I had a follow-up with Dr. Shen's PA today about a cuffitis issue and I mentioned something about working out. She told me that I shouldn't be lifting anything heavier than 25 pounds, ever, and I really shouldn't be lifting weights at all because of the risk of ripping my staples out of my pouch or getting a hernia. I was told that my best options are running, biking, or swimming since they don't pose this risk.

 

This kind of threw me off. I'm a runner, which is good, but I also like to lift weights and row. I'm still a young guy and I love being active, but I'm not so stubborn that I would continue to do anything that could potentially damage my J-pouch. You know, I'd been toying around with the idea of trying a triathlon and I thought it was funny she mentioned running, biking, and swimming. Maybe it was fate! Anyway, question is, do you all agree with this advice or do you think it was just one person's personal opinion? What do you do to stay in shape and are you mindful of your pouch when you exercise? Thanks!

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Others have also reported this advice coming out of Shen's office. I don't know if it's grounded in any sort of data, and I don't know if they've thought through how crippling this advice is. Most of us seem to ignore it - I know I do. I may be taking some risk, though Shen seems alone in this particular quirk. Certainly my surgeon gave no such advice, and he would have found it ridiculous.

Thanks Scott and Harv! Scott, I agree with you on them not giving thought to how crippling advice like this is. The PA said this to me while she was examining my abdomen wile making small talk. I thought it was odd how casually she told it to me, considering that she was basically telling me to change my whole lifestyle in a few sentences. I said I have always lifted weights and she said to stop immediately, unless I want a hernia and a mesh implant, which my body probably wouldn't take to, given my history of autoimmune disease. This freaked my mom out who was with me and she is now adamant that I don't lift anything ever again. I am still kind of on the fence about what exactly I'm going to do, as it kind of shook me up too. I'm definitely not going to give up an active lifestyle and become sedentary for the rest of my life though!

Pouch for 24 years. I just came from the gym, and yes, I lifted. 

 

Granted, I'm a girl, and I don't lift crazy-heavy, but I don't let it stop me. I'm also an ICU nurse, and I lift, roll, and push around adult patients (people keep getting bigger and bigger!) all the time, for years. Never had an issue, ever.

 

My surgeon never gave me this sort of restriction, and he's been doing pouch surgeries for at least 30 years. 

I've heard others report this from Dr. Shen, but it doesn't seem to ever be echoed by other specialists, and I'm curious as to where this recommendation came from and what data supports it. I've asked my own surgeon and GI and have been given the go-ahead. I myself lift weights and have been doing so for years. Obviously I don't crazy lift, but I'm a very active person, and as others here have said, I also think my pouch thrives on activity. I seem to do better the more active I am. I run, do yoga, and horseback ride several times weekly. I also do light weight training. The only time I was ever restricted from weightlifting was during the post-surgery period (8 weeks), and obviously when I started back I took things easy. I was cautioned about heavier lifting when I had my ostomy, but I was never flat out told no or that I couldn't lift anything ever again.

 

I also agree that this restriction doesn't seem to be very functional for daily life. I mean, 25 pounds is a very low permanent restriction, especially considering those with young children.  Two of my nieces are now both over 30 pounds and I still need to lift then up often enough for various reasons.  Even if you don't have younger children in your life, there are still tons of reasons to need to lift over 25 pounds - grocery shopping, snow shoveling, etc.

 

I also think it's somewhat counterintuitive.  I mean, if you do no lifting at all, you're going to be deconditioned for such an activity. What if an emergency arose and you had to suddenly lift and carry a child to safety, for instance? THEN you may be actually at more risk for a hernia because you suddenly did something you didn't have the fitness for. *shrug*

 

I'm not in a position to medically advise anyone on what they should or should not be doing, or to say that your doctor may be leaning toward being overly cautious. Obviously, if  you're just a couple of months out from surgery, it's probably not a good idea to bench press. But beyond that, I think it's ok to do what you feel comfortable with. It would be nice to see some data to go along with this no lifting recommendation, but until then, I'm not about to entirely alter my lifestyle, especially since my own surgeon has no concerns.

Although since my takedown 7 months ago, I've not returned to training, however, prior to and post surgery I discussed my fitness regime with my Surgeon, Consultant and Pouch Nurse and the only advice given was not to resume weight lifting or strenuous activities until my abdomen had completely healed; there was never any mention of not returning to such activities once I've recovered.

I described the type of activities I do; mainly core and cardio workouts, self defence, plus bodybuilding to achieve muscle definition and bulk; but not to an extent to achieve a physique like Arnold Schwarzenegger.

However, although I never mentioned dead lifts or squats, these were the only activities I was advised to take care with and not to use excessively heavy weights.

I believe most physicians confuse bodybuilding with Olympic type powerlifting techniques, such as the dead lifts and squats; their concern is in regard to the internal bearing down pressure created when performing these techniques 
and it's difficult to differentiate when explaining the limitations of such exercises to a patient in possession of a j pouch, especially when considering the extent some bodybuilder will go to achieve superior quads and glutes.

Aside from dead lift and squats I can't see how curling, bench press or any other bodybuilding type workouts can cause issues for a person with a j pouch.

I would say maybe see what your body is comfortable with and go slow. I can do about 25pounds comfortably but more than thirty pounds... not for me. I am seven years out and knock on wood, am feeling good. But I have also had three kids, am in my forties  and also had a 9 in midline incision and an almost 6 in. Incision to the right of that. I am sure this could impact me even without a jpouch. I think we are all different and how each of us tolerate food, activity, and bathroom issues are different.

 

My surgeon cleared me from most weight lifting restrictions about 9-10 weeks post surgery, and I work out 4-5 days a week, doing cardio and core every time, and alternating light weight training (generally I'm pushing weights in the 50-75lbs range, depending on the exercise, with high repetitions) and body weight work (pull ups, dips, etc) on different days.  This routine has been in effect since early January.

 

I was advised to be very careful with things like squats and dead lifts that put pressure on the sphincter area, but we'll be revisiting these on a follow up I have early next month.

 

Many others have reported this advice from Shen's office, but my surgeon basically told me to go for it, but stop doing anything that hurts behind normal soreness immediately.  Don't push too hard, especially at first, your body has been through a serious trauma with these surgeries, and you need to be mindful of that.  I can see how a willy-nilly undisciplined work out effort could be harmful, but being mindful of strengthening the core, the area most affected by the surgical work, should help protect you as you move towards upping your weight training.

 

All that said, all the exercise make me feel better, seems to improve pouch function and has me in the best shape I've been in since I played soccer my first year of college.  If my surgeon told me to stop doing what I'm doing, I'd start looking for a second opinion right away.  I don't think anyone's ever provided any data to support Shen's limits.

I believe in Dr. Shen's pouchitis clinic there was one case of pouch rupture. What I have never been able to find out is if there was aslo other problems associated with this (such as chronic pouchitis, poor blood supply, leaks, etc.) that might make a rupture more likely under pressure/strain. 

 

I can understand the restriction during the healing months, but no so much of a lifetime restriction. It just does not seem sustainable while living a normal life (tending to children, home improvements, yard work, lifting suitcases, you name it). Even bringing in the groceries can exceed this limit!

 

Sort of makes it sound like a ticking bomb... I would love to hear some real data on this.

 

Jan

I am an avid weightlifter and bench press competitively. I had my surgery at Cleveland Clinic in 2010 and have discussed this with my surgeon and he has no problem with my weightlifting. I lift heavy twice a week and am 56 years old. Last year I set a Michigan Senior Olympic record for my age group in the 198 pound division with a 320 pound bench press.

Thanks for all of the advice everyone! It was good to hear all of your stories about how you are still able to stay active and do the things you enjoy. I am going to continue to run and lift weights like I have always done, as I always am very controlled with my movements and not violently jerking around or anything.

 

I feel like doctors sometimes forget that most of their patients follow their advice to a T, so if they are merely giving a personal opinion that has not been validated by research, they should say that. Otherwise, people may end up changing their whole lifestyle, possibly for the worse.

 

I have never heard about someone ripping out their staples from exercising. I'm sure it's possible, but it seems like it would have to be from an accident while lifting heavy, similar to the way people get hernias. It certainly doesn't seem like a common occurrence that happens by lifting more than 25 pounds.

I was told by shen no more than 25pounds OVERHEAD. So I think you can lift just not overhead where you are strecthing and lifting your abdomen. They see all the problem cases there at CC. So After I heard that from him.. I stick to it. I'm already enough of a problem for him.

Just an update,

 

I had a follow-up with my surgeon a couple of days ago and asked specifically about working out and weights and the idea of nothing more than 25lbs.

 

He told me that he disagreed with Shen's advice on this, and that he doesn't believe there is any kind of serious risk to the pouch from lifting.

 

I also asked him about incisional hernia risk.  My takedown was late last October, but because of a complication, I had a third full open surgery a couple of days post take down.  None of my surgeries were done laparoscopically, so I have been worried about the possibility of hernias, and he said at this point in my recovery the risk is "very, very low," but did advise me to stop doing anything that hurts.

 

He also said to avoid squats and other exercises that put direct, weighted pressure on the sphincter, so "leg days" need a little flexibility or creativity.

I've had my k pouch for over 35yrs and have a very crazy active life living in a Paris suburb with no car and walking uphill everywhere. I carry a backpack with all of my books &files + lunch etc...it is very heavy.

So much for the context. I used to be a powerlifter in my teens prior to my k pouch surgery. I saw no reason why I should stop doing my favorite sport just because I had a pouch (hand sewn not stapled) ...so I lived my life normally (crazy active)

All well for about 20yrs give or take a few complications...nothing major. Then all hell broke loose...necrotic abdomen behind the pouch, pouch fell off of the wall, repeat abdominal hernias (around 7 in all)...no end to complications in sight and each surgery left me a bit more tired or weak and vulnerable...and put my pouch at risk.

I have about 5 mesh implants to hold my abdomen together now and had my pouch put back up at least 4xs in the last 10yrs.

No one has ever said that it was due to the activity, carrying heavy groceries up hills and stairs or anything else, as a matter of fact no one can really tell my why suddenly at 40 hernias started popping up like mushrooms and my pouch could't stay up but...you never know...

You are young and strong and your body heals differently than at 50 or more so just be careful...you did not get your pouch like you would get a nose job...thiis is major surgery and a life changing event...you do not want to lose it over a sport...it is just not worth it.

so lift if you like but don't over exhert, run, jump and play but remember no sport or past-time is worth losing your pouch over.

Just saying

Sharon

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