Any grads still have grouchy pouch?

I wasn't sure whether to post this here or on the complications board, but I don't really consider this a complication, just a weirdness.  Most times, I hear grads talk about not getting down to goal, regain, pouch stretching... those are so not my problem

I had RNY 10/07 and have done did really well (100% EWL plus some and all my co-morbids gone or completely diet-controlled). I didn't have any major post-op problems like leaks, strictures, adhesions, blockages, etc etc. I did get an ulcer 2 mos out, but that was from the artificial sweeteners in the shakes (arg - seems I'm allergic).  I never really had too much problems with dumping or bad labs. BUT....

2 years out and I still can't eat more than 1/4-1/2 cups (about 3 oz) at a time. I cannot drink for at least 30 minutes after I eat or I'll barf. Hard protein, like meat, is really uncomfortable and I pretty much can't do poultry at all unless it's been ground into a smooth/wet spread. Fruit & veggies with skins are the bane of my existence and I get foamies if I'm not careful. I'm super-conscious of taking small bites and chewing a lot, or I'd pass this off as eating too much too fast. Seems like anything that's the least difficult to digest gets stuck and gives me the foamies.

About once a quarter, my old doc would put me on Nexium twice a day for 2-4 weeks and things would be a little easier for awhile; but I don't want to depend on meds forever... especially since I don't have an ulcer (just a little gastritis on my last EGD). My stoma is healthy and the same size it's supposed to be, no strictures or other abnormalities. I always had a finicky gut, even before surgery, so maybe the surgery just made it more noticeable. I dunno.

My husband thinks I've developed anorexia or some psycho-somatic aversion to food... but I can (and do) eat soft proteins (like eggs and cheese) & other soft foods/liquids just fine. It's not like I avoid eating altogether or anything. I do suffer a little from reactive hypoglycemia and post-prandial hypoglycemia... but that's controllable by watching what and how much I eat in one sitting. But having a tummy full of really solid food does make me feel awful and miserable for 2-3 hours. Sometimes even one bite is enough to make pouchy punish me.  
 
Right now, I'm a little underweight because I haven't figured out how to get another 500 more calories in (I'm already getting 1200-1400) now that we've moved to a much colder climate and I'm doing a lot of physical labor outside. I'm already eating 100-200 calories every 2 hours that I'm awake... I can't eat more in one sitting, so maybe I'll have to eat even more frequently and start drinking more high-cal bevs?! I think I may be the only person I know whose docs & NUT encourage them to eat MORE slider foods and "graze" all day!
  
How common is this? Anyone else out there, regardless of surgery type, who is overall satisfied with their surgery and healthy except for just having continued problems with some types of food or continued tight restriction?  What did you do about it? Is there anything that can be done?

I'd really like to enjoy a steak, or a pork chop, or grapes, or a salad again without worrying if it's going to make me sick again this time...

I'll start with what I know first. I got down to low for me and both my PCP and WLS doc also told to to GRAZE on good stuff all day if I had to to get some weight back on. Mac and cheese is really good you can get those little frozen ones and zap them in the micr they cost about $1 per box.  Also drink shakes instead of your normal water intake. If you can snack on NUTS any and all kinds of nuts are good.
If your stoma is not to tight the doc might have just made it to small for you your pouch also. They do stretch out over time and your doc might have just made it to smalll and it will not stretch out any more.

Good Luck,
Robin

Thanks Robin. I eat a ton of cheese and nuts, so I'll just try to eat even more. Think I'm going to have to breakdown and grind up my meats into spreads so I can eat that again, too (at least until we decide whether I need to go back on meds). Sigh - that'll be a work out since we live in a tent and have limited electricity... hand-grinding grain is hard enough, but meat takes some serious muscle :)

I sent mail to my surgeon and he thinks I might be having these problems because I had a history of ulcers before surgery, and I healed really fast which might make pouchy a little stretch resistant. He's surprised that I still don't have any hunger response, he only has one other patient this far out that hasn't gotten theirs back yet. Now we're just considering whether I need to go on meds again, or whether going the "baby food" route would be better.

I don't really have any issue if I need to process my food a little bit more in order to eat the harder stuff... I just don't want to lose anymore weight or never be able to eat 'X" ever again. Baby food is cool with me LOL 

hi,
I wish I had reached underweight.. in fact the lowest I ever got was 180 and then I put 60 lbs on when I came down with thryroid cancer.. and cannot get it to go away for but a month or so at a time. 

However picky about food or not being able to handle certain foods has become my reality..
Not being able to drink and eat at the same time a reality.. and if I do.. everything winds up coming back up.. and I mean everthing..
Not being able to realize the full mark all the time... another reality..
Being able to graze all day... OMG reality..
Being able to eat carbs easier than protein.. reality with a **
Not being able to tolerate plain bread with food.. another reality.. alone I can eat bread..
Having to make sure food is chewed to mush.. yes another reality..
Not being able to mix certain foods.. like meats and veggies. OMg.. yet another reality..
Never fried veggies of any kind ... another reality... nor sauted

You cannot make this stuff up.. if I wasn't living it I wouldn't believe it..

hi,
I wish I had reached underweight.. in fact the lowest I ever got was 180 and then I put 60 lbs on when I came down with thryroid cancer.. and cannot get it to go away for but a month or so at a time. 

However picky about food or not being able to handle certain foods has become my reality..
Not being able to drink and eat at the same time a reality.. and if I do.. everything winds up coming back up.. and I mean everthing..
Not being able to realize the full mark all the time... another reality..
Being able to graze all day... OMG reality..
Being able to eat carbs easier than protein.. reality with a **
Not being able to tolerate plain bread with food.. another reality.. alone I can eat bread..
Having to make sure food is chewed to mush.. yes another reality..
Not being able to mix certain foods.. like meats and veggies. OMg.. yet another reality..
Never fried veggies of any kind ... another reality... nor sauted

You cannot make this stuff up.. if I wasn't living it I wouldn't believe it..

Hey DJ, I know just what you're talking about!  I can recognize my full mark, but everything else sounds eerily familiar.  Some stuff I can eat one way, but not another... like I can eat fresh spinach, but not frozen spinach, or bacon & sausage but not pork chops. Some days I can eat something but others I can't, no rhyme or reason... like olives or artichokes or rice. It's weird.

Oooh my goodness. I'm right there with you. My pouch can be downright bi-polar. I can handle some foods some of the time. STILL Having issues with really solid protien (Steak- only good when cooked, the annlowed to get cold in the frige. NEVER can handle much when it's still "hot") then there's the ongoing battle of the egg. Some mornings I HEART the eggs. Some mornings they make me vomit. Some mornings they make me dump. My pouch is quite silly! I'm OVERALL quite happy with my surgery and my results, it's just learning when I can and can't eat certain things that's become an ongoign and "exciting" challenge.

Amber -- I agree, pouches are silly, contrary things!  I have the opposite issue as you with meat proteins. I have to eat it, barely cooked enough (I almost eat beef and fish raw, I'm more careful with chicken and pork), right off the stove when it's still hot. If I let it cool down or try to have it for leftovers it's instant foamies and the stuck heaves. The only way I can eat "done" meat or leftovers is to grind it down to babyfood with oil or mayo and make a spread out of it.

I only have the egg problem with the yolks. I can always eat just the whites, but sometimes even one yolk in a 3-white omelet will gag me. And just plain forget about deviled eggs or boiled egg salad!  About the only way I seem to be able to tolerate yolks is if I have a fried egg sunny-side up or over-very-easy and the yolk is completely runny. Then I can usually sop it up with a corner of toast or mix it in with grits/porridge OK... but it's still tricky.

Veggies are fun. Some I can only eat if they are fresh. Others if they are frozen. Others if they are canned. I can eat asparagus fresh and lightly steamed, or pickled... but if they are boiled, grilled or have been frozen they kill me. I can eat a raw spinach salad, but can't cook it at all. Mashed potatos from powder are usually ok, but not from fresh potatos; I can lightly fry a fresh potato, but frying the canned ones works better. I can eat cabbage raw in a salad sometimes (but almost never as coleslaw), pickled in sauerkraut most of the time, boiled with corned beef some of the time.  It's just crazy!

Hello PlicketyCat :-)

I wanted to write you and suggest something that has helped me. Once in awhile my 'pouch' becomes cranky and refuses to comfortably accept solid meats even when chewed according to recommendations. The trick that has helped me through the years is: I have a few sips from a small glass of wine a couple of minutes before I take my first bite of meat. This seems to relax my 'pouch' just enough to accept of few mouth fulls of protein and allow it to comfortably pass through to the small intestine . My pouch is not often grouchy, only on those rare, strange and unpredictable occasions - for whatever reasons - it acts up. This may be one option for you to consider. Hope this helps.

BTW: My surgery was 10/05/05. I have reached my goal :-)

Thanks Candice, that might help. I wonder if it's the alcohol that relaxes that tummy, or something else in the wine. If relaxing the pouch is all that's needed, maybe drinking something warm prior to eating may also work?!  Worth a try in any case. Thanks for the tip!