The breaking point came for Paul Hamilton on June 25, 2016, as he labored up a stairwell and to his car after the NHL draft came to a close in downtown Buffalo.
He was gassed physically, mentally and emotionally. Drained by excess weight, swollen legs and a back so sore he could barely stand for more than 5 minutes. So self-conscious by the way he looked that he chose to spend most of his off-work hours alone in his house.
"I was always out of breath," said Hamilton, the veteran Buffalo Sabres beat reporter for WGR-AM 550 Sports Radio. "I was always in a complete and utter sweat. It was embarrassing to be quite honest. I'd walk from the press box to the locker room and I would have sweated through my suit by the time I got down there.
"These are warning signs before you have a heart attack or stroke. That's how far gone I was."
Hamilton decided as he stood in the First Niagara Center parking ramp that he would take the advice of his goddaughter, Caryn Domzalski, and explore gastric bypass surgery.
Domzalski, a social worker, had the procedure the year before, lost 135 pounds – and kept it off.
Hamilton set a similar goal.
"If I didn't do this," he said, "I didn't think I would have lasted another two years."
A GRADUAL CHANGE
It took decades for Hamilton to stand in the place he found himself last year.
He grew up in Amherst, where he played hockey in youth leagues and at Amherst High School. The 5-foot-9 forward, a self-described "sparkplug," weighed 165 pounds when he went on to play at Iowa State University during a school hall of fame career that included a tryout for the 1980 U.S. Olympic team.
"I knew I wasn't going to be good enough to play pro hockey," said Hamilton, who got his first radio gig at WBTF-FM in Attica, then worked for several years in the late 1980s and early '90s in the financially turbulent airline industry.
He found more stability in a radio career that began to take off in 1994, after WGR hockey talk show host Barry Buetel encouraged Hamilton to take a part-time job doing sportscasts and other work. When Buetel left a few months later to take a job covering the Cleveland Indians baseball team, the station turned to Hamilton to cover the Sabres. He's done so ever since. He also helps with Buffalo Bills coverage, and is a familiar presence on all of the station's locally produced sports talk shows.
Hamilton for years has worked shifts during the Buffalo pro sports seasons that have included calls in to provide content for morning and evening shows, live reports from training camps and practices, and pre-game, between-period and post-game interviews. He's traveled on Sabres road trips.
It's been a dream job for a guy who loves hockey – but one filled with busy days, inconsistent sleep schedules and lots of unhealthy food temptations.
The mix, gradually and over years, helped push him to 355 pounds – nearly 200 pounds more than his college playing weight – by the time he decided to make a big change.
Hamilton saw gastric bypass surgery as a last, best option.
He'd tried Weight Watchers, Jenny Craig and other weight loss plans. They worked for a while, but then he stopped working them. He ended up regaining the weight he'd lost, and then some.
In frustration several years ago, he visited Dr. Michael Um, a naturopath in St. Catharines, Ont.
"He treated me as an addiction patient," Hamilton said. "What was happening was that I couldn't stop eating; I would eat crap every day: pizza, Burger King, whatever. Fast food. I'd drive by La Nova and say verbally, 'Don't stop, don't stop,' and I would stop."
Not by a way of excuse, but explanation, personal loss also colored recent years. His parents, a sister and his closest childhood friend all have died since 2001. The biggest blow came in January 2011, when his wife, Dawn, a vice president at WNED-TV, died after a four-year battle with breast cancer. They had been married for 29 years. She was 51.
"I never want to make excuses," Hamilton said. "Maybe that was my problem. I just didn't want to admit I had a problem. ... You want to be tough as part of your upbringing." Regardless, "my diet got out of control. It was easier for me to go to a fast food place and eat, so I got lazy with it and kept packing the weight on and packing the weight on and did nothing about it, no exercise whatsoever."
The choice to pursue gastric bypass surgery started with a deeper exploration into those decisions. The process began with a one-hour presentation at Buffalo Minimally Invasive Weight Loss Solutions. His goddaughter, who also is his niece, was one of the guest speakers. Over the next five weeks, he visited his primary care doctor, a nutritionist, a psychologist, his sleep doctor, and Dr. John D. Rutkoski, who would perform his surgery.
"They have to be sure you know what you're getting into," Hamilton said. "It's for life. Patients have to know that."
Hamilton also became much more acquainted in August 2016 with Jared Byer, a health coach and owner of Made 2 Move Fitness in Amherst, who he'd seen sporadically over more than 15 years. It was important that Hamilton lose about 20 pounds before surgery to get some of the fat off his liver, making the procedure more manageable to perform.
"When he came in, he was probably in the worst shape I've seen him, both physically and just down and out," Byer said.
The two made arrangements to meet at least three times a week for 30- to 45-minute workouts in which Hamilton wore a heart monitor. The goal was to help Hamilton build endurance while he began to lose weight.
"I said, 'Hey, if you're going to do this, this is a serious commitment. This is not an end all, be all, either. There are many facets to it," recalled Byer, who has worked with several other gastric bypass patients. "There's complications that can arise if you're unhealthy going into most surgeries but especially something like this."
It turned out that Hamilton kept much of his muscle memory in the years he gained weight. "He's got that mental drive but wasn't engaging in sports," Byer said. "We tried to use that to his advantage."
The prep also included the caution that Hamilton would have to change his eating routine, to be prepared to eat much less but more often after surgery, while he continued regular exercise.
Hamilton also consulted Dr. Um during the process. "He said to me, 'Paul, this is not a silver bullet. This is a tool to help you. If you think you're going to get surgery and not change your ways, it's not going to work.'"
Hamilton underwent laparoscopic surgery on Oct. 3, 2016 at Sisters of Charity Hospital – St. Joseph's Campus in Cheektowaga. Rutkoski made several small incisions in the broadcaster’s abdomen and used pencil-sized instruments to staple an egg-sized pouch at the top of Hamilton's stomach. He then attached part of the small intestine to the pouch to more quickly bring food into the lower digestive tract.
The procedure gives patients a far greater feeling of fullness. Meanwhile, the lower end of the stomach continues to produce acids and digestive enzymes that flow into the small intestines to do their work further downstream.
The doctor told Hamilton it would take three or four weeks to feel better, but he wanted him up and around within a few hours of surgery. He told Hamilton to start walking after he got home, even if it was just a few steps to start.
Six days afterward, Hamilton enjoyed a walk from Main Street into Glen Park in Williamsville. He wasn't out of breath afterward, and barely broke a sweat.
"It was then I realized that a lot of my problems probably stemmed from what I was eating," Hamilton said. "I shudder to think how much sugar and fat I was putting into my body by eating fast food. It had been probably three or four weeks since I'd really had sugar. I figured once I got the weight off, I'd lose the cravings. They were gone in six days.
"I needed the surgery but it was more than just the surgery. Dr. Rutkowski told me, 'Your tastes will change,' and they do."
For years, it was no trouble at all for Hamilton to down 20 wings at one sitting, though he paid with gastrointestinal discomfort in the hours afterward.
Since his surgery, he can eat no more than three wings as part of any small meal.
"They have cookies in the press box and I might eat one," he said. "If I get into a second, it's a little too sugary and I don't want it."
Byer tells most of his clients to eat four to six modestly sized meals daily with a mix of protein, healthy fat, fruits and vegetables, and no processed or fried foods. He and Hamilton's nutritionist, Kristen Gill, have told the Sabres beat reporter to graze on even tinier portions up to 10 times a day, take in at least 70 grams of protein – a considerable amount, because of his workouts – and stay well hydrated.
If he eats too little, which can be common for gastric bypass patients, Hamilton runs the risk of slowing his metabolism and choking his weight loss.
Hamilton is more conscious about his food choices now.
"My stomach is smaller than a fist," he said. "What I've found is no matter what you eat, if you eat too much, you've got about a minute and a half, and it's coming back. You get sick quickly, so you have to learn. If I go to a restaurant and order pasta, it's dinner for three or four days – and I mean three or four days."
He eats lots of soup. "I've had to make friends with yogurt," Hamilton said. "I'm not a real fan but it has protein in it." He adds cinnamon. He takes plenty of protein powder and protein bars to work and on the road, and has become a fan of Healthy Choice prepared meals that pack a modest 200 to 300 calories "and fill me up right away." He eats chicken breasts, and turkey burgers without the roll.
Fourteen months after surgery, Hamilton continues to work out regularly, doing a mix of high intensity cardio and resistance training exercises that stretch 20 seconds, with 10 seconds of rest in between. Byer looks to have Hamilton standing through many of them, using his body weight to build strength.
"In one exercise, he drags me around on these gliding discs," Byer said. "We try to have some fun and mix it up."
The health coach also has given Hamilton workouts he can take on Sabres road trips.
"The schedule with practices and travel gets much tougher during the season," Byer said, "but it's something he's managed to do much better now than he did in the past. You can't just take off for two weeks and expect to come back at the same level."
Hamilton leads his new life under the watchful eyes of a support team that includes his health providers, loved ones and colleagues.
Among those with the keenest of gazes?
Former Sabre tough guy Rob Ray, color commentator for Sabres games on WGR radio and MSG-TV.
Ray warned Hamilton for years that he risked a health catastrophe if he didn't change his ways.
"On the road, Rob Ray is my workout partner," Hamilton said. "We get off the plane, check in to the hotel and we're in the gym in 10 minutes. That's the kind of person he is. He wants me to succeed.
""He's rough, but he cares. I'll never forget that once I started really losing the weight, in Rob Ray fashion, he comes up, grabs me by the collar and says, 'Don't you ever ... forget how you used to feel.'"
Hamilton took Ray to his last big dinner, at EB Green's, before his surgery last year, and picked up the $150 tab.
"That was my wife's favorite place," he said. "We had steak, monkey bread, dessert, everything. It was a very nice last dinner of my old life."
It was a far cry from the dinner the two shared last month with Sabres play-by-play broadcaster Dan Dunleavy during the team's first road trip to play the Vegas Golden Knights, the new NHL expansion team.
They dined in the old city part of Las Vegas at The Heart Attack Grill, a spot where customers are encouraged to put on hospital gowns and choose from a menu that includes the 4-pound Octuple Bypass Burger, a nearly 20,000-calorie dish that features eight meat patties and 40 strips of bacon.
"Rob offered to treat," Hamilton said. "I'm like, 'God, what am I doing here?' I ordered the hot dog, which had chili and bacon on it. The thing was huge. I ate a 2½ inches of it, without the roll, and it didn't even taste good, to be honest. … I thought to myself, 'A couple years ago, I would have had no trouble eating that whole thing – and would have."
Those who weigh 350 pounds or more eat free at the Heart Attack Grill.
Hamilton no longer qualifies.
He has lost 80 pounds on his gastric bypass journey, and looks to lose about 50 more.
He's' lost 10 inches off his stomach, 9½ inches off his chest and 4 inches off his neck.
"All the clothes I had have gone to Am-Vets," he said.
Over the summer, Hamilton resumed trips to Lewiston for Tuesday in the Park concerts at Artpark, confident he could make the walk from the parking lot to the amphitheater without stopping several times to rest. He played the outfield on his Town of Tonawanda softball league for the first time in several years, and he, former colleague Greg Bauch, and Bauch's wife hiked in the Niagara Gorge for 3½ hours on an 85-degree day.
"I was sweating, and I looked to see if Greg and his wife were sweating, and they were, too," Hamilton said. All three also were a bit out of breath after they climbed the stairs to the rim – but recovered quickly.
"It's overwhelming when I can do those things now and not even have to think about it," Hamilton said.
Byer – who also used to train Hamilton's wife – is pleased that with dedication Paul Hamilton brings to his new way of life.
Dawn Hamilton was a "super organized" Type A personality, Byer said. "I could tell her what to do and she would do it to the T," he said. "She was an excellent client. I'd see her once a week. I'd give her stuff to do. She'd do it on her own. She'd make notes stocked with every single thing.
"Paul is more group motivated or motivated to come to an appointment. He's typically not going to do something on his own. Two ends of the spectrum. Dawn would be ecstatic that it finally all came together for him."
TYPES OF BARIATRIC SURGERY
There are several types of bariatric weight loss surgery, each with pros and cons. This makes the choice to have one personal and specific. That’s why talking to doctors and specialists is important when considering such surgery. So is understanding all that goes into the process, said Dr. John D. Rutkoski, with Buffalo Minimally Invasive Weight Loss Surgery Solutions.
“Unfortunately, there are still a lot of Americans who look at weight loss surgery as an easy out or quick fix,” Rutkoski said. “It’s certainly not. It’s something that requires a close adherence to the changes that are expected.”
Another misconception: only those who weigh 600 pounds or more can benefit. Most patients at the practice served by Rutkoski and Dr. Dang Tuan Pham are 100 to 120 pounds above their ideal weight, with a Body Mass Index (BMI) of about 40. Insurance often covers the cost for such procedures, Rutkoski said, even if BMI is slightly lower but prospective patients have obesity related health conditions that include Type 2 diabetes, high blood pressure, obstructive sleep apnea and cardiovascular disease.
The following are the most common procedures, according Rutkoski and the Mayo Clinic.
Gastric bypass: This surgery, around since the 1970s, works by creating a small, sealed-off pouch at the top of your stomach that can hold an ounce or two of food. (Your stomach typically holds about 3 pints.) A feeling of fullness results. Nutrients are more quickly diverted down the digestive tract.
Sleeve gastrectomy: This procedure became available about six years ago. It has become the most common in Rutkoski’s practice. Instead of rearranging the small intestine – as is the case with gastric bypass – the surgeon removes the outer two-thirds to three-quarters of the stomach, leaving the patient with a stomach about the size and shape of a banana. This promotes weight loss by removing most of the hormone-making centers in the stomach that create a sense of hunger. Those with Type 2 diabetes or acid reflux often are discouraged from having this procedure in favor of gastric bypass.
Biliopancreatic diversion with duodenal switch: About 80 percent of the stomach is removed in this most aggressive form of bariatric surgery, a combination of gastric bypass and sleeve gastrectomy. The valve that releases food to the small intestine remains, along with a limited portion of the small intestine that normally connects to the stomach. This surgery limits how much you can eat and reduces nutrient absorption. “While it’s very effective for weight loss, it has more risks,” according to the Mayo Clinic, “including malnutrition and vitamin deficiencies. It’s generally reserved for people who have a body mass index greater than 50.”
Laparoscopic adjustable gastric banding: This form of weight loss surgery involves an adjustable band can reduce the size of the stomach. It typically leads to less weight loss than other procedures and the band may need periodic adjustments.
“All of the procedures that we do are intended to be permanent,” Rutkoski said, though the lap band can be removed and the gastric bypass and switch can be reversed. “That’s not the intent,” he said, and almost always leads to weight gain. “That’s what we see with the lap band.”
WGR-AM 550 Buffalo Sabres beat reporter Paul Hamilton said he's thankful for all those who have told him since his gastric bypass surgery that he sounds better on air. Those who see him amid the phalanx of reporters during post-game interviews on TV also may have noticed that he looks thinner, and his hair is curlier.
His doctor told him that some people who have gastric bypass surgery lose their hair after six months, though it does grow back.
"Mine got wavy," Hamilton said. "I've had six or seven women tell me, 'Keep it, it looks good.'"
Here's how he answered three sports questions.
Q. Who has a better chance of making the playoff this year, the Bills or the Sabres?
The Bills. ... Coach Sean McDermott gets mocked for his culture stuff. I know all coaches say it and it's a bunch of garbage for a lot of them. It was with Rex Ryan. But he knows how to do it. He has taken a roster – and you look at that roster on paper, it has no business (having their record) – but he has them believing in each other. He's gotten to know the players as people and he absolutely has built a culture there. … A lot of people who mock that have never been a part of a team.
Q. What's going on with the Sabres this year?
I can't tell you if they're ever going to get it, but I've said from the beginning that the NHL – and maybe Vegas will prove this wrong – but Florida, Arizona and Buffalo all have new coaches. Most times, especially when you're trying to change a system as drastically as (Coach Phil) Housley is, plus you have 10 new players, it could be December before they get it.
Q. What do both these teams need for immediate and long-term success?
Going through the draft like they're doing. The Bills have stockpiled draft choices and got rid of guys that didn't fit the program – and they're having a pretty nice year. (First-round 2017 Sabre draft choice) Casey Mittelstadt is having a great start of his freshman year at the University at Minnesota. What you do is what (former Sabre GM) Tim Murray was trying to do. Right now, Murray's picks haven't looked too good but they still can come through.
Twitter: @BNrefresh, @ScottBScanlon