Five Day Pouch Test

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.

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.

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.

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.

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.

Good luck! I believe you are going to like the results when you give this plan an honest try. Tomorrow I'll write about re-entry into a healthy eating plan that will allow you to take advantage of this pouch test and return to a weight loss surgery way of life.