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Spring 2012 edition



Our Staff Makes the Difference ... But Our Patients Tell the Story

Look At Me Now: Kathy Rose's Second Chance at Life

By Linda Trainor, RN, BSN

Listening to Kathy Rose speak, one can easily hear the excitement in her voice about the new life she gained after losing 130 pounds.

“I feel as though I have a second chance at life, much better than my previous life before having weight loss surgery,” says Kathy.

Kathy Rose: Before and After Weight Loss SurgeryPrior to her surgery, weighing 270 pounds, Kathy vividly recalls feeling depressed, trapped and stuck. She also remembers being unable to move physically and emotionally.

“I was taking three anti-depressants but still felt miserable,” she says. “I felt like I was jailed by unwanted pounds and crippled by undeserving emotions.”

Reflecting on her past, Kathy remembers many troubling moments that were filled with food and self-condemnation, and says she also experienced relationships that were “as unhealthy as my diet.”

“Today, my life is very different,” Kathy explains. “Today, I will not abuse my body by overeating and will not accept abusive behaviors in any relationships.”

Kathy adds that she is thrilled with only having room in her life today for healthy foods, positive people, and fun-filled activities — but discloses that her decision to have weight loss surgery did not come easily.

She says she tried many diets in the past but found her old eating habits returning when something unexpected would occur in her life, which left her unable to maintain long-term weight loss.

“I’d gain the weight I lost plus a lot more,” Kathy explains, adding that she suffered through periods of hopelessness and desperation before considering taking a major step to change her life and behaviors.

“I knew that having the Roux-en-Y gastric bypass was a serious surgery,” she says. “I had to really stop and think about what I needed to do because of my physical and emotional state of ill-being. I felt like I hit a brick wall. I could not even tie my shoes.”

Fatigue coupled with a lack of energy drew Kathy to a Weight Loss Surgery Information Session offered at Beth Israel Deaconess Medical Center. Following the session, Kathy scheduled an appointment at the Weight Loss Surgery Center.

“I was very appreciative that I was not judged in any way, shape or form at my initial visit with the bariatric staff,” Kathy says. “When you are obese, people can and do treat you unkindly. At BIDMC, I felt welcomed. Most importantly, I thank God every day for the surgical skills of Dr. Schneider. This procedure changed my life.”

Kathy RoseIt has now been two years since Kathy underwent surgery, and she has maintained a 130-pound weight loss. Her new attitude matches her new body.

“It is amazing to me that I become full with smaller amounts of food,” she says with a laugh. “I am not on a diet. I have a new way of life.”

Kathy also reports being diligent about seeing her nutritionist.

“It’s all about healthy choices,” she says. “Keeping my scheduled appointments is a healthy choice.”

Revamping her attitude, achieving her lifetime goal, and maintaining her success also provided Kathy with the strength to only have room for healthy relationships in her life.

“Now, when I am faced with difficult times, I don’t have to eat to comfort myself,” she admits. “Before weight loss surgery, any stressful situation would be comforted by eating pasta, pizza or sweets.”

Kathy’s new way of dealing with stress includes calling friends, seeking appropriate help, or doing something fun.

“At 140 pounds it is fun to go shopping!” she says. “What is really nice about this spring is that I can fit in the same wardrobe as last year.”

Kathy recently spoke to students at Harvard Medical School about her life-changing surgery and says that sharing her experience helps keep her strong — a big factor in her new life.

“A life,” she readily adds, “that I would not change for anything or anyone.”

All photos courtesy of Kathy Rose

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Expert Advice

Spring into Shape: Tips for Starting a Fitness Program

By Rick DiScipio, Med, CSCS, NSCA-CPT, NASM-PES

walking outsideSpring is here! Here are some helpful exercise tips for breaking into the sunshine months:

Set realistic goals.

Don't try to do too much too soon. If you have not exercised in a while, begin with walking for 15 minutes a day, increasing the time by adding 10 more minutes each week. If you belong to a gym, hire a trainer to help you design a personalized exercise program.

Become more active.

Pick ways that you can become more active in your life. For example: taking the stairs instead of the elevator, hiking with the family, gardening, mowing the lawn or taking an extra-long walk with the dog.
Enlist a workout partner. Whether it’s at the gym or walking outdoors, find someone that shares your fitness goals and motivation to succeed.

Choose a fitness program that you enjoy.

If there is no passion in what you do, you will quickly lose your motivation to exercise. Enjoying what you do makes the whole 'fitness experience' a lot of fun. Whether you enjoy group exercises classes or lifting weights, research indicates that people are more likely to engage in exercise that they like.

Schedule time for your exercise.

Research shows that when people skip a workout, there’s a 62 percent chance they’ll miss an exercise session the following week. Make your exercise program a part of your everyday life. Commit yourself to accomplishing your goal and don't make failure an option.

Enjoy your health journey.

It may take some time and effort to make your exercise regimen a part of your daily life, but remember to never give up and to stick with it!

Rick DiScipio is an exercise physiologist at BIDMC’s Tanger Be Well Center.

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Nutrition Corner

Spring Ahead with Healthy Habits

By Michelle Davis, RD, LDN, Bariatric Dietitian

tulipsSpring is here! What are you looking forward to the most? Longer and lighter days? After-dinner strolls with family and friends? Fresh and local produce from the farmer's market? These are all things that I love about spring. But, with the blooming of flowers and birds chirping, spring also reminds us that summer is around the corner.

With summer coming, we have the need to reach in the back of our closet and pull out all of our summer clothes that have been hidden for the past six months. Maybe this is the year that you’ll fit into a bathing suit deep in the closet that you have been holding onto for years. Or maybe this is your time to reset and think about some healthy habits that can help you meet the goals you have been working towards. Whatever it is you feel as spring and summer rapidly approach, remember these simple and easy healthy habits that can help you spring ahead with your health:

sleepingGet enough sleep at night.

Research has shown that a poor night’s sleep can activate the appetite control in our brain, thus making us hungrier and prone to consume more calories throughout the day. Make sure to hit that pillow and get the recommended seven hours of sleep each night.

couple bicyclingFind an exercise routine that you enjoy.

We all know the benefits of exercise — weight loss and maintenance, heart health, etc. But who thinks about exercise as extra “work” added on to their day? This makes it very difficult to continue with an exercise program, so find a routine that you ENJOY so you can stick with it! Maybe it’s the gym, Zumba class, swimming, playing Wii Fit with your children, or brisk walking with family and friends.

Follow the 90/10 rule for healthy eating.

fruit smoothieWhen it comes to healthy eating, nobody is perfect! Spring and summer can be a time filled with barbeques and parties, which can be challenging when working towards healthy eating. Using the 90/10 rule, stick to your healthy eating choices 90 percent of the time, and allow yourself to “splurge” on foods you enjoy the other 10 percent of the time — maybe at a party, on an anniversary or vacation with family and friends. When following this rule, you can enjoy things you love while staying on course with your nutrition goals.

No matter what your goals are for the upcoming seasons, enjoy life and use these tips to spring ahead to a happier, healthier life!

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On the Lighter Side

Spring Clean to Be Lean!

By Linda Trainor, RN, BSN

Spring CleaningIt's SPRING! Robins are tweeting. The baseball season has started (woo hoo!). And, our internal clocks are buzzing.

Spring is that magical time of the year that brings hope and gives people inspiration to move forward. All of our energy gears up with two goals in mind: To remove and replenish. Does this sound familiar? "Honey, it's time to do the yaaaarrrrd work!" Hour after hour, many of us throw away unwanted stuff, clean indoor windows, doors, floors, and cabinets while raking, pruning, and planting outdoors … yadda, yadda, yadda.

The same productive principal should be applied to ourselves with personalized spring cleaning. Time to pop out of winter hibernation and take the first steps towards removing unhealthy behaviors and replenishing with refreshing healthy routines.

Since it stays lighter longer, eat lighter longer. Spring is also the perfect time to resume physical training, just like our favorite guys of spring, summer, and (fingers crossed) fall, the Boston Red Sox. The first thing the boys of summer do is STRETCH! They stretch their arms and stretch their legs to condition their bodies for the long haul of the baseball season. They come out of the long winter slumber and pick up the baseball bats of lumber.

Let the Spring Cleaning Games Begin!

Stretch Yourself with these Practical Steps to Healthy Spring Cleaning

Lighten UP

  • Rid cupboards of junk foods. (Remove)
  • Fill your cleaned refrigerator with fresh fruits and vegetables (Replenish)
  • De-clutter your thought process. Use NUTS: Negative Unpleasant Thoughts Stopping. (Remove)
  • Enjoy lighter, more frequent meals that include filling fiber at every meal. (Replenish)
  • Stretch: Physically stretch your extremities morning, noon and night, both in the office and out of the office. Emotionally, stretch your imagination morning, noon and night, both in the office out of the office. (Replenish)
  • Condition Your Muscles: You don’t have to be at a gym. You can just use the cans of soup you reorganized (Remove) in the cabinet. Use them as weights while watching your favorite TV programs in the evening. (Replenish)
  • Have FUN: Put energizing music on while you rake. Sing "I'm Sexy and I Know It" (Replenish)

In 2012, Spring Clean to Be Lean. You might even practice forward thinking:

"If I can spring clean my house, I can spring clean myself with a healthy diet."

"Now that the boys are back in town being physical, I can get a jump start to hit the ball out of the park for my own healthy home run."

Game On!

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Signature Series

Meet Dr. Samuel Lin

By Christie Roy, BIDMC Staff

Samuel J. Lin, MD Samuel J. Lin, MD, is a plastic and reconstructive surgeon at Beth Israel Deaconess Medical Center, having joined the Department of Surgery as an attending physician in 2007. Among the many cosmetic procedures he specializes in is surgery after weight loss, or body contouring.

Body contouring involves removing excess skin that may accumulate following significant weight loss, and Dr. Lin is now the co-director of the Division of Plastic Surgery's Center for Life after Weight Loss at BIDMC, in partnership with the Weight Loss Surgery Center.

Currently an Assistant Professor of Surgery at Harvard Medical School, Dr. Lin earned both his undergraduate degree (in biomedical engineering) and his MD from Northwestern University and its Feinberg School of Medicine. He remained in the Chicago area to complete his internship and residencies in otolaryngology and plastic and reconstructive surgery at Northwestern University Memorial Hospital.

Dr. Lin also completed a fellowship in microvascular reconstructive surgery at the University of Texas M.D. Anderson Cancer Center, where he was a clinical specialist in plastic and reconstructive surgery. He is board certified in plastic surgery as well as otolaryngology-head and neck surgery.

"I chose plastic surgery because of the many ways we can help patients creatively and problem-solve different situations," Dr. Lin says.

Indeed — aside from body contouring, Dr. Lin's clinical focus includes breast reconstruction and the DIEP flap procedure; functional nasal reshaping and reconstruction for breathing problems; and facial aesthetics.

When he has some free time, Dr. Lin says he turns his attention to college football inside and staying fit outside.

"I like running for exercise, and skiing is one of my favorite hobbies," he says.

To make an appointment with Dr. Lin, call the Division of Plastic and Reconstructive Surgery at 617-632-7827.

Learn more: Dr. Samuel Lin »

Learn more: Surgery after weight loss/body contouring »

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News

Introducing the New Center for Life After Weight Loss at BIDMC

Samuel J. Lin, MD

Organized and initiated with the Weight Loss Surgery Center at Beth Israel Deaconess Medical Center, Dr. Samuel Lin, a plastic surgeon at BIDMC, would like to introduce the Division of Plastic Surgery's Center for Life after Weight Loss. This new center brings together elements of the post-bariatric regimen with potential surgery after weight loss (body contouring), along with continued dietary support and other physician specialties.

Dr. Lin is co-director of the center along with colleague Dr. Adam Tobias. Surgery after weight loss, or body contouring, relates to the removal of excess or lax skin that may accumulate in various areas of the body following significant weight loss. The removal of the loose skin/fat may help individuals go through their daily routine with greater mobility and also may help patients fit into different clothes. Body contouring procedures include tummy tucks, breast reshaping, thigh lifts, arm lifts, buttock lifts, liposuction, and face/neck lifts.

"It is a real privilege to be able to meet patients during their journey with weight loss," says Dr. Lin. "For some patients, this journey is years or decades in the making."

Gwendolyn Wright is one patient of Dr. Lin's who recently had body contouring. Ms. Wright states that some of the things that have changed since her weight loss includes the fact that she has "more energy." She is also "developing a healthier attitude towards food and nutrition," and says this is a tribute to the entire Weight Loss Surgery Center at BIDMC.

Gwendolyn Wright: Before and After

Ms. Wright's daily activities also have changed significantly.

"I can keep up with the 20- and 30-year-olds in my Zumba class," she says.

In addition to the health benefits of weight loss, individuals will often be more mobile and active. Ms. Wright also says that she "had a great summer in the pool with my grandchildren."

Following body contouring, Ms. Wright has told Dr. Lin that her "clothes look better," and, in general, she says she continues to be "feeling better about myself."

"I have increased self-esteem," Ms. Wright adds, "and now love having my picture taken!"

For more information about the Division of Plastic Surgery's Center for Life after Weight Loss, or to schedule an appointment, call 617-632-7827.

Learn more: Dr. Samuel Lin »

Learn more: Surgery after weight loss/body contouring »

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Ask the Trainer

How About Swimming?

Q. Would water aerobics and lap swimming provide enough exercise following weight loss surgery?

I am a candidate for knee replacements and find it difficult to walk for any length on a treadmill or bicycle. – Christy Zarella

water aerobicsRick DiScipio Med, CSCS, NSCA-CPT, NASM-PES: You can get a great workout with water aerobics. Because water aerobics is low impact, meaning that you are less likely to stress your joints, it is an excellent form of exercise for people with knee and hip osteoarthritis (OA). Aquatic exercise can help relieve pain and improve daily function. In addition, water aerobics offers many of the same benefits as other aerobic exercise (walking, biking), including weight control, improved bone and muscle health, improved cardiovascular conditioning and a greater sense of physical well-being.

How many times a week that you do water aerobics depends on you. You may want to start with two sessions and see how that feels. I would suggest after your knee replacement to work with a physical therapist in helping you begin a strength training program.

human body jointsKeep Your Joints Healthy with Exercise

Exercise is critical for strong muscles and bones. Muscle strength declines as people age, but studies report that those who exercise are stronger and leaner than others in their age group.

Joints are complex structures, designed to bear weight and move the body. They require motion to stay healthy and long periods of inactivity cause joints to stiffen and the adjoining tissue to lose muscle mass and strength. Strong muscles support joints. With inadequate muscle, joints are over-burdened, especially those in your knees, which must support your entire body weight.

Weight training exercises help build muscle and keep existing muscle and surrounding ligaments strong. This way, your joints don't have to do all the work. A moderate exercise program that includes low-impact aerobics and strength training will also increase bone density, another important factor in support of your joints.

Rick DiScipio is an exercise physiologist at BIDMC’s Tanger Be Well Center.

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Ask the Dietitian

Eating More Fiber?

Q. What is the best way to incorporate more fiber into my diet?

Fruits, vegetables and whole grainsKate Otto, RD, LDN: The best way to increase intake of fiber is by consuming more fruits and vegetables, and by choosing whole grains. Aim to fill about half your plate with fruits and vegetables, add a sprinkle of beans to salad, or choose a whole grain deli flat or wrap instead of white bread (be sure to check out the recipes below!).

If you have had bariatric surgery, keep in mind you may have a hard time tolerating fruits and vegetables that have tough skins, large seeds, or a stringy fibrous texture. If this is the case, you can try canned or frozen instead of fresh, and try dicing, shredding or peeling them as needed. Removing skins will decrease fiber content; however, peeled fruits and vegetables are still nutritious and more easily tolerated by patients after weight loss surgery.

Fiber intake should be increased gradually to avoid gastrointestinal upset. Also, make sure to increase fluid intake while increasing fiber intake to avoid constipation.

Fiber-Filled Recipes

Zesty Bean Dip & Chips

1 serving

Ingredients

1/4 cup fat-free canned refried beans
1 tablespoon salsa
1 1/2 teaspoons chopped fresh cilantro
1 minced scallion, (optional)
1 ounce tortilla chips, (about 10)

Directions

Combine refried beans, salsa, cilantro and scallion (if using) in a bowl. Serve with tortilla chips. Or, use as a vegetable dip or sandwich spread.

Nutrition Facts per serving: 210 calories; 7g fat (1g saturated, 2g monounsaturated); 5mg cholesterol; 30g carbohydrate; 5g protein; 4g fiber; 362mg sodium; 73mg potassium

Nutrition Profile: Low calorie, Low cholesterol, Low saturated fat, heart healthy, healthy weight, High fiber, Gluten free

Cherries with Ricotta & Toasted Almonds

1 serving

Ingredients

1/2 cup to 3/4 cup frozen pitted cherries
2 tablespoons part-skim ricotta
1 tablespoon toasted slivered almonds
(For additional sweetness, add 1 packet of no calorie sweetener or sugar free vanilla syrup)

Directions

Heat cherries in the microwave on High until warm, 1 to 2 minutes. Top the cherries with ricotta and almonds.

Nutrition Facts per serving: 150 calories; 6g fat (2g saturated, 3g monounsaturated); 10mg cholesterol; 20g carbohydrate; 6g protein; 3g fiber; 39mg sodium; 329mg potassium.

Healthy Heart variation: To reduce saturated fat even further, use nonfat ricotta in place of the reduced-fat ricotta.
(Revised nutrition facts: 133 calories, 0g saturated fat per serving)

Nutrition Profile: Diabetes appropriate, Low calorie, Low cholesterol, Low saturated fat, Low sodium, Heart healthy, Healthy weight, Gluten free

Sweet Potato & Black Bean Chili

8 servings (about 1 cup each)

Ingredients

1 tablespoon plus 2 teaspoons extra-virgin olive oil
1 medium-large sweet potato, peeled and diced
1 large onion, diced
4 cloves garlic, minced
2 tablespoons chili powder
4 teaspoons ground cumin
1/2 teaspoon ground chipotle chile (see Note)
1/4 teaspoon salt
2 1/2 cups water
2 15-oz. cans black beans, rinsed
1 14-oz. can diced tomatoes
4 teaspoons lime juice
1/2 cup chopped fresh cilantro

Directions

Heat oil in a Dutch oven over medium-high heat. Add sweet potato and onion and cook, stirring often, until the onion is beginning to soften (about 4 minutes). Add garlic, chili powder, cumin, chipotle and salt and cook, stirring constantly, for 30 seconds. Add water and bring to a simmer. Cover, reduce heat to maintain a gentle simmer and cook until the sweet potato is tender (10 - 12 minutes).

Add beans, tomatoes and lime juice; increase heat to high and return to a simmer, stirring often. Reduce heat and simmer until slightly reduced, about 5 minutes. Remove from heat and stir in cilantro.

Make Ahead Tip: Cover and refrigerate for up to 3 days or freeze for up to 3 months.

Note: Chipotle peppers are dried, smoked jalapeño peppers. Ground chipotle chile pepper can be found in the spice section of most supermarkets or online at penzeys.com.

Nutrition Facts per serving: 153 calories; 4g fat (0g saturated, 2.5g monounsaturated); 0mg cholesterol; 25g carbohydrate; 0g added sugars; 6g protein; 7g fiber; 247mg sodium; 474mg potassium.

Nutrition Bonus: Vitamin A (106% daily value), Vitamin C (24% dv), Iron (16% dv), Folate (15% dv), Potassium (13% dv), Calcium (8% dv).

Nutrition Profile: Low calorie, High fiber, Low saturated fat, Low cholesterol, High potassium, High calcium, heart healthy, healthy weight, Diabetes appropriate, Gluten free

All recipes adapted from EatingWell.com.

Kate Otto is a bariatric dietitian in the Weight Loss Surgery Center at BIDMC.

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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 2012

Contact Information

Weight Loss Surgery Center
Beth Israel Deaconess Medical Center
Shapiro Clinical Center, 3rd Floor
330 Brookline Avenue
Boston, MA 02215
617.667.2845
617.667.2866
wls@bidmc.harvard.edu

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