tracyringo

Restriction after 18 months

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I am just curious to learn about others and the restriction they have after 18 months and onward.   Early on I didn't see how I was ever going to get enough in and to be honest it hasn't changed much more then when I was at 10 months out.  I was told that we would be full sized at 18 months and I still have a hard time eating a tuna creation packet and 1/2 cup of cottage cheese for lunch or 1 egg and a turkey sausage for breakfast.  I am not complaining I am happy for the restriction I have, I am just curious to what others have this far out or further.

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2 hours ago, tracyringo said:

I am just curious to learn about others and the restriction they have after 18 months and onward.   Early on I didn't see how I was ever going to get enough in and to be honest it hasn't changed much more then when I was at 10 months out.  I was told that we would be full sized at 18 months and I still have a hard time eating a tuna creation packet and 1/2 cup of cottage cheese for lunch or 1 egg and a turkey sausage for breakfast.  I am not complaining I am happy for the restriction I have, I am just curious to what others have this far out or further.

Tracy, I don't sense that my post-VSG stomach is much different now (2 years) than it was at 6 months or so. I cook an amount of food for dinner most nights that is at my limit for being full, since I often don't finish it: typically 50 g of farro, 50 grams of lentils, with 300 g of chicken broth, some sauteed garlic and maybe some defatted sausage or hamburger meat - am sure it is less than 2 cups (500 cc) by volume. I'm 6' 2+" inches, not 5'6".  At this point I remain a cheap date by food volume standards!

 

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I can generally only eat around 100-150g protien, so two eggs, or two chicken wings, half a scotch fillet steak, maybe two thin sausages, one hamburger etc....I think you get the measure from that. I also eat probably around a cup of vegetables.  If I eat the veggies first then I'll get the meat in, but if I eat the meat first then I can't always fit the veggies in. I'm RNY though, and we are different to you sleevers because we don't have to wait for the pyloric valve to open so out food releases into the intestine.

If your still feeling good restriction then take that as the reward for having good portion control. 

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2 hours ago, Aussie Bear said:

I can generally only eat around 100-150g protien, so two eggs, or two chicken wings, half a scotch fillet steak, maybe two thin sausages, one hamburger etc....I think you get the measure from that. I also eat probably around a cup of vegetables.  If I eat the veggies first then I'll get the meat in, but if I eat the meat first then I can't always fit the veggies in. I'm RNY though, and we are different to you sleevers because we don't have to wait for the pyloric valve to open so out food releases into the intestine.

If your still feeling good restriction then take that as the reward for having good portion control. 

I have awful pain if I eat one bite over and I don't see that ever changing, which is a good thing.  That valve saves me but you are saying that your food pushes right on through into the intestines right away?  So if Rny ers over eat there is nothing to stop them from doing it?

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9 hours ago, tracyringo said:

I have awful pain if I eat one bite over and I don't see that ever changing, which is a good thing.  That valve saves me but you are saying that your food pushes right on through into the intestines right away?  So if Rny ers over eat there is nothing to stop them from doing it?

That's why they say dense protien first. That tends to fill the pouch and hang around for a bit. Other stuff though....well for me at least.....it's straight through into the intestine. We have about a 10mm opening o the intestine that fluids flow straight through...you guys have a valve that has to open before anything can move through. That's also why with bypass we can drink right up until we eat.

I'm unsure though if or how my revision makes me different. I was told I'd have a smaller pouch by necessity, but to compensate for that my opening to the intestine would be larger. I've only over-eaten (maybe under-chewed) once.....that was last year on Christmas Eve....oh the pain!!!! I vowed never do do that again even though it was purely accidental. A couple of days later I felt the same pain with just my morning latte in my stomach when I took my vitamins. I'm gathering from what I've since learned that the pouch becomes very irritated and swollen when it's limits have been tested and it's wise to return to a liquid only diet for a few days to let it calm down....given for me the next day was Christmas Day that was never going to happen anyway, and I probably just made matters worse!!!  I manage my food volume by dishing up the correct amount for me in tbe first place, and no going back for more. Eating out is a bit more difficult,  but I do find that by eating more slowly than others, by the time they finish what's on their plates, I'm pretty much done..... so just get my plate removed with theirs. That way I also don't hold up their other courses.

I also can't throw up after a meal. I've always assumed that's because the food has already passed out of the stomach pouch and into the intestine.  A surgeon, not my own, recently told me that is most likely the reason.

Edited by Aussie Bear

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18 hours ago, tracyringo said:

I have awful pain if I eat one bite over and I don't see that ever changing, which is a good thing.  That valve saves me but you are saying that your food pushes right on through into the intestines right away?  So if Rny ers over eat there is nothing to stop them from doing it?

I believe that soft food can push right through. I could easily overeat something like yogurt or cottage cheese. Dense protein though...I can eat about 4.5 ounces in a sitting. Anything more than that and I'd be in pain. I can eat more than I could at say 6 months out, for sure. But I don't push the envelope with dense protein, ever, and very rarely with yogurt, etc. I believe the lack of a valve ALLOWS for foods to push through, but if you follow the no drinking with meals rule, it won't. I don't drink for an hour after I eat, and sometimes even then I'm still kind of full. I think it's awesome that you still have as much restriction as you do. I still have quite a bit, but I felt it relax a bit after probably the 15-18 month mark. After my knee surgery and gastritis though, my pouch feels brand new...with all "new" restriction. 

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21 hours ago, Aussie Bear said:

I can generally only eat around 100-150g protien, so two eggs, or two chicken wings, half a scotch fillet steak, maybe two thin sausages, one hamburger etc....I think you get the measure from that. I also eat probably around a cup of vegetables.  If I eat the veggies first then I'll get the meat in, but if I eat the meat first then I can't always fit the veggies in. I'm RNY though, and we are different to you sleevers because we don't have to wait for the pyloric valve to open so out food releases into the intestine.

If your still feeling good restriction then take that as the reward for having good portion control. 

That's about my limit too, @Aussie Bear...I eat 2 eggs with a melted slice of cheese for breakfast and it fills me right up. I can eat a full 4 ounces of protein for my dinner, and still add some soft cooked veggies too. Maybe 1/4-1/2 cup, depending on the meat I choose.

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26 minutes ago, Nana Trish said:

That's about my limit too, @Aussie Bear...I eat 2 eggs with a melted slice of cheese for breakfast and it fills me right up. I can eat a full 4 ounces of protein for my dinner, and still add some soft cooked veggies too. Maybe 1/4-1/2 cup, depending on the meat I choose.

Hmmmmmm, this is interesting to me.   I could maybe eat the 2 eggs and cheese, but no way could I eat 4 oz of protein and the veggies too.  Yesterday I ate 4 oz of salmon with nothing else and was stuffed and it was sooooooooooo good !!  I get what you are saying about the meat type, had I been eating steak I would have only been able to eat 3 oz.

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32 minutes ago, tracyringo said:

Hmmmmmm, this is interesting to me.   I could maybe eat the 2 eggs and cheese, but no way could I eat 4 oz of protein and the veggies too.  Yesterday I ate 4 oz of salmon with nothing else and was stuffed and it was sooooooooooo good !!  I get what you are saying about the meat type, had I been eating steak I would have only been able to eat 3 oz.

I just recently (the last couple of months) started adding in veggies. I couldn’t do it before then. And I can’t always do it, lol. When I can, I do. It’s like a treat if you can believe that! And yeah, if I was eating steak, I couldn’t do 4 ounces of that either. I can eat red meat now, after all this time, but still less of it than fish or chicken. I think it’s fantastic that you still have that kind of restriction!! I’m not going to say I wish I did though. I’m very happy and comfortable with what I can eat. But I still weigh/measure everything I eat at home, and I’m pretty good at eyeballing it when we dine out. I’m comfortable with my portion sizes because when I’m done, I’m done...no going back for seconds. 

Salmon is one of my favorites, on and off, lol. My pouch has a love/hate relationship with it, and I can eat it about 6 months out of the year. The other half of the year, it will yell at me if I try to eat it, and it will either get stuck or make me sick. I still haven’t figured that one out yet... :) 

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I’m laughing pretty hard as I type this...I made pork loin for dinner tonight, measured out 4.5 ounces of it, and I could only eat half of it :lol:

I can’t ALWAYS eat that much, lol

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So, I don't have pain when I overeat... just a sense of pressure in my chest, and then every mucus-emitter in my head lets the floodgates open.  It sucks.

I basically stop eating when the first burp happens.  Just before if I can manage it, but sometimes I "miss" and overshoot by a bite or two.

I can eat a full container of yogurt or cottage cheese now (5.3 oz usually).  I can eat one chicken leg, if I skip the skin.  I can eat about a half-inch slice of pork loin, or half the meat in a large burger.  I can eat one scrambled egg if it's on one of the 50% of days that my stomach doesn't reject eggs, but I couldn't eat two. I can't reliably eat chicken white meat at all, so I usually don't try.

But honestly, 90% of my food is still mush, just because it's easier.  Yogurt, cottage cheese, string cheese, protein shakes, protein bars (kirkland), eggs, every now and then a bowl of oatmeal (single packet, low sugar) if I feel I need more fiber.  I generally don't try any solid protein until dinner time, because dinner is the only meal I regularly eat with (and cook for) multiple people.  I just never really feel like cooking JUST for one. 

I can definitely eat more now than I could at 6 months - I couldn't even finish a cup of yogurt at that point!  But the amount hasn't increased to a point that worries me.  :)

 

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This popped up on my YouTube last night and was very interesting regarding restriction changes. Definitely worth watching.

 

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18 hours ago, Aussie Bear said:

This popped up on my YouTube last night and was very interesting regarding restriction changes. Definitely worth watching.

 

I’m not a big fan of this guy as a rule, but there was a lot of good info in this video. Just like I posted above, I chose to add veggies to my meal with the ability to eat a little more in a sitting. I always eat my protein first, but I see nothing wrong with adding a 1/4 cup of soft cooked veggies in after that. I haven’t been worried that my pouch was stretching, and I’m glad I didn’t waste my time worrying about that, lol. Thanks for posting this, Aussie :) 

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6 hours ago, Nana Trish said:

I’m not a big fan of this guy as a rule, but there was a lot of good info in this video. Just like I posted above, I chose to add veggies to my meal with the ability to eat a little more in a sitting. I always eat my protein first, but I see nothing wrong with adding a 1/4 cup of soft cooked veggies in after that. I haven’t been worried that my pouch was stretching, and I’m glad I didn’t waste my time worrying about that, lol. Thanks for posting this, Aussie :) 

I'm not a great fan of his  "pound of cure" diet, but I do find much of his actual surgery information sessions quite informative.  The further I move away from my surgery the more I tend to agree with him. He definitely has an interesting stance on revisional surgery,  one that I very much agree with but would put him at odds with many surgeon's happy to make the bucks from revisions without really caring that there may be nothing in them for their patients. That's a bit of a soapbox issue for me I'm afraid.

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On 3/26/2019 at 6:56 PM, Aussie Bear said:

I'm not a great fan of his  "pound of cure" diet, but I do find much of his actual surgery information sessions quite informative.  The further I move away from my surgery the more I tend to agree with him. He definitely has an interesting stance on revisional surgery,  one that I very much agree with but would put him at odds with many surgeon's happy to make the bucks from revisions without really caring that there may be nothing in them for their patients. That's a bit of a soapbox issue for me I'm afraid.

I know my surgeon has the same views on revisional surgery. As he would put it, you get one bite of the apple. He says that revisions, in his practice, are only done in cases where the original surgery actually doesn't work, or when there are problems like you had. He will not do a revision because you have regained weight because you have failed to follow the post surgical guidelines. But you're right, there are a lot of surgeons out there that will happily take your money and keep doing surgery every time you gain the weight back. 

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1 hour ago, Nana Trish said:

But you're right, there are a lot of surgeons out there that will happily take your money and keep doing surgery every time you gain the weight back. 

They really are just meeting their patients demands though which is really sad as well. I was talking to someone a few months ago who had already revised from sleeve to bypass due to regain. She was regaining again after not following her diet, and when questioned about it by a third party to the conversation, just said she'd go back for another revision when it got bad enough. Seriously no concern at all for just how seriously these surgeries change up the strength of the stomach tissue. In Australia though the private health insurance companies don't have the final say when it comes to approval,  if a surgeon says you need it, they have to pay if your cover level includes bariatric surgery. In this case I think the insurers having more input into the process could be advantageous, especially from an education requirement. 

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20 minutes ago, Aussie Bear said:

They really are just meeting their patients demands though which is really sad as well. I was talking to someone a few months ago who had already revised from sleeve to bypass due to regain. She was regaining again after not following her diet, and when questioned about it by a third party to the conversation, just said she'd go back for another revision when it got bad enough. Seriously no concern at all for just how seriously these surgeries change up the strength of the stomach tissue. In Australia though the private health insurance companies don't have the final say when it comes to approval,  if a surgeon says you need it, they have to pay if your cover level includes bariatric surgery. In this case I think the insurers having more input into the process could be advantageous, especially from an education requirement. 

That's awful, Aussie. Both on the part of the patient and the surgeon. If I ever gained my weight back, I honestly could not put myself through this again, even if I thought a revision would help. The only way you will regain is if you can't follow the diet, and continuing to have revision upon revision is insane. I'm sure others would feel differently...that is just my personal thought on the subject. 

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On ‎3‎/‎25‎/‎2019 at 2:07 PM, Kio said:

So, I don't have pain when I overeat... just a sense of pressure in my chest, and then every mucus-emitter in my head lets the floodgates open.  It sucks.

I basically stop eating when the first burp happens.  Just before if I can manage it, but sometimes I "miss" and overshoot by a bite or two.

I can eat a full container of yogurt or cottage cheese now (5.3 oz usually).  I can eat one chicken leg, if I skip the skin.  I can eat about a half-inch slice of pork loin, or half the meat in a large burger.  I can eat one scrambled egg if it's on one of the 50% of days that my stomach doesn't reject eggs, but I couldn't eat two. I can't reliably eat chicken white meat at all, so I usually don't try.

But honestly, 90% of my food is still mush, just because it's easier.  Yogurt, cottage cheese, string cheese, protein shakes, protein bars (kirkland), eggs, every now and then a bowl of oatmeal (single packet, low sugar) if I feel I need more fiber.  I generally don't try any solid protein until dinner time, because dinner is the only meal I regularly eat with (and cook for) multiple people.  I just never really feel like cooking JUST for one. 

I can definitely eat more now than I could at 6 months - I couldn't even finish a cup of yogurt at that point!  But the amount hasn't increased to a point that worries me.  :)

 

I can now eat a full yogurt without any problems and it doesn't make me feel overly full. 

I don't have any problems with any foods.  Did you have any problems with eggs before the surgery?

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On 3/30/2019 at 8:08 PM, tracyringo said:

I can now eat a full yogurt without any problems and it doesn't make me feel overly full. 

I don't have any problems with any foods.  Did you have any problems with eggs before the surgery?

Sorry, @tracyringo - I've been away a bit and just saw this.  :)

Before surgery, I didn't have problems with anything.  I could eat a 3-egg omelette or a huge plate of scrambled eggs and never worry about it.  Now it's mostly white meat chicken and eggs and tuna that give me issues.  I would say mostly the white chicken, because just recently I've found I can eat tuna or a single scrambled egg if I'm careful about it (lots of mayo on the tuna; soft-scramble the egg with a bit of cream and add a bunch of cheese). 

Definitely still a learning process, and definitely still a process...

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A lot has changed in the last 7 months when I started this post.  I don't have the restriction that I use to have for sure and I can see how people regain.  I would say it gets harder the farther out you get.  I use to wonder what the honeymoon stage meant and for me it meant having all the restriction I use to have .  I am not saying I don't have any restriction, but there is a big difference now and maybe that comes at different times for everyone, but it does happen.  I can now eat a whole chicken thigh and a veggie for dinner.  I could not do that a few months ago.  I have been weighing my protein at mealtime because I can eat the 4 oz in one sitting, it use to be I would eat what I could and go back and finish later.  

I am just putting this out there for the newbies or to the people whos pouches haven't totally relaxed yet.  Be aware of what is to come and have a plan to keep yourself accountable.  I did get back up to 175 and am back down to 167.2 this morning.  I watch that scale like a hawk as part of my accountability, because I know I would regain if I don't pay attention to what I am doing.

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2 hours ago, tracyringo said:

A lot has changed in the last 7 months when I started this post.  I don't have the restriction that I use to have for sure and I can see how people regain.  I would say it gets harder the farther out you get.  I use to wonder what the honeymoon stage meant and for me it meant having all the restriction I use to have .  I am not saying I don't have any restriction, but there is a big difference now and maybe that comes at different times for everyone, but it does happen.  I can now eat a whole chicken thigh and a veggie for dinner.  I could not do that a few months ago.  I have been weighing my protein at mealtime because I can eat the 4 oz in one sitting, it use to be I would eat what I could and go back and finish later.  

I am just putting this out there for the newbies or to the people whos pouches haven't totally relaxed yet.  Be aware of what is to come and have a plan to keep yourself accountable.  I did get back up to 175 and am back down to 167.2 this morning.  I watch that scale like a hawk as part of my accountability, because I know I would regain if I don't pay attention to what I am doing.

Tracy,

I’m really glad you posted this. And I’ll tell you why.

I noticed my pouch relaxed quite a while ago. When I’m home, I still weigh my food. I never stopped doing that. But when I go out to dinner, I obviously don’t have that luxury. I used to ask for a take out container before my meal arrived at the table and I would immediately put at least 1/2 of it (usually 2/3 of it actually) right into the box. And I would never order a carb with my meal such as potatoes or pasta. Always just veggies. And I was only able to eat a bite or 2 of the veggies. 

I never ask for the take out container first anymore, and that’s a bad thing. I will wait a few minutes after I finish eating, then mindlessly start picking at my plate...which is exactly why my surgeon told me to ask for the box before the meal arrived. 

I feel like I’ve always been able to eat more than most of us here on the forum post op, until I got sick over the spring. Now that I’m healed up, my food almost never gets stuck. I can eat 4 full ounces of dense protein (which I’ve been able to do for a long time now), plus 1/2 cup of veggies. If I eat eggs for breakfast, it’s 2 scrambled or hard boiled, and sometimes a cheese stick. I made a nice chili a few days ago and did not measure the amount. I’m quite sure it was at least a cup and a half. 

I have not been able to rely on restriction for a long time now. It’s still about what we put in our mouths as well as how much. The surgery got us here, but it’s still our responsibility to maintain, and we will always have to be careful. I actually ate shrimp pasta ala vodka for dinner last week, and it’s the first time I’ve been able to eat pasta without it getting completely stuck and making me sick. I’m not sure that’s a good thing, because I don’t really want to make pasta a regular in my diet. I didn’t eat a ton of the pasta, but let’s face it, it’s still pasta. I’ve been entirely too lenient with the carbs lately and that’s got to stop. I’ve gained a couple of pounds, which I’m ok with because I’m still below where I wanted to be. But in my mind, it’s NOT ok for me to gain it by eating carbs, and not ok to gain if I’m not trying. I think we all need these reminders several times a year to keep us on track. I have weighed daily since I started my pre op diet, and I probably always will. I’m not obsessive about it, but it does keep me accountable.

I’m happy you were able to get your weight back down. Keep up the good work and keep yourself accountable! And thank you so much for the reminder that we won’t always have the same restriction that we started out with!!

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@Nana Trish its crazy how I feel my pouch relaxed over night, I really never thought I would see the day this would happen.  It is a little scary.

I get the take out when I have gone out to eat.  I always make sure I take at least half of it home.  I also enjoy pasta once or twice a month and see nothing wrong with it.  I had this surgery to be able to be normal ( or what I consider the norm)  I like being able to eat a serving and be satisfied.  I made a deal with myself that as long as I don't go over 167 lbs I can eat what I want within reason of course and not worry, but if I hit 168 I have to be strict with myself .  I am hoping that I will have continued success without a whole lot of struggling.

Glad you are doing well, keep up the good work.

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@tracyringo...I didn’t mean to say I don’t get the take out container when eating out anymore, lol...I just don’t ask for it when I first order anymore. For me that’s dangerous, because I will pick at the leftovers if they are sitting in front of me. Even if I’m not hungry. Huge no no!! 

I started allowing more bread/pasta/potato carbs back in to my diet when I got down to 119 pounds because I needed to gain weight. I told my surgeon, at that point, that I was ordering pizza like once every 4-6 weeks. I would eat one whole slice with the crust, then scrape the toppings off of another. He looked at me and said, you CAN do that more than once a month! Lol :) It just depends on how much control I can maintain while eating carbs. Some days I’m fine, and other days it will make me crave carbs like crazy for days afterward! 

I’m at the point in my maintenance where I feel like I eat like a “normal” person now. I just don’t want to let eating pasta become a daily thing for me personally. And I know my portion sizes are bigger now. It scared me a lot in the beginning, because everyone here was saying how they could barely finish a yogurt at a year and a half out, and here I am eating a 4 ounce chicken breast with broccoli, lol. 

It sounds like you have a good plan in place...I’m sure you will have continued success!! 

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3 hours ago, tracyringo said:

A lot has changed in the last 7 months when I started this post.  I don't have the restriction that I use to have for sure and I can see how people regain.  I would say it gets harder the farther out you get.  I use to wonder what the honeymoon stage meant and for me it meant having all the restriction I use to have . ... Be aware of what is to come and have a plan to keep yourself accountable.  I did get back up to 175 and am back down to 167.2 this morning.  I watch that scale like a hawk as part of my accountability, because I know I would regain if I don't pay attention to what I am doing.

Tracy, I think you are really right. Accountability. A head game.  I still get full with a moderate amount of food, but my downfall would be snacking mindlessly on high-calorie things in the evening. ... and that translates into a closely similar picking at food I don't need at a restaurant! Last week I went home with a take-out container for the main course, and a container for the cheese course, at a wine & food society dinner I went to. 

Clothes. I have some trousers with a 34" waist and some with a 36" waist, and (with a 35" true waist) alternate the trousers daily so as to stay mindful every day. Weighing. I also weigh myself... sometimes daily, sometimes once a week, it's just necessary to be objective about oneself. Social clues. My spouse says "What, you wanna be heavy again?" :eek: 

 

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9 minutes ago, BurgundyBoy said:

and that translates into a closely similar picking at food I don't need at a restaurant!

It sure does!! 

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