Monday 19 November 2018

Doctor on a diet: How a health scare forced this Irish doctor to change her life

She lost five stone in a year and kept it off. Dr Paula Gilvarry and husband Damien Brennan share the secrets and the recipes over lunch with Barry Egan

Paula Gilvarry and Damien Brennan.
Paula Gilvarry and Damien Brennan.
Doctor on a Diet

On the day in June, 1978, that Paula Gilvarry qualified as a doctor she weighed seven and a half stone. Her weight went up to eight stone when she got married to Damien Brennan on October 18, 1980. It subsequently went up another two stone due, in no small part, she feels, to the happiness of being married and the fantastic honeymoon in Antigua.

When first child Sarah arrived on June 9, 1988, Paula went up to 13 stone. Then she went down to nine stone again before going back to 13 stone once more when son Paul came along on November 26, 1990. Paula went down to 11 stone for a few years. Her weight would go up and down over the years, losing stones here and there through various diets before inevitably putting it all back on again.

In June, 2017 she weighed a not inconsiderable - and unhealthy for a petite 5ft 2in frame - 17 stone.

Having gone from a dress size 21 to 14 - necessitating her to buy, months apart, two new wardrobes of clothes over the last year - Paula now weighs 12 stone.

I ask her husband Damien was there less of Paula to love when she lost the five stone.

"There is an enormous amount less of her but I still love her," he smiles.

"We're madly in love," beams Dr Feelgood herself. Paula (born December 20, 1954) and Damien (September 1, 1952) met in March, 1979 in Damien's pub in Sligo, Beezies.

It was after something of a whirlwind romance that saw them married in St Mary's Church in Castlebar the following year after Paula had proposed to Damien on New Year's Eve by phone from England.

"He didn't ring back with a answer for three days!" laughs Paula.

"I was thinking it over!" laughs Damien.

On July 14, 2017, Paula didn't have time to think when she ended up in an emergency ward at a private hospital in Galway. Three days earlier Paula - who, having retired as a doctor in December, 2014, was cooking all the meals for the "steady stream" of visitors to her husband's Yeats Experience company at their house in Sligo - developed palpitations and felt her heart was "very fast."

She thought she was just tired because it had been a very busy time for her and Damien. She also ignored her fast heart rate, because she had had it a year or two before that, had had it checked out and was more or less told she had "cardiac anxiety".

Still, when the condition persisted that weekend, Paula went to see her local GP who recommended she go to hospital immediately. She got Damien out of bed. He drove his wife the 90 minutes from Sligo to Galway in their trusty Volkswagen Passat Estate. On that journey, Paula laughs that her husband was probably thinking: 'I have 21 people coming tomorrow night for dinner. How am I going to cook?'

"I was actually sending shopping lists and menus back by phone from my hospital bed, in between reading a book on murder by PD James on my Kindle," says Paula.

The doctors told Paula she had atrial fibrillation. This meant she had a high risk of having a stroke at any time because the chambers of her heart were working out of sync; "they usually work together, but they were wobbling a bit and it was putting pressure on the muscles which could cause heart failure.

"There was a high correlation with being overweight and atrial fibrillation but atrial fibrillation was the problem on its own," she says.

"Somebody of 60 who was 10 stone could have got it. But obviously the increased weight was going to be an increased risk for me because I also had high blood pressure and high cholesterol."

Paula was kept in hospital for four days and was stabilised before being sent home on "fairly mild medication". Within a month the atrial fibrillation recurred. Her doctor put her on a much stronger drug - "which I was not happy to be on because it has a lot of side effects".

The most disturbing of which to Paula was that she couldn't sunbathe, "because it causes photo-sensitivity.

"I was very unhappy because I was calculating that we were going off to the Caribbean in November and this was July and if I didn't get off it...!" she laughs.

You would rather put your life at risk than miss the holiday, I tease.

"Absolutely!" she hoots. "But I knew that there were other ones that I could take that would be as good without the side effects."

Undeterred, Paula and Damien went to the Caribbean. "We had a brilliant holiday. I ate according to my diet plan. I had plenty of nice drinks, cocktails and wine... and I lost seven pounds. There was an awful lot of steps and swimming."

How soon did Paula go on the diet after the shock of the Galway emergency ward? "I had already started it before the 14th of July. I had lost about 10 pounds," she says, adding that she was, however, already aware her weight was unhealthy. The cardiologist telling Paula that for every 10pc of body weight she lost she was reducing the risk of atrial fibrillation recurring 15pc, was, she says, "a no-brainer".

"I'm still getting used to it," Paula says referring to the weight loss. "I mean, I hold up a pair of jeans and I think, 'They'll never fit'."

"And they do!" she laughs over lunch in Dublin's Westbury hotel last Monday.

Paula says she was recently walking into Knocks, the restaurant where her son works in Sligo (he is opening a new place next week called Flipside, a beer-and-burger establishment on the corner of Rockwood Parade and Thomas Street) when her mind started to play tricks with her.

"You know the way there are tables at the side and there are tables in the middle and chairs on either side? I was thinking at the entrance of the restaurant, 'Will I fit?' Because I hadn't got used to it," she says meaning her dramatic drop in weight.

As Paula writes in the introduction to her new book, Doctor on a Diet: Five Stone Lighter And A Whole Lot Happier, "I have had a lifelong passion for food. Like most passionate relationships, though, food and I have had our ups and downs. As a public heath doctor, wife and mother of two children - and as a woman who can gain weight just by walking near the dessert trolley - I've learned things about my relationship with food. It's complicated. Food has been my friend and my key to good health, but it has also led me into temptation and disaster.

"I have learned how to establish a loving relationship with food and I've created some delicious recipes along the way," she writes of delights like baked avocado with eggs and tomato; courgette and mushroom frittata; quinoa pancakes; healthy beef casserole; beef bulgogi; Moroccan lamb tagine; Vietnamese lamb chops; pan-fried sea trout with pea and chorizo fricassee; fish biryani; trout with jollof paste.

Paula says the key elements of keeping the weight off include understanding what it is to eat "normally", along with watching but not obsessing over portion size and recognising the triggers that could cause you to overeat, and how to find other ways of rewarding yourself apart from eating. "It will take time for new habits to be embedded in the mind," she says, adding that with that comes the ability to "manage the triggers" that caused her to overeat once upon a time when she weighed 17 stone.

"You keep it off by learning to eat normally. Everybody has to learn it for themselves. Find out what foods you like and that give you a good balance of nutrition and they are the right kind of foods for your body."

Paula adds it is her experience that if she gives her body the right foods then it will respond by wanting more of them.

I ask Damien by virtue of the fact that he lives with, and is married to Paula Gilvarry, if he is on the same food regime.

"Partly," says Damien who is the big brother to RTE stars John and Francis Brennan. ("As John famously put it, he [Damien] is 'the oldest and poorest, the one who taught the others all they know'.")

"But I'm not really on the diet, no. My father [Tom, now dead] was always lean, because according to my mother [Maura, 95], he filled his plate only once. And I have fallen into the habit of filling my plate only once, unless it is mashed potato and marrowfat peas on a Sunday. I tend to have a relatively small portion."

Damien, who was with Failte Ireland for 20 years until he retired in 2012, says for the last five years he was commuting to Mullingar every day from Sligo. "I was eating out at lunchtime in the forecourts of petrol stations - 'dashboard dining' they call it - and by giving that up alone I lost a stone. And I would be having a Coke and Kit Kat afterwards as a consolation for being that far away from home."

Paula and Damien, who are in the process of selling their home, have moved to another home "one field across".

The new home, courtesy of giant floor-to-ceiling windows, is flooded with light, which helps Paula at this dark, autumnal time of year with the depression she has had all her adult year.

"I take anti-depressants. It is a chemical not a reactive depression," she explains.

"I have always had a tendency to be depressed, even as a teenager. It was probably post-traumatic stress disorder." Paula is talking about the two "horrible years" when she was 11 and 12 being taught in the Mercy Convent in Castlebar. She looks back on the national school with a certain gloom.

"It was a really horrible time. There was a teacher who was horrible to me, I was absolutely brutalised by her. I was also put into Coventry by the other girls."

Why?

"I was different."

I ask how she was different.

"I was the psychiatrist's daughter who lived behind the wall in the psychiatric hospital. Up until 1963 or 1964 we lived behind a 10ft wall to, well... keep the patients in. I was born in the hospital, in the doctor's flat over the boardroom, and then we moved to various houses along the way. That's where we grew up. We had very few friends."

Eleven-year-old Paula didn't talk to her parents, Michael Gilvarry and Maureen O'Kelly, about being degraded by a nun or being ostracised by her schoolmates; and she says they didn't notice. "I was good at keeping secrets. I was a very quiet child. I was a loner."

Her mother was by nature "quite reticent, reserved". Paula believes that her late mother "probably lived in her own world; and I think a lot of it was to do with the fact that she had been married beforehand and her first husband had gone missing in action in the Second World War and then she was 30 before she married my father. He was only 25. He was a junior doctor in the general hospital. My mother was theatre sister in the general hospital. They used to call her the Ice Queen".

Her mother had a lot on her mind?

"She had a lot on her mind," smiles Paula. "My mother, like I said, was theatre sister in the general hospital. But then in those days, it was before the marriage ban, people in her situation were not supposed to work. So she was left rearing children, even though she had a housekeeper and a maid and the laundry was done and everything was provided. There was a whole story of the psychiatric hospitals in those days. They were like little villages."

So why was Paula put in Coventry by her classmates?

"The first thing that happened was when my sister Mary went to school, she was left-handed. So the nuns started to make my sister use her right hand and my father was furious. He rarely lost his temper. He went down and he annihilated the nuns. So they had it in for us then. Then a couple of them would have grown up with my mum and then she married 'up'. So they were jealous. Then on top of that she had the effrontery to send us to school in shorts in the summer. Shorts in the 1950s was a sign of the devil! So we were singled out!

"The nun is dead. I do remember one occasion when my mum and I went for a walk through a cemetery looking at all the graves of uncles and aunts and we went past the Mercy plot and it was a big, big plot with a huge shiny headstone on it, and I said: 'Will we stop and say a prayer?' My mother said, 'We will not!'"

Despite the "brutalisation" at school, Paula wasn't put her off religion in later life. On her left arm is a tattoo. It reads: 'Faith in action, work for love, persevere through hope.' It is from St Paul to the Thessalonians in the Bible and was a 60th birthday present to herself to mark a new life after retirement.

"She is more a practical Christian than Catholic," explains Damien.

"That nun was a horrible person. She took every bit of confidence I ever had," says Paula. "I mean, I write very well but once I got into her class I was not able to put one word on the page." The former pupil of The Mercy Convent has no such problems now with her book set to top the bestseller list this Christmas.

'Doctor on a Diet' by Dr Paula Gilvarry is published by Gill Books, priced €19.99.

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