Long post - is my pouch broken?

I received this article in my email from Kaye Bailey and her Living After WLS web site. It is good reading, but a bit long. If you are wondering if your pouch is broken - read on and she suggest the 5-day Pouch Test diet - which I am thinking about trying. I haven't lost any weight in about 3 months....BUT I haven't gained any either. Just 40 more pounds and I would be such a happy woman. You would think after losing 147 - that 40 would just be a drop in the bucket....but evidently I don't have much room left in the bucket!!!! This is her web site: http://livingafterwls.com - there are good recipes there if you haven't visited. Hugs to all....Barbara Is my pouch broken? LivingAfterWLS August 14, 2007 Thoughts From Kaye Reclaim Your Precious Pouch Hello Neighbors! From the emails I received and conversations in the Neighborhood it seems quite common to wonder, "Does my pouch still work?" This question comes when it feels like we are eating more volume, or perhaps we have gained a bit of weight. There are many theories about legends about pouch stretch and "blown staples" as the outside world tries to explain why a weight loss surgery patient regains weight. I have heard claims that the pouch can stretch to the size of football, that staples can rupture and the pouch grow back with the distended stomach and even stories that the pouch "didn't work for me." The general belief in the bariatric surgical community is that the stomach may "relax" after surgery but not by much. What makes it feel like it's stretched is often related to the foods we eat. Moist soft foods or soft processed carbs, commonly called "slider" foods because they slide right through the pouch and out the stoma, therefore one never feels full. If we are drinking a beverage with a meal it creates a fluid river for the food to move along through the intestine. If one is eating soft slider foods and drinking as they eat chances are the pouch is working just fine, it's the behavior that needs a correction. About four years post-op I was concerned my pouch wasn't working because I could eat so much. Yes, you guessed it, I was into the slider foods because I'd lost track of my program and honestly, it is more comfortable to eat soft foods than it is to eat solids. I turned to my bariatic manual from my center and revisited the rules. The first thing I wanted to know was if my pouch still worked. Then, through trial and error I developed a Five-Day Pouch Test (article below) that not only works to test the pouch, it helps to bring me back on track and it triggers weight loss. It actually mimics the post-surgery eating stages. If you doubt your pouch or just need to get back to basics and away from a carb cycle I challenge you to give this plan a try. It's only five days and by the end of the test you will feel cleansed and confident that your tool is working and you are capable of working your tool. Give it a try and let me know how you do! Best Wishes! Kaye Bailey Five Day Pouch Test by Kaye Bailey For your convenience this plan is posted to the LivingAfterWLS Blog Does my pouch still work? Have I broken my pouch? Have I ruined my tool? These are questions many weight loss surgery post-ops find themselves asking occasionally during their journey. Perhaps it feels like we can eat more food or we know that we are eating more food. Sometimes these questions are asked when there has been a weight regain. Today I present a 5-day plan that I have developed and used to determine if my pouch is working and go back to that tight newbie feeling. And a bonus to this plan, it helps one get back to the basics of the weight loss surgery diet and it triggers weight loss. Also, it is not difficult to follow and if you are in a stage of carb-cycling it will break this pattern. Sounds pretty good, right? Here we go! Days One & Two: Liquid Protein The first two days are all liquids. You can have as many low-carb protein shakes as you like to satisfy hunger or cravings. In addition drink at least six 8-ounce glasses of water each day. The purpose of all liquids is to break any snacking, grazing or processed carbohydrate habits. In addition the liquids will work to cleanse your system and prepare you for the following three days. Try to reduce your caffeine intake as well, but do not stop caffeine cold turkey or you will feel sick and frustrated potentially losing the desire to continue with the pouch test. If you notice symptoms of carbohydrate withdrawal you can eat a small piece of melon or an orange. You can also try a dose of Emergen-C which should reduce headache, dizziness or cramping from carbohydrate withdrawal. Video Link: Obesity and Diabetes: A Strong Connection The next three days you get to eat as much as you want as often as you want! Ahhh, but there's a catch: it has to be solid protein and you only get 15 minutes each time you sit down to eat. Weight Loss Surgery Four rules Day 3: Soft Protein Protein Recommendations: canned fish (tuna or salmon) mixed with lemon and seasoned with salt and pepper, eggs cooked as desired seasoned with salt pepper and/or salsa, fresh soft fish (tilapia, sole, orange roughy), baked or grilled, and lightly seasoned. This starts your program with "soft" protein. Measure your portion (1 cup volume or 4-6 ounces weight) and eat only until you feel full, not overfull. Remember, no water for 30 minutes before or after you meal, and no fluids with your meal. We are going back to the beginning and fluids will prevent you from feeling the pouch. If you need to add a bit of Miracle Whip or mayonnaise to the canned fish I understand, but keep it to a minimum so the meat is not too moist. One reason we lose the sense of tightness in our pouch is that we eat "slider foods" - foods that are too moist and do not stay in the pouch very long, they slide right through the stoma. Try Oven Scrambled Eggs Day 4: Firm Protein Protein Recommendations: ground meat (beef, turkey, lamb) cooked dry and lightly seasoned, shellfish, scallops, lobster steamed and seasoned only with lemon, salmon or halibut steaks, grilled and lightly seasoned. By now you should be experiencing that familiar tightness that will reassure you that your pouch is working. Remember to drink plenty of water between meals. Take some time to meditate and rediscover the wonder of your pouch. Often we don't like that uncomfortable tightness of the pouch, which is why we gradually move toward slider foods that don't make us uncomfortable. It is always my preference to eat moist protein so I don't get uncomfortable, but this allows me to consume more than I should. Rediscovering the pouch with this 5-day plan reminds me of how the tool really works. I hope by now you are rediscovering your tool and enjoying the hope and excitement because your pouch still works. Recipe Suggestion: Grilled Garlic Shrimp A word about constipation: A shift to high protein diet often results in constipation. To relieve this you may try adding a fibrous fruit snack to your morning and a fibrous vegetable snack in the afternoon. Fruit suggestions are apples, berries, apricots, cantaloupe or oranges. For vegetables try leafy greens, zucchini, cucumbers, spinach, summer squash or string beans. Day 5: Solid Protein Protein Recommendations: white meat poultry cooked dry and lightly seasoned, beef steak (if tolerated) grilled or broiled. Remember to chew chew chew. Measure your portion (4-6 ounces) and eat only until you feel your pouch tighten. Remember, only 15 minutes per meal, so you'll have to work fast to chew your food completely. By now you should be out of any carb cycle you were in and perhaps you have lost a pound or two. You will have new confidence in your pouch and your ability to work the tool for your health and emotional well being.

Thanks so much Barbara!! I am gonna start this tomorrow, I really need to, I have been doing so very BAD. I need to try something to get me back on track. I'll let you know how I do. 283/190/140 Sheila

hey girl just adding my 2 cents here. it kinda sounds like the all protein diet we tried before.. what was that? something busters diet? I can't say I'm fond of diets post-ops are making since they didnt go to school for nutrition. I did the fat smash diet 3 times post-op and everytime lost between 4-9 lbs. Its 9 days, you can eat veggies, fruits, even brown rice, oatmeal and sweet potatoes, only exercise required is 30 minutes 7 of the 9 days. really, it works.. i check in on a south beach diet message board and someone who was stuck at 157 for almost a year, she did it and broke the plateau.. maybe worth a shot? hows everything else going? i went to the support group and found out this little surge im getting once in a while in my lip is more than likely due to not taking my b vitamins also learned horror stories about osteoperosis so I got the calcium out and took it today.. day 1 of the rest of my vitamin life by the way, someone talked about your unjury slushie at the meeting and how they LOVE It!! hope all is well with you and dh too, tell him I said love ya

Girlfriend...you better take those B vitamins! I didn't go to the support group meeting because the absolute ONE thing I do correct is religiously take my vitamins. I never miss taking them...don't ask me why I am so strict about them, but thank goodness I am! So....get those vits out and TAKE THEM!!!! Talk to ya soon - surgery buddy!

Hiya my friend! Thanks so much for this article. I may give it a shot. I have a huge dislike for protein drinks, but I need to do something to lose some more weight!!!! I hope you've enjoyed your summer. I'm not quite ready for fall and it already feels fall-ish at night. Let's meet up again soon, the three of us, and catch up! I have an event in Boston in September, but its on a Saturday. I'm happy to drive to Manchester or Nashua to see you girls! Hugs, Stephanie

Hi Stephanie...Karen and I are ready any time to meet again...Let us know what is convenient for you. We would love to see you again soon....Barb

Thank you for posting this I'm going to try this. So back to asking for any good low carb protien drinks. Thanks again Jan