians at Beth Israel Deaconess Medical Center wish you only the best in your healthy endeavors, these horoscopes are provided for your entertainment and enjoyment only. Please consult your doctor for specific advice about your medical care, as well as before starting any diet or exercise program.
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Meet Our Bariatric Nurse
By Linda Trainor, RN, BSN
Erin Hogan RN, BSN, joined the Weight Loss Surgery Center's multidisciplinary team in January 2013 as an outpatient clinical staff nurse.
She performs pre-operative and post-operative clinical patient assessments, triages post-op telephone calls, and offers support and education to patients and their families.
Upon graduating from the University of Massachusetts Lowell, Erin began her career at Beth Israel Deaconess Medical Center in the acute care surgical setting on Farr 9. It was at this point that Erin had the opportunity to work with bariatric patients; her responsibilities included caring for patients and their families from admission to discharge after various surgeries, such as the Roux-en-Y gastric bypass, sleeve gastrectomy, adjustable gastric lap band, Whipple procedures, various thoracic surgeries, and general abdominal surgeries.
After six years of working in the acute care surgical setting, Erin wanted to shift her focus to an outpatient care setting.
"I chose to work at Farr 9’s acute care surgical setting because I saw many bariatric patients immediately after they had surgery, but I never had the opportunity to see their success afterwards," Erin explains. "Working in the clinic in an outpatient setting gives me that opportunity, and it's so good to see the amazing results of the patients' hard work."
It is easy for anyone to recognize Erin in this new setting with her warm smile and focused, friendly approachable demeanor as she assists patients and their families in their lifelong journey to health and wellness.
When Erin is not working, she enjoys spending time with her family and friends. She also likes to write.
Welcome aboard, Erin!
Erin can be reached in the Weight Loss Surgery Center at 617-667-2845.
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Ask the Trainer
Simple Strengthening Exercises
Exercise physiologist Derek Walczak answers our readers' questions about different ways to build strength and endurance in the arm, leg, and abdominal muscles.
Q. I mostly use a wheelchair. I am able to walk a few feet,
but with other comorbidities (including obesity), it makes it hard to accomplish more than five minutes of exercise. Are there any exercises I can do to strengthen my muscles and tolerance levels? - Tribora
A: The best way to increase endurance is to begin with a workout that is easily completed and slowly add to it. You can break a workout up into two sessions throughout the day, resting in between. As you get stronger and your endurance increases, you can add repetitions and sets and decrease rest time.
Start by sitting up straight with your arms hanging by your sides. Perform the following three exercises from this position; start by doing each for one set of 12 repetitions. As you get stronger and your endurance increases, you can add reps and sets.
- Raise arms by your sides to shoulder height, keeping elbows extended and palms down. Make small circles forward and then backwards. Return arms to starting position.
- Raise arms straight out in front of you to shoulder height, elbows extended and palms facing the ground. Hold for a second and then return to starting position.
- Raise arms in front of your body to shoulder height, elbows extended and palms facing up. Now curl both arms in by bending your elbows until your hands touch your shoulders. Reverse movement to starting position.
Once you have mastered these movements and can do additional sets, you can do them while holding light weights or even small objects found around the house (soup cans, water bottles).
From a seated position, perform the following three exercises. Begin by doing one set of 10 repetitions, holding each rep for 3 to 5 seconds. As you build strength and endurance, you can add reps and sets.
- Lift up one leg and hold. Return to start, repeat nine more times, and then perform with the other leg.
- Lift one leg up with your knee extended (but not locked) and toes pointed forward. Return to start, repeat nine more times, and then perform with the other leg.
- Place feet on floor and perform a heel raise by pressing up on your toes. You can do this on both legs simultaneously or one leg at a time.
Q. Can you recommend several abdominal exercises?
A. Here are some exercises you can try to strengthen your abdominal muscles, ranging from simple to more difficult. If you have had weight loss surgery, you should be able to begin these exercises safely six weeks to six months post-surgery — but, of course, only with your doctor’s permission.
And, while these exercises can help you tone and tighten your stomach, remember that the best way to lose belly fat is to burn calories and increase your metabolism through proper exercise and nutrition. Consult your doctor when starting any new exercise or diet program.
Difficulty level: Easy
Complete: 5 to 10 repetitions of each exercise at a time
- Pelvic Tilts
Lie on your back with your feet flat on the floor and knees bent. (You can put a pillow or towel under your head to support your neck.) Slowly breathe in and push your lower back into the floor while tightening the abdominal muscles. When tightening the muscle, breathe out for a count of 5 to 10 seconds, then relax.
Lying in the same starting position, slowly raise your hips off the ground, squeezing your glutes (buttocks). Be careful not to forcefully push your head and neck into the floor, and keep your feet flat.
- Windshield Wiper
Lying on your back, keep your knees bent and elevate your feet while placing your arms out to your sides. Your head and shoulders should be firmly on the floor. Slowly lower your legs, keeping the knees together, to your side so that the knees are pointing away from your body. Make sure to keep your shoulders and upper back in place. Bring the knees up to the starting position and repeat on the other side.
Difficulty Level: Medium
Complete: Gradually increase to 10 repetitions for 10-second holds on each side.
Kneel on the floor on your hands and knees. Place your hands directly under shoulders, with fingers pointed forward and arms straight. Your knees should be directly under your hips (bent at 90 degrees). Tighten your abdominals, being careful not to round your back.
Slowly lift your right arm of the ground an inch or two, hold for a few seconds, then return to floor. Repeat action with left arm, then right leg and left leg.
That was your practice! Once you can comfortably perform this on each arm and each leg, you are ready to advance.
Now you want to extend your right arm out in front of your body so your hand is the same height as your shoulders. Simultaneously extend your left leg backwards in the same manner. Hold for a few seconds and return.
This counts as one repetition. Repeat by lifting your left arm and right leg simultaneously.
Difficulty Level: Hard
Complete: Start by holding this position for 5 seconds at a time. Gradually increase the time as you get stronger.
Lie on your stomach on an exercise mat or floor with your elbows tucked to your sides and directly under your shoulders, palms down and fingers facing forward. Engage your abdominal/core muscles by pulling your belly inward. With your legs out straight behind you, flex your ankles; you should be on your toes.
Slowly push your entire body off the mat or floor, keeping your torso and legs rigid. You should be on your elbows and toes. Do not allow any sagging in your ribcage or low back. Your hips should be straight and parallel to the floor. Avoid bending at the knees. Keep your shoulders directly over your elbows with your palms facing down. Pay close attention to your breathing and do not hold your breath.
Please consult a physician before starting any exercise program.
Derek Walczak is an Exercise Physiologist at BIDMC's Tanger Be Well Center. He holds a BS in Kinesiology from UMASS Amherst and is a Certified Strength and Conditioning Specialist through the National Strength and Conditioning Association.
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Ask the Dietitian
Adding Vitamins and Minerals
Q. What are some of the best foods to incorporate into my diet to help ensure I’m getting a good amount of iron, calcium and vitamins?
Michelle Davis, RD, LDN: If you’re looking to increase your iron consumption with food, meat, poultry and fish are great sources of heme iron — the type of iron most readily absorbed in our body. In addition, foods such as red, yellow and orange peppers are high in vitamin C, which enhances absorption of iron in the body. Try this recipe for a quick and easy meal packed with iron and vitamin C!
Balsamic Chicken Breast with Peppers and Onions
Serves 4 to 6
4 boneless, skinless chicken breasts
Salt and pepper to taste
3 tbsp olive oil, divided
4 cups thinly sliced peppers (red, orange, yellow)
1 medium onion, sliced thin
4 cloves garlic, chopped fine
1/4 cup fresh basil
4 tbsp balsamic vinegar
Season chicken with salt and pepper. In a large skillet, sauté chicken in 2 tablespoons of olive oil over medium/high heat, turning once for a total of about 8 minutes or until golden brown. Transfer chicken to a plate and set aside.
Add remaining tablespoon of oil to the skillet and cook peppers and onions, stirring often until just softened. Add garlic and stir for about one minute. Stir in basil and vinegar.
Return chicken to skillet; reduce heat to low and simmer until chicken is cooked through (about 3 to 5 more minutes). Add additional salt/pepper to taste, if desired. Serve and enjoy!
And, if you’re craving a nutrient-packed snack or appetizer, this dip is packed with calcium and protein from the Greek yogurt, as well as monounsaturated fats and a variety of vitamins and minerals from the avocado. Pair it with a rainbow of fresh vegetables and/or whole grain pita for a nutrient dense yet delicious dish!
Avocado, Mint and Yogurt Dip
Serves about 6 (1/4 cup servings)
1 avocado, peeled, pitted, and cut into chunks
1 cup plain fat free Greek yogurt
1 tsp fresh lime juice
1/2 tsp kosher salt
1/4 cup sliced fresh mint leaves, divided
1 tbsp pistachio oil or extra-virgin olive oil
In a medium bowl, mash together avocado, yogurt, lime juice, and salt until creamy. Fold in 3 tablespoons of mint leaves, drizzle with oil, and top with remaining mint.
Enjoy with chopped up veggies of your choice or toasted whole grain pita!
Michelle Davis is a bariatric nutritionist in the Weight Loss Surgery Center at BIDMC.
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BIDMC Study Featured on TV
WCVB-TV recently featured an ongoing study at Beth Israel Deaconess Medical Center that focuses on whether brain stimulation helps patients who have undergone bariatric surgery lose more weight and better control overall eating behavior.
We featured this study in the Fall 2012 edition of the Weight Loss & Well-Being e-letter. Read more »
Watch the video from WCVB-TV:
This study is a collaboration between the Department of Neurology and the Weight Loss Surgery Center at BIDMC. It began in July 2012 and is funded by the Boston Nutrition and Obesity Research Center (BNORC). Further details can be found at ClinicalTrials.gov.
For More Information
Please contact Greta Magerowski at (617) 667-2654 or by e-mailing firstname.lastname@example.org.
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Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Originally posted April 2013