NO HEAVY LIFTING WITH J-POUCH????

I've never been told that lifting weights was bad for the pouch. I do weights as part of my workout routine nothing huge, but occasionally I go up to 40 lbs on the barbell, and on the various machines I'm working up to 75. I know there are people on this forum who do are involved in weightlifting.

Obviously, in the early stages while you are still healing, there is more of a hernia risk, but I would imagine that 5 years out this would not be an issue. Did you ask your doctor why? You may want to find out what his reasoning is.

i was told this for the first 6 weeks but after that no restrictions...that would be interesting if this were true...

I was never was told that. Only after surgery for 6 weeks no heavy lifting. Then no restrictions after recovery. I work out at the gym everyday. Since I'm female I don't lift anything real heavy but I certainly use weights.

I have really struggled to lift much weight over 20 to 25 pounds even 5 years later. After the first year, I asked my doctor about why I just couldn't seem to get that ability to lift back(without lots of strained muscles and very painful abds.). He said for some people, it just doesn't come back and that's just the way it is. I feel like a super wimp but that beats being super sore which is what happens for me; so for me that is just the way it is. It was one of my trade offs.

I have heard this same admonition before from patients of Dr. Shen, also straining to evacuate or even pressing on the abdomen from the outside. I believe he has also cautioned patients against gaining or losing weight as it affects the j-pouch adversely. But, pretty much every other GI or surgeon has not given these warnings once the first few months of surgery have passed, unless there was something unique in a particular patient.

I think that Dr. Shen just sees so many j-pouch patients that he has seen it all, including the highly improbable outcomes. You cannot be harmed by avoiding every single possible issue so I guess it is a safety thing. On the other hand, I never seem to hear about the actual calculated risk- like is this risk greater than my risk of being struck by lightening? I know for a fact that I have lifted over 25 pounds hundreds of times since my j-pouch....

Jan

I have too Jan, comes with my job. But I have not lifted weights as a regular routine but wanted to start, but now I am depressed that I cant. I emailed him back to see if this was due to my sinus issue or all jpouchers in general, but yet to hear his response??? this sucks

I seem to recall a member posting here once who was a body builder. I can't remember the user name though.

I had my surgery in 2010 and lift weights competing in several bench press competitions. I have had no issues and my surgeon at the Cleveland Clinic is aware of this and has supported my weight lifting. I lift heavy twice a week and have been doing so for three years post surgery. Some people may be prone to developing complications and I would suggest starting slowly with any exercise routine and listen to your body and do not try to work through any pain.

Is there a difference between laparascopic surgery vs. open surgery as far as lifting weights?

The other thing too, is that 25 pounds really limits you in day to day life, even if you are not working out. I mean, I babysit my niece frequently. She's 3 now and gets around well enough on her own, but occasionally she still needs to be lifted and carried (i.e., I always have to lift her up to the sink to wash her hands, in and out of the tub, lift her into the van, onto escalators... etc, So on a typical day I'd lift her at least a dozen times). But she's over 30 pounds... technically I shouldn't even be lifting her if universally we have this restriction.

That being said, perhaps it's a case by case basis. I would also imagine that the vast majority of people Dr. Shen sees are already having complications, and his recommendations may not be intended for "typical" pouch patients. It might be interesting to ask him if he means this for all pouchers, or just on a case by case basis.

That being said, my surgeon told me not to lift more than 15 pounds when I had my ostomy...

He is a busy busy man. He has so many patients. He might think you are fresh out.

He knows I olympic lift, powerlift and crossift. Nobody has ever told me not to. I also do situps all the time. Usually I cramp at 100 so my Max is that now. And I have a stoma!

Situps help build your muscles and that helps pouches and hernia prevention in general.

All I can go by is the j pouchers I have spoken with and my personal experience at the 5 1/2 week post takedown mark... I know of 2 body builders that lift well over twice their own body weights and have been doing so for 5+ yrs.. in addition, My surgeon knew I was a religious weight lifter pre surgery and told me once the recovery time is over 6-8 weeks... I would be able to weight lift again with no weight restrictions.. As of now, I have a 30 lb weight restriction which will be lifted to a no restriction at the end of the month!

I have had a k pouch for over 33yrs and have lifted weights, pushed and pulled furniture and carry my fresh produce over a mile each way (around 20kg bags + on either side)....none of that ever caused me a problem but after a certain age I started getting hernias at the least provocation...as a woman I know that certain hormonal changes can impact how your body builds muscle and the resistence of your tissues but if you are a reasonably young guy (under 70?) and have a healthy and tone body with no hernias or other abdominal weakness other than the obvious surgery related problems...Then you should be able to build up slowly, work with higher reps and less weight in the begining and gauge your strength and capacity as you go...
Nothing, technically (and within reason), should be expressly forbidden if there is no underlying pathology...but use your good sense and maybe wear a support belt for good measure.
Sharon

Pouchomarx,

It sounds like this could just be on an individual basis and not every person with a j pouch. I think you should call and clarify with him and get a more detailed answer. I know he must be busy but you shouldn't be wondering why. I don't know your history but maybe this is what he is recommending for you.

I just received an email back from Dr.Shen to clarify the weight restrictions and this is what he stated, "from my practice, this has been the rule for all pouch patients re: weight lifting restriction in patients with or without sinus."

wow!! did anyone of us know that???

Wow - that's more than a little disconcerting. Basically it means I shouldn't be doing half the stuff I've been doing for the last 5 years, including carrying my niece. My own surgeon has never recommended this, except in the early stages, and when I had my ostomy (though I was really weak then so that may have also had something to do with it).

Well at least you got the clarification from him. It's certainly not practical for many people. What if you have kids that are young? Kids need to be picked up and when they get a little older they weigh more than 25 pounds! Like Spooky was saying with her niece. And that's just one example.

I would love to hear other surgeon's opinions on this. I have a check up coming up for a scope with my surgeon. He does a lot of pouches. I'm going to ask.

I certainly have no plans to alter my lifestyle after 18 years! To me, it is sort of like not driving your car to avoid getting in a car accident. I am not going to test the limits of my pouch (or any other part of my body) by doing crazy stunts, but I am not going to act like I am made out of eggshells either.

I'd be happy to change my opinion if there was any sort of data on the matter, but there are no articles, etc. that I can find. Even at the CC website, I have not seen this warning. Not one of the "care of your j-pouch" instructions I have seen mentioned a lifting restriction outside of the post op recovery period.

I do not suggest that you should dismiss your doctor's instructions, but I would want more of the "why."

I remember someone here saying that Dr. Shen told her/him that someone's j-pouch exploded (I presume they meant ruptured or perforated) from lifting and/or putting pressure on the abdomen. I suspect there was something seriously wrong inside for that to happen.

Jan

I just emailed my surgeon to get his take on this. his and Shens office's are right next to each other. keep you guys posted

I look forward to it! I know these top docs are super busy guys, but when you hear these rather extreme instructions, it just boggles your mind, especially when the "explanation" is anything but!

Jan

Yes, please let us know. Like Jan, I have no intentions of changing my lifestyle either.

My pouch is 29 years old and my surgeons had never warned me about heavy lifting. However, I noticed through my own experience that after lifting and carrying a "heavy" item, my pouch and pelvis feel quite strange, sore and strained for many many days, and sometimes after such an episode it doesn't function quite as well either, until things gradually resolve. It is probably just a regular strain, unrelated to the pouch per se. I am a small, slightly built non-muscular, rather sedentary woman, who rarely works out, so being out of shape may have something to do with this. However, when I do go to the gym I notice there are certain pieces of equipment that do seem to strain me in the general area of my pouch and I have since avoided those items and tend to stick to what I know is safe. When I mentioned all this to my doctors, they don't say heavy lifting is to be avoided for all pouchers but since heavy lifting/carrying doesnt seem to work for me, they support my avoiding this kind of activity. They theorize my discomfort may be related to pulling/stretching, straining on my numerous adhesions when engaging in this kind of exertion. I guess this is one of those issues that needs to be addressed on an individual basis.

What Dr. Shen told me several years ago was no more than 25pound lifting OVERHEAD. So you can lift, anything you want.. just not overhead. Maybe he has changed his thoughts since then. But several years ago, on multiple occasions, he clearly told me overhead was what needed to be limited.

Personally, my theory agrees with vanessa's, abdominal work.. whether pilates, planks regular and side, yoga, or what have you.. builds the core and helps you prevent hernias and other problems.

Just an update, I emailed my surgeon on Tuesday, and got a response from his nurse last night stating he was out till Monday but he will "call" me then. But she stated there should be no weight restrictions and do what I want. I love my surgeon cuz he does take the time to actually call me on the phone and answer any questions I may have. Dr.Kalady from Cleveland Clinic

I was told that straining while having a bowel movement can make pouch prolapse but nothing about a certain weight except after surgeries but that does not mean it is not good. I've had bowel obstruction/pouch prolapse/very painful/not the pouch prolapse except how it affects having a bowel movement. Anyway I don't pick up really heavy things. Better safe than sorry and w/exercise I don't think the weights have to be really heavy.

quote:

25pound lifting OVERHEAD

Hell. My push press is 80-100 pounds! I lift heavy overhead. My snatch is far heavier than 25 as well. I am keeping what I am doing. My pouch has less issues when I lift heavy I notice. My pouch does great and feels more supported as I gain more muscle. Once I get my leg issues figured out I will be back in the gym.

I mainly got the BCIR for Oly lifting alone.

One thing that helps me prevent hernias is the BCIR stoma is put in the muscle and I had all my abdomen muscles sewn together down the middle (yay for tummy tucks and reconstructive surgery). Also keep core always activated, bad core will weaken everything about lifting. I also lift with legs.

Vanessa, it is quite possible that there are different standards for a continent ileostomy as opposed to an ileoanal pouch. Sure, they are both ileal pouches, but an ileoanal pouch may have different stresses on it because of the location.

That said, I still don't get such an open ended lifting restriction for a j-pouch that has not been problematic. Seems like using a bazooka to kill an ant. I guess that is why we all want to know what the reasoning behind the admonition is.

Jan

True. I do have a friend that had a jpouch and went back to powerlifting since he was a professional body builder and weighed 110 pounds and got really under weight once getting the jpouch. He switched to the BCIR but his was due to leaking stool down his legs when in the gym. Maybe it is a stress issue on jpouches but I don't know. I am sure there are jpouchers that weight train. Has to be!

I did pick my BCIR for different reasons and one was the ability to train how I did with a colon. I was never told this so good point! Maybe it is a bit different.

Yes, there sure are! Here is a You-Tube from 2007 with an insane dead lift (600+ pounds) less than a year post op!! Not sure how this guy is doing today...

http://www.youtube.com/watch?v=EDoujZ1K8ww

Makes 30 pounds look like a bag of fluff!

Anyway, I was thinking that because of the ileoanal attachment, perhaps there is more strain at that connection of a j-pouch with heavy lifting, particularly if you are deconditioned and use improper body mechanics (are stupid about it). I also suspect there is a lot of variation out there in regard to how tenuous that connection is.

Jan

Tonight, I had to pick up one of those old 1993 Sony Trinitron TVs, which weighs about 150 pounds. Honestly, I was more concerned about my lumbar spine than I was about my J Pouch. After initially picking it up off its stand, I ended up rolling the TV end over end on used towels from the guest bedroom into my garage. I was worried I would herniate a lumbar disc, and/or rip a tear in the J Pouch. I am going to get a hand truck tomorrow and wheel it out to the dumpster.

Can someone explain to me why TVs were ever made in this fashion, with no handles on them? Was it to torture home movers, or to help them make money because nobody on Earth would want to move these things?

quote:

Anyway, I was thinking that because of the ileoanal attachment, perhaps there is more strain at that connection of a j-pouch with heavy lifting

They key to a heavy deadlift is a good Sphincter. So he might be working the kegals. I do kegals when I lift still even without anything down there anymore. I have to use more of my muscles in my vagina to achieve it. You have to engage your core, suck in deep then tighten with a kegal. Once everything is tight and good to go, you then lift. Release muscles when putting weight down.

So he might have a supreme Sphincter!

My preop deadlift was close to 250. I have not been able to lift more than 180 post op. I have to retrain since I had to take a break from the gym until I got the cramps under control so I will have to start at 135 like I normally do and go from there. I have a hard time lifting over 180 and it is so damn frustrating but it is due to not having an anal Sphincter.

https://www.youtube.com/watch?v=2TyDmhsixTM

https://www.youtube.com/watch?v=7A9PNFtScic

https://www.youtube.com/watch?v=XR4RM6DxLtM

 

Above are 3 links to videos of me lifting with a j-pouch.  I had my j-pouch creation in 2006 and takedown in 2007.  In 2007 I began powerlifting again.  When I lift weights I always push myself to my max capability.  It is now 2015, 2 nights ago I did shoulder-shrugs with 635 pounds for 20 reps at a bodyweight of under 190 lbs.  I am not as strong as i was 6 or 7 years ago in those videos....but I am now 42 years old and when I lift weights I still push myself to the limit.

 

I am not saying it is safe for anyone with a j-pouch to push themselves to their extreme limit.  All I am saying is this:  From 2007 to today (2015)...for the last 8 years I have been lifting weights...and always lifting as much as I possibly can.  I don't even remember I have a j-pouch 99% of the time.  So is it safe?  I don't know...I just know I've been doing it for 8 years and have never had the smallest issue or problem. 

I am going to play the devil's advocate for a minute here and err on the side of saftey.

Some of us, who were in good physical condition pre-op, who had good core muscles and/or muscle mass may find it easier to get back to it. Others who lifted weights, exercised regularly or had a job that required them to move and carry heavy objects may have no problem either  but those of us who were severely ill pre-pouch, who had high doses of antibiotics or corticoids that killed their connective tissue, ligaments & tendons etc...and who had pelvic floor disfunction may be putting their pouches in danger by attempting to lift heavy objects. (by the way, kids are not deadweight...They help themselves get lifted and then hang off of you so you are not really supporting their whole weight...unless they are asleep)

It is kind of like the joke about the man who asks the doctor if he will be able to play the violin after surgery. The doctor replys yes. The man is thrilled and replys, wonderful...I never could  play it before surgery!

Everything is a question of moderation, going slow, not pushing through the pain (for most of us), vitamin supplements, hydration and sufficient protien in the body. (also your sex and age)

I am a hot head, hate limitations, people who tell me everything that I cannot do or will never do and arbitrary rules...But the bottom line is simple. Do you want to keep your pouch or not? 

It may not be a problem tomorrow or in 2 years but it may cause excessive wear and tear that shows up 20 or 30 years down the line...there is no way of knowing. Or cause prolapse, sphincter problems or hernias. 

I've had my k pouch for over 35yrs...had 20 good years after step 3 and then boom. All hell broke loose. 

I know that some of the stuff I did was overkill and even most healthy people with all of their organs wouldn't have tried it...but I felt like I had someting to prove to myself and the world. I was naive. 

Nothing in the world is worth the price of my pouch. 

So it is a choice...I don't limit myself but I no longer push my limits either. (then again I am almost 55 and in constant pain too)

Just my opinion

Sharon

Dr Shen told me that there is a twenty five pound weight limint due to surgical staples that are permanently in place. He had a patient do heavy lifting and their staples came out, and they had to have surgery because of it.

I have had imaging done where docs could see my staples, so I know they are there

Doesn't it seem like the best option here is to get medical advice from your doctors, take that into account, and then listen to your body?

Everyone's specific surgery and response will be at least slightly different and that's just fine.

take into consideration to whom you are getting the advise from.  Dr. Shen has studied the J pouch for years and probably has seen it all.  I asked him at my last visit "am I frustrating you with all of my questions"?  and he said "absolutely not, this is what I do" to educate my  patients to take care of their j pouch for longetivity"...he also stated that he takes into consideration that each patient is very different and that one set of rules may work for one patient but do nothing for another.  So with that being said take heed to his advise and do everything in moderation.  I was fine for almost 20 yrs with my j pouch and then kaboom...all kinds of things started including a hernia.  if lifting weights is what you want to do then do it, but just take care to notice any changes of discomfort.  you know your own body well so just be kind to it.

well, 5 months after this post they discovered a leak in the tip of my jpouch that caused a very bad spinal infection and almost paralyzed me. I had to go back to a loop ileostomy. Surgeon tried to repair with surgery in Aug 2014 but it failed. Actually got word from Shen's office today that he was able to find a certain type of Fibrin glue that he will attempt one last time to close this leak with the glue and the largest bear claw he has ever used. He gives this a 50% chance of working. I'm not giving much hope to it but I need to give it one last shot. I will not do a redo, its a huge surgery and i dont do well with surgery as far as healing and infections,etc... I cant afford to be out of work that long and i have 2 daughters under 10 i need to be here for. 1st surgery almost killed me from an Ecoli infection and spent almost 10 weeks in hospital and went from 170 lbs to 115. 

My husband lifts weights and is fine.  In fact, it makes him feel better...

Pouchmax, I'd be careful.  Lifting weights is. It a bad thing but straining to do so may not be a good idea.  Jeffrey was told no weight lifting for now, but im sure when he gets better and after a period of time, he will start to do light lifting.  Take it easy.  You can get the same benefit with lighter weights as you can with monster weight.

Feel better.

dianne