I am almost 4 weeks out so I am trying to introduce new foods like the program I am in outlines.  Fish was fine, tuna fish was fine, fat free re-fried beans again fine.  Lean deli meat fine. I am struggling with chewing ground turkey to an applesauce consistency and it makes me nervous, I try...chew chew chew chew...but there are still little pieces...both times I have tried it I ended spitting a lot out and could only get about 1/2 and ounce down.  Not because my pouch was telling me no, but because I have been to afraid to swallow it. HELP PLEASE!! I had to work a lot with the nutritionist and psyche person because I did not want to transition to solids at all due to anxiety of choking/blockage etc.

Some things just don't ever get to quite applesauce consistency no matter how much you chew.  (Ever try to chew a carrot to that consistency?? Not EVER going to happen, LOL!)  The best you can do with some foods -- with almost all dense proteins, in fact -- is a very finely ground up consistency. Beef and pork, for example, are never going to be applesauce like.

There is no reason to worry yourself about getting it stuck, though, just because there are still very small pieces. Think of your stoma as an opening about the size of one of those big pencils that little kids use when they are first learning to write (or not quite the size of a dime). If you do that, you can see that it won't clog easily if you chew things reasonably well. You just cannot get away with what many people do pre-op: chew 5 or 6 times and then swallow!  

You are worrying too much. Even if you don't chew something quite enough, you aren't at any higher risk of choking than you were before surgery, and if you are chewing your food even reasonably well, it won't get stuck.  Just relax and chew every thing the best you can.

The reason for chewing so well is actually two fold: to avoid getting food stuck, and to utilize your teeth and saliva to break down the food and try to compensate some for the lack of stomach "juices" in your pouch that the food would normally be subjected to in the natural stomach. Chewing well also allegedly helps avoid constipation (I have heard that several places but have never seen any actual medical article supporting that.)

Lora

Thanks so much! I appreciate the feedback and never looked at it like you did about the pencil.. I thought it was the diameter of a normal #2 pencil eraser so I was freaking out a bit....I am so glad I can ask questions here!

Does chewing well stop the stoma from stretching?  What are people doing that gets so many stomas stretched?

It doesn't stop stoma stretching, but it eliminates the possibility of stoma stretching due to food that is improperly chewed being forced through it.

Unless you are aware of something that I am not, there aren't "so many stomas stretched". According to my surgeon less than 20% of the people she ordered scopes on (who were gaining weight and swore that they were following their food plan) had a stoma OR pouch that were enlarged beyond what is normal and expected.  The surgeons that I currently work for part time report similar statistics.  That means that over 80% of the time the problem of regain is not mechanical, but is what people are eating.

My surgeon said to put a little meat tenderizer in some water and drink it if something feels stuck.  Anyone else hear this?

hmmm I never heard that.....hey did u finally poop??? I hope so...I have had some issues with impaction and constipation...and its not fun.  The program I am in says if you don't have a bm in 3 days you have to let them know.  I have had to give myself enemas and take miralax

My program says to do this as well :)

yes, but never tried it.  I chose to use a chewable tablet called Papaya enzyme instead. I found this at a pharmacy. This chewable helps break down protein but it is advised to use sparingly because it could be hard on the lining of your stoma.  I've had that stuck feeling less than six times in the last two years.  I don't think it's because I'm careful--I think it's because I've never really had much restriction to begin with :(

Noooooooooo.  No meat tenderizer or papaya enzyme. You will cause more damage to your pouch. Any surgeon who says that to a new postop should have his license revoked.