Stretched Sleeve

[toler48 120]

@@jeaniebobeanie

Actually, I was told to stay away from carbonated beverages for just the first 6 months.

I have a soda stream also, and plan on getting it out again in a couple months.

Not really sure why the ban.

[JamieLogical 8,684]

@@jeaniebobeanie This is one of the hotly debated issues of sleeve patients and surgeons. I was never told that carbonation would stretch my sleeve (I was never told a sleeve COULD stretch), but I was told to avoid carbonation because it can cause gas and discomfort. Probably some patients have more trouble with that than others. I also think it's because surgeons and nutritionists don't want us drinking our calories and most carbonated beverages have calories. Even if it's diet soda, artificial sweeteners have their own host of potential problems. So a blanket "no carbonation" rule is probably just the easiest way for surgeons and nutritionist to avoid the potential issues of gas, discomfort, liquid calories, and artificial sweeteners all at one time.

[VSGAnn2014 12,992]

*WARNING: DO NOT TRY THIS AT HOME*

I did an experiment yesterday partly inspired by this thread and partly inspired by my half marathon training. I was curious to see how much food I *could* eat in a day if I truly tried. I set my goal at 3000 calories. I wanted to see how easy it would be to eat around my sleeve and also wanted to know how many calories I could get in if I forced the issue, since I've really been worrying about how to eat ENOUGH calories before my long runs and my half marathon.

I almost made it to 3000 calories. I finished the day at 2918. Close enough! Now, in order to get in that many calories, I had to eat 10 separate times and eat some truly outrageous stuff. Here is a list of everything I ate:

Three Protein bars (breakfast and two snacks), Pork Queso Chowder for lunch (so much fat!), pizza (one whole small slice and the cheese and toppings from two other slices), a Milky Way bar, two Pop Tarts, half a piece of cake, two servings of BBQ potato chips, and two oz. of reduced fat cheese.< /p>

So, it can be done. You can definitely eat enough to gain weight. Yesterday was my rest day for my half marathon training, so I had about a 1200 calorie surplus for the day. That's certainly plenty to gain weight if I kept it up every day. But I will tell you this, I felt like ABSOLUTE CRAP. I mean really really terrible. I had a horrible headache from all the sugar. The inside of my mouth had this gross coating around it (I think from the sugar and carbs?). I had no energy. I felt like a big fat slug. And I was up two pounds on the scale (I assume the sugar is causing Water retention) this morning. I definitely do NOT recommend this to anyone ever. Just don't do it. You would think it sounds great getting to eat all this junk you hardly ever eat anymore, but it was not pleasurable.

I didn't risk eating and drinking at the same time or drinking my calories, but those would have been a couple of ways for me to potentially get more calories in. Eating 10 times in one day was truly ridiculous. Still not sure what I am going to do to "load up" on fuel for my long training runs or the half marathon itself, but it won't be this again. I don't think I need to be going into a long run feeling that crappy!

I FREAKIN' LOVE LOVE LOVE THAT YOU DID THIS!

See, folks -- this is what science looks like. Real science. Read it and learn.

You rock, @@JamieLogical !

[tcrehm 101]

@jeaniebobeanie http://www.provostbariatrics.com/weight-loss-surgery-success-life-after-carbonated-drinks/

[CowgirlJane 14,259]

I don't know if the sleeve physically stretches permanently or not. What I do K ow is if I "eat small" and follow the sleever rules the feeling of restriction remains. I am 4 years post sleeve.

I have a skinny minny friend, we went on vacation together where we routinely overate. For both of us, when we got back home and returned to "eating small" and Protein first, that feeling of a smaller stomach returned - for both of us.

Neither of us have been scoped, but I am increasingly convinced that the key to long term success after ANY WLS is to continue to follow the program/rules that worked for you.

I am having a difficult recovery from a different surgery right now and having trouble eating enough. Like half a Premier Protein and I feel stuffed.

There is something else to this equation I do not understand, but I am going to keep doing what I do and hope it keeps working.

[2goldengirl 2,076]

I wonder if the "ban on carbonation" issue has to do with GBP mechanics. An awful lot of the diet guidelines for sleevers are adopted directly from guidelines for GBP. It's possible that gas/bloating are more an issue for GBP patients.

[toler48 120]

Spoke to my WLS surgeon today about this. He told me that the only reason a sleeve would stretch is if the original surgery was not performed correctly (i.e. not enough of the top portion of the stomach was removed).

I'm going with that. Staying on track and eating small.

[Kindle 8,667]

Way to take one for the team @@JamieLogical !

I wanna be next . I'm actually at the airport headed to my first vacation in 7 years so now is a perfect time for me to shoot for 3000 calories! Unfortunately my version will not be much help since they will mostly be in liquid form.

[Kaila312 19]

I just spoke with my Doctors office. They said your stomach naturally stretches over time, not back to original. They told me to do the liver reduction diet for a week to 2 weeks and this should get my sleeve back into shape.

Thank you for asking! What does that type of diet entail?!

[LipstickLady 25,682]

I just spoke with my Doctors office. They said your stomach naturally stretches over time, not back to original. They told me to do the liver reduction diet for a week to 2 weeks and this should get my sleeve back into shape.

Thank you for asking! What does that type of diet entail?!

For me, it was two weeks of:

Protein Shake for Breakfast

a piece of fruit or a cup of yogurt for a snack

Protein shake for lunch

raw veggies for snack

4oz protein and veggies for dinner.

[JamieLogical 8,684]

@@Kindle You should have a much easier time than I did then!

[libby43 136]

I don't worry to much about if my sleeve will stretch over the years. This is just my opinion but really shouldn't matter if my sleeve can hold 3 oz or 8 oz but what matters is what I put in my sleeve. I could very easily gain weight with only being able to eat 3 oz of food , if I eat the wrong foods all day long and graze. This is the main reason I personally get offended , when someone says we took the easy way out. No! It's a choice to eat right and fuel my body with the proper foods. Yes! My sleeve has help me lose weight and fight some of those craving but that's only temporary. The rest is up to us.. I asked my surgeon before my surgery the chances of regain. He told me " I'm operating on your stomach not your brain" the rest is up to you.

[MichiganChic 3,262]

I don't know if stretching is because the sleeve was done "improperly" or not. I do know that people can develop areas of bulges on various places in the stomach. My doc said there is no scientific evidence to show that correcting them makes any long term difference.

All I know is that I think my sleeve was done properly since I lost 145 pounds and have maintained two years. I can eat normal people size amounts of food, though I don't do that routinely. I try to keep the volume of my food at or under 1 cup. I do not believe that is an absolute certainty that a sleeve can't stretch unless it was done wrong, or unless you abuse it with over eating a lot. For me, it was a natural course that happened very gradually. I think our bodies are unique. Like all things, some of us are luckier than others.

[jeaniebobeanie 33]

@@jeaniebobeanie This is one of the hotly debated issues of sleeve patients and surgeons. I was never told that carbonation would stretch my sleeve (I was never told a sleeve COULD stretch), but I was told to avoid carbonation because it can cause gas and discomfort. Probably some patients have more trouble with that than others. I also think it's because surgeons and nutritionists don't want us drinking our calories and most carbonated beverages have calories. Even if it's diet soda, artificial sweeteners have their own host of potential problems. So a blanket "no carbonation" rule is probably just the easiest way for surgeons and nutritionist to avoid the potential issues of gas, discomfort, liquid calories, and artificial sweeteners all at one time.

I suspect you're on to something here, and I totally agree with you re: artificial sweeteners - but seriously, every pre- and immediately post-op diet I've ever heard discussed here, and even the ones I was given, were stupidly heavy on artificial sweeteners delivered through every conceivable form factor. The lack of consistency from NUTs bugs me. If it's bad in Coke Zero, isn't it equally bad in Protein Shakes and popsicles? And the blanket recommendations - again, I get it. It's easier to just lay down sweeping laws. It's also patronizing - I mean, we're fat, we're not stupid. Give us some freakin' credit for being able to differentiate between high-calorie drinks and plain Water that's had pressurized CO2 added to it. Explain the difference for those who aren't aware, but please treat me like a grown-up.

@jeaniebobeanie http://www.provostbariatrics.com/weight-loss-surgery-success-life-after-carbonated-drinks/

Thank you for this center's perspective! It doesn't really address my questions, though. They say that sodas can increase hunger, and the carbonation expands in the stomach, potentially causing stretching. So, yeah. Sugary sodas could cause increased hunger in the same way that sugary anything can trigger carby cravings, and diet sodas use fake sugar, which in some people triggers insulin production. I get that! I also get that CO2 under pressure will increase in volume suddenly when the pressure is released. However, the basic physics of drinking carbonation includes releasing the pressure PRIOR to putting it in your body. Once you've taken the bottle off the Sodastream, poured it into a glass, poured a fraction of that into your mouth, increasing the surface area exposed; swallowed, and pushed it all the way from your mouth into your stomach, you've given the bubbles plenty of time to expand (otherwise, there wouldn't BE any bubbles.) And then, assuming you're not doing this during or immediately after you've eaten solid food, your stomach immediately passes it into your small intestine. Haven't heard any concern from anyone yet about stretching the small intestine.

I wonder if the "ban on carbonation" issue has to do with GBP mechanics. An awful lot of the diet guidelines for sleevers are adopted directly from guidelines for GBP. It's possible that gas/bloating are more an issue for GBP patients.

This is an interesting idea. More in the vein of what @@JamieLogical was referring to (albeit more tactfully than I would) that the messaging we're getting from the professionals tends to be a little lazy. SImplest message, applicable to the lowest common denominator, without doing the work to actually educate and allow patients to make appropriate decisions based on OUR understanding of how our own bodies work - including specifics for the actual surgery we had. Makes me also wonder what else I was given as post-op gospel that is in fact completely appropriate - for a different procedure.

Before anyone has a hissy fit, know that I did and do respect the training and knowledge of the many excellent people at the center where I had my surgery (except for the PA, he was a total ****** canoe.) I also know that I'm not a "typical" patient - I've spent years working with all kinds of specialists to figure out why my body wasn't responding to diet and exercise like everyone else's, and in the process, I've become pretty well-versed in all sorts of minutiae about nutrition, digestion, auto-immune conditions, the microbiome, micronutrient absorption, and a host of other things that bore the crap out of my husband but make for super-interesting conversations with my NUT. But it also makes me a lot more hair-trigger to react to out-of-date advice about things like artificial sweeteners (really, really bad for you, even if they come in Protein Shake form!) and what fats are healthy (don't eat saturated fat? in egg yolks and pastured lard and grassfed butter? replace them with freakin' bleached, HIGHLY processed, estrogenic, incredibly-inflammatory-omega-6-heavy SOYBEAN OIL? in 2016? SERIOUSLY?).

So, yeah. I'm thinking I'm going to dust off the old Sodastream and do my little N+1 on that sucker. Water is water and gas gets burped. If it feels weird, I'll put it back in the pantry. If not, I'm drinking it.

Edited February 5, 2016 by jeaniebobeanie

[emk101009 18]

I'm on day 3 of the liver reduction diet to get my sleeve "back in shape". It's already feeling more restricted. It's good reminder to up up up your Protein when you've been slacking and get in the habit of healthy eating again. Plus, once you see the scale start moving again, it's gets you in the groove again. They have me on a shake for breakfast, a shake for lunch with either 4 oz. of yogurt or 1/2 cup plain oatmeal, or 1/2 cup unsweetened applesauce or sugar free pudding, a snack whcih would be something that you could choose from lunch and dinner is 2 oz lean protein with 1 cup of green veggies. If you absolutely have to you can have a shake in the evening. They would probably like you to make shakes with Water but I make mine with skimmed milk. Drink all the broth you want and eat sugar free Jello. The first day and a 1/2 are tough. You will have carb withdrawl but your energy levels will sky rocket and you will be reminded on how good this feels.