Very Concerned

Hi Everyone, I am just over 6 Weeks out and I am worried. It seems that I never feel full (even on more solid foods). I can even eat apples with the skin on...salad...anything. Also: I have never once thrown-up since surgery. I emailed Dr. Garber about my concerns. I said I feared my pouch was too big or the stoma was too big. He assured me that no, the pouch is made very small and that all the stomas are made the same size by the stapler. Yet when I saw Donna, his P.A., she said it was "very odd" that I have never vomited. I know I should have calmed down after getting Dr. Garber's reply last night...but I can't stop worrying. I never get hungry...but I also never get that full feeling. And apple's with skin....salad? Still no vomiting. Does this sound normal ? Thanks for any feedback on this. Hugs, Karen

Hi Karen It is not odd that you have never vomitted. I am 15 months post-op and I have never vomitted either. People who haven't had the surgery cannot tell you what is right and wrong unless they go through it themselves. Why a PA thinks its odd that you never vomitted doesn't know what she's talking about. Consider yourself fortunate that you never vomit. There's nothing wrong with it. Vomitting doesn't make or break your success. I also can eat apples with skin, salad etc. and I do just fine. Just continue what you are doing and you will be fine. Marie

Hi Marie, Thanks for the reply. It shows me once again how important this board is. Hearing that you have experienced the same "non-vomiting" helps alot. It is scary when you feel like you're the odd man out. And also the ability to eat an apple...knowing you can makes me feel a little better. But could you eat an apple with skin at 6 weeks out? That is why I am so concerned. Thanks again, Marie. Hugs, Karen

Why would you complain about not vomiting???? It sounds like a good thing!!! I didn't have the RNY, but from what i've read in other posts, many RNyers say that they did not get full in the first few months. From my understanding (according to Dex from the Men's forum ...he's kinda like the rain man of WLS), the pouch in it's early stages is "numb". The nerve endings that signal fullness are still not regenerated. So in the beginning it is best not to eat more then your surgeon tells you to eat, because you don't want to damage or stretch out your pouch. Eventually those nerve endings will regenerate and you will get fuller faster, and your hunger will subside for a while (hunger tends to return 1-2 years post op for RNYers). This of course will never satisfy head hunger. Sometimes your head will tell you it's time to eat when your body is saying it's not. I'd say if your surgeon is not concered, then your doing fine. Scott

Hi Scott, I'm not complaining about not vomiting! LOL It's a good thing...BUT..I feel it's not the norm and that worries me. I talk to a few post-ops who had their surgery the same day as me and they can not eat apples and salad. Also...they feel full after a few forkfulls. I can't stop my head from worrying that my pouch is too large or my stoma is, even after Dr. Garber's email reply. The pouch numbness is interesting; I have never heard that before but it seems to make sense. I hope that my hunger doesn't return for 1-2 years!! I would be thrilled with that. I haven't had hunger or head hunger in the past few weeks. Initially, post-op, I did...especially when I was around people eating my binge foods. That was when I said out loud, "WHAT DID I DO????". That has since passed and I am glad because now that I am back at work, there is always junk food around due to birthdays, holidays, etc. Bagels, bagels, and more bagels! I have been fine with that. I hope you are right and that numbness is a reality. Thanks for taking the time to respond, Scott...it means a lot. Hugs, Karen

HEY KAREN! JUST cointinueing following pouch rules and all will be fine. BE thankful things agree with you. I know early out i never did get sick. THAT came later. MY main reason for refunding my food is that i dont chew well and slow down! SO its my own caused trouble at times. GOOD LUCK! hugs and we should get together some time we live so close! PM me if your interested.

Hi Lisa, Thanks...yes, I am glad things agree with me. As I keep saying, I feel out of the norm because I never once "returned my food". And the P.A. confirmed that it was odd. When you say the throwing up came later, was it certain foods? Or was it just due to not eating slow enough? Yes! We should get together - that would be fun! I'll email you tonight after work. At 7am I am lucky I can read this! Hugs, Karen

Karen: Karen: HI! Repeat after me "THERE IS NO NORMAL"! Accepting this for most of us will relieve much angst and worry! First of all at 6 wk may I ask what your recommended food plan consists of? I ask because sometimes we have NO guidance, other times we decide to ignore the recommendations....Meaning despite guidelines we eat what we want even if not recommended. Sometimes forgetting we probably can eat many things, but many decide not to try and therefore ever know if they can tolerate. For instance I have hear of people eating shrimp, green lettuce salads, cookies, cookie dough, hamburgers from fast food restaurants all days out of surgery, some w/ complications (dumping/vomiting) others w/o.. Everyone's healing is different. The spectrum of typical is wide, some are full on liquids, and I know one person in my support group locally 2 mo out still cannot eat any food, only liquids! It is normal, no stricture it is how tender and sensitive his pouch is, he has no hunger either so he is going w/ it...doing protein shakes to avoid the muscle wasting, there are others I know such as yourself tolerate everything/anything never getting sick, for them this is +/- as they know they can eat certain non-recommended items (cookies, cake, soda, alcohol, caffeine, sugar etc). I have never vomited except when I had a stricture from adhesions, at 4 yr out I am typical, you should NOT vomit that is NOT intended as result of surgery and if you are vomiting daily there is an issue either physically or psychologically/behaviorally. Some people I know STILL yrs out NEVER FEEL FULL! It isn't typical but it happens! Each program is different, for instance my program had me on clear liquids 2 wk, then soft slider/mushies/softs for another 4 wks (2-4T a meal), then small amounts (1/4-1/2C) of blenderized foods x 2 wk, then at 2 mo small amounts of 'real foods' ~ 1/2 C....as tolerated, adding ONE new food at a time. Focusing all my energy on eating protein for 50-75% of each meal and FIRST! Then veggies/fruits, then complex/whole grain, low Glycemic index carbs (

KAREN personally for me there is no rhyme or reason to things. ONE day things sit will another the same item dont agree so for that i blame me and chewing and my fast eating. GO figure. I am okay with it...dont bother me. IF it dont feel right i do refund it. WHO knows. but its fine by me and im happy with my journey.

*cut me off in middle* Guess I am always too long winded! LOL less than 25% if room. But the food plan was more of a ketogenic/Atkins /High protein/protein sparing/low/no carb diet to first assist with the rapid wt loss and second to assist in saving lean muscle mass to avoid muscle wasting as much as possible, see the diet keys are taught for not only the healthy lifestyle but to also keep metabolism going, hunger low and keep the organs/muscles intact vs having body break them down. I am not saying there is anything wrong per see with an apple or a cracker etc I am just trying to give rationale why some programs say protein protein protein! That cracker, bread, apple or any carb is NEVER malabsorbed either, so defeating the tool where early on there is some protein/fat malabsorbtion of cal/nutrients. The carbs start digestion in the mouth w/ amylase! So we get every calorie. Now we do need carbs as well, but the good ones, and an apple w/ skin is good option, I rec. eating w/ a protein though for better glycemic control/satiety (like apple w/ PB or apple w/ cheese)..Have you tried protein? Chicken, beef, fish, turkey, pork? How much of an apple? Have you tried peanut butter? Cheese? So as I always advise this is a journey, different for everyone, unable to compare only be aware of the WIDE range of typical, there is no NORMAL! Plateaus, wt loss, food tolerances , satiety are all individual. It is all about the process and journey of making healthier lifestyle choices anyways regardless of food tolerances, we can probably eat anything as time passes even in larger amounts! In the beginning 2 PB crackers filled me up, now I am afraid to try how many it would take, I am using I could eat over a sleeve of Ritz we PB! it is typical and expected, some progress quicker, being able to eat amounts/items and choosing to do it is key as well. I can eat 2 slices of pizza if I string the time out long enough, Do I chose to? Yeah sad to say I have, usually though I can chose the 1 slice that satisfies me. Emotional eating is always a factor that the tummy surgery never fixes ever....Some have hunger, true physical hunger the day of surgery! It happens, not typical but happens. Some tolerate larger amounts w/o restriction early such as you, not the typical but does happen. If you can focus on the lifestyle changes eating slow, chew well, do not eat/drink together, avoid carbonation & best choices etc then that is all you can do. At 6 wk out even if there is an issue, we have little control over wt loss it happens, enlarged stomas/stretched pouches happen, and sadly not much that can be done, there is some treatments, not much success from what I hear...It is to soon to even thing k of a revision (IMHO) as the pouch has so much more healing to do. I recommend not overstuffing it, sticking with 1/2 c food period, esp. if you aren't hungry. Working on the emotional eating in the background as well. There does come a day and time for most of us we can eat much larger amounts, tit can happen 6-9 mo or so and is scary but it is part of the journey. Sometimes a pouch can be surgically corrected, sometimes the stoma can be sewn endoscopically, some use schlerotherapy injecting an irritating substance into the stoma to scar it down, some use lap band over bypass if able, these are not w/o risks, and sometimes due to adhesions, scaring, proximity of pouch etc band cannot be placed over, the surgical repair may be too risky..I guess what I am saying is try and make the best of your journey, if the wt loss stops to soon, regain happens despite doing all you can behaviorally, then at 1 yr or so perhaps a upper GI scope is in order. Gastro-gastro fistulas (connection between pouch/stomach) are VERY rare but can happen. That can be seen on a scope, sometimes they can fix others they cant...either way doing all u can now to change in my opinion is al you can do. It is easy for me to say don't worry, we all tend to think something is wrong as we differ a little from the 'majority' sometimes there is a complication but usually it is just our body being UNIQUE (ok and frustrating the heck outta us too!) Be well HUGE HUGS! Use all your energy on you, today and not on the what-if's/worry, doing that leaves us tired and emotionally exhausted and not able to do the best we can at the time! Keep in contact w/ your surgeon, so he can monitor your progress ok! Take Care, Jamie Lap RNY 10/9/02 Dr. Singh 320/163 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King http://www.obesityhelp.com/morbidobesity/members/profile.php?N=c1132518510 "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"