Joe,
I'm taking a guess here, but I wonder if because of your thickness/slow flow problem and the fact that you your get that full sensation pretty quickly you may not be completely emptying the pouch. I find when I am in a rush I shoot myself in the foot by not irrigating and I'm back in the bathroom in short order.

I also had Fazio convert me from a J to a K. He reused much of the J-pouch to form the K-pouch. Do you know if this was the case with you? The re-use meant that I was starting out with a 4 year old fairly mature pouch that wanted to act like a colon and thicken the stool.

In the beginning I had to irrigate at every intubation like they showed me at CC and have been irrigating for the 15 months since the conversion. I am going through chemo induced pouch problems now but last November before another surgery (non-pouch) I was was down to emptying every 12 hours! It was like clock work unless I've pigged out at lunch. This regularity convinced me I made the right decision to go with the K as opposed to the bag. I didn't make it in '06 and this years out, but I plan to go skiing in '08!

I attribute this low frequency to having a larger than typical pouch as well as my relentless itrrigation. I use a B-D 60cc syringe and go through up to a liter of water. I also towards the end carefull use the empty syringe to push in some air to blow out what remains. I find that provides a motive force to push out the remaining irrigation water. I also find that irrigating in short "bursts" can push back a chunk stuck in the tube and give it another chance at making it through the hole.

This may seem like a lot of trouble, but you adapt. I put together a kit I always have on me that includes besides the tube and patches a syringe. They sell them at Tolbot (800) 545-4254.

I know it's not easy but keep up the positive attiude and experiment alot with intubating techniques. I hope this helps.

Peter