Good Morning. Thoughts about stretching your sleeve or pouch

Just browsing my brain for topics this morning and I think I want to put this idea out here again and see what you guys think. You  know how many NUTs and surgeons want you to get your protein from dense protein only so it will keep you full and not prone to eating? Do you think that leads to stretched out pouches and sleeves sooner than is necessary? I watch some of the newbies on the DS groups getting all their nourishment from food and then watch as they struggle to rein in the carbs and get to goal. So, I'm wondering is the theory that all obese people need to feel full all the time just another cookie cutter approach that needs to be re-examined? I'm thinking that by eating all that dense protein to try to meet protein requirements, we actually stretch out the sleeve or pouch prematurely. It would be one thing if we all followed the NUTs and surgeons' other rules about measuring and weighing, but not many of us do after a few months. A double edged sword--eat for nourishment or eat to stay full--what are the other ramifications? Thoughts?

--gina

Seems like I have read somewhere that stretching doesn't really occur much.  I do think we can "eat around" our surgery and I guess we can stretch to some extent, but I think it is more a matter of what goes in than how much. 

I do find that dense protein keeps me full longer.  I can eat a bowl of greek yogurt, even with a scoop of protein, and I am hungry again immediately.  Protein drinks don't fill me up.  I have 2 36oz protein decafs right before breakfast.  I still use them because I like them and I seem to need that extra protein in a usable form to keep my levels up.  Don't know if that will always be true.  Sometimes I when I am drinking one I think I should have just had water.  Then I think my 100 calories is a whole lot better for me than the 100 calories folks are having in their sweet tea or cokes.  At least my calories are protein, not sugar.

I don't have a good full signal like burps, hiccups, runny nose.  So I eat what seems to be an appropriate amount, 1 c or so and stop and wait.  Sometimes I find I am not full yet and eat a little more.  Sometimes that is plenty and I stop there. 

Interesting topic.  it will be good to see others responses.

I really enjoyed reading what everyone had to say.  It is these types of posts that help keep me compliant.

The stomach is a marvolus organ...it will stretch back out but we will never get back to what it once held. Right after surgery 1-2 oz would fill me up and I would sneeze. (MY full signal). Now I can eat a plate full but WE use plates that are salad size NOT dinner size plates. So filling a salad plate is FAR less food than we use to eat. I can easily manage 3-4 oz these days. Dh on the other hand must have had a smaller sleeve part of his DS to start with and fills up faster than I do.

What IS helping me right now is slowing down. I use to shovel my food in (holdover of being at ROTC camp) and even after surgery, that was a very hard habit to break. Now, I HAVE to slow down as I can't get but tiny bites in, it has to be mushy and dh is usually long done before I am. It's actually a chore to eat right now.

Like yesterday, we had hamburgers (cut up really small, I could manage it) but ate half a pattie and so did dh...I did eat some cauliflower with cheese...nice and easy to eat.

But back to our stomach, a normal stomach, empty, holds about 45 ML (1.52 ounces) but can stretch to hold: anywhere from 1-3 litres (33-100 ounces). So while it does stretch some, it doesn't stretch back out to anywhere near what we use to eat.

Liz

Hi,



I know I am not a year out yet, but I think it would be hard for the stomach to stretch out much.



As far as dense protein I can eat about 2 oz at a time and that is it. Now, if I have "softer" meat - like meatloaf I can eat 4 oz, occ. a full hamburger, but usually just 2 oz of hamburger. I think a lot has to do with how soft it is. When I saw my NUT at my 6 month app't I was to be off all protein drinks and get protein only from food at that time. I still drink protein drinks - probably get at least 50 gms of protein from drinks alone daily (usually higher than that). They state 60-80 gm of protein is all we are to get daily. They say more than that is just more calories and unnecessary. I think I feel better with higher protein numbers.



I agree with others about eating around surgery. On my indulgent days, even this early out, even if I feel full I can still eat the sliders. So, maybe it isn't the stretching of the stomach, but eating more processed foods that go right through? I am not sure, but processed foods are my enemy and I'm not perfect, but try to keep them at bay.



I do still weigh and measure 90-95% of all the food I eat, and realize I will probably always have to do that. Also, I use a salad or luncheon plate most of the time so I feel like I'm eating a lot of food.



I love these discussions! Thanks Gina!

Very interesting topic Gina.  I have seen lots of discussion on this and always enjoy reading what others have to say.  So, here is my two cents and that's about all it is worth because I have no documents to back it up!!

I think the stomach does stretch back out some or we would continue to eat the very small portions that we had right after surgery.  I think how much depends on how we treat it and how small it was made during our surgery.  Some surgeons tend to make them smaller and some larger.  I don't think we could stretch it back to where it was before surgery because I see people that go back to the basics after having a gain and they still have the full sensation after having dense protein. 

I know if I pick the wrong foods, I can eat alot.  Like Ice Cream and potato chips both go down really easy and don't fill me up at all.  So I think we still have to depend on some self control which is harder at some times than others.  Drinking with meals-RNY-(which I still do not do) will wash the food right out and allow you to eat more.  Some say this will stretch the opening at the end of the pouch - I have no idea and don't want to find out.

I get a runny nose as my full signal.  Yesterday DH grilled pork chops and they were so good.  I cut a whole pork chop up in small bites and just kept on eating way past my full signal and was in pain. 

My NUT is not on board with protein drinks, but I still do 3 a day.  They do fill me up and keep my hands occupied in a better way than eating chips and ice cream!!

Can't wait to read what others say.

Linda

When I was early post op, I used to get a runny nose too.  It lasted almost 1 year.  I miss it.  I wish I still did. 

Good question Gina!  I don't know if anyone will agree with me BUT......

I believe your pouch can stretch over time.  I think all of us start eating more as we reach goal and start on mainteance but I think starting slow is one of the keys to being successful.  If you start out eating 2 or 3 oz. then you might be eating 5 or 6 oz. of protein plus other foods per meal later on.

My sister-in-law never understood what was expected of her to be successful and she can eat practically what she did before WLS and of course she has gained most of her weight back and she has all kinds of health problems.

From doing M&M for so long I've noticed that the posters that start out eating dense protein and getting their protein from food can eat a lot more at a meal than I can.  I've also noticed that the posters who eat 3 meals a day compared to small meals and snacks seem to struggle more.

I still have a lot of restriction and get the hiccups (which I think of as a blessing), I  also still get very uncomfortable if I don't listen. I can still only eat 2 oz. of dense protein like steak and pork. When I'm at home I might eat a couple bites while I'm cooking and then a couple of bites during the meal so.  If chicken is moist I can usually eat most of the meat on a drumstick and part of a thigh in one sitting which is probably about 3 oz.  but I usually don't have any room for anything else so that is my entire meal.

I've also found that if start eating earlier in the day I'm able to eat more at dinner so my restriction is different every day.

I rely on Protein drinks for my Protein.  I don't feel like suffering trying to get enough dense protein in (or in my opinion...stretching my pouch).  I also don't like having to add up my totals.  It makes me feel like I'm on WW again. 

I've also noticed the longer I go without drinking liquid prior to eating, the better my restriction...also the later in the day I begin eating/drinking once awake, the better the restriction the remainder of the day. 

I read that post a couple years ago about the longer we go w/o liquid prior to eating, the better the restriction because our pouches are dry.  I tried it, and it works for me.  I was told on the RNY board our pouches cannot get dry.  Whatever the cause, it definitely works, and it is very interesting how our restriction fluctuates.  Some days I think I'm ruined....but the next day I can hardly eat anything. 

 My middle daughter invited us for dinner Sat.  My husband made a strawberry yogurt bundt cake.  I have had it one other time.  I ate 4 bites of that cake, and the cake balled up in my pouch and got stuck.  I immediately became sick and needed to throw up.  That has not happened to me in over a year, at least.   This is such a strange and interesting journey at times. 

Pouch Dryness...that's interesting.  I'll have to pay attention to that when my restriction is tighter than usual.