Lifesaving surgery lead to life-changing outlook
It wasn’t until Rachel Cunningham-Exavier had a daughter that she understood the health risks and dangers of obesity. Cunningham-Exavier weighed more than 300 pounds and was at risk for early death. The health effects of obesity are well documented, often linked to high blood pressure, high cholesterol, type 2 diabetes, coronary heart disease and stroke.
The arrival of her daughter led CunninghamExavier to realize it was time to make a choice. A choice for her future and her daughter.
“I’ve been plus-sized my whole life, as long as I can remember. I never saw a problem. I’d go to my physicals, and no high sugars or blood pressure. Then I got pregnant in 2019,” she said. “The pregnancy went smoothly until the end when I developed preeclampsia. Then I developed high blood pressure and other complications. I thought ‘OK, you want to be around for your husband, for your daughter, for you. And I wanted to make a change.”
Cunningham-Exavier went to St. Vincent’s Medical Center to see Dr. Craig Floch, the Director of Metabolic and Bariatric Surgery. Together, they mapped out her best options, and she chose the laparoscopic sleeve gastrectomy, a surgery that reduces the stomach from about the size of a football to the size of a banana.
“She was considered morbidly obese with a BMI of 50 and hypertension at a young age. Losing weight was imperative,” Dr. Floch said. “Because she was young and had those medical problems, I thought the sleeve was a better operation for her.”
The sleeve is a newer operation compared to the better known gastric bypass surgery which has been around for more than 50 years. The sleeve operation is much less invasive than bypass surgery, and the potential complications are less risky. The cost-benefit ratio of the sleeve makes it a more popular option. Dr. Floch said 80 percent of patients now get the sleeve operation, 10 percent get the bypass and 10 percent other types of weight-loss surgery.
With the sleeve, the average person will lose 60 percent of their excess weight, according to Dr. Floch. This is not to be confused with 60 percent of their total weight, he said.
“Let’s say you’re 5’6”, and you shouldn’t weigh more than 130 pounds. If you weigh 230, your excess weight is 100 pounds. With the sleeve, you will lose about 60 of that,” Dr. Floch said. “It’s an important step forward and makes big difference in health outcomes.”
Cunningham-Exavier is six months out from her surgery, and she’s dropped from a size 22 to a size
14. But she says bariatric surgery is very much about lifestyle changes.
“A lot of people think this is the easy way out because at first you have a smaller stomach, and it can’t take that amount of food,” she said. ““But you have to change your mentality, your thinking, just like any other weightloss journey.”
Cunningham-Exavier said she’d tried several diets in the past, and none would stick. She was an emotional eater, she said.
“Happy, sad, any emotion up or down, I would use food as something to be able to cope with that,” she said. “I’ve never been addicted to any drugs, but I feel like I know what it is like because that’s what I used food for.”
For months before the surgery and in the time after, CunninghamExavier has been planning her meals, and cuts out temptation by not having sweets and chips in the house.
“I started in the summer just eating differently— veggies, low carb, I tested out protein shakes. There was a mental preparation, and it was me just changing my eating habits,” she said. “I was a big sweets person, a big carbs person. Now I have to prepare my meals. I think about what I’m going to eat before I eat it.”
Dr. Floch says he performs five to 10 bariatric surgeries a week and the lifestyle changes are the most important indicator of patient success.
“[The surgery] helps, but, it’s not a magic bullet. They have to eat the right things, eat at the right times, do some exercise, and avoid wrong types of food. They also need to eat a fair amount of protein.”
Patients considering this surgery need to go through months of preparation. Different insurance companies have different rules and requirements, but Dr. Floch says there are several commonalities. Hartford HealthCare provides every patient with a seminar first, then they will get an appointment with the surgeon where they go over patient history. Patients need a letter of necessity from their primary care physician, a cardiac clearance, and will need to see a nutritionist at least once. Everyone needs a mental health evaluation, and anyone going through Dr. Floch needs to get an upper endoscopy too, just to make sure there are no tumors or ulcers in the stomach. This process takes most patients between two to six months.
Cunningham-Exavier’s surgery went very smoothly, and she said her experience with St. Vincent’s Medical Center was nothing less than spectacular.
“I loved the look of the facility—very clean, very modern. But, more than that, the people themselves, they are awesome. They are so helpful, even now, months after surgery. Dr. Floch was amazing; he answered my questions, any concerns that I had. I never feel intimidated to ask them anything.” This is just one example of Hartford HealthCare St. Vincent’s Medical Center bringing more specialists and providers to the community. Tune into Hartford HealthCare St. Vincent’s Medical Center’s Facebook Live discussion, where you can ask your questions, March 25 at noon. And for more information, log onto stvincents.org/services/ surgical-weight-loss or call 203.926.8835.