Michael Feldman’s decision to have bariatric surgery was a long time coming. Over the years, he found himself putting on 10 pounds, then 20 and 30 pounds at his annual physicals.
In early 2020, when he weighed in at 340 pounds, his physician diagnosed him with high blood pressure. He was already suffering from hip pain, the beginnings of arthritis in his right knee and sleep apnea, all related to his weight. He was also at risk for diabetes and heart disease, his doctor advised.
Feldman realized he had to act. “I projected it out and finally faced the fact that if I continued gaining weight, I was not going to have a long life.”
Increasingly, people who consider weight-loss surgery are motivated more by the secondary health problems related to obesity than appearance, says Dr. Brian R. Smith, a board-certified UCI Health gastrointestinal and bariatric surgeon who met with Feldman in February 2020 to discuss his options.
Feldman went to UCI Health because of his long association with UC Irvine, where Hung Fan, his husband since 2008 and partner of 41 years, is an emeritus professor of virology and molecular biology and associate vice chancellor for strategic initiatives for the university's Office of Research.
“I know firsthand that UCI Health is at the forefront of technology and research," he says. "If there were any complications, I wanted to be at a university hospital."
A whole team to help you succeed
Feldman was impressed with the UCI Health bariatric program from the start, especially when he learned an entire team would be helping him. The team includes a social worker to counsel patients, a dietitian who meets regularly with patients to support their weight loss, and psychiatrists and psychologists to evaluate patients before and after surgery, says Smith, a professor of surgery at the UCI School of Medicine.
“I really liked Dr. Smith’s confidence that I was a good candidate,” says Feldman. “His approach was to assess whether surgery would be successful and safe for me. He was not trying to sell me something.”
Together, doctor and patient decided a vertical sleeve gastrectomy was the best option. But first Feldman would have to begin a serious weight-loss program involving diet and exercise.
“They were very honest,” he recalls. “There would be hard work on my side. But it was comforting to know I would be monitored and mentored the whole way.”
Understanding the ‘why’
During the preoperative stage of treatment, Feldman was asked: “Why do you want to do this?”
“I said, ‘I’m tired — not just physically,’ ” he recalls, citing the many little inconveniences that were limiting his life, such as:
- Being told when driving with friends, “Michael, why don’t you sit in the front seat,” because there wasn’t room in the back seat for him and two others.
- Having to check with a restaurant in advance to see if he could fit in a booth or would need a chair.
- When traveling by air, which he and Fan do a lot, “I’d be praying I wouldn’t need the seatbelt extender.”
Even though his partner was always supportive and people were generally nice overall, his weight took an emotional toll.
The path to bariatric surgery
Feldman is quick to say that his journey was not easy. He had MRIs, CT scans and regular bloodwork to monitor his health and progress. He had nutritional counseling, which he initially found very difficult.
“The month prior to surgery, I was on a liquid diet to lose weight and shrink my liver,” he says. “You have to prove you are mentally and physically ready to stick with the program.”
Smith compares a patient’s success to a three-legged stool: the bariatric procedure, regular exercise and consistently good dietary choices. “Without all three, the stool tips over,” the surgeon says.
On Dec. 1, 2020, Feldman underwent the vertical sleeve gastrectomy, a laparoscopic procedure performed through keyhole incisions, allowing patients to recover faster with little or no scarring.
The surgery involves removing the majority of the stomach and lower intestine and creating a small, tube-shaped organ — about the size and shape of a banana. In addition to reducing the size of the stomach, the surgery removes the majority of gastrointestinal tract cells that produce ghrelin, the hormone that triggers feelings of hunger.
"It’s like they took out a part of my brain so I don’t have cravings like I used to,” Feldman says.
But the weight-loss surgery was hardly a quick fix. The first three weeks after the procedure, he was sore and hungry. When he tried exercising, he could barely walk the length of two houses in his neighborhood.
He also had initial issues with staying hydrated and difficulty balancing his body’s protein needs with the steep reduction in calories. “I was on a liquid diet at first, then you get to add a power bar, and eventually eat soft foods,” he says.
Fortunately, the UCI Health bariatric team was only a call or email away to offer support and prompt answers to his question. A good friend who’d had gastric bypass surgery 20 years earlier also served as Feldman’s guru through his struggles.
The long walk
Down 40 pounds three months after surgery, Feldman flew to Maui for a vacation. For the first time in many years, he didn’t need a seatbelt extender.
"I actually teared up — it was very emotional," he recalls. "And that was 100 pounds ago.”
He had another epiphany on that trip. He woke up early because of the time change and went for a walk, something he’d never done before.
“It was 5 a.m. and I came back two hours later,” he says. “I’ve never stopped since!”
Now 64, the Laguna Beach resident exercises six days a week for a minimum of two hours a day, either walking 4 or 5 miles or cycling for 20 miles.
At a recent follow-up visit, Smith was delighted with Feldman’s progress and his new passion for cycling.
“My most successful patients are those who find a physical activity that doubles as a hobby,” says Smith. “If they find an activity they love, something they enjoy doing, their weight loss will seem easy. Michael is a perfect example!”
Riding into the future
A year after surgery, Feldman has lost 148 pounds. His body mass index (BMI) has dropped from 47 to 29. Blood pressure medicine and sleep apnea are a thing of the past. His body now matches his energy and compelling personality.
Retired from his career as a corporate travel agent, he has the vigor to volunteer for multiple organizations, meet with his new exercise buddies and travel when COVID-19 protocols allow.
“I have to say that the COVID-19 quarantine worked to my benefit,” he says. “Having no parties to attend or restaurants available really helped me stay on track.”
The shocked and happy reactions he gets from friends he hasn’t seen for a year or more make it even more fun.
But the best part might be getting a new wardrobe.
“When my partner and I first got together, we wore the same pant size. We were shopping recently and realized we were getting the same size again!” he says, laughing.
“I can’t thank UCI Health enough for helping me regain my health so I can live my life to the fullest.”