Info from my consultation with dietician pre-stomaphyx

HI - I just wanted to share more info I received this week.  My upper GI showed my pouch is the same size 7 years post op (prox lap RNY), but my stoma has stretched to the diameter of my esophagus and contents from my pouch empty instantly into my small intestine.  My surgeon referred me to the dietician (part of the whole insurance routine) before we had the reults of the GI, but by the time I saw her we had all read them.  So, for all you "stretched stoma, pre-stomaphyx" candidates, here's some info that helped me understand a lot: - The severe hunger is not our imagination or our addictions.  The top portion of the original stomach that is retained as the pouch has the most sensors for fullness.  If the stoma releases the food, no pressure is applied to the pouch walls signaling fullness.  That combined with the fact we can eat large portions results in rapid weight gain. - a revision such as stomaphyx will solve the hunger issues because the pouch will experience fullness (if you follow the proper eating habits, especially no drinking before, during and after eating) - weight loss will not be as significant and effortless as it was after our original surgery.  This was a difficult point for me to understand because if my anatomy  is restored to post- bypass, why wouldn't I lose like that?  From my understanding, it has to do with the malabsorption.  My original weight loss was in large part due to that, but now my intestines have adjusted and absorb.  I had very little removed and my surgeon is generally opposed to removing more becasue he'd prefer to see his patients develop healthy habits. - the dietician said that with those healthy habits I can still hit and maintain goal, but it may take a bit longer.  I will have the tool of a smaller stomach, but that's about it. - dumping may resume.  I experienced dumping before my stoma stretched (which both the surgeon and dietician are attributing to softening of scar tissue during two pregnancies).  However, I have to eat a lot of bad foods for it to happen now.  The dietician and I are both hoping I have that sensation again to remind me to not cheat after the revision.  She gave me a better [picture of what dumping is and I think I will experience it again post revision if I eat chocolate - my mortal enemy. - for now, there isn't a "diet" that can help me.  I'm going to feel hungry because my pouch can't hold food.  She said I can try eating dry high-protein foods like chicken breast and avoid beverages for as long as possible afterwards, but other than that, I just have to eat low calorie foods until I can have something done about this. My surgeon, Dr. Wetter in Burlingame, CA is holding some sort of private discussion of the Stomaphyx procedure for a few of his patients next Tuesday.  The nurse called to invite me and I plan to attend.  My main questions will be about insurance and effectiveness for treating the stoma specifically.  It sounds like it definitely makes the pouch smaller, but I want to get a better idea how it will repair the stoma.  Please let me know if there are other questions you think I should ask. ~Shelley

"I had very little removed and my surgeon is generally opposed to removing more becasue he'd prefer to see his patients develop healthy habits" If we could do this we wouldn't need surgery.  We NEED the malabsorptions  help.  That is why they call it "gastric bypass."  For me, I would need a surgeon who understands this,