It's official, my pouch is huge!!!

After surgery I always thought it was weird that I could tolerate a lot more food than I was anticipating pre-op. I know there is restriction and I get a big reminder of that when I eat too fast or don't chew my food well. But I have come to the realization that my pouch is probably the size of a large lemon.

Here is an example of what I can eat, for dinner I have been able to eat 3/4 of a cheeseburger (bread, lettuce, tomato and all) or two small beef tacos (with the works). In the morning I usually don't eat as much but by dinner time I am starving like crazy.

My surgeon mentioned to my wife that he customizes the surgery for the patient. He told her that if a person only needs to lose 80 pounds after he puts you on his pre-op diet, he'll get you pretty close to that weight without getting you too skinny. My fear is that because I had lost a lot of weight pre-op (about 35 pounds) that he might have thought I only needed to lose another 85 pounds or so and didn't give me enough restriction!

He mentioned in our support group that he usually makes the pouch about the size of a lime but I know for a fact that two tacos do not fit in a lime-sized pouch! Any thoughts or suggestions...anyone else experience this? I know when I mentioned this a few weeks post-op everyone said to give it time for the nerve endings to heal and start working again. I would think after nearly 3 months out they would have kicked in by now.

Hey Brain. I know what you are talking about, I think I am able to eat more food than I should. I can eat 2 taco's, (not the shell )with no problem. I am 3mos out too and only have lost 66lbs and I am scared becuz ,my dr wants me to lose 210lbs, now without  much restricion, that is going to be hard. Don't get me wrong, I don't eat nothing like I use too, but I think I am able to eat more than my pouch should let me. GOOD LUCK

Hey Brian. Well you sound a lot like me.  As of 5 months out I could eat the enitre south beach meal kits minus the jello and one 1 tortilla with added extras like lettuce and sour cream to the southwest one.  I have always felt like I could tolerate foods others could not and larger portions... I got to my goal weight and even below.  I had to be extremely careful about my food choices b/c I could eat more than the average joe.  I am 18 months out now and I can eat 6 oz of meat (no more than that tho) solo.. or I can eat a HUGE salad (b/c it crunches down to nothing) even with 4-6 ounces of meat on it.. lettuce makes it slide some.  Make sure your meals have little bread.. this will keep you from starving later. You need to focus on DENSE protein.. eggs, ham, beef, chicken, pork, etc.. forget the bread on the hamburger or the shell on a taco for now.   This just spikes your blood sugar and crashes it down later leaving u wanting more food. As for the lime sized pouch, that sounds right.  A pouch even tho its the size of a lime still stretches when food goes in it.  Btw.. the first time I felt "full" was at 8 months out.  And it lasted 2 weeks. I go through patterns where I can't tell if I am full to being really full now.  I think I have one of the STRANGEST pouches.. always have had that.  I've never thrown up, gotten anything stuck.  Goes to show all of us are different.  Trust me tho, you are fine.  I was freaked my entire journey, people on here can tell you that.  I am a size 4/6 now, never in my wildest dreams did I think I would down this low.  I am blessed that my pouch isn't "finicky" like that, but I do dump so really I have the best of both worlds.. I can go out to eat and not worry if something won't sit right but at the same time I have to avoid sugars as much as possible.  Last night I went out to dinner with my husband.  I got kinda ****y and ordered 1 pancake with my eggs.  I had it with SF syrup.. dumped hard the whole way home.  Must have had some sugar in the pancake b/c I eat SF syrup at home all the time and do fine with it. again.. look the consistency of your foods.  A hamburger, 3/4 of it.. is about 4-6 oz and you ate 3/4 of it.  So u ate 2-4 oz of meat (depending on the size of the burger) and bread smooshes down to nothing b/c its a slider food also so does the tomato and lettuce.  Tacos.. well shells mush down to nothing.. prolli 2 oz of taco meat on each one.. cheese maybe an ounce or two and well the rest is slider.. lettuce, sour cream, tomato.. etc.. Go get a steak and sit down to 6 oz of it with NOTHING else with it.. no sauce either.. I triple dare ya :)  Hugs, you are fine, I promise!

I have the same fears, because only 4 weeks out I can eat 2 oz. of steak with 3-4 tablespoons of sides without hurling. BUT pre-op I could eat a "man-size" steak with all the trimmings and have dessert, too! I am reminded of this by other post-op friends. all things in perspective, perspective, perspective. We now chew the bageezus out of our food. We take twice, if not three, times as long to eat half the food we used to. A lot of food slides down in the process. I am guessing you didn't want to even touch the fries. Dessert is no longer an option for most. If you are starving before dinner, eat a light snack in the afternoon. That will push back the angry-hungries at dinnertime. I was taught in pre-op classes that the pingpong ball size pouch grows into a tennis ball size pouch, if not a little more...but it will never get to the football size it was before. Have you asked your surgeon to pin down what he meant about customizing? and your fear? Ask, or sign for release of, his pre-op and operative notes from your chart. Maybe there is some insight there. Hang in there...you have done great so far. :)

Hey..I got really worried about how much I could eat when I was about 5 months out. (I think it was the same day I realized I could eat two tacos too!)

One thing you can do to check the functional capacity of your pouch is "the cottage cheese test". if you google it you can get the rules. I found out I had a 5 oz "functional capacity" at that time. Now, it's probably just a guestimate but it will give you a better idea of your pouch size. It made me feel better.

And remember that just because you can doesn't mean you should always. I have to tell myself that every day now. I've lost 133 pounds so far and am confident my pouch will get me to my goal.

Ok so what's the big deal again? You have restriction but you don't think it's enough because you will out eat your success? Is that what I'm reading?

A lemon or lime is like an ounce difference. Maybe 2. If you follow the cardinal rules of protein first then what's an extra ounce worth of dense protein? You are a man. Generally men lose very fast and losing too much can definately be a problem. So he made it a little bigger so you can accomodate more protein. I don't see this being very serious if you follow the cardinal rules. Just my 2 cents worth.   Also I really don't think you're going to have issues getting to goal my friend. And not everyone has to throw up to be a RNY patient. I know a lot of people who tolerated everything from the get go. I would have if I chewed right in the beginning! I tolerate everything now so it's just a matter of following the rules and getting filled up on protein first. No questions asked.  Keep working it - you are doing great. Take this time to learn and listen to your body. It's telling you what it needs!

Hey Brian, Just so you know.. i worry about that Constantly! that i can eat to much.. or that i wont make my goal weight.. now My Doctors Goal and My Goal are 2 very different goals.. he says i should be 178 lbs.. I say he's a complete LUNE! I was my happiest at  245 lbs.. but i am shooting for 220  so that if i bounce back any (which i dont intend to) I"ll be Right were i want to be. but i'm at 275 now.. i have 55 more lbs to go.. before i reach MY personal goal.. and i'm on ly on month 4.. so i dont see why i wouldnt reach my goal.. i am following my doctors orders.. i DO have a Fear also of Loosing TOO MUCH! I like being a little bit Big.. ya know that foot ball players build.. and most of the people i'm attracted to like that as well.. anyway.. your not the only one who Worries.. just wanted to let ya know.. LOL Good Luck..

Wait.... 2 tacos CAN fit into a lime sized pouch if chewed in to oblivian,lol. I was told that my pocuh would expand, over time to almost the size of a baseball/softball. The pouch is part of the stomach and the stomach is a muscle, therefore, it'll stretch. I thought from day one that my surgeon left it a bit larger because it seemed I could eat more (100 pounds to lose) but he said no. He said that I just wasn't feeling it yet and he was right, now I do. In the early stages you just can't feel what you do later. I am 20 weeks out and it took just over that 3 month mark for me to REALLY get the picture. It'll change, give it time. Best of luck cindy

Call your surgeon's office and ask the nurse to check your file.  Your pouch size will be noted in your surgery notes.  And while you're at it, have them check the length of your bypass.  Good information to know. Also remember that your pouch is not fully functioning right now.  The nerves that communication between your pouch and your brain were cut during surgery.  Your pouch can not tell our brain when you're full.  Which is why you MUST measure your food and only put on your plate the amount of food you are allowed to eat.  If you eat more then the food is being forced through your pouch and stoma into your intestines.  That forcing action is what will stretch your stoma.  A stretched stoma is a MUCH bigger issue than a large pouch.  You are only 2.5 months out.... you shouldn't even have bread on your plate.  So get back on plan and work your pouch the way it was designed to be worked. 

You're still not even three months out. It took me a little over three months to feel full at all. It should kick in at some point soon.