Question:
Need help with physical hunger post-op

I posted the following on the message board, but am posting here as well: I could sure use some support and encouragement right now. I am 11 weeks post-op today from my RNY proximal and I have lost 35 lbs, and two dress sized. Now before you stop reading, please don't think I'm going to complain about the slowness of my loss because all things being equal, I feel great about it. However, all things are not equal and it's one of those 'things' that I need support and encouragement about. I'm nearly in tears because I'm doing everything right, but am constantly hungry - a gnawing, deep hunger. It's not head hunger - I'm not craving anything like pre-op, but I'm never without hunger, except for 10 or fifteen minutes after I finish eating. Then the hunger just grows and grows. One of my reasons for having this surgery was to beat the hunger demons. Well, guess what? I feel like I'm doing battle constantly even more than before surgery. It's ever present and only diminishes while I'm eating and for a short time afterward. I feel like I'm on a diet. I envy the post-ops who are having difficulty even eating 1 or 2 oz of anything and are never hungry. It's a hunger that I want to go away, but nothing seems to take it away. It just makes me so sad that my life post-op remains a battle ground around food/hunger instead of the lifting of the burden that I had hoped for. I could just cry. And I'm afraid I'm experiencing some sort of mechanical failure of the surgery - maybe a staple line disruption or an enlarged anastomosis? I can, but am trying not to, eat more than the 3 or 4 oz per meal that I'm allowed. Please, if anyone has some encouraging words, or wisdom, or even advice, I would welcome it. When I first began experiencing this hunger at 4 weeks post-op, the suggestion from my nutritionist was to add a bit of fat to my diet, but that didn't help and actually became a slippery slope to eating more than I should. My meals consist of the following: Breakfast: Real Meal shake; Snack: 4 oz lite yogurt or ricotta cheese; Lunch: 3 oz lean meat and 1/2 cup veggie; snack: same as morning; Dinner same as lunch; evening snack: 1/2 banana. My calories average about 650/ day; I'm drinking on average 90 oz water a day and walking every day. Thanks in advance for any thing you can offer.    — rebalspirit (posted on May 22, 2003)

May 22, 2003
Original poster here: my average calories/day are 750-850 - I don't know what I was thinking. Thanks, Robin
   — rebalspirit

May 22, 2003
Let me preface this advice by saying I am not a doctor - and don't even play one on TV, so take this with a big grain of salt... What instructions have you been given about drinking your water? If you haven't done so yet, try "water loading" - which is drinking 8 to 12 oz of water in 15-30 seconds (if you can). Then wait 15 minutes before you eat. Make sure you wait 1 1/2 or more hours after you eat before you drink again. The water you drink when not water loading can be drunk as slowly as you want. Try it and see if it makes any kind of difference. I think you'll find that you'll be well-hydrated, but that the food that goes into your tummy pouch will satisfy you longer.
   — Kathy B.

May 22, 2003
Robin, have you asked your surgeon to do an upper GI or an endoscopy on you to see if you have an intact pouch? There are a few who have enlarged stomas which do not allow the food to remain in the pouch at all. Also, if you have not been transected, there is a possibility of a staple line disruption and the little food you are eating is going directly into the old tummy and would not fill you up. Do you know if you have been transected? You first need to get it checked out-rule out any medical reason/failure with the surgery itself. You should not be so hungry just 15 minutes after eating-its almost like you haven't eaten. Your certainly eating enough calories at your stage and it seems that you are eating well. I assume that you are not drinking anything for a good 45 minutes or longer after you eat? If you were drinking with or right after your food, that would be the answer.
   — Cindy R.

May 22, 2003
Original poster again: Thanks everyone. I really appreciate people's support and suggestions. Let me answer a few questions. I was not transected, so yes, I could have and SLD. I'm planning on calling my surgeon's office tomorrow to discuss get tests run. As far at the water is going, I don't drink for at least an hour after I eat and in fact do wind up "water loading" right before I eat because I often get very busy with my work and then remember that I need to drink the rest of my cup before I can have my next meal. I don't think I have an enlarged stoma, because although I experience intense physical hunger in the pit of my old stomache, I do get the post-op "full" sensation if I've eaten too fast or taken one or two too many bites of food. I do make sure I get at least 5 small meals a day, so I know it's not that I'm going too long between eating. It's also not that I'm hungry for my favorite snack., and in fact, I can take a bite of something, get the taste and be satisfied and not "want" any more, even though I continue to feel hungry and my apetite is strong. I've had not nausea or throwing up experiences since I left the hospital. I have dumped on Atkin's bars, milk, and n/f s/f banana cream pie. So, I know somethings are different and I'm avoiding these things now. I did speak with my therapist this evening after work and she definitley is encouraging me to call my surgeon and to assertively advocate for medical testing, so that's my next step. One thing I realized in talking with my therapist is that I'm not so much down on myself as I am petrified of my hunger and my ability to remain strong and on track in the face of it. I mean I'm really scared, like I haven't been in a long time. Also, I think the other thing I'm going to do is stop eating yogurt and cheese for my snacks and switch to more lean meat protein. See if this in any way will help with curbing the hunger demons. Anyway, I appreciate your suggestions and support and just wanted to let everyone know I'm being proactive, now that I've had a good cry with my therapist. Thank you all for your help and concern. Robin
   — rebalspirit