- Associated Press - Monday, September 25, 2017

HONOR, Mich. (AP) - Ken Laurence dropped half his body weight in just over a year. Bariatric surgery was the key to his dramatic weight loss.

Laurence struggled with excess weight through much of his career with Chrysler Corporation, which culminated at the position of Director of Global Marketing. The job involved travel. His peak weight of 406 pounds forced him to ask for a seat belt extension whenever he flew, and made it impossible for him to squeeze into a commercial airplane bathroom.

He tried many diets over the years, but the weight wouldn’t stay off.

“I’ve probably lost 600 pounds - and put 700 back on,” he told the Traverse City Record-Eagle .

His decision to opt for surgery - which drastically reduced the effective size of his stomach and put much of his small intestine out of business - came after a grandchild arrived.

“I said, ‘If I want to be around and play with my grandkids, I’ve got to do something,’” said Laurence. “I had sleep apnea, diabetes, high cholesterol, a-fib (arterial fibrillation). I had bones breaking. I just said to myself, ‘If I don’t do something, I’m gonna die.’”

“I saw an article about Grand Traverse Surgery, so I called them and went in to talk to them.”

A year later, he underwent bariatric surgery at Munson Medical Center. The word bariatric has origins in the Greek language and means “relating to treatment for weight.”

Laurence, now 70, was 67 at the time of the procedure. He lost some weight as part of the lead-up to the surgery, but the pounds really started to drop off after the change in his internal plumbing.

“It took me about a year to get down to 203,” Laurence said.

Since then, the 6-foot-4 Laurence has gained 19 pounds, as doctors told him is normal after bariatric surgery. His weight now is stable at 222.

“Essentially, we’re trying to make the stomach smaller,” said Dr. Michael A. Nizzi, medical director of Munson Medical Center’s Bariatric Program.

Munson performs between 250 and 300 such surgeries each year, Nizzi said.

“We used to do more, but our numbers have declined over the years,” he said.

Most bariatric surgeries are performed with weight loss as the goal, but a few are performed for other reasons.

“There are some patients who may have gastric bypass for a tumor or other issue,” said Nizzi.

Three different surgical techniques commonly are used to force weight loss, he said.

One technique surgically cuts off most of the stomach, reducing its effective volume “to the size of an egg,” Nizzi said. A second technique involves moving the connection from the stomach to a point farther down the intestinal tract, which reduces the system’s ability to absorb nutrients. A third technique uses a device to constrict stomach volume to the size of a hot dog.

Laurence said his surgery was a combination of the first two.

Another technique, called the lap band, was the most common type of bariatric surgery in the 2000s, said Nizzi, peaked in popularity in 2010, but then rapidly lost favor. That technique had generally poor weight loss results, he said.

Laurence carried extra pounds for much of his adult life.

“I was a jock in high school and college - and so that always kind of kept my weight under control, because I was working out all the time,” Laurence said.

“I graduated in 1970 and went to work for Chrysler, and traveled a lot. And eating out at the best restaurants … the weight just kept piling on,” he added.

He retired in 2001 and moved from the Detroit area to Benzie County with his wife. He enjoyed retirement, but still struggled with excess weight.

“Five years ago I lost my wife to breast cancer, and that kind of really put me on a downer and took a lot of the pizazz out of my life. I didn’t know what I was going to do. My son got married, and I had a granddaughter.”

That’s when he took stock and realized that he had to improve his health if he was to spend time with the youngster. Other circumstances added to his desire to lose weight.

At his maximum weight, Laurence would come down the stairs from his bedroom in the morning, and wouldn’t go back up again until bed time - because it hurt so much to climb back up. Anything that needed to go upstairs, he said, he would leave on the lowest stair, where a pile would accumulate, to be carried up at bedtime. He would tackle the painful stairway just once a day.

“Now it’s 20 times a day. And it doesn’t hurt me one bit,” said Laurence.

Changes have been many. His waist measurement shrank by 20 inches. His shirt size has dropped from 4X to Large. His irregular heartbeat became regular, he said. His knee pain disappeared.

“I’m so happy with how I feel and how I look,” Laurence said. “It’s so worth it, I’d recommend it to anyone.”

The surgery drastically limited the effective size of his stomach, to a capacity of about 4 ounces. He no longer eats large meals. And because the surgery bypassed much of his intestine, vitamin supplements are required to maintain good health.

“You just watch what you eat,” said Laurence. Weight loss follows, “as long as you have the commitment to do it.”

Two and a half years after surgery, Laurence is delighted with the result. He feels none of the physical limitations he did when he was 180 pounds heavier. He feels healthier.

“I’m starting to feel that muscle mass coming back,” he said.

His second grandchild just turned a year old. Laurence delights in playing with both his grandkids.

Munson Medical Center this summer received a three-year “Comprehensive Center” national accreditation from the American College of Surgeons and the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. It received similar accreditation from the organization in 2015.

Accreditation is awarded to a bariatric surgical center only after a thorough review process, during which the institution must prove it maintains high practice standards and provides the physical and human resources needed to meet patient needs. To demonstrate ongoing compliance, accredited centers report patient outcomes to a national database maintained by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

“We are committed to providing high quality care to our patients before, during, and after bariatric procedures and this accreditation again affirms that we remain true to that commitment,” said Nizzi.

Nizzi joined Munson’s staff in 1999.

“We have been privileged to provide life-saving care to qualifying people in northern Michigan since launching the program in 2003,” he said. “I believe the comprehensive nature of our weight loss surgery program continues to be key to our patients’ success.”

Munson, surgeons from Grand Traverse Surgery, PC and a multidisciplinary bariatric team meet qualifying standards through documentation of outcomes and maintaining continuous improvement to improve those outcomes. Munson’s bariatric team includes surgeons, nurses, medical consultants, nutritionists, psychologists and exercise physiologists.

The National Institutes of Health estimates that 15.5 million people suffer from severe obesity.

Who is a likely candidate for bariatric surgery?

A body mass index greater than 40 - or 35 plus other conditions like sleep apnea, Nizzi said. “About 100 pounds over ideal body weight.”

The different types of bariatric surgery have varying success rates, as measured by amount of average weight loss.

But the success of all three surgery types depends on a long-term commitment to lifestyle changes, said Nizzi.

That’s why insurance companies require a 6- or 12-month program before they will pay for most bariatric procedures. Patients must prove they can follow a supervised diet plan, sustain long-term changes in eating habits and lose some weight - before insurance companies will help pay for the surgery.

“They still have to diet after surgery,” Nizzi said of bariatric patients. “You have to change your lifestyle.”


Information from: Traverse City Record-Eagle, https://www.record-eagle.com

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