Transcription:
Deciding to Have Bariatric Surgery: A Candid Conversation with a Patient and Her Surgeon

Scott Webb (Host):  The decision to have bariatric surgery is not an easy one. But trust in your surgeon and your weightloss team is an important part of that decision and journey. On this special episode of the Healthworks Here Podcast, from Emerson Hospital, we are featuring a candid conversation between bariatric surgeon Dr. Laura Doyon and Celine Leger, one of Dr. Doyon’s weightloss success stories.

Laura Doyon, MD, FACS, FASMBS (Guest):  Hi Celina, it’s Dr. Doyon. I’m so glad to talk to you about everything related to your surgery. I know it’s been just over a year now and your results have been really fabulous and impressive, and it’s just been wonderful to sort of watch you go through this process. And I wanted to just take a moment to sort of pause and recognize that and to talk to you a little bit more about why was it or what was it that made you originally pursue surgery? Did you know that you were going to do as well as you did?

Celine Leger (Guest):  Yes, hi. How are you? It’s so great to be chatting with you today. So, how I got here is kind of a long story, but we’ll try to sum it up as best that I can. I was feeling pretty depressed in my life. I felt like I had lost myself by gaining so much weight. I couldn’t do the things that I always thought that I was going to do in my life or wanted to do in my life and I was just constantly uncomfortable in my skin both physically and mentally. I tried all the fad diets that you can imagine. I even was put on medication from my primary care to try to help me lose weight and I just continually failed at all of these things.

And by failing, it just made me feel worse and worse and worse about myself. And I got to a point where I knew I had about 100 pounds to lose. And that number became so overwhelming to me that I didn’t even want to try to lose weight at that point. Because I knew like after failing so many times, I was never going to get there. And I remember people saying to me, well just set small goals. Set that five or ten pound goal and when you get there, set the next. But I knew the ultimate number was that 100 or so and it was so overwhelming to me and I was just feeling like such a failure and just feeling really bad about myself.

I remember looking at a picture and in the time that the picture was taken, I felt so large and uncomfortable. But then, a year went by and I looked at that picture and I remember saying, oh I wish I could just get back to that weight. But at that weight, I was uncomfortable. So, it just – and that happened for – it just went on and on for years. I just felt miserable in my skin and I knew it was time to do something.

Dr. Doyon:  That’s so sad to me because you’re such a positive person.

Celina:  Right and I generally am positive but a lot of that – I was overcompensating. I looked like I was on the outside, but on the inside, I just wasn’t feeling that. And since surgery I can say that that’s changed and – but in the moment, I couldn’t – yeah, I couldn’t have that internal positivity and internal smile and internal happiness because of all the weight that was weighing me down on the outside.

Dr. Doyon:  So, was there something that turned you onto surgery? Because I think sometimes people think about surgery for a period of time or maybe they have some worries or then they meet somebody who has had surgery. I mean tell me a little bit about what sort of made you actively pursue it?

Celina:  Sure so, when my primary care doctor suggested the surgery to me, I’m going to be honest, I was offended. I was like I am not that big. In my head I was thinking this is for people that I see on TV that are humongous and I just – I had this like preconceived notion that was – now I know it was not how I should have felt but I was offended. And I was ashamed that I would even have to take this drastic measure in my life. I did not know enough about the surgery and what I could bring me in my life. I became even more depressed and defeated and sad that I let myself go to the point that I would need this surgery.

Dr. Doyon:  Yeah and I would say that something that I see is that that’s really common. People say things all the time like I didn’t even know that I would qualify for weightloss surgery at this weight. I’m really not that big. This is not like the television shows. This is – I feel like I’m kind of normal for my friends and family. But apparently, I am a candidate and just to refresh, that’s a BMI of 40 or 35 to 39 with comorbidities. So, people are surprised at the medical evidence and the data to support weightloss surgery at that lower weight range to increase longevity, reduce medical conditions and so forth.

So, yeah, it’s interesting that you also had those feelings.

Celina:  Oh yeah and then once I came to terms with it, I said okay well let me look into this. all right so if this is for me, let me look into it. And I went on social media blogs and things like that and there was a lot of great information but then there was information like you’re going to lose your hair. You’re going to be bald. You’re going to have to take vitamins for life. Like that’s a bad thing. Your skin is going to be loose and saggy and you’re going to look old and so these were some of the fears that I had going into it before I really learned more about it. And i even questioned is this going to even work? Am I going to fail at this? Am I going to die on the table and leave my kids with no mother because I wanted to do something for myself? And then I had heard that some people have to lose weight prior to the surgery and I’m like, well I couldn’t lose weight before how am I going to lose it now. So what are they going to deny me?

Dr. Doyon:  Right, right, right and just to kind of speak to some of that. I hear all these things all the time. And just to start with what you finished with that fear about well do I need to prove myself and lose weight. I mean I think at our center, and I think that hopefully more surgeons and practices are understanding this as time goes forward, but there’s been a lot of pressure put on patients to lose weight ahead of surgery. And I find and my partner Dr. Lutz finds that’s really sort of not a helpful tactic because we know people can lose weight with some kind of a fad diet but you’re not gaining anything by doing another fad diet before your surgery.

It's much more meaningful to adopt the healthy eating practices that the dieticians will work with you on rather than trying to kind of trick your body into losing 20 pounds to prove that you’re a good patient. I mean, I think that’s more damaging actually than beneficial. So, that’s generally not a requirement in our program. So, I’m glad you spoke to that. Some of the other worries about am I going to lose all my hair. It is certainly, there can be hair loss early in the postoperative timeframe. And that is a phenomenon telogen effluvium where basically the hair follicles that are in a kind of standby state and not actively growing, they get lost, usually around two to four months after any kind of major surgery, emotional or psychological stress, rapid weightloss, postpartum states. It can happen in a lot of different conditions. So, it’s not unusual for people to lose a little bit of hair around that four month postoperative mark. And kind of the silver lining of that is that when the hair loss is coming, it’s actually because the new hair regrowth is pushing out the old hair so people will notice those little fuzzies around the edge of their scalp.

Typically by the one year mark, after surgery, maybe Celina can kind of speak to this, if you’ve experienced that but hair regrowth is usually really noticeable. And I’d say it’s the rare person who has ongoing issues with their hair.

Celina:  Yeah, my hair definitely thinned out. I didn’t get any bald spots or anything like that, but it definitely thinned out and it was scary at times as I’m in the shower and there were quite a bit of hair loss and things like that. And that was only a couple of month period and then I started to see the little spikies coming up and the hair and my hair is definitely getting thicker again. I can see all the new growth coming in. So, a fear that almost stopped me from having this surgery, to think about how short of a period of time that I had to deal with that and now it’s growing back. I mean to think that I maybe wouldn’t have done this because of that is just – it’s silly now to think back.

Dr. Doyon:  Yeah and it really is a common phenomenon. I mean I can – I’m having a little telogen effluvium right now from my lovely five month old so, it’s a thing that happens but we’re going to grow our hair back. It’s going to be okay. Yeah, it’ll be okay. You know I think it’s good to kind of bring out these fears and address them because from a medical perspective, it makes me sad to think as you suggested, that maybe something so ultimately insignificant is going to hold somebody back from such success with weightloss and such life changing weightloss. And so, we try and speak to some of these fears at our information sessions which we run weekly. Now in the era of COVID, they are Zoom meetings that you can log into remotely and I think that has actually made it pretty easy for patients to get that information and start thinking because there’s a lot of stuff out there on the web and I think it’s good to hear kind of directly from the surgeons who are presenting the information you know, what the data is with each of the surgeries and how to compare and contrast them and what to expect before and after surgery.

So, yeah, all good. So tell me a little bit about and I know some of this, but I want our listeners to know just how amazing you are doing. Tell me a little bit about what has the surgery done for you, how are you doing now, tell me about your life kind of after surgery.

Celina:  I hit a year on July 15^th. So, I’m just a little over a year and I’ve lost over 105 pounds. I’ve reached my goal weight and I am genuinely happy. I am confident. I feel healthy. As I spoke to you before, I wasn’t smiling on the inside, I am smiling from the inside. It’s such a great feeling. Actually one of my fears was am I going to end up divorced. Because – just because you read these things and I’m like it that going to be me? Is my husband not going to like me thin or is he going to be intimidated by it. I didn’t know what to think. But my marriage is stronger. Part of that is because my husband’s an active human being. And I’m able to be active with him now. We purchased a Peloton bike. And yes, and we are riding, and I downloaded the an app to run a 5K so I’m training myself to run a 5K. I’ve never even thought that was a possibility in my life and now it’s like a bucket list item that I think that I’ll be able to achieve.

I am a dance instructor. I’m able to keep up with my teenage dancers now and not feel like I’m dragging, and I feel like I’m a role model to them now, like my body is healthy and they can see what a healthy body can do in dance. And that I’m 42 years old and I’m still dancing and keeping up with 16 year olds. So, I feel like I’m inspiring to them to my children. I feel like I’m a better mother because I’m not so obsessed with how much I weigh and what I look like. I mean I can take a picture with my kids and not feel like I need to crop half of it out or hide behind them. I’m living life. I’m not just existing and I know it sounds so cliché, but it’s true. Like I’m living. I’m more excited about the activity in my life than what I’m going to eat. And because I know that food now is just fueling my body. It’s not making me happy or going to take away stress. It’s just there to fuel my body and keep it healthy.

Host:  Yeah, it’s interesting that you mentioned that because I think sometimes people worry well, I really like food and I don’t want to miss it after surgery. But part of the reason why surgery is so different from dieting is because it fundamentally changes a person’s metabolism, the hormones and the nerves that control how we desire food, when we feel hungry, when we feel satisfied and that kind of evens the playing field, I like to think of it. So, that you’re now functioning with a little bit of a more normal metabolism. So, weightloss surgery is really metabolic surgery that helps people just like you said, helps you view food a little bit more as fuel and nutrition rather than entertainment, a hole to fill the boredom, all of these potential other ways that food gets used sometimes.

Celina:  I am so, so thankful for this tool as we call it. I just – I would not be where I am without the support of the Emerson staff too. I mean so with my tool, and the support that I have, between you and the staff in the office and my people around me that have stayed with me. Some people have left my life and that’s okay. Because they shouldn’t have been there in the first place apparently. But I am so grateful for everyone on my team, we’ll call it, for being so supportive and helpful and I truly couldn’t have gotten through this without anyone and you’re part of that. And when you walk into a doctor’s office and they are ligit celebrating your success with you; there’s nothing better than that. There are people that don’t really know me outside of the office but are so genuinely happy for me and my happiness and my success. I mean you can’t get that very many places and I’m just so grateful that I landed at Emerson for this journey of mine. So, I thank you and your whole team because I would not be where I am without all of you.

Dr. Doyon:  Thank you Celina. That means so much to me. And I think that for me, part of what I just love about this field of medicine is not just the kind of technical kind of beauty of the surgery which I think pretty much every surgeon is going to enjoy but that human connection and that celebration of each individual person’s success. I mean it’s so uplifting and we all kind of need a ray of sunshine right now during these “uncertain times” with COVID and just to hear your story is just so positive and powerful and uplifting and so, thank you for sharing it.

Celina:  Yeah, well thank you for having me because if I can inspire even just one person to go out and do what I did, then I feel like my job is done because it is absolutely the best thing, I’ve ever done for myself.

Dr. Doyon:  Ah, that’s so cool. That’s part of your legacy now. It’s not just your own success. But potentially others as well. So, that’s so cool. And not that we want to necessarily talk lots about COVID because we I think all need a break from it, but I’ve had a number of patients in the office talk a little bit about being grateful for having had surgery sort of in spite of COVID or during the time of COVID or do you have any reflections on that since it is such an unusual time?

Celina:  I was losing my weight rapidly during all of this. Being quarantined I though oh, oh, am I’m going to sit here and eat chips and gain all my weight back and I actually took a different approach to it. Being stuck in the house, I was like listen, we cannot go back to our old habits. That’s when my husband and I’s relationship really started blooming. Because we were stuck in the house together and we had to do this workout and that’s when I really started working out and I had that fear of the lose saggy skin. Well, I’ve been working out and doing weight training and Peloton riding and things like that. All my skin is like starting to tighten up so, if COVID wasn’t here, who knows what I would have looked like.

The other thing is, being healthy I feel like I can fight off – I feel like my immune system is stronger just being at a healthy weight and eating healthy and exercising and less stress and less toll on my body. I feel like if I were to get COVID, God forbid, I would survive it. I would be okay. Where prior to surgery, I don’t – I would have questioned like can I survive this. So, it’s definitely peace of mind that I had the surgery during this scary time because A., my life and my marriage is better and B. I’m healthy and I feel like I can fight off, I’m not scared of the virus now where I think I would have been scared before for myself.

Dr. Doyon:  Wow. That’s amazing. I love it. Congratulations Celina. You are a rock star. I am so honored and humbled to have been this part of your journey, but I want you to know that so often people will say things to me like thank you Dr. Doyon for doing this. I feel like certainly there’s coaching and working together and I’m always here to support you and you know, we did about an hour long surgery and yet you have taken that and you, have done an incredible job to run with this and be successful. So, you know this. You know surgery is not the easy way out. You know that you’ve done all the right things. I just want you to feel empowered. You’ve just been so successful, not just because of surgery, but because of how well you’re doing.

Celina:  Thank you for that. I appreciate it.

Dr. Doyon:  A plus.

Celina:  Thank you.

Host:  Thanks to Dr. Laura Doyon and Celina Leger for this candid conversation and weightloss success story. And thanks for listening to Emerson’s Healthworks Here podcast. Make sure to catch the next episode by subscribing to the Healthworks Here podcast on Apple podcasts, Google podcasts, Spotify or wherever podcasts can be heard.