How do you stretch your pouch?

 Yeah I agree. I'm not really worrying but I do like to have as much knowledge as possible about it. I a eating a lot more at a time than I did just a couple of weeks ago and I am not measuring. I just eat until I'm full. But I'm going to keep doing that. I'm still not getting in more than 800 calories and I know that's probably the minimum.

I kinda think a lot of people who have had surgery feel like they NEED something to worry about. We have all tried dieting - a lot of us our whole lives, and when we dieted we worried about that. Now we lose weight so fast that it seems TOO GOOD TO BE TRUE. I find myself trying to worry about stuff because I'm used to it, if that makes sense.

I guess that makes sense.  Ok, so all you worriers out there...    If you must worry about something, worry about whether or not you are doing everything you can do to break your old eating habits and get your healthy eating habits in place... because you WILL need those once you get to maintenance (for the rest of your life) to keep the weight off.  Worrying about that will be more useful to you than worrying about stretching your pouch.

Lora

Amen! I am several years out and working on maintenance is extrememly difficult for me. I have learned a lot over the years, but old habit creep up every now and again.

All the newbies should take advantage of the first year. Lose as much as you can, because it does  slow down. After that it is all you.

Alicia

If you think about it, it would not even make sense to have this surgery if it was as easy to ruin your pouch as some people think it is.  If you could ruin your pouch by taking three sips of diet soda or eating one bite of well-chewed chicken when you supposed to still be on pureed foods or by eating 2/3 of a cup of something when your instructions say you're just supposed to eat 1/2 a cup... I mean, would it really be worth having major surgery if you could ruin it all that easily?

Yes, good point!  I hadn't thought of it that way.

Lora

Lora, do you know how much pouch stretching is considered normal?

My pouch was stretched 40%, and I haven't been able to find numbers in the literature for the size of a "normal" mature pouch.

No, after hearing how rare it was, I didn't ask much else (and have never gone searching for anything  on it).   I have my 4-year follow-up coming up, though, so I will try to remember to ask her. 

It's most common, however, for people to be able to eat from 1 to 1.5 C of food after 2 years... but different surgeons make pouches different sizes to start with.  We could do some rough calculations, though...  The first problem, though, is that, although it is common for people to eat only 4 ounces at 3 months out (you cannot really use the food volume from the first month or so because the pouch is still healing and may remain swollen or extra tender), I do not know whether the pouch really only HOLDS 4 ounces at that point in time (since we are usually going more by measutring the food than fullness. If we use that number anyway, however, and say that people go from eating 4 ounces to eating 10 ounces (taking the median of  8 and 12 ounces) at 2 years out, that would be an increase of 150%.  

A 40% increase would be going from 4 ounces to less than 6 ounces, which is less than the 1 cup that is very typical once people are a year out.  You are obviously over 2 years out... but surely you can eat more than 6 ounces of food at a time...?!?  What was the 40% based on?  Maybe your surgeon makes the pouch somewhat bigger (so the 4 ounce figure in my guess-work calculation might not be any good)...?

Lora

My pouch was measured via endoscopies, so I think the measurements are as accurate as possible.  At my 1-year mark, my pouch was not stretched at all.  Some stretching was expected, so it was surprising that I had such a small pouch.  At my 2-year mark and beyond, all endoscopies showed an increase in pouch size.

I did not have restriction or fullness or satiety, so it was difficult to maintain my 200+ lbs weight loss.  Honestly, it was a lot of discipline that got me through it.

I just had a Revision on 7/11/2011 (due to ulcers), and my new pouch is 25 CC in size, according to my surgeon.  I still don't have any sensations, so I am just eating by the general guidelines (1/3 or 1/2 cup of mushy foods at a time, for example).

I feel better! I've been worrying about this too, now that I am almost 4 months out I can eat more than before and have been worrying about stretching.

Thank you for sharing your wisdon, Lora and Kelly. You guys are awesome!!!!