Let Me Be Your Test Tube

I was just throwing up in the bathroom when I thought, "Quick!  Get online and tell the Marchers about this!"  And you all thought I'd forgotten about you.

A few months ago, a gastroenerologist went spelunking and found that my stoma is wide open.  My PCP thought this was a good thing.  In my head I'm saying "You Boob!  Where did you get that medical degree?" That was just in my head.  Coming out of my mouth is the explanation that in the weight loss world, this is the kiss of death. All your food passes through with little nutrients being absorbed. 

I throw up a lot. It's what I do when I'm in pain.  How many times have I asked God why I don't weigh 98 pounds.  Here's why...  I normally dry heave.  There's normally nothing in my tummy to come up.  There have been times that I have sat on the edge of my bed and heaved and heaved and heaved without ever attempting to run to the bathroom and worship at the altar of porcelain gods because I know nothing is coming up.  Sometimes I'll swallow my pills, drink water and not even they come up when I start to heave just a minute later.  Why you ask.  It's because I have that great big ol' Holland Tunnel of a stoma.  Everything goes swooshing through. 

This morning my girldfriend came over early and we had some coffee and chit chatted for hours. I didn't have anything other than coffee (yes, I know.  CAFFEINNE!  And I LIKED it!)  Anyway, she left and I figured since I hadn't eaten all day, I should eat something.  Yes, I know that breakfast is the most important meal of the day.  I wasn't hungry, but I should eat.  For that matter, I hurt a bunch, but I kept forgetting to go over and take my meds.  I am a really lousy drug addict. Nausea starts up... it's 1:00 and I haven't taken anything for pain since 6:00am  so I quickly swallow some pills.   I warmed up about 2 ounces of left over steak, cut it in very small bites and started to chew slowly.  I probably ate 4 or 5 small bites, all chewed well, but gave the rest to the dog when nausea hit.  Breathe.... let it pass....  deep, slow breath....   breathe again....  I fought the nausea for about 10 minutes and finally gave up.  Luckily, this time I actually went to the bathroom because I THREW UP.  The protein stayed in my pouch long enough to actually throw it up instead of heading through the tunnel door.  The pills didn't follow the food out so I can only guess that they flew through my stoma and were lounging in my small intestine. 

I play out this scenario several times a week and I almost never do anything other than dry heave.  Looking at what was left of a sirloin steak reminded me that since denser proteins like chicken and steak don't feel that good in my tummy, I usually don't eat more than a bite or two and usually eat ground meat, fish or eggs. if not a shake. 

So what have I learned from today's experience?  Dense proteins stay in the pouch much longer.  Yeah, yeah we all knew this, but even with an open stoma, they stay longer.  Those pills never stay in my stomach so I suppose the same is true for every M&M, or other snack I've thrown in my pie hole.  When I had the flu a month ago and was really throwing up everything I swallowed, I could wash down the pills with water or tea and immediately start throwing up.  The pills never came back up, but the liquids did.  And get this...  I have no stomach acid.   

This was probably way too much detail, but I thought I'd share my "discovery".  So anyone have any recipes to share for the more dense versions of protein?  Chicken and beef beed some sort of sauce for me to be able to get it down.  Almost 6 years later and I still can't keep down dry chicken.  Actually, it's not a matter of keeping it down; rather, dry protein like chicken and steak irritate my pouch to death.  Thinking of food that might stay in the pouch longer... Beef stroganoff, Swiss Steak...

Connie
Connie

let me tell ya i don't usually come on line that much anymore cause i'v emissed your refeashing and extrmeely imforming postings. what can i say i have an odd sense of humor...

but the dense protein is just what my natralist doc and i were talking about this past week!

still trying to lose the additonal 20 pounds. still trying to do it the skinny non-rny way.

don't work. cause things fly through the stoma highway.

i had a ah-Haaa moment when i was talking to her and explained that the no fat low calorie tangy tasting greek hig protein lo 90 calorie in a cup yogurt (which i have come to love) doesn't last 2 hours which is what i need it to do. if i add more foods to make it stay like wheat thins (oppps did i type that? they are my cheat BAD me cause once i start i can't stop) i add wasteful calories. i said to her in a whiney voice. only the dense proteins stay..........ah_HHHHHaaaaaa and a duh.

so right now as i type i have a pot on the stove boiling eggs. as most of you know i need to have things due to my job that can be eaten quickly on the road. not that i'm drivng when i eat them but its cold and i am in the car plus for me time is money. sooooo i eat fast.

over the last week i was in my own little rehab detoxing from wheat thins. it was hell but i've cut them out for that length of time. but i know (all kidding aside) that these are a big deal for me. i can wolf down a whole box over an 8 hour time period. what is it i did not realize who many calories were in there and that they were giving this low blood sugar nut case the feeling of just fine but needed to continue to eat them every few minutes to keep things regularted? ah-Haaaaa

the lunch bag is protein packed. cheese, boiled eggs, chicken slices, and a piece of fruit to go with each one. apples we should all have one a day, seedless grapes - they aide in digestion and are very good for you,  clemetine this is only one a day for me i am senseitive to the high sugar that is in these sweet treats. NO WHEAT THINS

i love that doctor.

she also told me that i need to excerisze more and do it differently than what i'm doing.

when i whined she firmly said - you ask me to help you but your not listening to me.

so i stopped whining and took notes. she has helped me the best so far and i'm gonna listen to her wise butt.

gotta go take the boiled eggs off the stove!

sorry connie i dont' have any neat flavorful protein packed recipes for you. i'm one that can't handle anything with spices or that tastes too good it makes me sick. i kinda like the blah now.

O paulie story just for you!

i've been working with Paulie to say Ho Ho Ho merry christmas. I figure i've got a few months til the next one. so every morning i say that same thing and every morning he just says Ho Ho Ho.
But yesterday he said Ho Ho Ho Happy New Year! never did say that to him im' wondering if he was watching dick clark that night when i was out. so now i'm using reverse phsyic I say Ho Ho Ho happy new year to him!

Another O...my guy gave me a beatiful diamond heart necklace for my b-day. its msall and delicate (just like me HA!) I had seen it one day when i was with my daughter. she said you should tell him thats wha tyou'd like for christmas I said no that snot my style to tell someone what i want. hey they gotta try to read my mind. we all know how well men are atthat right? soooo she goes and calls him without my knowledge! they had a great time texing and callinjg back and forth sending pictures by email until he found the right one. i was very thrilled.

he's working on the animal business. loves the dog, is liking the cats more than he'll admit and even talks to paulie. its positive working on postiive.

god bless!

This is soooo wierd cuz my first thought when I woke up this morning was, "Wow, I haven't thrown up since my surgery." This doesn't include the episodes of dry heaving when I'm dumping, and I think I may have actually puked something up from a dump - but I mean real throwing up, that heave it out like a fire-hose kind of throw up - haven't done it since surgery. So your post on the heels of my wake-up thought is just plain wierd to me! I'm so glad you're back. Here's what I know at this stage: (1) a dilated stoma is perceived by insurance companies as a mechanical failure of the original surgery - you should be able to get a revision covered if you choose that path; (2) a dilated stoma IS in fact a mechanical failure of the original surgery and it will eventually lead to regain of the weight and more importantly, serious health consequences - both in terms of the co-morbidities returning, and consequences to your system because of the rearrangement of the guts and that malabsorption that is a life-long issue (for instance, your anemia which is causing black-outs - research will tell you that this is happening at an alarming rate this far out of surgery); (3) if in fact your theory is true (and I suspect it is) that dense proteins continue to stay in the pouch longer despite a dilated stoma, then your/my focus needs to be on dense proteins, what we can tolerate (my stoma is absolutely significantly dilated - another common cir****tance this far out of surgery) - all I can suggest is keep experimenting until you fild what works for you - I can tolerate most anything and everything so some of my favorites are tuna salad with lots of veggies and mixed with a bit of mayo and olive oil and spices; scrambled eggs or omelettes, ground beef fixings, I love cheese of any kind - maybe you can go back to cottage cheese to start out with until things settle? I don't know, darlin' but keep experimenting. To better help with suggestions, tell me (us) - what are you taking for pain regularly? Do you know for sure that it's cleared to take with your pouch? When they did the endoscopy, were they also able to tell the size of your pouch and if so, are you in normal range to your knowledge? Are you gaining and, if so, is it a result of failed mechanics, your meds, your diet, a combo of all of this, anything else? I love your spirit, Connie. You have Super Human Strength and I believe you can turn this around - if anyone can, you can! Love ya, Maureen

Can't tell you how many times I've dry heaved right after eating when all the food went ziiipp... right on through. the ONLY thing that stays in my pouch for a small amount of time is like everyone said... somethign dense... for me that is like 2 things. steak and chicken. but ive even eaten chicken once and gotten sick from nausea (boston market) the smell just hit me and I gagged and that was it... i think i might have puked maybe a dime sized chunk the rest was gone! it was like 3 mintues after i ate the darned stuff. steak will stay longer and sometimes shrimp. but everything else just slips right on through. wonder if thats why i am having some large intestine issues... (inflamation). hmmm.... seeing my regular doc about that, ive been promising myself to go to my wls surgeon for years and never have. i mean if my stoma is enlarged what can they really do? A rose procedure? or something like that? isnt that what that is for? and to get approved for that and go through all the hullabaloo and then not really loose but 10 pounds would be nuts when i can diet it off if i get my lazy butt (and brain) to get down to business! 'sigh'

i'm lucky (knock on wood) i'm not a puker. thank you very much! I know how lucky i am with that too.
but for quite a while now i've wondered what the old insides are thinking.
i remember reading how most everyone feels intense hunger now. i'd not had that but was prepared for it by reading the different posts. i've noticed that i'm slightly behind everyone with symptoms. so when one of you guys say hey i'm intensely hungry now i know in a few weeks that it will hit me too!
it hasn't been that bad. i still feel hunger different than before surgery.
but now that i have to eat every 2 hours sometimes i hit that one hour mark and man i could eat a house!
i still cna't eat that much it doens't fit in the old tummy. so my question is do you think my tummy size is still good and the different holes the food travels through are larger? god does that make sense?
my cup of food doesn't last 2 hours. i keep trying to get it to stay but by the time that 2 hours is up i've got the head ache and some other symptoms of my low blood sugar.
my endo thinks things are ok but he's not a wls endo he's good i like him don't get me wrong i just like to keep up on things.
its time for my visit to DR A. i really do NOT want to go through tests. those tubs down the throat thing scare me to death!
my blood work is good. now with my subliments.
i have such a hard time losing weight. its almost impossible.
i went on fitday.com to chart and read from last summer. i'm the same weight that i was in june! now to me thats bad cause i want to lose but in a way i can't complain with the amount of food that i have to eat that i've not gained.
i DO need to excersize. arggggggggg
i'm doing the best that i can.

Hi Pam, I'm on the fly but wanted to respond to your post - you've done so well in being pro-active in dealing with your issues. Here are my thoughts: (1) I'm done with Dr. A. (my choice) - his ego is detrimental to my success and he will not entertain the idea that gastric bypass procedures (his Golden Lamb) fail mechanically in a huge percentage of patients - not just his, I'm talking industry standards. The stats are alarming with regard to weight regain after RNY. That, coupled with the medical issues due to malabsorption of vitamins and nutrients - the consequences can be more severe than the surgery itself. I'm not going back to him - grateful that he performed my surgery? You bet. He's a terrific surgeon - but a lousy and pretty uneducated doctor to post-ops, especially long-termers. (2) Yes, it is VERY common for the pouch to remain within a normal size-range with the stoma being significantly dilated. The theory is that the stoma dilates as a result of beginning to eat too fast, which exacerbates over time; and starting to drink carbonated beverages and/or drinking with meals. Whatever the cause, the effect is the same - food passes directly through a dilated stoma, so we don't absorb the nutrients from the food but we surely DO absorb the calories! A dilated stoma is considered by insurance companies to be a mechanical failure of the initial surgery. The only way to diagnose a dilated stoma is via endoscopy. (3) Yes, losing this gained weight of 22 lbs. seems to be impossible for me as well. On the other hand, having only gained 22 lbs. is a miracle and I send a silent, heart-felt thank you to God every time I get on my beloved horse, Laela - every time I jog on the treadmill - every time I jump up and down with pup Ollie, etc., etc. If I could STAY here, I'd be golden and happy as a clam. But the fear of continuing to gain leaves me awake at night and staring at the ceiling trying to understand it and figure it all out. (4) I'm going to L&M Hospital tonight for its WLS support group meeting, 6-8 in the main conference room, right across from the gift shop. Dr. Ehrlich is the guest speaker, he is supposed to be incredible (out of Danubry) - and believe me, I have some serious post-op questions to pose to the Good Doctor. Would LOVE to see you there with me - can I save you a seat? Be well, my friend. Maureen

Hi Reenie,

I didn't get your message until after work almost 8pm I would have gone too. Are the meetings there each week? i'd like to go just to be around some more people who have had the surgry.
there isn't anyone that i know anymore who lives near me or works with me. its nice to have a connecton with someone else who has had the surgry.
I'm not thrilled with Dr A for different reasons. maybe not so much Dr A but the office and the staff.
I dont' beleive that any of them give peolple or knew the extent of wht happens many years out. I know that we are not the first people to have had this done. Its been around for 30 years so where are those 30 year out people? thats who I'd liek to talk to!
And their surgery was different than ours just liek the people coming after us.
Whats this D surgery I hear and have read about doen'st sound like its too healthy when I've googled it.

It's interesting that you ask about people who had the surgery a long time ago; at the meeting last night there were two women who each had 'stomache stapling' in the 1980s! Both of them had revision surgery (open RNY) within the last 4 years. It's a pretty good meeting, Pam, but only once a month - always the 3rd Wednesday of the month at L&M - I would be happy to join you next month. Dr. Ehrlich spoke last night - reminded me so much of Dr. A. - egocentric, sort of dodged me when I said (in my typical fashion) "I don't think bariatric surgeons are paying enough attention to what's happening to us many years post-operatively..." He said he didn't believe that was true - but otherwise would not support his position. I tried to keep him on task in addressing our issues - both in terms of health consequences due to malabsorpotion, and the weight regain - he basically reiterated Dr. A's position that if people are regaining (IF???? - take a look at the statistics, Good Doctor!) - it's because we are grazing and not doing what we are suppose to do.  I believe this to be true to some extent (I fully own my M&M's compulsion), however, there are other factors that MUST be considered.  The DS surgery is one of the two options available to RNYers in terms of revisions - the other is to band your pouch, which Dr. Ehrlich highly recommends. In layman's terms, the DS basically re-routes what's already been re-routed but because so much more of the intestine is bypassed, malabsorption is more severe - to the extent that only 20% of what you eat is absorbed. This means that the DS post-op MUST eat copious amounts of high fat, high calorie foods to sustain health - in other words, if a DS post-op eats 3,000 calories in a day, a full 80% will pass right through the system. So they  MUST eat a ton of food to stay healthy. This is the Calling Card of the militant DSer - they say they get to eat "normally" - well, maybe by U.S. standards - which is why America has become so fat! I'm up to 166 this a.m. and I feel terrible. I begin anew... take care, and let me know if you want to meet up at L&m next month, that would be Wednesday, February 17 from 6-8. M.

Connie,
Yep I dry heave - absolutely cannot throw up no matter what nothing comes up.  It's the same situation you describe - within minutes of eating I can have dry heaves with no return on the investment.   I am a bit different than you in that even liquids don't come back up.  I have had an ulcer but have no stomach acid. 

I can also guzzle copious amounts of water.  I'm guessing I have stoma issues but with all the other things I have going on I'm currently not interested in addressing the stoma problems. 

Things that keep me full longer are crab legs, shrimp.  My WLS recommended I have peanut butter and a whole grain cracker or a slice of whole grain bread  several times a day to help control a problem with low blood sugar.  It does seem to help....

The fun just never ends.....
Va

I find that natural peanut butter (no sugar added) like smuckers also helps with hunger cravings if you have them. it just seems satisfying to me for some reason. I get the smuckers natural. very very yummy... oh and i get the crunchy kind so it seems like there is a little extra treat in there. LOL!