Nina Van Cleave, residency coordinator for the Department of Emergency Medicine at University of Maryland Medical Center, grew up an active person. Starting in sixth grade she took tap, ballet, and jazz lessons.
When she was 20, Van Cleave attended community college and studied business management and physical fitness technology. In a weight control class exercise, the students strapped their bodies with barbell weights and stuffed pillows into their sweatshirts to experience how cumbersome activity could be for heavier people. Doing that she learned that weight ties a person down not only physically but also emotionally and mentally though she had no idea that she’d “actually carry that weight around later in life.”
Still she notes that people then “weren’t on the brink of health consciousness. We grew up on Dunkin’ Donuts and cheese steaks and had chips and ice cream every night. I didn’t have good eating habits, but I was physically fit. As a runner and dancer, I burned the calories off.”
At 21 the 5’7” Van Cleave, who had always maintained her weight at between 130 and 145 pounds, gave birth to her first child and began a “never-ending” struggle with her weight.
She tried to gain control through what seemed to be every available diet plan. She tried Weight Watchers, medicine, and, at one point, even worked at a spa.
During that time Van Cleave birthed two more children. “Raising three boys alone didn’t leave me much time or emotional energy to spend on myself,” she recalls ruefully. Through her single parent years, she developed “an emotional attachment to food.” And she developed sleep apnea, diabetes, and high blood pressure, co-morbidities commonly associated with obesity.
Then during a routine examination, her primary care physician suggested she consider gastric banding and referred her to Mark Kligman, M.D., director of the Center for Weight Management and Wellness at the University of Maryland Medical Center. When she contacted the Center for Weight Management and Wellness, she was told that Dr. Kligman did not perform gastric banding but only the Roux-en-Y gastric bypass procedure.
Her initial reaction was that she wasn’t big enough for that operation, and she hung up really disappointed. Within ten minutes, however, she called back because she knew she couldn’t continue on her own to fight the weight, which had at its high point reached 255 pounds.
Prior to being accepted as a surgical patient, Nina had to attend a weight loss surgery seminar given at Baltimore Washington Medical Center by Dr. Kligman. She found the presentation very informative, especially in regard to the short and long-range statistics on the hazards of being obese.
What really impressed her though was when Dr. Kligman showed a slide in which a former patient held a huge pair of jeans that she’d worn prior to surgery. “If this is why you’re doing the surgery,” Dr. Kligman said, “it’s the wrong reason and you should leave now.”
The next two slides showed pictures of a nightstand: the first was covered with medications and the second showed just the bare nightstand. It was a moment of reckoning for Van Cleave: “I didn’t have a nightstand but I had a middle dresser drawer full of medications, and what Dr. Kligman said really got to me because at that time I was taking thirteen different medications—some more than one pill a day.”
Weighing 243 pounds, she felt she was “a thin person trapped inside a fat person’s body” and decided to undergo the Roux-en-Y procedure. After the surgery, Van Cleave who religiously listened to and followed everything she was told by the Center staff was amazed at how fast the weight dropped off. In the long run, the level of follow-up care has really helped and impressed her.
“Dr. Kligman and the bariatric program staff have always been so supportive and that really makes a difference. I believe they really do care about you.”
As exercise was continually stressed, the day she returned home from the hospital, she began the habit, incrementally at first, of walking forty minutes a day. Mary Beth Sodus, the program’s full-time dietician, was “very responsive” to her individual needs and gave her a diet that she continues to follow.
Van Cleave now exercises regularly, combining cardiovascular activity with weight training. She no longer suffers from the weight-related conditions she had prior the surgery -- the diabetes, high blood pressure and sleep apnea are all gone. And after twenty years she’s dating again. “It feels very good,” she says, recalling that “When I was heavier just getting up out of bed in the morning was difficult. I was tired all the time.” Now she is thrilled with her quality of life: “It’s so much easier to breathe, to move and exercise, even to sleep, and now I take just two medications a day. I’ve eliminated eleven medications and now weigh 144 pounds. I’d have the surgery done again at the drop of a hat.”
By Rosemary Klein