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