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Locals Regaining Health, Embracing New Lifestyle after Newly-Offered Bariatric Surgery in Leonardtown

The tipping point came in the  form of a toddler. 

Paul Horner’s two-year-old grandson  David, affectionately called “Junior,”  and big sister Jamie wanted to play  with their grandpa. Paul wanted  that, too — but his weight made  participating in everyday activities  difficult.

The 56-year-old aircraft mechanic  says he has been heavy his whole life.  A U.S. Navy veteran, Paul had to lose  weight in order to join the military  at age 17. He served eight years in  the Navy before being honorably  discharged for failure to meet body  composition standards.

Decades later, the father of two and  grandfather of seven reached his  heaviest point: 467 pounds.

Interacting with Junior only  reinforced how restricted Paul was.  Knee pain made walking difficult  and painful. He stopped shopping in  stores, choosing to stay in his truck  while longtime girlfriend Rose ran  the errands. Sleep apnea prevented  Paul from getting adequate rest  — especially challenging given his  schedule; he’s worked the night shift  for 25 years.

And there was the mental pain, too:  stares and comments from strangers.  “Kids would say, ‘Oh, he’s fat.’ It hurt,”  Paul said. “Of course it did.”

Previous attempts at weight loss had  been unsuccessful. And traveling  to medical centers in Washington,  D.C., to explore surgical options  and find support was inconvenient for the California, Maryland-based  mechanic.

Through Health Connections at  MedStar St. Mary’s Hospital in  Leonardtown, Paul met nutritionist  Catherine Dowling, RDN, LDN. In  May 2017, he committed to following  a bariatric menu: smaller portions  that are high in protein, low in  carbohydrates.

Catherine shared information on  a bariatric support group that  meets monthly at MedStar St.  Mary’s. There Paul found a wealth  of resources and support: through  medical professionals, yes, but also  from attendees standing in the  same shoes. Paul’s goal was to get  prepared — physically and mentally  — for the sleeve gastrectomy that  would be performed by Nicholas  Tapazoglou, MD, a board-certified  bariatric and general surgeon at  MedStar St. Mary’s.

Also known as a gastric sleeve  procedure, this technique involves  removing the outer margin of the  stomach so only a “sleeve”— roughly  the size and shape of a banana —  remains.

Paul was determined to get into “the  right mindset” before his surgery.  With the camaraderie and resources  offered by his nutritionist, support  group, Dr. Tapazoglou, and his  staff, he lost 112 pounds in five  months simply by following the  bariatric menu.  The extensive pre-planning made him  feel “ready and prepared” by October  2017, he said, when Paul became the  first patient to undergo  a sleeve gastrectomy at MedStar  St. Mary’s. After one night in the hospital,  he was sent home with a smaller stomach  — and a new lease on life.

Now a self-professed “label reader,”  Paul pays close attention to the protein  and carbohydrate content of everything  he consumes. He still eats three meals  a day, but they’re 4 ounces of lean,  healthy foods, with protein shakes in  between.

The Navy veteran reports to Naval  Air Station Patuxent River when most  people are going to bed. His “lunch,”  then, comes at 2 a.m. Paul brings small,  healthy selections like Greek yogurt,  salad, and light soup for his breaks.

Gone are the medications he was  taking to combat high blood pressure  and depression. His knee pain has  disappeared. Most notably, weight  loss has lessened the pressure on  Paul’s airways; he has not used a BiPAP  machine for sleep apnea since last fall.

The financial savings have been  considerable, too. He estimates he was  spending $20 to $25 on fast food daily.  Rose, Paul’s girlfriend, now prepares  most of the couple’s meals with an  emphasis on vegetables. He loves  Fairlife milk (“the best milk,” Paul  enthused), and bread  and pasta have been  eliminated from his diet  completely.  With his increased mobility and energy, Paul pursues a passion shared with his best friend, Gene: working on antique cars.  Navigating the workshop  is much easier these days.  The two are restoring a ’23  Ford T-Bucket, Gene’s dream  car, while Paul is fixing up a ’67  Chevrolet Nova.

By late December, Paul had dropped  an additional 48 pounds — 160 and  counting. He plans to reach 220 before  shifting to maintaining his weight.  Paul attributes his success, in part, to  the support of nutritionist Catherine,  MedStar St. Mary’s patient services  coordinator Jennifer McDermott,  and nurse Rita Michelle McDonald,  CMA. He also speaks highly of Dr.  Tapazoglou, who impressed Paul and  his family greatly by always making the  time to answer questions and follow up  on Paul’s care.

The bariatric support group attendees  have been a tremendous resource,  too. The group has a private Facebook  page to stay in touch between  meetings. “When I’m feeling down,  maybe stalling in my weight loss, I  go there and find encouragement,”  said Paul, recently scrolling through  inspirational words from friends — some  with surgeries behind them, others with  surgeries to come.

Considering the advice he would give others thinking about this “life-changing”  procedure, Paul said, “Make sure your mind is straight. You have  to be ready to do this mentally. The  surgery is just a tool; if you don’t use  the tool right, you’re not going to get  the job done.”

Junior and Jamie see the difference  in their grandfather, who moves more  and smiles easily. “Now I’m doing the  chasing,” Paul said. “Junior doesn’t  chase me; I chase him.”

The Happy Struggle

For Rashida Blake, the weight came on gradually. 

A mother of three and new  grandmother, Rashida has lupus; a  decade’s worth of weight fluctuations  were a source of frustration. When she  reached 384 pounds, the Lexington  Park woman knew she needed to seek  a solution to be there for her family.

“I started noticing I wasn’t doing things  like I used to. I had small kids, and I  wanted to be able to do physical activities with them — being so tired,  dealing with back pain . . . it was time for a change,” she said.

With the help of Dr. Tapazoglou and dietitians at MedStar St. Mary’s,  Rashida began a journey that started with reframing her thoughts  about eating.

“The nutrition counseling was really inspiring,” she said. “I didn’t think  you could look at food in that sense: measuring it, considering protein  . . . it was very educational.”

Eight months of preparation set Rashida up for success, she said,  when she started 2018 by undergoing a sleeve gastrectomy on Jan. 2.

“Nutrition counseling literally broke everything down day by day and  gave me confidence going into that procedure,” she said.

After just two days at MedStar St. Mary’s, Rashida was released to  continue her progress at home. “Recovery has been really good.  The pain was not as severe as I thought it would be,” she said.  “Dr. Tapazoglou is very in tune with his patients; he’s very thoughtful,  and wanted to make sure I felt OK to go home. Dr. T wanted me  to walk [in the hospital], and I started walking around literally that  evening [post-surgery].”

And Rashida just keeps going. “When my Fitbit says to move, I move,”  she said, noting that a three-story townhouse and young children  at home help keep her hopping. “Going up and down the stairs  is a constant. I just started walking on a treadmill, and that has  been great.”

A few weeks after her procedure, Rashida was down 29 pounds  toward her personal goal weight of 220. She’d already noticed her  feet were no longer swollen and her legs felt “looser.”

“This is more mental than anything else,” said Rashida. “You have to  prepare and be ready to make the lifestyle change. But to anyone  dealing with obesity, tell yourself: this is needed. This is a healthy  decision. It will be a struggle, but it turns out to be a happy struggle.

“Go for it!” she said. “It’s your life. Life is too short to waste it. Just go  for it.”

Visit MedStarStMarys.org/Bariatrics for more information or to schedule a consultation. 

Eating Right After Surgery

Complete dietary changes are at the heart of the bariatric journey. Depending on  insurance requirements, patients will meet  with a nutritionist for two to seven months  prior to surgery.

“Four ounces of food — half a cup, about  the size of your fist — is roughly what  the stomach will hold after a sleeve  gastrectomy,” explained Wendy Chatham,  RDN, LD, a dietitian at MedStar St. Mary’s  Hospital.

After the initial liquid and soft food diet  stages post-surgery, patients can expect to:

  • Consume a protein-rich diet that is low in carbohydrates and fat.  Proteins are the priority: meat, fish,  poultry, eggs, low-fat dairy, soy,  nuts, and legumes.
  • Drink all fluids separately from meals. Fluids must be calorie-free,  non-carbonated, and caffeine-free.
  • Avoid sweets, alcohol, and high-fat foods.
  • Take a daily vitamin/mineral  supplement.

Meet Wendy

A U.S. Navy veteran,  Wendy pursued her lifelong interest in diet and nutrition after raising her four children. In  addition to counseling  bariatric patients, Wendy  works with patients on concerns including  eating disorders, digestive issues, and  more through Health Connections in the  Outpatient Pavilion. Physician referral may  be required. For appointments, call  301-475-6019.