Question:
POUCH RULES FOR DUMMIES Declared Unhealthy by my Surgeon, anyone else?
He said it was unhealthy, could stretch things, we needed to eat food and that water loading prevents us from getting valuable nutrition If you do the pouch rules, what have been your experiences? — cherokey55 (posted on March 22, 2003)
March 22, 2003
Hmmmm, what version of "Pouch Rules" is he looking at? I haven't
seen a set of "Pouch Rules" that forbids eating food. Most
versions encourage filling up on water between meals, but also encourage
waiting a period of time between eating and drinking, precisely so you
*don't* wash food out of your pouch too soon.<P>However, it doesn't
make sense to me that drinking lots of water washes nutrients out of our
bodies. If that worked, we'd all be "water-loading" instead of
having WLS in the first place, wouldn't we? I don't get that one ....
<P>As far as "stretching things" is concerned, eventually,
the pouch is supposed to stretch as we heal, up to 6-10 oz. capacity, as we
become long-term post-ops. At that point, what you choose to put into the
pouch determines how well you do with the surgery (hence the need to change
eating habits, as that "honeymoon period" of losing without
changing habits doesn't last very long). That's one of the most
interesting things about the original study that gave rise to the first
version of the "Pouch Rules" -- where they found no difference in
long-term success between posties with 10 oz pouches versus those with 6 oz
pouches, because it's what you put in the pouch that matters, more than the
size (where HAVE we heard that one before?). ;~D <P>Lots of surgeons
don't seem to focus on what it takes for the surgery to succeed in the long
run, when your pouch is no longer traumatized by the surgery, when you can
eat most things again, and when the weight doesn't come off or stay off too
well without exercise and healthy eating habits. Parts of the "Pouch
Rules" really don't apply well to somebody who is, let's say, two
months out, whereas they would have a lot of relevance to somebody six or
ten months out or more. The surgeon is usually long gone from the picture
by then (or if he's around, it's back to the old pre-op advice of
"push yourself away from the table and get to the gym;" well,
duh!) Sadly, some of them just don't understand that it takes more than
their Stupendous Surgical Skills to *keep* the weight off in the long run
(as opposed to losing a lot, almost miraculously, in the short run).
:~P<P>Many people don't follow the Pouch Rules to the letter, anyway
-- they just adopt what works from it for them. Drinking lots of water
between meals seems to help a lot of posties cope with head hunger, which
doesn't go completely away for most people in the long run. Eating lots of
smaller meals during the day, instead of "three squares," also
helps a lot of people -- yet, you will find some docs and nutritionists
specifically warning against that, as if we can't teach ourselves the
difference between "grazing" (a no-no) and small meals.
<P>In addition to your surgeon's opinion, I think it's helpful to
start watching what successful long-term post-ops do in terms of eating,
exercise, and watching their labs. Try hanging out at the Yahoo
"Graduates" group, where we're not even allowed to post until
we're at least one year post-op. It's at <A
HREF="http://groups.yahoo.com/group/Graduate-OSSG/?yguid=106670120">http://groups.yahoo.com/group/Graduate-OSSG/?yguid=106670120</A>.
I've learned more there about what to expect down the road than anywhere
else. Many things I learned there, my surgeon doesn't particularly
recommend (but isn't opposed to, either). I think the posties understand
better than he does, though, so I go with their experiences. Good luck!
— Suzy C.
March 23, 2003
I am not a dr but I dont agree with the water loading idea in the pouch
rules for dummies. Thats not to say weather it could damage your pouch or
not but logically thinking its counter dicting since we are told to NOT
drink water prior or after eating. I can understand what your dr is saying
about nutrients as the water can wash them out before we absorb them...also
if you think about it, u drink a full glass of water and then you eat your
stretching your pouch big time...I would stick to your surgeons advice!
— Deanna Wise
March 24, 2003
Terri,
My dietician and surgeon don't stress or even include the pouch rules in
our post op insutructions. I have not really followed the rules myself
except not drinking with meals, and getting my water in between meals, and
I am 7.5 months post op and down 107 lbs. I think the rules in general are
ok to follow and for some, may be necessary, but you can and will lose
weight and be healthy without following them too. I would recommend
following your own surgeon and dieticians recommendations.
Tami
— Tami D.
March 24, 2003
The pouch rules were devised by a surgeon with 33 years of experiance in
WLS. They were what he observed as characteristics of people who lost the
weight and kept if off. They are for long term maintenance in the
"post-op" life, and aren't for the early post-op weeks. You can
take them or leave them, but for those who haven't lost 100% of their
weight, or have trouble keeping it off, then observations by a surgeon with
33 years of experience analyzing the success and failures of his patients
would be something that I would take seriously.
— mom2jtx3
March 24, 2003
Thank you Suzi C for that great answer. I am currently dealing with a lot
of head hunger/stress hunger and needed to be reminded of a lot you said in
your post/answer. Thanks!!! Have a Sparkling Day!! ~CAE~
— Mustang
March 24, 2003
ORIGINAL POSTER.... thank you for the advice. My surgeon was saying that
the water loading fills the pouch (possiby stretching if I were to down too
much H2O in such a short period). He stated that filling ourselves up on
H2o would prevent us from eating much food...food that is important for the
nutrition... my labs are not so swift as it is. I wanna lose the lbs and
keep them off...I dont do the shakes UCK..so I get my protein from food and
the occasssional Detour bar (1/3 or 1/2 at a time). The pouch rules were
the actual ones with all the info from the surgeon included with the rules
and I got the link from this site. My wl surgeon has been doing this since
1976, is a poineer in the field ect...he's a good dr. I trust him to a
point though...he said that it was ok to have an ounce or 2 of milk (only,
no other liquids) with meals after the first 6 mo. So as much as I think
hes a good surgeon, I am concerned about his post op info....which is why I
asked the Q here...so I could get answers from the front lines so to
speak!!!! thanks bunches, Terri
— cherokey55
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