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May 18, 2018

A Healthier Heart and Renewed Zest for Life After Bariatric Surgery

By SharingMayoClinic

A host of serious medical concerns were making daily life a challenge for Robert Watts. Comprehensive care at Mayo Clinic helped him tackle each of them and successfully restored his health.

A host of serious medical concerns were making daily life a challenge for Robert Watts. Comprehensive care at Mayo Clinic helped him tackle each of them and successfully restored his health.


At 525 pounds, Robert Watts was morbidly obese. He had diabetes and high blood pressure. Then in 2013, Robert was diagnosed with congestive heart failure.

"I was on oxygen 75 percent of the day, including while I slept. My five siblings did everything for me," Robert says. "I couldn't walk to the end of the driveway and had to go on disability for six months."

Today, Robert is 200 pounds lighter, and he's been able to quit taking several of the medications he used to require daily. He has a new job and a new lease on life. Robert gives much of the credit for these remarkable changes to the multidisciplinary care he received at Mayo Clinic.

A serious situation

When Robert was diagnosed with heart failure, his ejection fraction — the percentage of blood the heart squeezes out with each contraction — was 16 percent. Fifty-five percent or higher is considered normal. Robert's care team at Mayo Clinic's Florida campus also found that his heart condition had caused fluid to build up in his lungs. Robert met with Jorge Pascual, M.D., a Mayo Clinic pulmonologist, who promptly referred him to cardiologist Mohamad Yamani, M.D.

"He had severe shortness of breath and leg swelling. He was in florid congestive heart failure," Dr. Yamani says. "We did a cardiac catheterization, and while his coronary arteries were normal, he did have significant pulmonary venous hypertension."


"For the time you're with [Dr. Yamani], you always feel like you're the only patient of the day." — Robert Watts


To treat the condition and ease symptoms, Dr. Yamani put Robert on diuretics and three different heart medications. After five months, Robert was strong enough to begin cardiac rehabilitation three times a week.

"Dr. Yamani is brilliant. He is able to create a treatment plan and interpret data unlike anyone I've ever seen," Robert says. "For the time you're with him, you always feel like you're the only patient of the day."

As part of his care plan, Robert was referred to a nutritionist and assigned to a seven-month bariatric program for medically complicated obesity.

A plan for better health

Elaine Macomb, a nurse practitioner in Mayo Clinic's Department of Cardiovascular Medicine noticed that Robert was depressed, and she suggested he start seeing a therapist. She also urged him to consider bariatric surgery to help with weight loss.

"Elaine showed me that a better way was possible. I felt enveloped by the whole team. Every aspect of my care was considered," Robert says. "I was making my heart support two-and-a-half people when it should only support one."

He decided to undergo a laparoscopic sleeve gastrectomy. Before he could have the weight-loss procedure, however, Robert needed to learn more about it to confirm that it was a good fit for him.

"I was required to attend 26 pre-op appointments and classes to make sure this procedure was right for me and understand that it would only work if I did a lot of the work," Robert says.


"Now I know that I went through this to live the life I always knew was possible." — Robert Watts


After going through all of the appointments and classes, Robert was confident in his decision. Mayo Clinic surgeon Steven Bowers, M.D., performed the laparoscopic sleeve gastrectomy on March 14, 2017. The procedure involved reducing the size of Robert's stomach and changing its structure to restrict the amount of calories his body would absorb.

The results were substantial. Robert lost 50 pounds in the first three months after the procedure and saw other significant health improvements.

"It causes a metabolic reset, and within 30 days I was off six prescriptions, including insulin, two diabetes medications and one of my heart medications," Robert says.

A healthier way of living

But Robert knew he couldn't rely on the weight-loss procedure alone to meet his health goals. He began exercising six days a week, three of them with a personal trainer, to help him continue to lose weight. He's also looking forward to spending time at a health spa this fall to learn more about healthy living and further enhance his exercise routine by hiking, swimming and doing yoga.

"This whole process and the Mayo team have taught me how to live healthy," Robert says.

Robert's made other positive changes, too. In September 2017, he started a new job as the executive director of the South Carolina Muscular Dystrophy Association, and he's working toward a master's degree in organizational development with an emphasis on health care.

Although it hasn't been an easy road, Robert appreciates the benefits he's receiving as result of the changes he's made and his care at Mayo Clinic.

"Now I know that I went through this to live the life I always knew was possible," he says. "That's what Dr. Yamani and his team have given me. They've given me a zest for living."


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Tags: bariatric surgery, Cardiology & Cardiac Surgery, congestive heart failure, Dr. Jorge Pascual, Dr. Mohamad Yamani, Dr. Steven Bowers, Elaine McComb, Gastroenterology, MayoClinicFL

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