DLCoggin

Clinical studies that would yield statistics on how often pouches or sleeves are actually stretched are almost impossible to come by. Probably because they would require endoscopies to diagnose which would make large scale studies prohibitively expensive. That said, I suspect that stretching the sleeve (or pouch in the case of RnY) is less common than most folks believe. What is common (pretty much unavoidable) is an increase in the compliance of the sleeve or pouch. A common analogy is that of a new balloon. The first time you blow it up it takes more pressure to inflate the balloon. The one hundredth time you blow it up, less pressure is required. The volume of the balloon has not changed - the compliance has. If you're not doing so already, consider maintaining a food log. I use My Fitness Pal and highly recommend it but many are happy with SparkPeople as well. I've been logging for over two years and it is the most powerful tool I know of for weight management. With a little experimentation and fine-tuning, logs will increase your confidence a hundred fold. If you're interested, I'd be glad to share some ideas on how to get the most from your log. Welcome to the forum and please come back often! There are a lot of great folks here who are more than willing to share their experience and their support on your journey. Have a great day!

Ms. Dee your honesty is nothing short of inspirational! Just amazing. Soooo, time to step up and share embarrassing stories. This one is a beaut! I seldom dump but when I do it's late stage dumping - aka reactive hypoglycemia. Too much simple carbs (white rice) or too much sugar (I dumped once on grapes for Pete's sake) and two to three hours after eating my sugars drop like a rock in a pond. I mean REALLY drops. First time it happened I checked my blood sugar and it was 37. Now I know this. I know the symptoms. I know the cause. I even know the "cure" - I eat just about anything with sugar in it and in 15 minutes I'm absolutely fine. So a couple of weeks ago my wife and I had been running some post holiday errands. We finally get home and I'm thinking "I am so going to have a glass of wine". But we have some leftover eggnog and my wife says she'd love an eggnog with a little Captain Morgan's spiced rum and a dash of nutmeg. Wow. Why didn't I think of that? I think I'll join you! So I have my rum laced glass of eggnog and guys I have to tell you, it was like the nectar of life. I knocked down that first eggnog in about a minute and a half. Honey, you ready for another one? I go to make us a second round and I'm thinking the only problem with this plan is that my glass just isn't big enough for "the nectar of life". No problem! We've got some of those Dixie plastic cups. You guys know the ones, bright red, hold 16oz. Perfect size for the nectar of life right? Eggnog, check. Rum, check. Can't forget the dash of nutmeg, check. About an hour to an hour and a half later I fell asleep watching TV. Another hour or so later my wife wakes me up - "time for bed." Right behind you Honey! So I stand up and right away I'm thinking I don't feel so good. Cold sweats, my whole body has the shakes - you dumb a** you're dumping! On the nectar of life no less. Bummer. But hey, I'm on my way to bed. I'll just grab my Vitamins and hit the sack. So I get my vitamins down and... The next thing I remember I'm sitting (sort of) on the floor of our kitchen. My little plastic box that used to have my vitamins in it is sitting on the floor in my general vicinity. The vitamins that used to be in my little plastic box are - well, everywhere. It looked like my little plastic box had exploded in a shower of Vitamin shrapnel. My black lab is sniffing her way through the carnage to see if there's anything that would appeal to her meat-o-saurus taste buds. Fortunately, she apparently is not a vitamin kind of girl. Then she realizes that Dad is awake and on "her floor" so of course it's time for black lab kisses. LOTS of black lab kisses. So I'm sitting there trying to breathe while avoiding lab tongue in my mouth. I'm thinking. If I tell my wife about this, I'm dead. No, I'm worse than dead. She is not going to be amused. Then it comes to me - she's already upstairs in bed. Probably asleep already. You dummy, don't tell her! Pick up the vitamins, swear the lab to secrecy, life is good. Good plan! And it would have worked too. Except for one little detail. Apparently on my way to my unscheduled meeting with the floor, the kitchen trash can got in my way. The metal, kitchen, trash can. The one that now looks surprisingly like I drove my car into it. Wonder if she'll notice? Maybe I could blame it on the dog (sorry Libbi!)? She noticed. And sure enough, she was not amused. I survived. But it was touch and go there for a while. And the nectar of life? Never, ever again. Hey, I ain't no fool! Come on you guys. You know you want to. Dee shared her's. I shared mine. Let's hear some of those embarrassing stories!

Life after RnY is not so much about what you can't eat - it's about what you choose to eat, or not eat. Big difference. I'm always surprised at how many folks are under the impression that RnY guys have a long list of foods that they will never be able to eat again. That is simply not true. I'm right there with you Dee, I eat just about anything that I want to eat. Or perhaps more accurately, that I choose to eat. Are my choices different now than they were before my surgery? Absolutely. Do I always eat "healthy" food every day of my life? Of course not. That's not realistic and it's not sustainable. I think a more important question is am I always aware of what I eat? And the answer is without exception.

Perhaps we can take just a minute and examine your expectations - your perspective if you will. You've lost 55 lbs in 18 weeks. An average of three pounds a week. You're currently at 223 lbs and your goal is 165 lbs. So you have 58 lbs to goal. So if you maintain an average loss of three lbs per week, you will be at your goal weight in 19 weeks. So let's fast forward 19 weeks. Starting weight 278 lbs. "Current" weight 165 lbs. Weight lost = 113 lbs. In 37 weeks. In just over nine months, you've changed almost every aspect of your health and your life. Slow weight loss? I'm thinking spectacular! You are half way to your goal in 18 weeks! Discouraged? I'm thinking ecstatic! Problem? What problem? Stay positive, stay patient, continue to follow your plan regardless of what your weight is doing. Stop second guessing. Trust the process. Allow your body to find its own way in its own time. Do those things and the weight will take care of itself. You are doing GREAT! Celebrate your success every day! You're gonna love the new you!!

Some folks, myself included, are more prone to forming scar tissue (aka "adhesions") than others. It isn't associated specifically with wls but with ANY surgery. For example, I was scheduled to have my gall bladder taken out laparoscopically. But when the surgeon got in there he was unable to do it laparoscopically because of adhesions from an appendectomy that I had as a kid. Ten years later when I had my bypass the surgeon was able to do it laparoscopically in spite of adhesions from the appendectomy AND the gall bladder. Laparoscopic techniques, like nearly everything in medicine, are constantly improving!

A powerful story and one that perhaps has an equally powerful lesson. This journey is about control, not denial. So what would be the first sign that a bypass patient is losing control? Weight gain. More specifically, MINOR weight gain. That's the time to seek help. You won't be the first and you certainly won't be the last. For Pete's sake, seek help from your team - that's what they are there for. Losing ten pounds is nothing. Losing 100+ pounds, again, that's a very different story. The surgery can be defeated. In the words of Winston Churchill - "It is of no use saying 'We are doing the best we can'. Success means doing what is necessary."

Esophageal strictures are one type of stricture but anastomotic strictures may be more common with gastric bypass patients. An anastomosis is a surgical connection between two hollow structures. In the case of gastric bypass, it is the connection created between the newly created pouch and the small intestine. In about 2% of bypass patients, excessive scar tissue forms at the anastomosis and restricts the movement of food from the pouch to the small intestine. Strictures are uncomfortable but treatment is relatively straightforward and additional surgery is rarely required.

I believe there are folks on the forum using the Fitbit scale so you'll likely get some good feedback. I bought this one - http://www.amazon.com/EatSmart-Precision-Bathroom-Capacity-Technology/dp/B001KXZ808/ref=sr_1_1?ie=UTF8&qid=1389914975&sr=8-1&keywords=scale on Amazon and love it. Accuracy is great when checked against my doctor's scale, it's super easy to read and under $30. Works for me!

The title of your post says it all - "Ignorant People".

After being back on a regular diet, I tried white rice twice and had late stage dumping both times. So much for white rice. Brown rice - no problems. You for sure want to stay away from it until you're on a normal diet and it would probably be even better to wait until you're a year post-up. Even then, I'd take it very slow until you find out how well you can tolerate it. With or without rice - you're gonna love the new you!

I've had late stage dumping a few times which is reactive hypoglycemia. Usually two to three hours following eating something I shouldn't have. I can eat almost anything with sugar and symptoms disappear within 20 to 30 minutes. But in my case, I have always been able to identify the food that caused the dumping. From your description, it sounds like your sugar is low and pretty much stays low. I'd discuss that with your doctor. It's not common but hypoglycemia can be serious and result in loss of consciousness if it gets low enough. I'd check with the big kahuna.

Welcome to the forum and congratulations on getting the first steps out of the way! You're gonna love the new you!!

Welcome to the forum and congratulations on your decision! You're gonna love the new you!!

Heating protein in coffee, soups, etc. will cause it to coagulate - think egg white when you put it into a hot pan.

Eating too fast or not chewing well are the most common causes of food getting stuck. Strictures usually occur within about four weeks of surgery (of course there are exceptions) and symptoms are nausea, vomiting and difficulty swallowing. If it's happening every three days your doctor may decide to go ahead with the endoscopy which will answer the stricture question conclusively. If it is a stricture, it's easily treated with a balloon dilation and the success rate after one dilation is very high (close to 90%) and almost 100% after a second dilation if needed. Hope you get it resolved quickly and please keep us posted on your progress!

I have experienced "late stage" dumping (which normally occurs two to three hours following eating) in the form of reactive hypoglycemia a few times. First time it happened I checked my blood sugar and it was 37. In my case, eating just about anything with sugar sees the symptoms resolve within 10-20 minutes. But this is not a daily occurrence for me and without exception, I have always been able to identify the food that caused the problem. How long after eating your breakfast does the hypoglycemia occur? Would appear to be a totally different scenario to experiencing low blood sugar on a daily basis unless your breakfast is normally Cereal or something else with a high sugar content. Have you talked with your doctor? If not I would recommend that you do. Hypoglycemia can be serious in some cases. I don't think it's common but it can result in loss of consciousness and worse under certain circumstances. The good news is that it's usually very treatable. Huge congratulations on your weight loss!!

Thanks for your reply misty! Some doctors consider stretching of the stoma (pouch opening) more serious than stretching the pouch. In spite of considerable research, I haven't been able to locate any reliable sources for statistical percentages of bariatric patients that experience stretching of the pouch, stoma or stomach (in the case of the sleeve). Probably because accurate data would be difficult to obtain without large scale clinical studies. Patients often mistakenly conclude that their pouch has stretched when in fact it has naturally become more "compliant" over time. One analogy compares it to a new balloon vs. one that has been inflated many times. When you inflate the new balloon it takes more pressure. When you inflate it for the hundredth time, it's much easier. The volume of the balloon hasn't changed, but it has become more compliant. The exact same thing naturally occurs with a stomach or pouch over time. The volume doesn't change (usually) but it is easier to put more in it if you choose to. There have been a number of examples on the forum of folks who are concerned that they have stretched their pouch, only to learn from an endoscopy that the pouch still has the expected volume. The pouch is not stretched, but it is more compliant. That may result in delayed signaling of satiety from the stretch sensors in the pouch/stomach to the brain. Bottom line - portion control remains crucially important (for life) in order to avoid weight regain. Thanks again and have a great day!

Good for you! On a normal diet carbs provide about 60% of the energy your body needs. But when you're on a low carb diet, your body will metabolize Protein for energy. No carbs + no protein = no energy. Doctors usually recommend 60-80g for the ladies and 80-100g for the guys. Whatever protein goal your doctor gave you, you may want to consider increasing it by 20g or so for a week and see if your energy improves. Your body uses Water to process protein so keep an eye on your water intake and do everything you can to get that 64oz a day in. 48 pounds in four months - great! It's always a bad idea to compare your weight loss to anyone else's. Just keep following the protocol as closely to the letter as you possibly can and allow your body to find its own way in its own time. Trust the process. That said, I'm sure you know the importance of exercise. Keep in mind that "exercise" is not synonymous with working yourself to exhaustion. For me the name of the game was walking. Plain and simple. Start slow and work your way up as your energy improves. It's easy, you can do it just about anywhere, and it will make a difference in your weight loss and your energy. You're gonna love the new you!!

Are you getting ALL of your doctor's recommended daily protein?

I get free shipping from Amazon. :-) Me too but unfortunately the Crunch O's are not Prime qualified. :-(

Excellent post and very informative. Congratulations on the resolution of the diabetes! I'd appreciate it if you would expand on "One downside to RNY is the part of the stomach left behind is very prone to stretching." It is my understanding that a portion of the stomach remains following either surgery. With the sleeve, approximately 75%-85% of the stomach is removed. With the bypass, the pouch is created from the upper part of the stomach. In either case, pouch or reduced stomach, the tissue is the same. Patients for either surgery are routinely cautioned that stretching the stomach/pouch is always possible (although I suspect less common following either surgery than is often believed). Please note that I ask only from the perspective of increasing my knowledge. I don't have any basis for doubting the validity of your statement. I would just like to know more including sources of additional information if you have them available. Thanks so much!

Good for you! It is so important to have confidence in your surgeon. Sounds to me like you're ready!!

I can't imagine a better source of motivation! They're lucky to have such a great and committed Mom!

Thanks so much Tina! I'm most certainly not a doctor or any kind of healthcare professional. And I had the bypass which by definition means that I am not a completely unbiased source. But I'm a little surprised that the only reason that your surgeon favors the sleeve is because it is less invasive. I have done a considerable amount of research over the last two and a half years and continue to do so to this day. There is no doubt that the sleeve is medically less invasive. But that is only one consideration in an obviously important decision. Success rates in resolving type 2 diabetes, hypertension and sleep apnea are important. As are minor and major complication rates and averages for total weight loss for both surgeries. Sleeve to bypass conversions are not uncommon but a second surgery is obviously not an ideal option. What is the percentage of sleeve to bypass conversions and what are the reasons those revisions become necessary? What percentage of revisions has your surgeon done and how does that number compare to national averages? Are the surgeon's office and the hospital bariatric centers of excellence? I don't mean to be cynical but in the context you have shared, it also raises the question of the how much the surgeon's recommendation may (or may not) be influenced by the financial advantage to him/her of two surgeries vs. one. Again, there are many, many success stories following the sleeve. But you may want to consider getting answers to some of these questions and possibly even a second opinion before making your decision. Please keep us posted and don't hesitate to share your questions and concerns. We're here for you!

Are you maintaining a food log? I've been logging for over two years and find it to be an extremely powerful tool. If you're interested I'd be glad to offer some suggestions for getting the most out of your log. Just about everyone struggles at one point or another. You can do this and we're all here to help!!