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Bypass Revision due to pouch opening being widely dilated?
KarenLR75 posted a topic in Revision Weight Loss Surgery Forums (NEW!)
I had gastric bypass in July of 2019. Highest weight was 400 before losing a bit on my own. Current weight varies from 167 to 173. I still feel some restriction to this day. My meals are usually small although I know we can all 'eat around' the restriction by eating smaller, but continuous meals and this was a slippery slope I fought back against. About 2 yrs ago, I started having right sided pain. It felt like the pain I used to feel when I ovulated so I assumed it was ovarian. Saw OB & had 2 ultrasounds and they couldn't even see right ovary (and the left was fine. Since they couldn't 'see' the right one, they said that was good since there was no obvious signs of..I don't know tumors, growths? The pain continued to worsen & I finally had gall bladder taken out 1.5 yrs ago. I adjusted diet again to deal with gal bladder being gone and things seemed ok. A few months after that the right sided pain returned. About 4 mos ago, the pain got so bad at times I'd be in a ball on my bed considering going to ER (which I HATE doing). Went back to primary got CT scan. CT came up with no findings. Then he referred me to GI doctor for colonoscopy & upper GI. I thought finally 'this was it, we've ruled out most other things'. I also had seen blood in my stools and it was old blood, like coffee grounds so I thought ok, not hemorrhoids? Just got back home from colonoscopy & upper GI. I thought doing prep was bad yrs ago, but much harder having had bypass surgery. Good news is no polyps or other concerning things. Bad news is main finding was on bypass "Patient's surgical anastomosis noted to be widely dilated, raising possibility of Dumping Syndrome as a cause". OK, most know what dumping is. I thought it was post surgery when we ate food (i.e. sugar, high fat) that processed too fast, etc. and you had dumping. Is the type of dumping they are alluding to different from our post surgery dumping? They recommended I see gastric bypass revision specialist. Has anyone else had revision NOT due to 1st bariatric surgery not being successful but for a "medical reason" like this (other than GERD, heartburn). I'm not even sure insurance will pay, but I have 2 yrs worth of history on this pain. Even it if does pay, I dread what this means for me - more hair loss? If I do this, will I need another revision in 5 yrs again at which point I'll be getting up there in age. I also still feel restriction kick in although yes, nothing like 1st 2 years My highest right now hovers at 173. I hoped I'd get to 150 but closest I've come is 167-168. Is revision another 'nuclear detonation option'? I've also wondered with the CT scan, etc. is there any chance of some straggler/stone from my gallbladder surgery 1.5 yrs ago that should be considered? Should I post this in the revision group instead? I read through some and was unsure. Are we allowed to cross-post? Any input would be appreciated. This is causing issues on my job as the pain hits out of nowhere (not X amount of time before OR after a meal, that I have been able to discern. Thank you!- 11 replies
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Gastric Bypass 5 yrs out - side pain for 2 yrs, surprising "cause"
KarenLR75 posted a topic in Gastric Bypass Surgery Forums
I had gastric bypass in July of 2019. Highest weight was 400 before losing a bit on my own. Current weight varies from 167 to 173. I still feel some restriction to this day. My meals are usually small although I know we can all 'eat around' the restriction by eating smaller, but continuous meals and this was a slippery slope I fought back against. About 2 yrs ago, I started experiencing right sided pain. It felt like the pain I used to feel when I ovulated so I assumed it was ovarian (post menopausal). Saw OB & had 2 ultrasounds and they couldn't even see my right ovary (like, where did it go?) and the left was fine. Since they couldn't 'see' the right one, they said that was good since there was no obvious signs of..I don't know tumors, growths? The pain continued to worsen & I finally had gall bladder taken out about 1.5 yrs ago. I adjusted diet again to deal with gal bladder being gone and things seemed to go ok. A ew months after that the right sided pain returned. About 4 mos ago, the pain got so bad at times I'd be in a ball on my bed considering going to the ER (which I HATE doing). Went back to primary and he sent me for CT scan. CT came up with no findings. Then he referred me to GI doctor for colonoscopy and upper GI. I thought finally 'this was it, we've ruled out most other things'. I also had seen blood in my stools and it was old blood, like coffee grounds so I thought ok, not hemorrhoids? Just got back home from colonoscopy & upper GI. I thought doing the prep was bad 10 yrs ago, but it is much harder having had bypass surgery. Good news is they found no polyps or other concerning things. Bad news is I was stunned their main finding was regarding my bypass "Patient's surgical anastomosis was noted to be widely dilated, raising the possibility of Dumping Syndrome as a cause for her complaints". OK, most know what dumping is. I thought it was post surgery when we ate food (i.e. sugar, high fat) that processed too fast or was too much for us to handle. They recommended I see a gastric bypass revision specialist. My question is, has anyone else had a revision NOT due to their 1st bariatric surgery not being successful but for a "medical reason" like this (other than GERD, heartburn). I'm not even sure insurance will pay, but I have 2 yrs worth of history on this pain. Even it if does pay, I dread what this means for me - even more hair loss? If I do this, will I need another revision in 5 yrs again at which point I'll be getting up there in age. I've also wondered with the CT scan, etc. is there any chance of some straggler/stone from my gallbladder surgery 1.5 yrs ago that should be considered? Should I post this in the revision group instead? I read through some and was unsure. Are we allowed to cross-post? Any input would be appreciated. This is causing issues on my job as the pain hits out of nowhere (not X amount of time before OR after a meal, that I have been able to discern. Thank you!- 2 replies
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May 2024 Surgery Buddies 😁
WarrenInEC replied to Bypass2Freedom's topic in PRE-Operation Weight Loss Surgery Q&A
I'm doing gastric bypass revision surgery on May 4. I'm familiar with the prep and post-op routine, so that's not a problem. I'm looking forward to getting back on track!! -
Anyone preop for a revision.
ShoppGirl replied to ShoppGirl's topic in Revision Weight Loss Surgery Forums (NEW!)
Congratulations on your upcoming revision. What exactly is the TORE procedure? That’s another one I haven’t heard of (there are a lot more options than I realized in WLS). I am looking to get a sleeve revised to SADI and I’m wondering if they will do anything to my sleeve since it’s probably not the same and I never felt like it was as small as others described to begin with. . Also, do you have a surgery date? have an appt on the 30th with the surgeon to tell him if I want SADI or bypass and to ask my questions and I’m getting a bit nervous about him setting a date. As much as I want to get this behind me and start my journey I am nervous about making this decision and it being so real if I have a date. It’s weird because I wasn’t nervous at all about the sleeve. But I guess it was much safer than a revision procedure. I am just nervous and there doesn’t seem to be many people to chat with about it. How long has it been since you had your first surgery? Sounds like it was a bypass? Were you happy with it? -
Anyone preop for a revision.
WarrenInEC replied to ShoppGirl's topic in Revision Weight Loss Surgery Forums (NEW!)
Yes, I am pre-op for a revision to my RNY. I am having the TORE procedure done to restore the size of the pouch outlet and the dimensions of the pouch itself. -
How did your GS revision help you lose weight and keep it off?
starladustangel replied to Elizabeth21's topic in WLS Veteran's Forum
I had a revision for GERD. began regaining weight at 6 months post revision. I've had issues with rapid gastric emptying after my bypass, I feel limited restriction and have blood sugar issues. Most people only get these issues with sugars or simple carbs ie: dumping. I get it after everything. I started wegovy a week ago and it seems to be helping. -
Beginning process to revise GS to GB or DS
ShoppGirl replied to Virginia B.'s topic in Revision Weight Loss Surgery Forums (NEW!)
Them tests and being off PPi’s for a week do not sound like fun. Hopefully all that is a means to an end, though and you get scheduled for your revision very soon. -
Beginning process to revise GS to GB or DS
Virginia B. replied to Virginia B.'s topic in Revision Weight Loss Surgery Forums (NEW!)
They decided I needed an upper GI and noticed that I had a very small hiatal hernia and that I'm beginning to develop cricopharyngeal hypertrophy. Because of the test results of that, I am now scheduled for a motility study with impedence using manometry and a 24 hour impedence ph study. Can't wait to get these tests over with so I can take my omeprezole again. This GERD is killing me since I can only take Tums right now. Have to be off the ppi medicine for a week. This should help to get my revision scheduled. -
Hi, all. I'm new here, but I'm scheduled for an endoscopic gastric bypass revision for early May. Looking forward to hearing from others who have had the procedure. My RNY was in 2001 surgery weight 465, bottom weight 290. I have slowly regained almost half of that amount back over the past 23 years. I never really felt that the pouch or the anastomosis were made small enough. I was one of the very first RNY patients in our area and the technique was in its infancy at that time.
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I hope someone will be able to comment on a scenario similar to my own. I underwent a mini gastric bypass procedure several years ago. I have lost 60-70% of my original body weight and now look very emaciated! The mini gastric bypass procedure has proven to be too powerful in its malabsorptive nature. Scans revealed no anomalies to the index procedure or other parts of my anatomy that would contribute to why I am not putting on weight, despite eating like a horse. My only option now is to have a conversion of the mini gastric bypass to RYGB, and the surgeon will be looking at the limb lengths, to help increase my absorption so that I look healthy. Currently, I am not even absorbing nutrients or vitamins to a satisfactory level. My body aches and I have next to no energy. Original weight 130kg. Now 55kg. Does anyone have experience of a revision to RYGB where the desired outcome was to achieve absorption and weight gain? Most revision posts are geared towards achieving weight loss, which is understandable. But there must be cases of MGB or even RYGB whereby it has proven too powerful to the detriment of achieving a good quality of life. My message to all those who are considering MGB/OAGB, please do not be fooled by the “mini” part. This procedure is much more powerful than RYGB. Unless a patient is excessively excessively overweight, the safest bet in my opinion would be to go for RYGB over MGB. I chose MGB because it was a safer procedure over the RYGB and I erred on the side of caution, thinking that I may not lose sufficient weight. I could not have been more wrong.
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First, there is no one right way to eat to lose or maintain your weight. There’s just the right way for you. I agree to the suggestion to get in contact with your old dietician or find a new one. I’d also teach for a couple of weeks just to check your calorie & nutrient intake. I’d also get in contact with your surgeon as well to see what other options you have - revision surgery or maybe GLP - 1 meds. You’ve likely reset your body’s set point. The surgery lowered it but returning to larger portions, poor food choices & bad old habits have raised your set point again. So you’re actually fighting your body now. You’re trying to lose weight & your body is doing all it can to hold on to it. Have a look at Dr Matthew Weiner’s Pound of Loss metabolic reset diet (not that I’m an advocate for any ‘diets’.) It may give you some ideas you could try to see if works for you. He’s a great source of information around all things weight loss, bariatric surgery, etc. (He has a website & a you tube channel.) If you like being active, I’d add in some weights. Building muscle will help burn more calories & help counteract any muscle loss you experience while losing. Walking will help with general fitness. Remember though, activity only contributes to about 10% of any weight loss. Oh & don’t listen to your family & friends when they offer advice about your eating, nutrition or weight loss. They mean well but unless they’re qualified nutritionalist, dieticians, bariatric surgeons or medical doctors or had bariatric surgery they really don’t know what they’re talking about. And they’re not you. You know yourself best. You know your psychologically, physiologically & emotionally self best & know how you want to live your life. All the best.
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Post Op Pain and Lung issues
SleeveToBypass2023 replied to LunaA's topic in Gastric Sleeve Surgery Forums
I know here, if your oxygen is 90 or better, they send you home. I don't agree with it, but they don't seem concerned about it. Chest pain could possibly be gas pain from the gas they used during the surgery to inflate your stomach. When I had my first surgery, the pain was in my chest and shoulders. Freaked me out. My revision, all the pain was in my abdominal area. Constipation right out of surgery is also very normal. But the rest? I would go back to the hospital if it gets worse, or if you're feeling uneasy about it. -
1300 calorie pre-surgery diet
ShoppGirl replied to SecretAgentDD's topic in PRE-Operation Weight Loss Surgery Q&A
This situation is a catch 22 because no one knows exactly what the insurance requirements are and no one will tell us. The dieticians job is to help you lose weight, period. Whether that’s in your best interest or not is where it gets tricky. On one hand If you are in a supervised weight loss program (the six month requirement by a lot of insurances) they are trying to see if you can lose the weight on your own before they approve it. So in theory if you lose too much they could deem you not a good candidate for surgery. On the other hand, every pound you lose the heathy way should make you that much more fit for the operation (not if you malnourished though). Plus, if you really can lose it without surgery obviously not putting your body through surgery would be ideal. if the dieticians way is something you have never tried before and when you try it you feel like you can do it, losing weight without surgery is obviously preferred. BUT, just because the insurance company sees progress and decides that you should be able to lose it based on the trend doesn’t mean they are right (they are not doctors and should not be making these decisions IMO). I know myself I have probably lost 1000 pounds in my life but that’s because I have always lost a few and gained them back but never got near a healthy weight. Whether you have tried everything, including the dieticians way, only you know. I had sleeve three years ago and my high weight was 235 and I’m taller than you. So I was lower BMI as well. On surgery day I was 220ish and I was fine but I did not start losing until my pre op diet began. During my 6 month supervised diet I did follow the diet they set out for me to the best of my ability BUT the cheat days basically offset my progress so I didn’t really lose anything. Now I am considering revision and there is not any weight requirements as far as I know but I started at like 245 this time anyways so I’m not as afraid to lose a little. I asked him what I should do and he said to keep my Carbs below 40 for now (I am most likely having the SADI so carbs are gonna be most important post surgery). Well I am losing but less than a pound a week so no one is raising any eyebrows at my loss. Anyways If I was in your position I would reduce my calories by like 100 at a time and see how I felt after a week adjusting to that. (Mayne you can get to 1200 with the dieticians help and maybe you decide that you want to try it once the dieticians way before you decide). On days like you four hour swim I would ask the doctor their opinion because 1200 calories does not seem enough for that level of activity. I think if it was me, I would stick to eating healthy choices for now. Try out new, healthy recipes and get used to the food you will need to eat post surgery. I would try to get to the 1200 because they are the dietician but portion wise I would cut my calories slowly to get there and see how my body reacted at each stage. (Just be honest with yourself about whether you really need or just want the calories) if I was really losing more than ever before and it seemed like something I could sustain, I would then re-evaluate whether I should be jumping into major surgery just yet. But if I decided that i couldn’t do it on my own and for sure wanted surgery i would talk to my doctor about how much they would like to see me lose to be fit for surgery. -
Having second thoughts.
SleeveToBypass2023 replied to Scaredloser's topic in PRE-Operation Weight Loss Surgery Q&A
I didn't have much pain when I woke up from my sleeve surgery. The pain came after i got home. It was a ROUGH 2 week recovery. HOWEVER....when I had my revision from sleeve to bypass, no pain. I was literally up and moving and walking and doing well while still in the hospital. The recovery was night and day compared to the sleeve. My only regret is that I didn't just do the bypass to begin with. I think you'll be fine. Just breathe through the nerves, remember why you're doing it, and take the leap. I promise, once you're on the other side of the surgery, you'll be so glad you did it. -
Mine resembles abdominal "guarding" because the sides pull in and the front protrudes. Went to my PCP about it and she said as long as there's no pain or tenderness or sensitivity then there's nothing to worry about. Gotta be honest, though, I really hate it. I noticed it slightly after my revision last June, but it was REALLY pronounced after my hernia surgery in December. Maybe my abdominal muscles have just had enough of surgeries lol I'm having a total hysterectomy in May (they have to cut me open since the uterine fibroids are so big) so I wonder what my abdomen will look like after that...
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Hi! I’m having revision from VSG to RNY in June. I’m 52, and had the sleeve almost 10 years ago. I did well with the sleeve as far as no complications, but I regained almost all of what I lost, so here I am now. I’m older, hopefully wiser, and my reasons are different this time around. Best wishes to you!
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Will I ever be able to drink while eating?
Christina B1128 replied to Aloo77's topic in Gastric Bypass Surgery Forums
I was told about the 30:30 Rule by my team. For all of the reasons stated above. It can cause fullness and washing the food out of the pouch. I am 14 months out, and I will say this is one of the cons of RYGB. I don't like it but I get it. But it is a lifestyle change for life. In February, I had a bottle of water almost 30 minutes after lunch. What happened next was dumping where I didn't eat for the rest of the day. I was still a little shaky the next morning. Luckily for me, I was going to see my primary doc that morning. All in all, it turned out fine. So now I wait at least 45 minutes to an hour before drinking again. It may not be that way for you. But is the risk worth it? Especially, the chance of stretching your pouch? Where you may have to get it revised. -
What you should know about WLS they don't tell you
ShoppGirl replied to BlondePatriotInCDA's topic in General Weight Loss Surgery Discussions
Ooh yea. I am doing fine now. Thank you for asking. I haven’t needed any more NSAIDs. I gained my weight back and I’m facing revision to a surgery where even occasional NSAIDS are not okay though so this is on my list of questions to ask about. -
Revision for GERD to bypass- what was your process?
QMLOHD replied to MacEBE's topic in Revision Weight Loss Surgery Forums (NEW!)
any updates on this? I had the sleeve October of 2020 and my Gerd has been bad the whole time taking PPI's. I am trying to get a revision to RNY. just got a denial for my appeal from UHC (United Healthcare) who says my Esophagitis is only Grade A and they won't approve unless it is a grade C or D. I want to appeal again but I don't think it will work. Now I am considering paying cash for the procedure but I was told if I did and there were complications later in life there would be no coverage. HELP. Any information would help. Thank you -
A revision - lapband to RNY story! 4 hrs in surgery
pamela posted a topic in Revision Weight Loss Surgery Forums (NEW!)
Welp! I’m 4 days post op. I had a revision from lapband to RNY and it was much more than anticipated! My surgeon told me I needed to have my gallbladder out at the same time (I had gallstones) so I was prepared for that but once he got in there he found A LOT of scar tissue from the lapband (mind you, it’s been 20yrs since I got it) and then a hernia!!!! So I was in surgery for 4 hours! I feel as good as expected I guess but wanted to give everyone a heads up… just be prepared for the unexpected! ❤️ -
My maximum weight was 303 lbs. I am currently 133lbs. I got my gastric by pass on May 7th 2019 in Pennsylvania. Since then I have had so many issues and I do not know where to turn to anymore. I feel the dr and I have gone through every option there is to go through and it is still not enough. Immediately after surgery I was having issues with eating. I followed all the rules took all the vitamins and meds I was supposed to. Still could not keep food down. I ended up having to take my gallbladder out in Oct of 2019. I was with a horrible person and she left me because of my issues with my stomach. I moved back to my home town of Peoria Il. I had to go on a search to find a new Dr. that would take me as a patient. I found this to be a rather horrible task as some Drs do not like to do that because they don't know all that the previous Dr did with the surgery. I finally found one and he is a great Dr. He has kept me alive. After the gallbladder surg. I was still having issues with keeping food down. This started in February 2020. The only thing i could tolerate was broth. At this point I had to take all my meds in a liquid form. Finally The dr. sent me to a gastrologist for an endoscopy. It was shown that I had some scar tissue covering the entrance to my stomach so they did a dilation. There was also an ulcer found. I was put on 2 diff acid reducing meds to get rid of it along with nausea meds. To prevent a tear they had to do this several times. I had dropped down to 118lbs. very malnourished. My health was becoming a huge concern. One of the times that they went in to dilate the Dr ended up putting a hole in my intestine. I had to have an emergency surgery for repair. I spent 2 weeks in the hosp. When I woke up in recovery i had a wound vac, drains and a feeding tube. i went home with the feeding tube. This is now Sept 2020. My new Gastric bypass dr was trying to get me healthy enough to do a revision to help me tolerate food. I had a revision scheduled for Dec. 2020. Since this was during covid I had to be tested before surgery. Yes I tested positive. The surgery was postponed until Feb. Finally i had my surgery and was hoping that this was going to be the last and all would be good. The feeding tube was removed and I had to start over from scratch with eating. Clear liquid on up. At this point I am weak and thinking the worst that it is all over for me. I kept up the fight and it kept kicking me back. I was able to eat a little better for a few months after surgery. Then it all started over again. Every time I tried to eat i threw up. I called the dr. He said probably more scar tissue and that meant more dilation like before. So that was the plan more endoscopies. There was also another ulcer found. Upped the intake of the acid reducers and still not going away. I just kept dealing with this and eating what I could. I put up with this for a long time. Then in Oct. of 2022 it got really bad again. I was in and out of the ER for pain so many times I lost track. The dr. went in to check things out and the ulcer was back. There was no Rhyme or reason for this to keep coming back. I was referred to a Thoracic Surgeon in 2023. I finally was able to get in to see him. He scheduled me for a surgery to have my vagus nerve removed. (vagus nerves produce the acid in our stomach and mine was producing to much there fore causing the ulcer to never heal. When i came home I was still not able to eat food it made me sick. I wasn't in anymore pain but still could not tolerate food except for soft foods. Then it would be next to nothing. Somedays i could eat a bit more than others. I was released to go back to work on 4*12*24. I have been to the er once again for pain and not keeping food down. I was given a gi cocktail and felt better. I called the Dr and was told when it hurts drink Mylanta. I am now to the present day and have no answers. Please tell me there is solution for this. I cannot do this forever. I don't wish this on anyone but I hope someone else has been through this and can help.
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It takes more calories to run your body at a higher weight & fewer to run your body at a lower weight. So yes being able to lose at a similar calorie intake at a higher weight but then being unable to lose still eating the same at a lower weight is to be expected. It’s like reaching maintenance. Remember too,1800 calories is 1800 calories regardless if it comes from a burger & fries or three nutrient dense healthy meals. The quality of the food matters for the health benefits & ensuring your body functions most effectively. I’d hammer your surgeon & dietician for help & answers. Maybe GLP 1 meds may be of help or a revision. If my maths is correct, you’ve lost 8 stone in total? That’s great! Don’t forget to celebrate that.
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IM. SO. HUNGRY. ALL. THE. TIME.
SleeveToBypass2023 replied to LindsayT's topic in Post-op Diets and Questions
I never lost my hunger. Not with the sleeve and not with the revision to bypass. I just have more of a hard stop now that can't be ignored. My big thing has always been training my head. It's HARD, but very necessary. I always made sure I had 3 meals and 2 snack and a TON of fluids. And by a ton, I do mean A TON. My head told me I needed to eat, even when I knew I didn't. And that can manifest into physical hunger. I put myself on a schedule. Breakfast between this time and this time, snack here, lunch around this time, snack here, dinner between this time and this time. And then DRINK, DRINK, DRINK. Eventually my head and stomach learned when it's time to eat and when it's not. I only really run into trouble if I miss those times by a lot. THEN I'm in a minefield. Focus on protein as your #1 with food and snacks. That fills you up and keeps you full longer. Veggies are 2nd. Then carbs and HEALTHY fats. Sometimes at night, I'll have a sugar free popsicle if I really can't ignore the 3rd snack craving. I don't do it often, but the tropical ones are my favorite and they hit the spot. Make sure you're getting enough calories. Don't starve yourself, but also don't over eat. It's all about balance and training your brain. It takes a lot of time, patience, and effort. But I promise it's worth it. -
I’d never heard about up them (they’re not available here so no wonder). I did notice they say to avoid if you have IBS or other gut conditions as they can upset your small intestine bacteria. Can cause bloating, diarrhoea, etc. too. May be see what your dietician & surgeon say especially with your revision.
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Will I ever be able to drink while eating?
ShoppGirl replied to Aloo77's topic in Gastric Bypass Surgery Forums
I am three years post op and I can drink while eating but I don’t recommend it. For one, I’m pretty confident my pouch was left bigger than most since I was always able to eat more than expected from day one. For two, I gained my weight back and this could have contributed. I am thinking I am doing a revision and the PA reminded me I should be doing all those things such as the 30:30:30 (30 before and after with no water and take at least 30 minutes to eat your meal). They haven’t checked it yet but if it is possible to stretch the sleeve in any way, I worry that I have stretched mine. Regardless, he explained that the purpose of not doing both even once you have room is because the liquid flushes the food through your system quicker so you don’t feel full as long. In terms of the size bites you can take they will gradually increase BUT, ideally you will still stay with “normal” sized bites but with time in between so that full signal can get to your brain. Hopefully others can Learn from my mistakes. Apparently they make these rules for a reason 😔