Question:
Worst Case Senario

I had surgery in September. I have lost a little over 70 lbs. I do not dump, therefore can eat anything. I haven't dealt with the food control issues, or the emotional issues of food in my life. I never considered myself bulimic before, but now, if I overeat and feel uncomfortable, I make myself throw up. I can't tolerate vitamins, they stick and come back up up. I know I'm not getting in enough protein and probably enough water. I acknowledge all these problems and I am going to get help, so please don't tell me to do that. What I am wanting to know from you is what kind of damage can I do by this behavior to my pouch? I've always been a closet eater and I think I am just finding a way to "sneak" all my old crutches, like chips and crackers, and then I feel guilty or sick because I've eaten too much, so I throw it up. I'm getting scared. I hope everyone who is reading this understands that this surgery WILL NOT do the work for you and if you're doc doesn't require a psych evaluation, maybe you should get one anyway. I wish I would have.    — [Anonymous] (posted on January 1, 2002)

January 1, 2002
I am so glad you asked this question. I cannot answer you. But your statement that this surgery does not cure every ill, is true and profound. I wish you so much luck and I am so happy to hear that you are going to seek help. As for your vitamins , I used to have issues with them , so I took one a day-just the plain ones with nothing added. They are small and odorless I took 2 or 3 a day until I was able to move on to something more complete. Good luck and God bless you.
   — Rose A.

January 1, 2002
Hi there, I'm sorry to hear you are struggling. I am not post-op but I work with clients who have bulimia and I have to tell you that some of the side effects of that disorder are erosion of teeth, electrolyte imbalance resulting in heart failure, throat ulcers, swelling, retaining water, poor self esteem, shame, and guilt. I don't want to scare you but I would highly recommend that you speak with your doctor and get some counseling. I will say a prayer for you for strength and I think as one of the posters said before, recognizing you have a problem is half the problem. The good news is that the problems you are having can be helped and you can feel better. you are awesome and deserve to be well and healthy.
   — psychdoc B.

January 1, 2002
I don't want to second guess anything here and if you beleive you have issues then I'm glad you are addressing them. However, I think it's possible that some of your fears and concerns come from diet mentality. Are you really eating too many chips? Has your overall calorie intake jumped too high? I eat chips occasionally, and sweets occasionally too. This is part of life. It's a treat, but I have frequent treats. They are always small and I always get my protein first. Sometimes I feel really bad about it but then I remember that I'm human. It was very hard for me to get my protein in early on. Heck, it was hard to get anything in consistently. I'm just getting the hang of it now at six months. If the vitamins aren't staying down, try a different kind. Specifically regarding the vomitting. It's not really the same as with a normal stomach. It's not as dangerous in terms of the stomach acids because your new stomach has much less acid period. I think you need to look at the feelings around it. Do you feel guilty about eating too much and find that throwing up releives the guilt? Or is it really more of a physical response. I think I threw up at least twice a week for the first 4.5 months. Somehow between Thanksgiving and Christmas, I finally learned how to stop and when. Again, I'm not excusing or recommending these things. I'm reminding us all that we are human. This surgery is not something you fail at with every mistake. You are succeeding right now. Love that success and build upon it. Look at how well you're doing even with all your slips. The hardest lesson for me has been not beating myself up anymore.
   — kcanges

January 1, 2002
Hi there: Don't be so hard on yourself. Sounds like you are addressing your food weaknesses head on....THAT'S GREAT!! I am almost 5 mos post op RNY distal....I have good days where I stay right on track(kind of :) and days where all I want is JUNK...WE ARE ONLY HUMAN AND ONLY HAVE SO MUCH BUILT IN WILLPOWER. I find that when I want to be "BAD" WITH FOOD, I make myself a half piece of toast with peanut butter and jelly....great snack and it gets me past the sweet craving....my other favorite snack is peanut butter cookies.....1 cup peanut butter(xtra crunchy) 1 cup splenda 1 egg....bake 350 10-12 mins....LOTS OF PROTEIN
   — Joi G.

January 1, 2002
I know I make bad choices but try to eat the right things. Were ONLY human, and none of us are perfect. Now I never intentionally throw up. You concern appears to be about the possiblity of long term pouch damage. This question will be best answered by your surgeon. But I will ask at wednesdays support group meeting and post what answer I get. If your a RNY the lack of acid may make make such behavior less risky, but still not a good idea. In any case your surgeon should be made aware of the problem, they may have a specalist who could help. Frankly I think ALL surgery patients should be seen by a psych doctor, for every patients safety.
   — bob-haller

January 2, 2002
have you thought about joining a support group? as for the vitamins try a liquid form somtimes they taste that great but if they are all you can keep down, you need your vitamins. good luck amber
   — Amber T.