Water Exercise Helps Melt Pounds

By PATRICIA NORRIS
pnorris@repub.com

The exercise looks low-key, but the benefits Karen L. Nadeau's patients receive from moving their limbs through the warm water in the Holyoke YMCA pool pays dividends.

Nadeau, a physical therapist with HealthSouth in Holyoke, runs a class for men and women before and after weight loss surgery at Baystate Medical Center in Springfield.

The two-day-a-week class requires a prescription from a physician at the medical center's bariatric surgical program. "This helps to strengthen patient's core, arms, legs and increase their endurance," said Nadeau, who designs stretching and exercises on an individual basis for the hour-long class.

Both preoperative and postoperative patients are encouraged to join the class because losing or maintaining weight helps increase patients' endurance and gets them acclimated to an exercise program, said Dr. John R. Romanelli, medical director for weight-loss surgery at Baystate.

"The problem bariatric patients have pre- and post-op is it is very hard for them to exercise because most have pain in their weight-bearing joints like their hips, knees and backs. You cannot just ask them to hop on the treadmill. It can be hard for them," he said.

Patients in Romanelli's program, in addition to the exercise, must also take part in mental health, nutrition and eating counseling for six months before undergoing the surgery. The $30,000 lifesaving surgery for the morbidly obese - those with a body mass index over 40 - has been under scrutiny because it is a procedure on the increase and carries a risk of dying that is 1 in 200. At least one insurer, Tufts Health Plan, plans to deny the surgeries or require prospective patients to participate in a year-long counseling and exercise program before undergoing surgery effective in March.

Although Romanelli agrees with the concept of evaluating patients before surgery, he believes many surgical programs do lengthy in-house assessments with patients that would make such insurance requirements redundant and even unnecessary.

The longer obese patients wait for the surgery, the higher the risk that corresponding illnesses such as diabetes and hypertension will worsen, experts say.

But reasonable exercise programming as well as counseling is important for patients considering weight-loss surgery and for those who undergo the procedure because the surgery is only a "tool" to help patients lose weight, not a cure-all, said Romanelli.

At poolside Susan M. Bouchard waits in her wheelchair until Nadeau can assist her with getting into the water. Bouchard is waiting for approval for surgery. Her weight, 319 pounds, has made it difficult to walk long distances and her hip pain compounded the problem. But since joining the water exercise class, she has noticed a drop in hip pain and has lost some weight. She also gets the psychological benefit of speaking with other class members who've already gone through the surgery.

"I feel like this is reinvesting in myself," Bouchard said. "I want to walk again."

Nearby Dori Ference is half as large as her former self. A physically fit size 10, she came to class after her operation because her back was in pain.

Ference, who has completed 10 water sessions so far, said her pain level has dropped and her stamina is better than ever.

"My body is responding," said Ference, who has lost 103 pounds.

Besides water exercise, Ference also goes to Curves, a women's gym.

"I feel like I am turning 40, not 50," she said.