1 July 2019

Getting fit for surgery has been a labour of love for David Lamese.

It is a daily grind, but he knows it will pay off in the long run.

In February David tipped the scales at 147 kilograms, but since embarking on the Fit for Life, Fit for Surgery programme run by Whanganui District Health Board he has shed more than 30kgs, weighing in at 114kgs at the end of June.

The programme, led by head health board anaesthetist Marco Meijer, was developed in partnership with Sport Whanganui and local GPs, and encourages significantly overweight patients to make lifestyle changes to reduce weight and increase their readiness for surgery.

Previously, David was a fit and active logging truck driver pulling 10 hours days, and while he has weighed in at around 150kgs previously, his active lifestyle kept his body fat low and he had upper arms measuring a whopping 22 inches around.

However, during an awkward exit from his truck one day, he stuck his foot in a hole and ended up with torn knee ligaments in one leg – the resulting cartilage and “bone on bone” damage assessed as needing full reconstructive surgery.

While placed on a waiting list for elective surgery, his doctor at Taihape Health referred him to the Fit for Life, Fit for Surgery programme.

From there he met with Sport Whanganui’s Fit for Surgery navigator Christine Taylor, whose job it is to make sure clients are physically and psychologically ready pre-operation.

The two met several times in Bulls, which is roughly halfway between their respective bases of Taihape and Whanganui. The meetings included conversations about David’s goals, obstacles, concerns and weekly progress in training.

Mrs Taylor says the success David has shown, despite being located outside of Whanganui, is evidence that the programme is beneficial for people living rurally or in remote areas.

If unable to meet in Bulls or Whanganui, they chatted via phone, email or text message to ensure David had the support he needed.

However, it was at their first meeting and his initial programme assessment that David had what he calls a “lightbulb moment” -- he discovered he had gained an additional 10kgs since originally being referred to the Fit for Surgery programme.

He puts this weight gain down to being unable to perform his usual physical activities, and a substantial drop in income that led to him being basically housebound and eating too much.

From that moment, he embarked on a journey to change his lifestyle, and to become healthier and fitter in preparation for his pending knee surgery.

This included a dramatic change of diet, something David says is key to his weight loss so far.

“It’s 90 per cent diet and 10 per cent training and attitude. Before, I was eating all the wrong things at the wrong times. I’ve now got some structure to how I eat.”

David now has a new dietary regime that is paying dividends, and he has come a long way from his old favourite dish of three donuts with fish and chips.

He has also learnt a lot about weight and fitness training and, with Christine’s help, has developed a routine which he adheres to six days a week.

“That involves a five kilometre walk, which I do on the treadmill in just under an hour - 54 minutes actually. I then do up to three hours weightlifting, including leg and back presses.”

The resistance training has helped build and tone his muscles.

David says his local gym staff are helpful and supportive and he enjoys pushing himself physically.

“It’s important to work out what you want to achieve, see what you can do and begin within your limits -- from there you can add to what you’re doing. But I do think sometimes you need to go past what your mind says you can do, and keep on grinding.”

Along with gym work, David is active outdoors and goes free-diving twice a week for several hours at a time. He dives to between six and 12 metres and collects kaimoana, which fits in well with his new healthy diet.

All this training has seen David quickly achieve beyond the 17kgs weight loss goal set for him through the Fit for Surgery programme, and his aim now is to get to 100kgs or less.

“I know that if I lose as much weight as I can, I will put on less after surgery when I’m less active. The other thing is that the fitter I am going into surgery, the faster my recovery time will be.”

Along with Christine Taylor – whose role it is to help clients “navigate to surgery and beyond” ­– David has been in contact with Fit for Surgery programme leader Dr Marco Meijer who’s advised him on everything from pre-operation preparation to what surgery will entail.

David appreciates the fact that everyone from the Whanganui health board, Sport Whanganui and his own GP practice have worked as a team to get him to where he is today.

“Everybody has a gift, and these people have come together with their gifts to benefit an individual. It’s all about teamwork and Whanganui DHB has been great at that.

“The real benefit of the Fit for Life, Fit for Surgery programme is that it aims to get people to keep up our healthy lifestyle changes for the rest of our lives – and I now know that is possible. I’m not going to be Mr Olympia overnight, but if I work at it, the fruits will come.”

At present the Fit for Surgery, Fit for Life programme is applied to patients who are candidates for elective hip and knee surgery.

Hospital staff and GPs can refer patients to Sport Whanganui, where they are assessed and given an individual care plan, including advice and motivation. The programme can also provide referrals to appropriate community support services such as dieticians, physiotherapists and psychologists, as well as the Fit for Surgery, Fit for Life activity coordinator.