Why such variability in perceived pouch size?

Ramie A.
on 4/2/12 6:44 am - Bronx, New York, NY

It is my understanding that most doctors make RNY pouches about the same size for everyone. So, after the swelling goes down and you are fully recovered, say, 6-8 months postop, why is there so much variability in how much food can be eaten at one sitting? I read on here that some people can barely eat half a 6-inch sub -- and then I assume they stop because they are FULL and more would make them vomit, feel awful, bloated, etc. Then there are some (me included) who could easily eat a 6 inch sub (plus more sometimes) and feel perfectly comfortable. Full, but not uncomfortably full. (This isn't a discussion about "Just because we CAN eat it, it doesn't mean we SHOULD.")

Anybody have any ideas of why we are all so vastly different if our pouches are made approximately the same size?

Thanks!

Lapband Nov 2006; revision to RNY 8/17/2011
5'3", HW: 205 / Consult: 189 / SW: 184 / CW: 140 / GW: 130

nfarris79
on 4/2/12 6:52 am - Germantown, MD

RNY on 04/13/11

I'm not sure if it's a pouch-size thing but a food-density thing. E.G. veggies chew down to nothing, breads are easy to condense but proteins take a while to chew & have staying-power. For me, I do have "big pouch days" and "small pouch days", but I think that has more to do with perception than actual pouch size. Though thru the healing process, swelling goes down & it just gets easier to get more in.

First ultra: Stone Mill 50 miler 11/15/14 13:44:38, First Full Marathon: Marine Corps 10/27/13 4:57:11, Half Marathon PR 2:04:43 at Shamrock VA Beach Half-Marathon, 12/2/12 First Half-Marathon 2:32:47, 5K PR Run Under the Lights 5K 27:23 on 11/23/13, 10K PR 52:53 Pike's Peek 10K 4/21/13, (1st timed run) Accumen 8K 51:09 10/14/12.

Ramie A.
on 4/2/12 7:03 am - Bronx, New York, NY

RNY on 08/17/11

I didn't state my question clear enough: if you and me have the same pouch size, are many months (or years) out from surgery, and are eating the same exact thing (whatever that is) why can YOU eat only half of something, when I can eat the whole thing?

My question is about variability between different people, not between different meals in the same person.

Thanks for the quick comment though!

Lapband Nov 2006; revision to RNY 8/17/2011
5'3", HW: 205 / Consult: 189 / SW: 184 / CW: 140 / GW: 130

nfarris79
on 4/2/12 7:05 am - Germantown, MD

RNY on 04/13/11

I still wonder if it's perception or tolerance. Like pain tolerence? Or possibly how nerves grew back, making increased sensitivity to fullness or not? I honestly have no idea, just putting my opinion out there.

First ultra: Stone Mill 50 miler 11/15/14 13:44:38, First Full Marathon: Marine Corps 10/27/13 4:57:11, Half Marathon PR 2:04:43 at Shamrock VA Beach Half-Marathon, 12/2/12 First Half-Marathon 2:32:47, 5K PR Run Under the Lights 5K 27:23 on 11/23/13, 10K PR 52:53 Pike's Peek 10K 4/21/13, (1st timed run) Accumen 8K 51:09 10/14/12.

Ramie A.
on 4/2/12 7:12 am, edited 4/2/12 7:12 am - Bronx, New York, NY

RNY on 08/17/11

That's definitely a possibility -- like differences in pain tolerance, we have differences in pouch fullness tolerance.

On a separate note, I personally think that people who have had a lap band before have a higher tolerance for more food in the pouch. The reason is that when we had the band we stretched the heck out of the upper part of the stomach, above the band. Of course, that doesn't explain why one "virgin" RNY has a different sensitivity to fullness than another "virgin" RNY person.

Lapband Nov 2006; revision to RNY 8/17/2011
5'3", HW: 205 / Consult: 189 / SW: 184 / CW: 140 / GW: 130

slashes
on 4/2/12 6:59 am

That was a great question !!

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RNY: 01-23-2012 Weight day of Surgery - 286lbs ~ Weight as of 09-13-2013 164lbs

Cicerogirl, The PhD
Version
on 4/2/12 7:16 am - OH

RNY on 08/27/07

I think it is caused by a number of factors. First, there probably would have been the same issue when we had our natural stomachs... Due to differences in how much each person's stomach stretches and how attuned we are (or are not) to fullness signals, one person could eat 3 slices of pizza and someone else could eat 6. Second, I think Nicole is correct that some people are more aware of fullness signals. Third, while the pouch size and stoma size may be somewhat standardized, because of scar tissue on the stoma, some people may have a tighter stoma which would then not allow food to escape the pouch as easily/quickly and therefore they would be ae to eat less than someone with a larger stoma or one without scar tissue.

Also, some people eat until completely full (that "one more bite and I will be sick" point and some people only eat until they are molonger hungry. That alone could be a significant difference in amount.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Dee.spunk
on 4/2/12 7:16 am - Sacramento, CA

RNY on 11/30/11

Ha! I'm a "virgin" again then...

Height:5'1.5 RNY:11/30/11 HW:307 SW:234 CW:136 GW:140 (LOST 73 Lbs. PRE-OP)

poet_kelly
on 4/2/12 7:46 am - OH

RNY on 11/04/08

I don't know for sure. My guess is that, while the pouch stretches slightly over time and is supposed to, it might stretch more slowly for some people. Like, at one year out, most people seem to be able to eat one to one and a half cups of food. But at three months out, some people can only eat 1/4 cup and some can eat 1/2 cup. Or more. So we mostly seem to end up in the same place but some take longer to get there.

Some people might chew more thoroughly than others, too. We're supposed to chew well, but I bet we can eat more if we chew really well. It would go through the stoma easier, you know.

And it would depend a bit on what we're eating. I can eat a six inch sub, minus just a little bit of the bread. But I don't eat meat. So my sub would be bread, veggies and a slice of cheese. I bet if it had some meat on it, I wouldn't be able to eat as much.

Kelly

Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.

lish249
on 4/2/12 10:11 am - OH

RNY on 03/12/12

Lol Dee.

Great question.
This site is amazing and so comforting at times!!

So glad there are so many awesome people on here

Why such variability in perceived pouch size?

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Why such variability in perceived pouch size?