Too fat for a pouch??

Douglas,
I just reread myself and I sounded unreasonably harsh so I am editing this.
My first question would be, what are the possibilities of losing some of the pounds that you gained due to your situation? What are the options? Do you feel that it is possible?
It really doesn't matter who was right and who was wrong, they both agree that the weight is a potential problem and for you the ostomy is a bigger problem (I understand perfectly!)...
You feel that the only comfortable and liveable option is a j pouch...would it be possible for you to meet them 1/2 way?...it might also be better for the anesthetic and the healing process. Did they have you on cortisone pre-colon removal?
I carry and extra 10-15lbs for my frame and my surgeon is making faces at me, regarding that, so I can understand...and I have difficulty losing 5lbs so I do understand the added stress to your situation of needing to lose more....
Is he planning open surgery or Laporoscopy? It makes a big difference both for the surgery and how you heal afterwards.
Good luck no matter what you/they decide...don't forget to be your own advocate and fight for what you feel is right for you and listen to gut feelings.
Sharon

If it were me, I'd spend a few months trying to lose weight (really try with strict calorie reduction). Even 10 pounds can make a difference. Then I'd go with the surgeon with the optimistic 94%. Who needs a pessimistic surgeon? Excess fat can make it more difficult, but they say having your weight yo-yo up and down post op is not good either (for a j-pouch and an ileostomy).

I was very overweight when I had my j-pouch surgery, and 19+ years later, it is still there. And, I even had a 1-step and was very ill at the time!

Jan

Thanks guys
I am trying to lose weight but I can't walk for 5 minutes straight due to my spine so very hard to burn calories and I can't eat vegetables at all due to my ostomy they tell me to eat rice peanut butter and marshmallows so yeah nobody would love to lose the weight more than me but who knows what's in the cards

Douglas,
Without being indescrete, could you explain your physical limitations? I might be able to help you to exercise without causing undue pain, strain or complications. There are a lot of exercises that you can do while sitting in a chair. Every little bit helps when you are trying to lose weight. Also, blended soups can help you to not gain weight and reduce your calorie intake.
I make a lot of non-gas forming blended veggie soups that really thicken things up (not exactly what I need but they thicken anyway).
I use things like pumpkin & carrot, both high in vitamins and minerals but low in calories. I cook them with garlic, parsley, corriander and zuccini and then blend them...lovely soups, very filling and very low calorie.
I use whatever is hanging around in the bottom of the fridge and needs cooking. It all goes into a pressure cooker (a big pot will do) and gets cooked for 10 mins. Done. Blend and eat. Add salt, pepper and other spices and you have a very satisfying meal.
I don't do well with pre-prepared meals and expensive powders so this works well for me.
Pureed veggies, soups, stews etc are all filling and can be very low cal.
Like Jan said, even 10 lbs can make the difference and show the doc that you are motivated.
Sharon

Cleveland Clinic did a study for quantifying risk of pouch failure based on pre-operative risk factors (stuff like having peri-anal disease or indeterminate colitis, age, etc) and obesity is considered to increase the risk of pouch failure by 0.5 pts (on their 12 pt scale). On average, according to CC, that's still a pouch failure risk of less than 10%.

That said, if you have other health problems, especially health problems secondary to the obesity (like hypertension or diabetes), that increases your risk of pouch failure on top of the risk due solely to obesity.

Do you work with a physical therapist or a PM&R doctor? Or do you have access to a nutritionist? Just being in a wheelchair shouldn't mean you're resigned to obesity.

Sharon is right about pureeing veggies -- that would be a great option as well.

Yeah, I've spoken to several nutritionists. I was actually a D1 college athlete and was a trainer at a gym while in grad school actually up to the point when sickness set in. Ironically in very good shape at one point. So despite my condition my excercise and nutrition knowledge on my own is pretty solid. It is not the wheelchair alone or diet, I had also 10 years on prednisone and other drugs that cause weight gain. When I could run and do circuit training etc, the "artificial" medicine weight would melt right off. However since I have been reduced to a more sedentary lifestyle unfortunately it just kind of piled on. It took less than a year or two.

Although the other factors you mentioned, high blood pressure, diabetes etc I've been pretty fortunate to stay away from, largely I think because my weight is "non-traditional." (Although there is zero science behind that speculation)

The question respectfully isn't how to lose weight as I understand the concept of a calorie deficit but even then the surgeon said don't do too much of a deficit because the body should be strong at time of surgery.

I do appreciate all the information on potential weightloss though. Most recent nutritionist advice is fatty proteins and no carbs. I have lost 10-15lbs but can't seem to get past that threshold yet although that's neither here nor there.

The last post with the statistics was the type of stuff I am lookin for basically that for some reason I could not find on my own. I wanted to know just what the real numbers and real risks are since I had gotten quite I discrepancy. Less than 10% is somewhat of a relief. Because life with the stoma has been terrible. I understand from reading posts around the site that life with a pouch isn't carefree. But just personal preference I'd like to move the functions back to the inside of my body.

Although for quality of life reasons I still hope to reduce my weight.

Thanks to all who replied.

Like Jan, I was very overweight at my surgery as well. My surgeon said the only issue that presented itself was that making the end ileostomy was difficult getting it through the abdominal wall, as I carried a lot of weight there.

Many years later, and my pouch has been a rock star with excellent success. I think the surgery risks due to obesity are similar to what they would be with most surgeries, regarding healing, blood sugar, etc. But yes, I am thankful to have a successful pouch, to the point that I rarely think about it and live my life normally.

Good luck and keep us posted.

That's a great story I hope it goes that way although I still'd like to shed a few (or many)