S.O.S. REQUESTING HELP WITH A REAL CONCERN

Maureen - Did they transect your pouch or is it attached to your old stomach? The reason I ask is because I wonder if you have a staple line abruption and the food is going into the old stomach? Other than that it could be something like too large a stoma. Something I think you need to discuss with your surgeon. I would do two things. First, I would start logging everything I ate on fitday.com for awhile. Get an idea of how much you are eating. Second I would do the cottage cheese test and see how much you can eat before getting full. Just keep eating out of that tub. You could certainly have a real situation here that might need attention. What I'm thinking though is that you have a larger pouch like me, and that you might have a little bit enlarged stoma which keeps you from having food stick. My method of eating is so much different than many others. I eat quickly so as to fill my pouch up. I do get hungry between meals, but I try to focus my attention on protein when I feel that way and sometimes I ignore my hunger. I am used to that anyway. The thing I'm trying to focus on for me is that although I don't feel I have as much restriction as others who are doing better than me, I still have some things that make it easier for me to lose. If nothing else, I can fast now and not feel incredibly sick. Hunger I can handle, intense nausea I cannot. I am just having a feeling that you are looking at more of a 4 oz pouch like me (which mine seems to be more like 5 or 6 oz now). If that is the case, I would say talk to your doctor first, but then go ahead and increase your portions to satiate you for longer periods of time. Just make wise low-calorie choices. I am not allowed to eat between meals per my doctor's instructions, so I try to make my meals count. Heck, I was able to eat a Lean Cuisine 8 oz dinner yesterday without a problem. True, there was probably 2 oz of gravy there, but still....no discomfort. I did finally get that full feeling, but it took that much. What I'm taking from that is I'm not going to have as intense a tool as everyone else, but it's still a tool I can use. I just have to be wise about what I eat and focus on not snacking. Let us know if you try the cottage cheese test. I'm really curious as to how it turns out for you... Dina

Thanks, as always, for your insight Dina. Just before surgery I asked my surgeon how big my pouch would end up being. He said, "As small as I can make it." After surgery, he told me I would be able to hold 2 oz. of food, no more. I suspect it might be more of a stoma issue. My typical day of eating goes something like this: A.M. 1 scrambled egg w/1 oz. LF cheese AND 1 Healthy Choice sausage patty LUNCH: 1 c. chili beans w/1 oz. LF cheese, melted DINNER: last night was about a 4 oz. burger patty w/out the bun, and some finger veggies Otherwise I sip on water all day trying to get it all in. Once I understand the cottage cheese test and how it works, I will give it a try. Thanks again. Maureen

Maureen - the cottage cheese test is easy. Get a container of cottage cheese...brand new. Start eating out of that container and don't stop until you feel full (but not uncomfortable and ready to huck). When you are done, pour water or milk into the container and fill it to the level of where you started. I would leave an edge around the container of the cottage cheese so you can see where it fills to. Then you dump the liquid into a measuring cup and see how much you ate. That then is the volume of your pouch. Once you understand how large your pouch is, then you can work your meals around that. Dina

Oh - and I've heard it should be large curd and you should eat it as quick as you can....Dina

Ok, I'll give it a try. Thanks! M.

Hi Reenie: Here are just a few bits that might help you out. The first is a post that one of the physicians that practices with my dr posted on our forum with regard to the "cottage cheese test." "cottage cheese test the "cottage cheese test" as noted on many, many sites is always subject to the variable that the outlet of the stomach softens, therefore allowing more substance (food, cottage cheese, water) to exit into the roux limb. Some surgeons have even called this a 'second stomach'. Therefore, when using this test, so much may/does leave the stomach before the 'end point' that there is NO accuracy whatsoever to measuring what is left in the container. Next, all general surgeons who operate on stomachs know that it is extremely rare for the pouch to stretch out permanantly, this is supported by xray. My own personal experience on reconstructive and revisional operations on pts operated on prior to '95 all the way back to the originals from '79 reveal the measured old pouch to be the same size as noted in the original operative note from those dates. Please do not ever attempt to stuff your pouch and this includes the highly ineffective cottage cheese test." The next thing is... I am very much like you, I CAN eat more than I should. I don't have problems with most foods unless I eat too fast or don't chew well enough. My physician told me that the relearning of how much to eat is crucial and even though I may be able to eat more that does not mean I should. I was eating from a plate but since I heard that I have switched to eating from 3oz dixie cups that I picked up at Costco. It has helped me to eat slower and to feel more satisfied. Also, I follow their recommendation of 70% protein and 30% vegetables. No fruit, bread, sweets, etc. Except when I cheat of course, which I have, and that is how I know that I do not dump Anyway, sorry to go on so long. Just wanted to let you know that I can relate and it a little harder when things go down easily but the truth is it happens to everyone eventually and hopefully we are able to use the skills and support we have now to develop good habits. Best Wishes, Angela

I use the glass custard cups for most of my meals. I will occasionally use one of those tv dinner plates my MIL has saved when I need to. I guess the key here is to realize that we don't need to feel full. The difference in how we ate before and how we eat now is that we aren't eating to fill up - we're eating to satisfy and satiate. I get satiated on less than it takes to fill me up. Dina

Thanks, Angela. Your response is very informative and gave me a lot to think about. If I were to be truly honest with myself, I would have to admit that I have not changed the way I approach eating, that is, slowing down, being mindful of portions and chewing. I've done all of this to some extent but not the way I should be behaving. Good habits are the key. I wonder if perhaps I have enlarged my stoma because I haven't been eating exactly according to protocol. Maureen

Maureen, I'll share why my surgeon has us do (Not that I always do this), but you probably already know this stuff. We are to sit down at the table with our meal and no distractions. No TV, no kids, no dogs in my case and no phone. We can have soft music in the background. The meal should take no longer than 20 minutes. Bites are dime sized and you pause between each bite. You have to really pay attention to what is going on and how you feel. We're not supposed to eat to the point of being stuffed or even full, but stop when we are no longer hungry. It took me at least a month to get the hang of this. She also says only 3 meals a day, but I get hungry about every 4 or 5 hours so I have a protein shake at about 9:00 or 10:00 at night. One other thing that I've found is that I really do get hungrier sooner if I don't follow the water rule. Nothing to drink 30 minutes before and 30 minutes after a meal. I've found that denser proteins like pork roast or tenderloin or chicken fill me up faster and stay with me longer. Eating things like yogurt or refried beans and expecting not to be hungry soon after is just silliness for me. I'm not eating many fruits or vegetables only because I'm filling up on protein and don't have room. Just a thought, are you weighing and measuring your foods or eyeballing it? I know that I'm a horrible judge when it comes to figuring out how many ounces something is. Maybe you're not eating as much as you think you are. Connie

Thanks, Connie. Although I've read about the behavior you describe, I certainly haven't subscribed to it. I just have to get honest with myself. I still eat while watching television and I certainly don't take my time. This is the crux of the matter for me, I think, and I will consciously try to do better today. THANKS EVERYONE FOR HELPING ME OUT WITH THIS ONE. Maureen