Catch a Neal family reunion and you would be swept away by friendly smiles and relations with a kind, supportive nature. They are a family genuinely thrilled by one another’s successes. At second glance you might notice the reunion food and hors d’oeuvres spread. On the menu would be an assortment of high-protein seafood, tiny bite-sized appetizers, and the newly famous Neal family high-protein peanut butter cookies. “During the holidays last year, the family members with regular stomachs had to follow our routine and enjoy it,” Peggy (Neal) Faust of Fargo jokes. As it turns out they did just that! What she is referring to is the size of her stomach pouch that was reduced to the size of a golf ball during her Roux en-Y gastric bypass surgery at the hands of St. Joseph’s Area Health Services surgeon, Dr. Dan Smith. Peggy is one of five Neal family members (out of six) to have the surgery, not to mention other extended family members who have undergone or are in the process of having the procedure done. Together Mary (Neal), Dale and Stacy Gulsvig, Kathi (Neal) Schwan, Bob Neal and Peggy, all of Fargo came to St. Joseph’s Center for Weight Management in Park Rapids for weight-loss surgery. They’ve become familiar with a friendly and caring staff, an immediate personable response to their inquiries, shorter waiting periods, and, of course, the reputation of Dr. Smith and his team of professionals to provide quality care. In addition, their insurance companies required that they go to an ASMBS Center of Excellence. (St. Joseph’s Center for Weight Management has also been designated a Blue Distinction Center for Bariatric Surgery by the Blue Cross and Blue Shield Association.) Collectively they’ve lost 744 pounds since their surgeries: the equivalent of a GE Profile side-by-side refrigerator/freezer. They already have a built-in support network and are working to change their family legacy so far as health is concerned.

All in the family

He weighs other risk factors especially when those risks are life threatening. When totaled, the Neal family exhibited a string of co-morbidities and associated health conditions. Their family history was a grave concern. A pre-operative Robert at 387 pounds would administer six shots per day plus oral medication for his diabetes. Complications led to eventual neuropathy in his hands and feet. He knew gastric bypass surgery was a vital step toward health having watched others in his family die as a result of chronic health conditions. A Neal family sister had weight-loss surgery five years ago where she lives out east and did well. That sparked an interest among the siblings. They looked into the surgery as an option for themselves. In conversations with one another, they all decided to investigate and find a good program. Rachel Rudel, a Registered Dietitian with Innovis Health, Fargo, eventually directed them to Park Rapids. Robert had his surgery in 2005. He says the care he received was the best ever of all of his many hospitalizations. His weight loss helped to relieve many weight-associated conditions, but not all. His only wish is that he had the surgery sooner. After Robert’s surgery and subsequent success, one by one, the others followed suit. Mary’s (Neal) husband, Dale, was next, followed by Mary and daughter, Stacy, who had their surgery on the same day. Dale weighed 392 and experienced back, knee, and ankle pain. When he came home from work many times he would fall asleep before bedtime. When he did go to bed he would be plagued with leg cramps. Mary works on her feet all day long. With 235 pounds on her 5-foot, 2-inch frame, her feet “felt like sausages” by the end of a work day. Getting from her car to the house was mighty painful. She would be in bed by 9 p.m. Her daughter, Stacy, who works with children would often feel winded and out of breath at 282 pounds and was on the verge of some serious health problems. Peggy (whose husband had the surgery in Minneapolis six years ago) decided it was her turn. An angina attack at age 55 left her frightened. Her father was 53 when he had his first heart attack. “I knew it was time for me to do something,” she says. She weighed 213 prior to her surgery. Kathi had spinal surgery seven years ago to treat herniated spinal discs. During the long recovery period, her weight climbed to 230 pounds. Every attempt at weight loss failed. “Being overweight is with you every minute of every day,” she says. “It’s difficult walking up stairs, tying one’s shoes or running through the airport.” Serious medical issues loomed unless she could do something about it.” Kathi’s insurance company had her tied up in red tape, so as soon as she got the go ahead she was ready. “By this time we were all acquainted with the (St. Joseph’s) staff,” Kathi says. That, coupled with the personal attention she saw staff provide every patient, made her decision an easy one. “This (Park Rapids) is where all of us wanted to have our surgery.” “Dr. Smith and his team were the first in the area to receive the Center of Excellence designation for bariatric surgery based on the way the program was designed and supported with education,” Kathi continues. “I found that others who had the procedure elsewhere seemed to be on their own and didn’t have the most important program components; support and education. Surgery can be scary enough, we wanted to go where we had the greatest confidence in the surgeon and hospital,” Kathi says. St. Joseph’s has a unit specially designated for bariatric patients. “The nursing staff could tell me what to expect because many of them also had this surgery,” Kathi adds. “Many of those I had met for the informational workshop stopped by to provide support. It gives a tremendous boost to know you’re in such good hands. Staff was there for support, day or night, and even after being discharged.” Kathi will go so far as to say that in doing her homework, Park Rapids has become the “gold standard” by which all weight-loss surgery programs are looked at by potential patients. Peggy will tell everyone who will listen about Park Rapids, Dr. Smith, and his team.

New life

Their numbers add up fast. Total pounds lost since their surgery with Dr. Smith to date are:

• Robert, 180 pounds lost
• Dale, 140 pounds lost
• Mary, 104 pounds lost
• Stacy, 120 pounds lost
• Peggy, 90 pounds lost
• Kathi, 110 pounds lost

Former medical conditions rebounded or reversed. As mentioned, Robert’s status improved. Peggy says today she is in the best condition of her life. She had been taking 16 pills per day. Today? None. Dale can now walk without pain, no longer uses his CPAP for his sleep disorder, can get up from the floor without help, ducks in and out of cars easily, stays awake longer, and no longer takes naps on the couch. Mary gets around with ease, has more energy at work, no longer goes to bed early, and doesn’t fret about traveling by plane because she knows the seats will fit her frame. Stacy feels great and is a ball of energy. Now she can enjoy her job working with children to the fullest. She ran a 5K race last October and plans on another this spring. “I know it’s only a little over three miles, but when I finished, I couldn’t believe it,” Stacy says. “It felt incredible to be able to do something I never thought possible.” Initially after the surgery, water was a little tough to get down because she had been used to “gulping.” She retrained her eating and drinking style to accommodate her new stomach. She has maintained her weight loss for two years. This is the first time in her child-care history that she hasn’t had to call a sick day, not even one, in a year. And she can say, “no,” to any more nebulizer treatments. Talk to Kathi and she is signed up to run the Fargo Marathon this spring with her two adult sons. She’s doing things she has never done before: “I wish this (surgery) had been an option years ago.”

New traditions

Going through the surgery process as a family was beneficial in that they pretty much knew what to expect and could discuss challenges with one another, Mary says. “We did what we were told and knew not to rush the process or to be eating anything we shouldn’t.” Peggy notes that the family is an ideal source for food ideas and recipes. “It’s great having family support on a daily basis,” says Kathi. “When we go out for dinner, we all want the same thing. There’s no debating the menu.” Many in the family attend monthly support group meetings held at Innovis Health, Fargo, to remain inspired and support others. When asked about the surgery they are open and honest. Their support group leader, Rachel Rudel, a registered dietitian at Innovis Health on South University in Fargo, is the one who initially referred the Neals to Park Rapids. Their support group meets on the fourth Thursday of every month. They’ve developed a camaraderie with Rudel and are happy to share their story with any of the potential surgical candidates who attend meetings. Rudel says it has been an adventure working with this family. “They are so well connected and in tune with each family member,” she says. “Our Innovis Health gastric bypass surgery support group has doubled and tripled in size since the they came on board. They faithfully attend meetings and openly tell how their journey has gone.” Each has a different story to share about foods they can or cannot tolerate, she adds. They each figured out how they individually can meet their goal for protein, water, vitamins/minerals, exercise, fiber, and eating more slowly. The Neals’ own developed recipes for protein peanut butter cookies are a hit. Still, the greatest joy Rudel shares about the Neals is the improvement in health benefits. “As a registered dietitian and certified diabetes educator, my greatest reward is seeing how this surgery can change lives. The Neal family is an example of how to follow the rules for the best possible outcome,” Rudel says. “They support one another, and perhaps this is one of the keys to the high success rate for each family member.” “Some people are shy when talking about weight problems because it can be so personal,” Kathi says. “None of us in my family feel that way. We know we all faced serious health problems that were predominant in our family, and together we needed to find a solution. Dr. Smith and his staff provided the answer. We are very grateful.”