5 DPT
Hope this helps to answer some of your questions! Days 1 & 2: Liquid Protein low-carb protein shakes, broth, clear or cream soups, sugar-free gelatin and pudding.
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.
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 moist condiment ( 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.
From Amy: On day 3, is cottage cheese o.k. for soft protein? When I was first starting my wls diet, it included cottage cheese, but that wasn't on your list. Also, when you are doing the liquid part of the diet, can you drink chicken boullion with protein added to it?
Kaye Answers: Amy - Cottage cheese is a good protein and you can include it on Day 3. I didn't have it on the list because it is considered by some to be a slider food. To firm it up a bit you could add a chopped hard cooked egg to your cottage cheese. And yes, during the liquid phase chicken boullion with added protein is great.
"We MUST give the pouch a chance to do it's job--and not try to get around it with our "monkeying" with the thing." --LivingAfterWLS Neighbor Sandi
Question: What are slider foods?
Kaye's Answer: In a malabsorptive procedure the pouch is made and the stoma or outlet is attached to the lower part of the middle intestine called the jejunum. The majority of caloric absorption takes place in the jejunum, so depending upon where your surgeon created the outlet the level of absorption can vary. Skilled surgeons will adjust the length of intestine bypassed according to their patient's projected needs based on dieting history and pre-op psychological screening.
Slider foods slide right through the stoma into the jejunum. My first test of the slider foods was graham crackers and coffee for my after work snack. Now imagine, I could eat a stack of graham crackers and wa**** right through the pouch with the coffee and never feel any satiation. What resulted was an easily absorbed slurry that my jejunum sucked up like a sponge - it didn't have to do any work to absorb this simple carbohydrate slurry. Of course, weight gain resulted and I had to give up this little indulgence. Another popular slider food is pretzels. I speak with post-ops all the time who are addicted to pretzels - again, this is a simple carb that your jejunum is very happy to receive and convert to fat. Traditionally dieters are encouraged to eat pretzels or popcorn - fat free and fiber, right? But that doesn't work so well for us. Giving our re-routed bodies these simple carbs is dangerous because our bodies have spent years perfect the art of fat storage - slider foods are to the body a great big lottery win.
By the way, in my example I spoke of a slurry from graham crackers and coffee. Simple carbs, however, will slide right through without the added benefit of a liquid. And several others can talk about cheese nip crackers, popcorn, mashed potatoes, ice cream/yogurt etc.
Lots of times I hear, "But I don't like that uncomfortable tight feeling of solid protein in my pouch." But the very purpose of the pouch is to signal fullness, which often comes by way of slight discomfort when we are eating in compliance with our bariatric owner's manual. The slider foods will never ever signal fullness. They are dangerous and in most cases non-nutritional. When I feel that full-pouch discomfort I try to mentally psych myself up, "YEAH-BABY! The pouch is on the job!!" Silly, but whatever works.
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 doing so 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.
There are two things I know about human nature. First, nobody ever wakes up and declares, "Today is the day I will relax my enthusiasm and get off track." Second, nobody ever wakes up and gets back on track without first saying, "Today is the day I get back on track and I have a plan." Falling off track happens without a plan or script. Getting back on track requires a conscious decision, a carefully designed plan and the determination to make it happen.
Why do we fall off track? There are hundreds of reasons: stress, complacency, happiness, grief, celebrations, devastations, distractions and reactions. Nobody wants to fall of track, but life is full of twists and turns that disrupt our focus. It makes me sad when people talk about shame and failure when they have left the weight loss surgery track for a myriad of reasons. This is not a cause for shame or failure, this is a fact of humanity and indeed of living. But human nature is also resilient and powerful. We have the ability to recover from set backs time and time again.
While you are doing the 5 Day Pouch Test I encourage you to create an inner storm of enthusiasm and hope and energy. Go back to those pre-op and early post-op days and live that moment over again. Read motivational articles and visit the Neighborhood forum. Talk to pre-ops and newbies. Look at your before and after pictures. You can go back and you can use this surgical tool to lose weight, become healthier and feel good about yourself.
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.
Don't go hungry! Remember, you can eat as often as you want as long as it is solid protein, consumed without liquids and measured in 4-6 ounce portions.
Rediscover Jonathan Livingston Seagull
The story is a charming allegory with a profound message: push yourself as hard as you can in pursuit of you dreams. The story of Jonathan and his friend Fletcher reveals two ordinary birds who, with passion, chose to better themselves. They were not content to merely eat and sleep. They wanted to become extraordinarily good at what they could do - fly.
It is easy for me to parallel the story of the seagulls with the lives of weight loss surgery post-ops. The brave decision to take control of our health with surgical weight loss is the first step in learning to fly higher, faster, and more beautifully than we ever have before. It is the first step in becoming extraordinary.
Near the end of the story Jonathan is in conversation with Fletcher. He asks, "Why is it that the hardest thing in the world is to convince a bird that he is free, and that he can prove it for himself if he'd just spend a little time practicing? Why should that be so hard?" In the world of seagulls few exceed the ordinary. The story tells us, "Most gulls don't bother to learn more than the simplest facts of flight - how to get from shore to food and back again. For most gulls, it is not flying that matters, but eating."
But Jonathan was different. "For this gull, though, it was not eating that mattered, but flight. More than anything else. Jonathan Livingston Seagull loved to fly."
The elder Chiang told Jonathan, "You can go to any place and to any time that you wish to go." The trick, according to Chiang, was for Jonathan to "stop seeing himself as trapped inside a limited body." And so should the elders of surgical weight loss tell us the same. "Stop seeing yourself trapped in a limited body."
Jonathan's rise to perfecting flight was not without bumps and bruises. Often he faltered. The story reads, "But way off alone, out by himself beyond boat and shore, Jonathan Livingston Seagull was practicing. A hundred feet in the sky he lowered his webbed feet, lifted his beak, and strained to hold a painful hard twisting curve through his wings. The curve meant that he would fly slowly, and now he slowed until the wind was a whisper in his face, until the ocean stood still beneath him. He narrowed his eyes in fierce concentration, held his breath, forced one... single... more... inch... of... curve... Then his featliers ruffled, he stalled and fell."
"Seagulls, as you know, never falter, never stall. To stall in the air is for them disgrace and it is dishonor. But Jonathan Livingston Seagull, unashamed, stretching his wings again in that trembling hard curve - slowing, slowing, and stalling once more - was no ordinary bird."
Like Jonathan Livingston Seagull, weight loss surgery post-ops are no ordinary birds.
