Puyallup woman’s medical weight loss helps her avoid knee surgery

In the spring of 2020, Lynnette Duenas, 59, paid a visit to her primary care doctor to get what she thought would be a referral for knee replacement surgery. Instead, she received a referral she wasn’t expecting.

“I had a lot of knee pain and knew there was very little cartilage left in my knee,” explains Duenas. “I thought my doctor would refer me to surgery, but without warning, he said, ‘At your weight, you don’t qualify for surgery. You need to lose weight.’ I was devastated. I knew I was heavy, but I didn’t expect to hear that.”

Her doctor told her he would refer her to a medical weight-loss program.

“Because I was still a little upset about what happened, I didn’t pursue getting an appointment,” Duenas says. “But when MultiCare called me to follow up on the referral, I thought, ‘OK, I might as well,’ and made the appointment. I’m so glad I did.”

A non-surgical approach to weight loss

When Duenas went in for her first appointment with Ayumi Salva, DO, at the MultiCare Center for Weight Loss & Wellness in Puyallup, Duenas immediately liked her.

“At my first visit, Dr. Salva and I discussed my options,” she says. “We created a plan together, and I got started right away.”

The medical weight-loss team at MultiCare Health System works with a person’s specific needs and health goals to create a personalized plan to help them lose weight effectively. The plan consists of healthy eating, exercise, behavioral changes and may also include the use of certain medications.

In Duenas’ case, Dr. Salva believed medications would help, so she prescribed Contrave — a medication used to help curb food cravings. And since Duenas has insulin resistance (but not diabetes), she was also put on Metformin, a medicine that helps control high blood sugar. Dr. Salva is also a registered dietitian, so she has the extra experience in nutrition counseling to help her patients make informed decisions about food.

At her monthly appointments, Duenas gets weighed, has her body measurements taken and meets with Dr. Salva.

“Dr. Salva has been supportive, encouraging and not judgmental,” says Duenas. “It has been one of the best experiences I’ve ever had with a doctor. Dr. Salva really listens and made me want to succeed.”

As she lost weight, Duenas noticed her body was changing, which made her even more motivated. At the start of each appointment, Dr. Salva shows her a graph of her weight loss progress, which has been a consistent downward slope — another motivating factor.

Making positive changes

Taking a slow-and-steady approach, and with the support of Dr. Salva, Duenas created habits over time by eliminating unhealthy foods and replacing them with healthier ones. Dr. Salva encouraged her to choose clean, whole foods over processed ones.

“I had the time to change the way I felt about food, and eventually, making healthier choices became natural,” Duenas says. “I got to a point where certain foods didn’t taste good, either. After a while, you just don’t want those foods anymore.”

Duenas says she doesn’t deprive herself of anything, and her meal sizes are much smaller.

“I’m more in tune with my body now and know some foods make me feel like I’ve eaten garbage,” explains Duenas. “Visualization helps. I can visualize eating a piece of cake, knowing it’s all sugar, and I know it would make me feel lousy. So, instead I make a conscious choice to eat something that will make my body feel good.”

Improvement in health conditions

Weight loss is shown to improve or resolve medical conditions such as diabetes, GERD and sleep apnea, among others.

For Duenas, once the weight started coming off, she no longer had high blood pressure, trouble sleeping or anxiety, so she was able to stop taking medications to treat those issues. And she no longer needs to use a CPAP machine.

“The medication I was taking for anxiety contributed to my weight gain, which was keeping me from progressing with my weight loss,” she explains. “That fact was motivation enough for me to get off the medication, so I could get the full benefit of all the work Dr. Salva was helping me do.”

In addition, Duenas has had asthma since she was a young adult, but since the weight loss, she hasn’t had to rely on inhalers like she used to.

“Losing weight has helped me not just with my physical health, but with my mental health as well,” says Duenas. “I used to feel ashamed to be out in public, and it made me feel bad about myself. Now, I’m more comfortable in my own skin.”

Staying active

Duenas is more active now than she’s ever been. And to stay active, she goes to a gym. She does a mix of cardio, stretching and weightlifting. She also works with resistance bands.

“I focus on strengthening my muscles, so they support me,” she says. “This also helps in not aggravating my knee issues.”

Her knee pain has decreased since her weight loss. She says she’s no longer experiencing the pain that was pushing her toward knee replacement.

“I recently took my two granddaughters to Disneyland, and we were walking all day. I was able to get on all the rides with the kids,” says Duenas. “During past family vacations, I felt too heavy to participate in any activity.”

‘This is what I’m doing for the rest of my life’

Over the two-and-a-half years she’s been in the program, Duenas has experienced steady weight loss and has lost more than 80 pounds. And because she lost the weight over time and created healthy habits, she feels confident she can keep it off.

“I have 35 pounds to go, so I’m still on Contrave. However, once I reach my goal weight and go off the medication, Dr. Salva will continue to monitor me to make sure I stay healthy,” she says.

Duenas now sees Dr. Salva once every three months for a checkup instead of monthly. She notes her insulin is staying in check and she’s maintaining a healthy diet.

“I am privileged to be part of Lynnette’s weight-loss journey,” says Dr. Salva. “Even though she was hesitant to make that first appointment, she adapted very well to the plan, stayed motivated and made positive lifestyle changes that will be long-lasting.”

“I tell anyone who asks about my weight loss that I went to MultiCare’s weight-loss center, and I recommend you do it if you want to lose weight,” says Duenas. “I know this sounds like a commercial, but it really is that great. It got me on the right track to eating better and being more active, and I know this is what I’m doing for the rest of my life.”

To schedule a consultation with the MultiCare Center for Weight Loss & Wellness clinic near you, call 253-301-5280 or request an appointment online.