Patient Stories

Gastric Sleeve Surgery Restores Matt’s Mobility — and Zest for Life

Mar. 30, 2021

Weight-loss surgery enables patient to have knee replacement surgery, return to his normal life.

When Matt Carmack, age 55, reflects on his relationship with weight over his lifetime, he begins by saying, “I guess I’ve been husky all my life — I wore ‘size husky’ pants in grade school.”

Once Matt graduated from high school and later, married his wife, Kelli, he says, “That’s when the weight really packed on.”

Gaining weight happened quickly as he was surrounded by many good cooks in his family who made delicious, homemade meals regularly. "I was around good food and I found it hard to resist,” he says.

As time passed, Matt knew he had to lose the weight he had gained. Over time, he tried any fad diet that was on the market. “I’d lose 40 or 50 pounds, then ‘it’ would find me again and I’d put the weight back on — and more.”

At the peak, Matt’s weight was 403 pounds and he was wearing a size 5X shirt.

In addition, when he was in his early 40s, Matt began to experience pain in his knee joints. “I saw an orthopaedic doctor who was using injections to relieve the pain. “I was receiving shots regularly – initially about every six months.” After several years of injections, effectiveness of the medicine began to wear off. “After about three months, I knew that it was time for another injection because the pain became much worse.”

The Final Straw

The final straw broke in 2018 during Matt’s appointment with Todd C. Kelley, MD, UC Health orthopaedic surgeon and associate professor in the Department of Orthopaedics and Sports Medicine at the University of Cincinnati College of Medicine. “Matt originally came to me in 2013, and he was, in his mind, ready for knee replacement surgery,” says Dr. Kelley.

But Matt’s weight prevented him from moving forward with that surgery. “We want all of our patients to do well after a surgical procedure,” Dr. Kelley states, “However, performing surgery on a patient who has obesity and who has a high BMI, means that the risk of complications is much, much higher.” Those risks include blood clots, heart attacks, infection and healing issues. “Before having surgery, we often ask patients to quit smoking in order to gain control of their diabetes and/or to lose weight. Joint implants must survive and do well in the body to allow patients to get up, move and do physical therapy.”

The other critical fact is that a knee implant can only hold so much weight. Dr. Kelley is supportive and positive when he encourages his patients to lose weight. “For some people, the reason is metabolism, for some, it’s a thyroid disorder and for others, it’s a psychological challenge.” He adds, “My role is in talking with patients about weight loss is more about listening than lecturing.”

“Before we perform the surgery, we need people to be under a body mass index of 40 (the high end of the scale), and post-surgery, we want them to continue to lose weight and then maintain the weight loss long term.”

Matt’s weight continued to shift up and down. “Finally, Dr. Kelley told me, ‘Matt, your knees are now bone on bone. You need joint surgery and you’re going to have to get the weight off in order to do so.’” Dr. Kelley understands that taking weight off can be tough, and a lot of people just need some help.

Moving Forward

Dr. Kelley suggested that Matt connect with the UC Health Weight Loss Center to explore the possibility of having bariatric surgery — to lose the weight once and for all.

“I actually had been to several weight loss seminars, but never went through with it,” said Matt. “But at the time, I just couldn’t give up soda — I was drinking a 2-liter bottle every day.” Another ritual he admits was stopping on his way to work to buy Bavarian cream donuts.

“I was miserable before I had the surgery and lost the weight,” said Matt. “When I walked, I was sweating buckets — my shirts were always wet. I was out of breath and wasn’t able to talk. I let myself go, and I did it to myself.”

Then, in 2017, a coworker who was planning to attend a UC Health weight loss information seminar asked him to come along. Matt went once more and listened more intently. Something seemed to click in his mind and he continued on with the process, completing the prerequisite nutritional therapy, diet instructions, psychological review and perioperative preparation in order to have the surgery.

Ready for Surgery

After successfully completing all requirements, Matt’s gastric sleeve surgery was performed by Jonathan R. Thompson, MD, UC Health bariatric surgeon and assistant professor in the Department of Surgery at the UC College of Medicine, on April 15, 2019 — his birthday. “My wife asked me if I was sure that I wanted to have surgery on my birthday. I told her that I wanted it to be a birthday present to myself — and it was the best birthday gift I have ever had.”

“The weight-loss surgery process begins and ends with education, training, coaching, encouragement and empathy,” Dr. Thompson explains. “Behavioral change is hard. The environment doesn’t help as we are all surrounded by terrible food options. Weight-loss surgery is not an alternative to having healthy eating and exercise habits — those are required. Matt embraced every aspect of the process and his results speak for themselves. I tell patients that the surgery is actually the easiest part of the process.”

“Matt attended several seminars before finally enrolling in the program, which is very common,” said Dr. Thompson. “A lot of this hesitation is patients becoming mentally prepared for the commitment. We want our patients to be ready so they have lifelong success; however, they should not wait to start the process — and people with a BMI greater than 40 should not wait. No weight loss intervention comes close to the success of a multidisciplinary weight loss program that includes bariatric surgery.”

Life Transformed

Matt’s current weight is 219. He has lost 184 pounds since his peak at 403. He is proud to tell you that he no longer needs a 5X shirt and is now in an XL. In fact, the change in his appearance has been so dramatic that some people don’t believe older photos he shows them are actually of him.

Matt practices good nutrition every day. “I love seafood, and it’s high in protein. I also eat a lot of chicken, tuna and lean meats, preparing them in various ways. Broccoli is my favorite vegetable, and I continue to drink a protein shake every day. My wife and I often split meals — it’s easier and has fewer calories,” he says.

Like many people, since the COVID-19 pandemic hit, Matt has been working remotely at home. While he misses being able to get his steps in by walking around his work environment, he now walks around his neighborhood regularly and enjoys the outdoors.

“The best thing about weight loss is that I don’t feel tired all of the time,” he says. “I have so much more energy to do things — and the little things mean a lot.”

Spending Quality Time With Family

Speaking of little things, Matt’s only daughter, Brittany, had their first grandchild in late 2020. “I am so over the moon excited! I’m having a wonderful time with my granddaughter, Sophia Kathryn, and am doing so many fun things that I could not have done before my weight-loss and orthopaedic surgeries.”

“Motivation is key for success,” Dr. Thompson says. “Finding one or two things that your weight is preventing you from doing, and keeping that at top of mind can help prevent loss of focus. Motivation can come from a medical condition like osteoarthritis and the need for a joint replacement; it can by having diabetes and getting off insulin. Like Matt, it can be to play with your kids or grandchildren; or it can be the desire to ride a roller coaster again. Weight loss is a process that takes time and effort.”

“For years, I thought that choosing weight-loss surgery was the easy way out,” Matt said. He now knows that is not the case — it’s definitely a journey that requires hard work. “You really do have to work at it.”

Matt is a big fan of the UC Health Weight Loss Center team and only has positive things to say about the entire team, including the surgeons, physician assistants, dietitians, behavioral health counselors, schedulers and, as he likes to say, “The girls at the front desk. Everyone there is great!” He encourages people who are looking to transform their lives through weight loss to seek out their expertise, as the team truly equips patients with the tools to be successful.

Ivan Bennett, physician assistant for the UC Health Weight Loss Center, serves as counselor and coach for patients before and after surgery. He works with other team members including dietitians, nurse practitioners and behavioral health counselors to help patients keep goals top of mind and achieve them.

“Matt had great motivation not only to lose weight, but also to have better quality of life and to improve his orthopaedic issues,” Ivan says. “Both are good motivators when a person wants to feel better, and to get out and do things they used to do. Matt has kept the weight off and has been doing a very good job of losing weight while maintaining muscle.”

Ivan and other clinical staff meet with patients monthly to provide support and guidance. They discuss things such as:

What are you working on?

What’s going well?

What are your struggles?

“We also monitor their medications for diabetes, high blood pressure, etc. After surgery, we are there to answer questions, review good habits and set new goals because after surgery, they are ‘new people,’” Ivan adds.

Encouragement to Others

Ivan’s message to those who need encouragement during a weight loss journey is: Remember why you started this process. Are you getting closer to your goals or further away? Reframe your mindset. “We all get caught up in daily life, it can be easy to lose sight of goals and they get placed on the back burner. But everyone can get back on track again when you set your sights on the goal,” he states.

He says that maintaining weight loss has been a bit more challenging for people since the start of COVID-19. “Everyone’s routine has changed due to the ramifications of the pandemic. He tells patients to pause and reset their daily routine and personal goals. Those who can do so are often able to can get back on the wagon and continue to live healthy, happy lives.”

Discover More

Learn more about the UC Health Weight Loss Center by completing a free virtual information seminar. Please call 513-939-2263.