Paranoid About Stretching Pouch

Today I had 2 doctor's appointments and I didn't eat lunch.  It was my boyfriend's birthday so we went out to eat at Outback.  Since I hadn't had anything to eat in about 8 or 9 hours I was really hungry, which is pretty rare for me.  Usually I wait for my entree and eat the meat before I have some salad but this time I couldn't wait.  I ate most of my salad, no croutons, with shredded cheese and very little dressing.  I just dipped the salad in the dressing before I ate it.  Then when my dinner came I ate all the grilled shrimp, 3 of them, and some of the steak and about 1/4 of the sweet potato with a little butter.  I don't think I have eaten that much at one time since my surgery. 
On one hand it felt good to be eating like a normal person.  I pretty much finished when everyone else did.  I feel good about my food choices and I'm not worried that I ate too much calorie wise, just volume wise. 
I am paranoid about stretching things, especially my pouch or stoma.  I usually measure everything I eat at home but when I go out to eat I just try to eat what looks like a normal amount and stop when I sense myself getting full.  I realize that my capacity is growing since I am almost 10 months out. 
Part of the paranoia is because with my first surgery I never felt much restriction and I always pushed it, trying to see how much I could eat instead of eating a small amount and seeing if I could be satisfied.  By the time I had my revision I could eat as much as I could  before surgery.  I didn't have a pouch at that time but a sleeve that my surgeon made way too large.
I did feel very full after wards but I didn't really get the too full signal until a while after I ate, not while I was eating.  I wasn't uncomfortable or in pain, I just felt full like I didn't want to eat any more.
Part of me wants reassurance that I didn't eat too much or that I won't stretch things out but the other part of me realizes that compared to pre op I ate very little.  I hardly ever left food on my plate before, even if I wasn't still hungry.

Usually, when I don't eat for a long time, then do eat, I eat too fast, feel sick, and regret the meal. SOMEtimes I eat a lot more than I expect to be able to eat. I have BIG pouch days and little pouch days. Salad squishes down to nothing much, and if you had a bit of a break between the salad and the rest of the food, you likely had a lot of stuff pass through before you ate the main course. Plus SHRIMP is so divine, I can always eat more food when I eat shirmp.... and sometimes it happens.

But stretching the pouch, as in abnormally turning it into a real-stomach-sized-monster..... that takes a LOT of effort. Like eat what you just did, then two hours, and have another meal of the same size, again and again and again, day after day, progressively larger meals, etc. Do it over months and months without relenting, yeah, you'll stretch it all out, but you aren't doing that.

When you have an abnormally large eating day or meal, it's essential that you RECOGNIZE what happened, and be ALERT to keep from seeing a return to old habits. Best time to squish a bad habit trying to return is recognize and nip it in the bud before it can reestabli****self in your life.

******LIKE BUTTON!!***

I've had those same days/meals and the same concerns.  Sometimes I just don't seem to have a full responce when I think it would happen.  Most of the time I can stop myself when out and at home I weigh and measure also.  But sometimes I feel like I could eat most of the meal without ever feeling full. 

Others report burping, nose running, sneezing.  I may burp but it is 10 min after I finish eating what I have measured, not on time to stop me if I am still eating.  I know I am eating faster, maybe that is part of the key.  Slow down to let the full response happen on time. 

I do agree, although that seems like a lot of food now, in the grand scheme of things, it isn't.  When I feel like I have eaten way too much, it is usually half of what a normal person eats.  Even when I feel I have eaten way too much when we are out to eat, what I bring home is usually 2 more meals.

Hi Tazz darlin...

Come closer...closer...a bit closer.

I'm going to tell you a secret. Don't tell anyone, k?

Your surgeon made your pouch out of the strongest part of your stomach. Think of it as the Hefty Force-flex of your stomach. THAT is what your pouch is made of.

Your stoma. It can be stretched. It does happen. Usually either a) as some unexplained phenomena or b) as a result of long-term HABITUAL overeating, drinking with meals, etc.

So what am I saying? First that your worry is normal and probably even beneficial and hopefully will come into the realm of reality someday. (At 3 years out I know my stoma is still in tact as I have an "incident" at least every few weeks still). Second, we have pretty easy to understand rules to avoid stoma stretching. Don't drink with your meals. Don't eat too much at a time to where you are uncomfortable. You do that you should be ok.

If you are not ok it's probably a freak accident over which you couldn't have had any control.

Hugs. Now don't tell anybody what I told you!!!!

Yeah... everything Nik said. 

Also, my surgeon told me that of all the times she has gone in to look at the pouch and stoma of  a RNY patient who is regaining weight (and swears they are eating properly so it MUST be an issue with  the pouch or stoma), the pouch and stoma are boht "within normal limits" the vast majority of the time.  I forget what her actual statistic was, but it was more than 80%.

Fear not...  As long as you are not routinely abusing your pouch, you are almost certainly just fine!

Lora

I am so pleased to see this thread, and all the sensible responses. At last.

I went through the first three months post-op just quietly terrified that if I didn't eat micro portions perfectly pureed I would undo all the benefits of my surgery by stretching out my stoma. I finally asked my surgeon the last time I saw her about how it could be that drinking with meals would stretch out my stoma, when liquids just kind of ran through it, since there's no pyloric valve to hold them back.
I mean, slider foods can't make you full, bu****er can?
She looked at me like I was just a wee bit retarded and asked my why I thought that liquids would stretch out my stoma, and I said, "Isn't that why we can't drink with meals? Because it forces food though the opening and stretches the stoma?

Uh... no. It's because if you wash the food through your pouch too fast, you're likely to feel hungry sooner. Let it sit for a while, give yourself a chance to feel full. If you keep washing it out with liquids, you won't have the experience of fullness, and you are more likely going to head back to the kitchen in an hour.

Then what about stretching the stoma?

Basically, she explained what you have all expressed already. Once it's healed completely, the pouch is a fairly tough little sack. You can stretch it out, but it would take an almost deliberate effort, repeated regularly over time. (I personally think one of the reasons they do the pre-op diet, along with the stated one of shrinking the liver, is to identify people who are truly unable to restrict their eating in any way. If someone had a compulsion to eat that was literally uncontrollable, they could very well hurt themselves post op trying to force food into a stoma that couldn't handle it.) She reiterated that the vast majority of regains were from snacking all day - grazing - and/or high fat high carb eating. The usual suspects.