Question:
What exactly is the stoma?

Can the stoma be too small or too large. Also, how do you know if it is too large. I feel like I can eat a lot! For example I can eat an 8oz steak. My surgery was 8/24/02. So far I've lost 70 lbs. I have a protien drink everyday, minimum of 64 oz of fluids, 95% of my meals are protien. I do not eat sugar or caffiene. I workout 6 days a week at Curves and I walk at least 1 mile 5 days a week and do a Richard Simmons video 2 times a week. I have lost several inches all around, but My doc says I'm about 40 lbs behind in weight loss. He says I'm just on a really bad plateau and not to worry about. Of course he won't worry about it..but I am discouraged! I feel like I'm working so much harder than the average postie. Help! What can I do?    — Arlene C. (posted on March 13, 2003)

March 12, 2003
Yes, the 'stoma' can be to small or to large. To small... you get what they call 'stricture' where food and liquid cant pass, and the person has to get scoped and have the opening 'widened'. To large... yes. (something I have) If you have to large a stoma food falls out of the pouch; in my case, I have no pouch function, the upper gi showed food was going directly into the itnestines. This prohibits food limitations you normally get in a regular RNY and you can 'basically' overeat. This does not nulify the malabortion part of the RNY so you will continue to loose weight... during your 'honeymoon' phase. When I started research on this problem, there was very little out there. I finally got some response from the American Bariatric ASsociation. basically they stated surgeons have known about this problem for years, have had little success in fixing it, so they dont. and MOST surgeons revert their patients to 'diet and excericise'. From what I have gatherd... having the DS has really 'bypassed' this problem. Its only a RNY problem. My surgeon would only consider triing to do something if I gained weight... which didnt happened until about 15 months post. Personally, I have found this to be a nightmare. The tool everyone states you have is basically diffective, you have to refert to diet and excerice which EVERYONE here has failed to do PRE OP thats why you have the surgery in the first place. Sorry Im not more possitive, but its very hard. Im seldom ever hungry which is good; but NEVER full when I eat....at least pre op you got full at some point. But, to answer your question... first thing you have to do is see if you really have this problem. Have your surgeon order an upper gi test... this will tell if you have pouch function.
   — star .

March 13, 2003
No wonder you are discouraged- b/c your doctor told you you're not on track! As my surgeon admits honestly to me, he is a surgeon and not a dietician, so he doesn't know everything, the rest we findo ut from his dietician or RN. But for him to say that 70 isn't enough in 6 months, right? I think that is wrong, we all lose at different paces, and you cannot compare weight loss and say you should have lost 40 more by now. Would you have been as worried if he said you were doing great? (Which he should've b/c you are!) Keep doing what you are doing, and you probably are on a plateau, so it will pass. ANd you mentioned that you lost alot of inches, to me that is more important, since muscle weighs more than fat, and with exercising you are gaining muscle! Maybe you can change things up a little, our bodies get used to food and exercise quickly, so it can just stop working for us sometimes. At curves, try a different routine, and try eating differently, not better, just different. You are working your butt off, maybe cut down a little, see if that helps? Our bodies work in strange ways sometimes. <p> You probably should get your stomach checked just in case. But you can also eat more because the honeymoon period is over, and now it becomes more of a tool. Also, you exercise liek crazy, that is going to work up an appetite, and you should be eating more than a person who doesn't exercise- your body needs fuel to burn! You are doing great- you should really be proud of yourself!
   — Lezlie Y.