Navigating your weight loss journey
September 10, 2024 | Episode 24
Producer’s Note: The following is an AI-generated transcript of The Wellness Conversation, an OhioHealth Podcast
SPEAKERS: Lindsey Gordon, Harriet Rollins, Dr. Sonnanstine, Marcus Thorpe
Marcus Thorpe 00:14
Weight loss is a topic that seems to be everywhere you look these days, if it's something you'd like to achieve, the journey is certainly special and unique for everyone. Welcome to the wellness conversation an Ohio Health Podcast. I'm Marcus Thorpe.
Lindsey Gordon 00:26
And I'm Lindsay Gordon. We're joined by OhioHealth Bariatric Surgeon and Ohio Health Medical Director of Bariatric Surgery, Dr. Tom Sonnanstine, and one of his patients, Harriet Rollins, thank you both for being with us today.
Harriet 00:40
Thanks.
Dr. Sonnanstine 00:40
Thank you.
Marcus Thorpe 00:41
We talked about the journey at the beginning of this, and it certainly is a journey. So, Dr Sonnanstine let's start with you. How do you define weight loss? And really, who makes an ideal or a good candidate when we're talking about that weight loss plan and weight loss journey?
Dr. Sonnanstine 00:57
Your weight loss is a lot of different things. You know? There's different motivations for it, there's different goals that people have and amounts they want to lose, but I really like to consider weight loss to be more than just losing pounds. I like to consider weight loss being part of a journey and changing one's lifestyle. And I think when it's viewed that way, I think it has a greater chance of being successful, plus it puts a focus on the fact that many things in a patient's life needs to change, needs to be modified, in order to be successful with not only the weight loss, but that lifestyle change.
Marcus Thorpe 00:58
So many different options when it comes to weight loss, there's traditional that you think of with just like diet, exercise and those kind of things. We've seen this newer class of medications that have really taken the world by storm, that everybody is interested in or talking about, and those kinds of things. And then there's the bariatric path for a lot of people, that needs to be the right candidate. And it's not just a "hey, you're going to get this. Here we go. We're going to start it right away." There is a process to it. I know it's going to take a while, but I think it's important to kind of work through each one of these in detail. Let's talk first about this newer class of medication that that everybody wants to know more about. Can you talk about that a little bit?
Dr. Sonnanstine 02:24
Absolutely, there's, there's the newer class of medications. Are known as GLP-1 medications. They're new-ish. They've been around in some iteration, some form, for almost a decade now, initially developed in order to treat diabetes for people who have had difficulty maybe treating their diabetes or getting their blood sugars under better control with more traditional diabetic medications. And then it was found, you know, that patients were actually losing not only a little bit of weight, but a considerable amount of weight. And then, when the numbers were crunched, cardiovascular disease was improving more than what you would expect, than just with the weight loss. So really, over the past probably three or four years, maybe a little bit longer, there's been an even greater push towards these medications, different types or forms of these medications, different delivery mechanisms of them. And really a broader amount of patients who qualify for them.
Marcus Thorpe 03:27
I also think it's important, and we want to make sure that people know this. You're a bariatric surgeon, so somebody might say you're probably going to push people away from these medications, but you and I have talked previously for the right candidate, these medications might be the best option.
Dr. Sonnanstine 03:44
Absolutely there's there's no perfect fit for everybody. There are good fits for everyone. And our goal, and sometimes this changes over time, is defining which fit of weight loss, which mechanism of weight loss, or route of weight loss is best for each individual patient. And that may mean just the dietary modifications. It may mean different medications. It of course, you know in my field, oftentimes does mean surgery for weight loss, but by no means is surgery for everyone, nor do we try to push everyone into surgery, at least not before all the other methods are tried.
Lindsey Gordon 04:27
If surgery is determined to be the best option for someone, what does that process look like? Is there prep work? Is there post care? Are there different types of weight loss surgeries?
Dr. Sonnanstine 04:38
It's definitely a process no one, at least in our program, and hopefully no program, just comes in off the street after deciding last night that they want bariatric surgery and then get their surgery tomorrow, next week, or, frankly, even next month. It's a process. It's very deliberate, and it's what we call multidisciplinary. We have a team of dieticians, psychologists, nurses, and of course, you have the insurance aspect of things. It's a process that takes not weeks but months to get from beginning to end. And our goal is to really make sure that the patient is prepared, both mentally as well as physically, and is ready, and hopefully has the support around them to make these lifestyle changes. That's ultimately, regardless of how good of an operation they get or which operation they get, is going to help determine how well they do long term.
Marcus Thorpe 05:35
We are going to talk about potential risks for weight loss surgery. We want to talk about lifestyle changes post-surgery. But we also want to bring in really a very special guest and someone I know, Dr Sonnanstine, that you know really well. It's Harriet Rollins. Thanks for being with us first and foremost. But congratulations on your weight loss journey. We're going to talk about that quite a bit here. You're celebrating, what? Three years?
Harriet 05:58
Yeah, three year anniversary. July 13!
Marcus Thorpe 06:01
How do you feel?
Harriet 06:03
Well, on all different levels, medically and physically, I've never felt better. And I'm old, so that's a long time and but emotionally, I'm much more focused, and I'm able to do so many more things. Usually, a person at my age is trying to wind down a little bit, and I'm actually gearing up to do some of the things with my career. And as I had mentioned earlier, I really want to share my journey in specific detail with other people who are scared to do it or don't think they're right, or I've got like, hundreds of tips,
Lindsey Gordon 06:49
And you really do. We talked about a few when we first spoke on the phone, and I've been thinking so much about your story. I want to know. Harriet, when did you know it was time to begin this weight loss journey. How did you know this was something that you needed to seek medical help for?
Harriet 07:05
Well, back in 2007 I found a book in the bookstore called the 'Sleeved-Life'. So it was 2007 actually, and I have had issues with my weight my whole life. I toted up some numbers in my own mind, I've lost 60 to 70 pounds about six times in my life. Wow. So I'm an expert at losing the weight. I am not an expert at keeping it off. And this is a lot of why I did the shift to go. "There's got to be some help out there". And I have to tell you, I started in another bariatric program, and I didn't like the way they treated me, to be perfectly honest. And then my personal physician and my pain doctor knew Dr. Sonnanstine personally and professionally, they said, Well, go over there. And so that's how I landed and we had a journey too, because I had some esophageal issues that maybe not make me the best candidate for the sleeve surgery. So I pushed all my endoscopy results over to him, and we had a meeting over online. We're still the back end of the pandemic, and so he agreed to even consider me for it so and then finally, someone called from his office. Says, "Okay, we'll accept you" that was January. I have to say my surgery was in July, so it took me six months to get through my first elongated contact was with Pamela Rowe, the nutritionist, because she starts out and we talk about what we're doing now and what what we need to prepare for and what we need to be faced with afterwards. She was just amazingly competent and thorough, and I wasn't scared at all going through this. But what really got me here was I was on four insulin shots a day. I had full blown critical diabetes. My A1C at one point was 12.1 and that's a lot. And I was on four shots. I kept going to my endocrinologist. All she could do was give me more insulin I was on, you know, one after every meal, and then the long term. I mean, I was cranked up to, like, 75-80 units of this long term, and I just had to stop. I mean, I kind of likened it to, you know, when you say you hit the wall, something made me do that, and I go, "there's got to be something that can help me". And so that's how that got started.
Marcus Thorpe 09:49
Dr. Sonnanstine, let's talk about Harriet. What procedure did she have? But also she mentioned that this was a January agreement and then the procedure didn't happen. You said until July. That's very typical and very purposeful for you and your office of finding the right candidate. Talk about why that six months is so important for this process.
Dr. Sonnanstine 10:15
Yes, of course, it's very deliberate, and I think that's kind of the best term to place on it. Harry had the sleeve gastrectomy. There's two main operations that that we consider gold standard operations and that we primarily offer to our patients. That's the sleeve gastrectomy, the other being the Roux-en-Y gastric bypass. And just like there's no cookie cutter or tailored operation or diet for every individual, our job is to work with the patient to help determine which is the best operation based on the patient's individual characteristics, medical problems, motivations, fears and all of those things. And as Harriet, very well said, we kind of went through an investigative period of, is surgery a good idea? Is the sleeve a good idea? Would the gastric bypass be a better idea? And weigh the pros and cons of both, allow the patient to have input, but also use the expertise of the surgeon.
Harriet 11:22
Yeah, I loved the collaborative aspect of all of this. I never felt like I was taking a test to get a grade. I just felt people were wanting to find out more about me. And, you know, there's a whole psychological preparedness thing you have to go through.
Dr. Sonnanstine 11:36
what we take a lot of pride in. It's not just the surgeon setting up shop in order and offering surgery. We understand that we're only as good as our team. We're only as good as the operation that the patient gets, but ultimately, we're only as good as the patient is prepared, prepared, both before surgery, but also after surgery, in the follow up, the commitment to the lifelong lifestyle changes.
Lindsey Gordon 12:03
What were some of the biggest lessons you had to learn and biggest adjustments you had to make in your own lifestyle? Harriet?
Harriet 12:05
Oh, where shall I start? It was emotional. There's a high probability that right after the surgery, you're not very hungry. Well, I was like the not person. I was starving. I just was starving. But I had been so well educated and so prepared for whatever was going to happen, that I just said, well, and we call that "head hunger", that my emotional fitness to what I just had done medically. Hadn't caught up with the surgery yet, and it took me about a month for my hunger to calm down. But, man, there were many times, like gripping the refrigerator handle going, "you should not eat on this", you know? I mean, I really had to talk myself out of it quite a number of times. But then you kind of get into the groove, and I started a very structured daily routine of protein and water. I used to live in New York City, so, you know, it's used to looking at a cab meter. So I have my little cab meter there. Here's my protein, here's my water. I just, you know, yank it up when I get something in during the day. I had to find a million ways to get protein, because right in the middle of all this, I became lactose intolerant, so, and that was, had nothing to do with my surgery, but so that was the main source of my protein was dairy. So I found some, you know, products that say they don't have but I had to give up the, you know, the icon of pull surgery, the protein shake. And I had to find, because I was popping in 30 grams protein, you know, before 11 o'clock in the morning. So I had to find some other outlet, and I have and that that was like kind of a big bump for me, but I continued to lose weight on a regular basis. I went back and looked I lost most of my weight by about a year and a half or so ago, and honestly, I have not gained a pound. It's awesome, amazing. And honestly, we had talked about me losing a little bit more weight, but I saw Dr Sonnanstine in May, and I had just had a whole bunch of blood work done for my endocrinologist, who says, Oh, well, I don't need to see you anymore. But he said, you have no idea the profundity of what you said to me that day. He looked at all my blood work, and he goes, Well, you know, you don't have to lose any more weight for your health, because you have achieved. I was in the middle of the middle of the middle my A1C went from 12.3 to 5.1 which is not even pre diabetic. And I went, what, you know, like, really? And then I thought about it, and I went, this is the first day in my life, since I've been 11 years old, that someone said, I'm good, just the way I am. That was 26,000 days by the way that I have thought about my weight, but I knew I was in the right place. I've discovered two like epiphanic moments in it. One was, I think overweight people on a certain level are extremely arrogant, because they are the experts at losing weight. They've tried every diet, and then you have to finally admit that you don't know the rest of it, because there's nobody out there to help you. But the surgery took me from the last insulin shot I had was Friday, after the Tuesday I had my surgery. So it's like it wasn't even a slow down. It was gone. Basically, diabetes. And I do believe I'm not, you know I'm not a doctor, but I just think it resets your entire body. I think it kind of took my pancreas back to a healthy moment. Doc, you hear the story, you hear the emotion in her voice, and you know this was life changing for her when you hear those things. I mean, this is why you do what you do, isn't it?
Dr. Sonnanstine 16:38
That's exactly right. These, these are, these are some of the most rewarding days to hear the testament of our patients. And you know, as difficult as some days can be, being a physician, especially being a surgeon, this is, this is as rewarding as it gets.
Lindsey Gordon 16:54
Harriet and I were talking on the phone, you said a couple of your tricks that you still use every single day, and I actually have thought about them quite often myself. You said you always have hard boiled eggs ready to go on hand for your protein. You said, if you are feeling hungry, you drink some water first, because maybe you're getting a little dehydrated. And then I'd love for you to share more about how you kind of had to part ways with the scale.
Harriet 17:17
Oh yeah, that was the second epiphanic moment. I hadn't been able to share that with you yet, but about nine months ago, I had two scales. I would weigh myself here and see if it was different over here. I thought I had it like under control, because I only weighed myself every other day. I thought like I was there again, a little bit of the arrogance running in like, oh, well, I'm not like those other people who weigh themselves four times a day. And there are people out there who do that. I looked at those scales one day and said, you know what? I go to the doctor often enough I don't need to have weigh myself at all at home. And I took both those scales, and I gave them to my cleaning lady, and it was like one there again, another of the most extraordinary, freeing moments of my life. Because once again, I don't have to worry about this, because I have a plan in place, and I have all these wonderful people surrounded. I see a person from OhioHealth. Every month. I see Dr Sonnanstine. Every three months, I see my I have a bariatric psychologist who I see every three months, and in my nutritionist every three months. So, I'm up here once a month. I do believe that that's part of my huge success with this, because I just never let it go. And always, I have a million questions every time I go. So, I'm into the finer points of this now after three years, but I still want to learn. I still want to I want to stay here and now I don't have to be a slave to something on the scale because my other medical tests have shown up like you did good. I would imagine that's why you're successful with this, because you are taking that front seat driver role, and you're not just being like, well, whatever happens, happens. I think that's a great way for other people to think about it. Dr. Sonnanstine let's talk about, you know, risks from weight loss surgery. There obviously are some, but also the risk for people who maybe don't adopt that lifestyle change, right? There's plenty of people who have gone through the process, and it didn't work for one reason or another after they got done. Can we talk about those two things too? I think they're important topics.
Dr. Sonnanstine 19:29
Yeah, definitely, very important. There's really nothing in life that I can think of that's risk free. And certainly when you're talking about a major operation where we're changing the body's anatomy. There are risks. There are the risks involved in that, what we call the perioperative period, the several days after surgery, but risks can also spread out long term risks related to the surgery, and that's one of the reasons why we do so much education beforehand. So that patients will avoid some things that may put them at greater risk. They will hopefully recognize if there's a problem ongoing. And I think Harriet spoke well to it to be successful in life, whether it's your weight, whether it's your lifestyle or just your overall health, and which we're talking about here, it requires maintenance, and it requires daily work. And while she's not weighing herself on a daily basis, the reason I think that she is so successful, she thinks about this on a daily basis and doesn't just let it go. She's tuned in. She's focused. She understands where she needs that extra help. She utilizes the extra help, and she's not afraid, as again, she said, to ask those questions and to want, even three years after surgery, to want to learn more.
Lindsey Gordon 20:49
I mean, the commitment is wonderful to see that. And three years later, I want to know too, you mentioned the feeling of being free, that freedom. But how else has this weight loss changed your life? I mean, it's got to change it in many ways. What are some examples?
Harriet 21:06
Well, clothes, you know, it's a fashion thing. And I'm actually on my second set of small clothes. I mean, like, I bought a whole bunch after I lost like, 60, 50-60, pounds. I've had to throw them out because they were too big. So I'm on my second set of small just, you know, just the vanity part of it. We can't underestimate that, because women just don't take good care of themselves on any level. And this has made me want to take better care of all my different things, and that's been a big deal, and it's also made me a little more selective about the work I do. I teach singing lessons in my home, and I'm able to, you know, maybe not, take every person who shows up at my door because, you know, for various reasons. So I'm feeling that it has changed my work life a little bit. And actually, I had joined a church choir. I hadn't been able to do that for a while. I've had some major orthopedic issues, which Dr Sonnanstine knew walking in the door, and so makes me a little careful when I have to walk and things. But I was able to join a choir and be with musicians, which is my life. So that's been very profitable for me on a on a real artistic level.
Marcus Thorpe 22:30
I want to leave our listeners on the clinical side of this, and then the personal side of this too, with you, Harriet, is is there an overarching message that you would want folks to know once they come out of hearing this podcast, Doc, I'll start with you. Is there something that you want folks to really think about as they're considering their own journey?
Dr. Sonnanstine 22:48
Yeah, there is. And I think to really sum up all of the several points that we've discussed today, is the principle, and you really have to think about this, is that weight loss surgery is a tool, and like any tool, whether it's a sophisticated tool, a simple tool, this is a sophisticated one. You need to learn how to use it, and you have to keep practicing with it, and you've got to keep it sharp. You've got to keep it working. And that that requires that investment, and truly that investment on a daily basis. And if the tool doesn't work well today, boy, you better figure out how to get it working better tomorrow, if you want to be successful long term.
Marcus Thorpe 23:30
I love it. And Harriet from the personal journey perspective, what would you want to leave our listeners with, from your experience?
Harriet 23:40
Well, what I'd like to say is you owe it to yourself to come and find out about this if you have been struggling like me and a bazillion other women, because this gives you a plan of action. And I'd also like to say OhioHealth offers the whole weight management program. You don't have to have surgery. I mean, the whole program is just so solid. And when I was given, like the rules, there's some rules you have to do, you know, like you have to sip water carefully and don't drink during a meal, and you have to wait. When I put all those rules in place before my surgery, I lost 10 pounds just doing the good educational part of it. And I think people deserve to come and look at this program, because if I was very fortunate, I'm on Medicare, it took care of all the costs. And so I just urge people to look into this, because this gives you the tool, the big, sophisticated tool, plus all the education that you need after you have the surgery. And if you can stay on the path, you will be successful, whether you like it or not.
Lindsey Gordon 24:58
Well, you are an inspiration. And thank you so much for opening up and sharing your story and for being so honest, and even if you just help one person listening, I think it's all worth it, right?
Harriet 25:08
Yep, well, call me!
Marcus Thorpe 25:10
Open book. That's great.
Lindsey Gordon 25:11
I love that. This is the time in the podcast where we like to have a little fun and get to know our guests a little bit better, so we have some fun rapid fire questions. You ready for that?
Marcus Thorpe 25:22
Dr Sonnanstine, we'll start with you. Look, you're super busy. We know that. But when you're not helping patients, what is it that you like to do? Maybe in a little bit of free time that you have?
Dr. Sonnanstine 25:33
I follow sports a little bit, but I read. I'm an avid reader. I've usually got a several books that I'm reading at any given time. You know, history, current events, things like that. You know, in case I was doing something other than medicine or surgery, I like to become, be an expert on something else.
Marcus Thorpe 25:48
Never know. There's always a chance for a second career.
Lindsey Gordon 25:55
That's very cool. And Harriet, you mentioned your performing arts background that you help people with vocal lessons and learning to sing. You've performed in some big shows before.
Harriet 26:06
Yes, I was in the original production of Sweeney Todd with Angela Lansbury back 40 plus years ago. But if you watch the DVD, I'm in it!
Lindsey Gordon 26:16
That's awesome. Are there any Broadway shows that you'd love to be a part of?
Harriet 26:22
Currently, no, but I do have a couple of roles that I wish would come my way before I, you know, hang up my makeup or whatever. I love Leonard Bernstein. He wrote this beautiful musical back in the 50s based on Voltaire's story of Candide. There's a wonderful old lady character there. She's, you know, I would love to do her. And the other one is, there's because of my orthopedic problems in the 'Little Night Music', the grandmother she sits in the wheelchair the whole time. I'd love to do that role.
Marcus Thorpe 27:00
Well, if you're a casting director and you're listening to our podcast, reach out to us. We'll get you connected. And yeah, who knows? Thank you both for joining us. It's really been one of my favorite episodes we've done. It's, it's informative, it's, it's opening a world to folks that I think always had that question but never have the answer. And I think hopefully this podcast really helped that. So thank you both for being part of it. We appreciate it.
Harriet 27:22
You're welcome.
Dr. Sonnanstine 27:22
Thank you.
Marcus Thorpe 27:24
And of course we thank you for joining us for this episode of the wellness conversation, an OhioHealth podcast. Before we wrap up, we do invite you to follow us on all our major social channels, so you can stay up to date on any new episodes, as well as other health and wellness topics. And if you're looking for more information on OhioHealth services, maybe the bariatric program and locations you can visit ohiohealth.com
Lindsey Gordon 27:43
The information in this episode will also be available in written form at the podcast page. Thank you so much for joining us, and be sure to subscribe as we continue our exploration of important health and wellness topics with OhioHealth experts.