On pouch/stoma stretching

 Because I feel like this is one of those fears that has more power in our minds than in reality.

Let’s just get a few things straight.

YES, it is entirely possible to stretch your pouch…although the stomach, by nature, is SUPPOSED to stretch and accommodate more food over time after WLS.

YES (and possibly more pertinently) you can stretch your stoma, the opening from your stomach into the intestines. If you do that, it is easier for food to pass and you would feel hungry more often than you should.

BUT

Neither of these things are easy to do, barring certain medical anomalies and situations. Your surgeon makes your pouch out of the pretty tough part of your upper stomach. It takes a while for it to stretch even to the point where a portion of what you formerly ate would be comfortable.

So far as your stoma, this is one of many reasons the eating/drinking rule is important. That can contribute to the incremental widening of the stoma and over time that can be problematic.

BUT

I’d also like to point out that I’ve seen so many shows where WLS folks *****gained all their weight were featured and I remember a few even being scoped and guess what? Their pouches weren’t stretched nor were their stomas!

So what does that tell us?

That our CHOICES are probably the predominant factor in regain. The people *****gained made different food choices than those who did not. I can say from personal experience I can see how choices can lead to regain. There are certain things I can eat tons of (potato chips for example) that could gain my weight back FAST. If I chose to only eat potato chips, I would not necessarily stretch my pouch or stoma but I’d gain a lot of weight.

I don’t mean to belittle pouch stretching or stoma stretching but to fear those is to put power into something that doesn’t have complete power over us. Our pouches don’t rule our processes, our brains do! Your BRAIN is what you should worry about stretching. Because if you don’t do the head work and you keep justifying and rationalizing, little by little, you will delude yourself into thinking certain things are acceptable in your life when they simply are not.

Only you can determine what those things are. For me, I can say I can’t do the “oh, I’ll just have one" game. It doesn’t work for me. So I try to remain diligent about that.

But honestly, if you truly, really feel like you ‘ve stretched anything anatomically you should definitely see your surgeon. For the rest of us, work on the head stuff and I honestly believe it won’t be that big a factor for you.

I have known a few people to have regained after RNY and I notice the same story.. "My pouch must be stretched", basically never blaming themselves for the gain and only blaming the surgeon (not making their pouch small enough, making the opening too wide, etc). And seeing the things those people are putting down is insane. I have one coworker that had it and never made it to goal. Well, every sales meeting she eats a large sandwich on a croissant, bag of chips, a few candies and cookies. All within a few hours. Our heads can sometimes get the best of us in that regard. "Oh no, it chouldn't be me failing.. it must be the surgery failing."

That is why I didn't let all of the stories of weight gain after surgery and all that get in my way of having this surgery. If I had a dollar for every person that told me that "no one" is forever successful with this surgery, I would be so rich. I have been really spending this time pre and post op on working with my issues with food. My head hunger and my want for crap foods. I have been finding great alternitaves for things I used to consume before surgery. Also, a lot of that is thanks to you, and eggface and others I see on here with great ideas for curing the cravings. Thanks, really. This forum helps me make better choices in my life in general every day.

 Yeah...I had to own up to that fact myself. It's a tough pill to swallow. But swallow it I did! 

I didn't have a total regain but it's significant enough where I cannot simply blame the surgery or the requisite "bounce back."

Just so people reading this are clear... There any many vets here who are more than 3 years out who can assure you that regain is VERY easy even if you are not eating chips and cookies.  For a lot of people, all it takes is a few short weeks of no****ching the carbs or portion sizes as closely as you had been previously.  So not everyone who gains weight is eating whole sandwiches, cookies, and chips.  The people who ARE eating those things, though, are NOT the ones maintaining at close to their goal or lowest weight.

It never ceases to amaze me how powerful denial can be (and I have BTDT -- just with other things --myself).

Lora

amen!

I'm fighting a small regain right now, and frankly, when I watch what I'm eating, I'm NOT eating cookies or cake or potato chips or any of the other stuff. BUT, I am moving a bit less, because I've been in pain a lot, and perhaps it is simply a mechanism of not moving as much. And/or the general normal expected changes as a person gets older. It's frightening to see teh weight creeping back on with the diet not changing. It feels like it is pouring back on, but really it's stabilized. not where I want it to be, but it has stabilized. I'm sure that the stabilization is about the calories in (the same) versus calories burned (less) = weight gain.

I follow the rules, but it seems that unless I up my activity my weight is going to be a bit more than  want it to be. So hubby and I are going to start going for some walks. It's not much, but anything is better than nothing! 

By the way, I don't go ANYWHERE where there are cookies. I can't say no to them. I want them, they want me, they get little faces and talk to me and say "you want to eat us!" (not really).

Luckily, the "bad" stuff sets off my dumping or my reactive hypoglycemia, and therefore I don't find much encouragement for eating poorly

I have the exact same problem with cookies, LOL! 

I have to have my mom keep my Girl Scout Cookies (loooove Thin Mints) in her freezer so I can take just 5 or 6 cookies home at a time!

Because of my knee(s), I don't get nearly as much exercise as I would like most of the time, so I know that makes the battle harder.  So far I have been able to keep in under control (the 5-lb creep limit), but I have noticed that it is more difficult during the winter since I don't walk (outside... indoor walking is WAY too boring).

Lora

When I drove to my PCP today, I passed a tiny little unincorporated island in the middle of our housing complex where they have cows and chickens. I said to myself, "hey, hubby and I could take a walk here to have a chat with the cows." Round trip it's probably no more than a mile, but I told him we're walking on Sunday to see the cows. Neither of us has any oomph after spending 4 and a half hours standing in front of fractious teenagers during the week, and nearly every Saturday we go in and offer free tutoring at the high school, so that is pretty much out, but Sunday we have no other plans. It will be fun, and I like to talk to cows. It's not much, but it's better than nothing.

Here in AZ we have the opposite problem. Walking in the winter, spring or fall is fine, but walking in 120 degree weather? suicide.

Ok Lith, here's the thing that boggles me about you.

I remember you when you were a lil baby pre-op. And you were very clearly all "I am not in this to be any certain size, I'm in it for my health!" I even remember in chat one time either right before or after surgery you saying it just really wasn't that important to you.

Frankly it drove me a little bit batty. You see, everyone must be at least as crazy as I am! Well adjustedness is the antithesis of everything that I am.

So from my perspective, hearing you talk about being at a higher weight than you want to be is sort of interesting. Not good, not bad, but interesting. How, if at all, do you think your perspective has changed?

Interesting question.

I think that if my pants didn't start getting tight on me, I probably wouldn't have started to weigh again. I could have gained another 100 pounds, but if my SIZE didn't change, I was okay with that.

But having FINALLY taken the plunge and given away ALL of my larger sized clothing, having come to really appreciate my new size, and felt GOOD about how I looked.... to have some of my pants get a bit tight put me back into how I felt a gazillion years ago when I was a teenager, and I kept going up up up in size. It was mentally a very hard time for me as a young person, at that point in my life, being "attractive" was literally tied to weight. Fat = ugly. Thin = pretty. That was how I felt when I was gong up up up in size.

Since I gained all that weight, I eventually had an epiphany, I came to realize that my own self-worth had absolutely nothing to do with my beauty or lack thereof (yes, there is still a sort of fat = ugly mindset I haven't been able to purge from my brain.... as regards myself only though). Knowing that my worth as a human being, my abilities as a professional had absolutely nothing to do with my size, that gave me a contentment in life regarding my size. I was happy, and I didn't need to change. Not to find self worth and self-acceptance. So when I went into the Weight Loss process, the ultimate nutshell goal for me was health. But there was a part of me that of course wanted to experience thin. Or at least thinner. Then, when I got there, there was a part of me that didn't want to let that go. Also, of course, there's a part of me that has evolved to feel that "success" in this WLS "game" is to not have a serious "regain" .... and so being in a position to have half of my pants too tight, to see the scale creeping up (not really, but it seems to be... but today's pants were falling off me... go figure) .... I don't want to be a "Failure" I don't want to be a statistic. I don't want the creepy bullies on here who kept declaring that I would be a failure to be RIGHT.

Again...  I know that a lot of my psychological buttons are being pushed by having pants being too tight. Not the weight, the tight pants. It's not sensible. I never was that sensible about stuff like this. I remember when I got to 165 and stayed there for a long time. That was a GREAT weight/size for me. Optimum I call it. But even though it was exactly perfect I was hung up over the stupid NUMBER on my goal, even though I was the right size. I dropped down to 146, 19 pounds below "optimum" and 8 below goal, and I was "proud" to be there because a part of me was focused on the number rather than the reality. But when I looked in the mirror, I was really AWFUL looking, it was bizarre to see every vertebrae in my spine, ever rib, the inner curvature of my hip bones because I had so little flesh left. that was NOT the good weight for me. When I regained back up to my Optimum and I saw the right person in the mirror. I saw the number on the scale, and while I wanted it lower (psycho!) I knew it was the right weight, the right size. But then, I put on a few more pounds, and I felt it all around me.... the extra weight..... the extra fat... and it scares me... particularly when I really hadn't changed anything. I don't like not being in control. (yes, I'm a control freak)

It's a balance between being sensible about size (and knowing I have a good solid 5 extra pounds to lose at least) and being psycho about numbers (which is silly/psycho!).

I was happy when I got down to 18. Perfectly content in a 16. Blissful in a 14. Astonished when I got to 12, and knew that 10 was almost unbelievable. Yes, I got to a size 8 in my teeny tiniest, but it was a mistake that I bought the 8 (they brought the 8 for the price check, and put the 8 in the bag instead of the 10). Size 10 and 12 are "me" ....and I'm scared that my 10s are not fitting anymore. I don't want to go back to a size 28, and even going up to a 14 seems like the road to regain.

I don't know Lora.....I eat a LOT of sandwiches! But admittedly I do not wash them down with chips, cookies OR soda. Most of the time I eat like a very healthy, normal person; normal people eat WHOLE sandwiches.

But I agree that a few days of eating "crap carbs" (not to be confused with the healthy carbs I make my sandwiches with) can lead to weeks and/or MONTHS of cravings and "what the hell" type eating.
 
I have regained 20-30 pounds THREE times in ten years; all three times it wasn't because I was eating sandwiches made with whole grain breads, tons of veg and a lean protein. It usually started by allowing myself to eat those "healthy" treats, like skinny cow icecream sandwiches and WW muffins....but only once in a while; then it transitioned into everyday and finally I was eating candy, cookies and crackers. I was also eating CONSTANTLY instead of sticking to a meal and snack schedule. And I was NOT checking in with my support groups, both in person and online. So I guess my point is that it's not usually one thing that leads us to regain; it is a lot of little things that we THINK we can get away with but taken together lead to a very bad place. And I would also say that, FOR ME, those fake foods are very unsatisfying, which leads me to want more and more to try to feel sated. I'd rather have a smaller portion of a REAL treat. Fake foods just leave me wanting more; real food does not.