5DPT Owner's Manual: Good & Bad News

Hello Neighbors!

Just a quick update on my forthcoming book, "5 Day Pouch Test Owner's Manual" that I have been telling you about for several weeks. First, the BAD NEWS: We have experienced a minor production delay and the books will not be available for shipment until December 1. I am so sorry - I am told these things happen in publishing. If I could turn the wheel of the printing press myself I would because I know how important this is to so many of you.

Here's the GOOD NEWS: we are extending our Free First Class Shipping offer on all pre-orders!!! This offer is good through November 30th. Free shipping on all books to all destinations, including outside of the United States. And don't forget - all pre-orders come with 2 FREE GIFTS.

Go Here to Reserve YOUR Copy

Please take advantage of our pre-order sale and receive free shipping and 2 free gifts: the 5DPT Wallet Card & 2-Page 5DPT Journal.

Order Now

CHEERS!
Kaye

5 Day Pouch Test: Refresher Course

There has been a great deal of lively discussion lately about how to do the 5 Day Pouch Test correctly. The guidelines for the plan are very specific and deserve review.

First Off - the 5DPT is a drastic measure to stop a carb monster or slider food habit. It is a rapid return to compliance with the general rules of successful weight loss or maintenance after weight loss surgery. The 5 Day Pouch Test is not intended to be a way of life - it is a trip to the dietary and mental emergency room in order to stop further injury from out of control or improper eating.
Understanding Hunger, Appetite & Satiety

The 5 Day Pouch Test is intended to prepare us for the eternal Day 6 way of eating that includes a high protein diet with the inclusion of nutritious complex carbohydrate vegetables and low-glycemic fruits and limited whole-grain starch. In addition Day 6 means following the Liquid Restrictions and avoiding slider foods or processed carbohydrate grazing.

From the Plan:

This is the 5-day plan that I (Kaye Bailey) have developed and used to determine if my pouch is working and return 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?

The 5 Day Pouch Test should never leave you feeling hungry. You can eat as much of the prescribed menu as you want during the day to satiate hungry and prevent snacking on slider foods and/or white carbs. You must drink a minimum of 64 ounces of water each day. A reduction of caffeinated beverages is suggested, but do not stop caffeine cold turkey.

Weight loss is not the intent of the 5 Day Pouch Test, however, many who have tried this plan report a significant drop in weight. More importantly they celebrate a renewed sense of control over their pouch and eating habits and easily transition back to a healthy post-surgical weight loss way of eating.

Although weight loss often occurs on the 5DPT it is when we follow Day 6 consistently that we achieve greater weight loss and weight maintenance. We also feel better about ourselves.

Days 1 & 2 are difficult - liquid both days. This is necessary to rest your tiny tummy pouch and reduce any inflamation that has occured from eating food that irritates the tiny pouch and the stoma opening through which food flows to the digestive track. It is very similar to how we prepared for surgery and how we nurtured our new digestive system after surgery. Think of it as coddling an infant - you would not feed a new baby fried chicken or pretzels or ribeye steak or chocolate cake. So why feed a new bariatric tummy these difficult foods? If you feel frightened or unable to do Days 1 and 2 then do a modified test starting with Day 3. Repeat Day 3 twice, do Day 4 twice, move on to day 5 twice (this makes it a 6 day test) and then begin the eternal Day 6. It is better to do the 5DPT as outlined, But doing a modified test is better than sinking further into a processed carb cycle or slider food addiction.

A Plan to Work the 5 Day Pouch Test

There is no such thing as perfection in life or the 5 Day Pouch Test. In fact, nobody has ever done the test perfectly, not me or Queen Gretchen or Toris or any of the other 5DPT experts. But what we have done is our best on any given day and learned our way back to following the proven rules that work with our weight loss surgery. Use the 5DPT as a learning tool; not a measure of success or failure. We have spent enough of our lives measuring personal worth by the way we eat and the number on the scale. The 5DPT is about reclamation of your power to do the very best at living healthy with surgical weight loss and beyond to maintenance. Be kind to yourself.

Some keys to working Day 6:
**Plan you meals

**Add new things to your diet in the way of lean protein and healthy complex carbohydrates.

**Forgive slip-ups and let them teach you.

**Embrace the WOW moments and let them motivate you.

**Never underestimate the power of the pouch - it is there for you if you work it.

**Finally - Remember you are never alone. One year out, 20-years out you have a friend in the Neighborhood.


Questions & Answers:
This sounds like just another short fad diet.
I can understand this feedback, particularly if it comes from one who has not had weight loss surgery or gone through the stages of the post-op diet. The 5 Day Pouch Test is drastic and it has to be. If a person is feeling out of control with their eating, feeling like they have failed at weight loss surgery and gaining weight then drastic action is necessary. This plan allows that individual to take control in 5 days and exchange destructive eating behavior for appropriate eating behavior that results in feeling good and weight loss. In addition, those who started the plan feeling hopeless and desperate come away with new confidence in their ability to work their surgical weight loss tool.

What are liquid restrictions?
After surgical weight loss patients are advised to avoid drinking water 30 minutes before meals and 30 minutes after meals. (The time restriction varies from surgeon to surgeon, but must use the 30 minutes before, 30 minutes after restriction. Follow your surgeon's specific directions.) In addition there should be no liquid consumed while eating. Following these liquid restrictions allows the pouch to feel tight sooner and stay tight longer, thus leaving the patient feeling satiated for longer periods of time without experiencing the urge to snack.

One exception to the mealtime liquid restriction is an alcoholic beverage. Due to the rapid absorption of alcohol after a gastric stomach reducing surgery patients should not drink alcohol on an empty stomach. Patients who elect to include an alcoholic beverage in their regular food plan should drink it only with meals. Alcoholic beverages should be limited to one serving per day or less

Why do I need to take only 15 minutes for meals? My center told me to take 30 minutes for each meal.
Many bariatric centers recommend patients take 30 minutes for meals. Some even instruct patients to use a stop watch and time 3 minutes between bites of food. The reason is to slow down the eating habits of the recovering morbidly obese person. After some time patients who comply with the 30 minute meal rule tend to be able to eat more and often linger over the meal, even though satiation has resulted. Consequently they eat more food, particularly if they are not following liquid restriction and using liquid to wash the food through the pouch.

During the pouch test a person is following the liquid restriction and eating a high protein diet. By limiting the time to eat to 15 minutes one will enjoy the satisfaction feeling that is the desired result of a gastric pouch.

Finally! Read Read Read!
5 Day Pouch Test Blog5 Day Pouch Test Website

Does the pouch size change from morning to night?

Hello Everyone!

Over in the LivingAfterWLS Neighborhood we have several great conversations going on right now. catsroomie, also known as Vivian, asked if our pouch size changes from morning to evening. Seems like many of us are familiar with this sensation - take a look at some of the conversation:

It seems that my pouch is physically smaller in the mornings than the evenings - seems like it expands during the day. Anyone else experience this?

Often in the morning, one or two bites (doesn't matter of what) will make me feel full to the point that another bite would push me over into discomfort and nausea. Lunch, it takes a bit more to make me feel full. "Full" here means comfortable, satisfied, and ready to stop - not stuffed. Then evening comes and I can eat all evening without ever feeling full or satisfied. Not as in sitting down and eating a big meal all at once, but eating a meal and then following up with lots of nibbling. If I tried that in the morning, I couldn't do it.

Again, it doesn't seem to matter what I'm eating: oatmeal, chicken, chile, steak, cottage cheese, string cheese, veggies, fruit.

Any insights, I'd love your input.

Vivian

Read the full conversation

JanetLSE Replied:

I am like that! In fact when I first wake up I have to take thyroid medicine and just that with water makes my pouch full. Then I have to wait at least an hour before I can eat anything (because of the meds). I can definately eat more at night than I can for breakfast and lunch. It's almost like my pouch opens up wide after 5pm.

Steph added:

I am usually never hungry in the am. But I have learned that if I don't do breakfast within about an hour of waking I seem to crash and then I am starving. It is like it hits me all of a sudden. So I now get my boy's up, get there breakfast going and make mine as well. It seems to keep that horrible crashing feeling from hitting me. I guess my body is really odd though, because my hungriest time is in the afternoon. I am usually not even wanting to eat at dinner time, but I do force myself to or else I am hungry right before bed and I don't want to eat right before bed.

Then I threw in my 2-cents worth:

Excellent topic Vivian - and great feedback Neighbors.

I'm in camp with Vivian: tough time with morning food. That's why I've given in to the bland and predictable hard-cooked eggs, sugar free gelatin or cottage cheese. Not all in one meal, that's my rotation. Gelatin for the most difficult days. I think I can say I've had nearly nine years of morning sickness.

As for the pouch being smaller vs the afternoon or evening. It isn't smaller, but after 8 hours of rest it is collapsed and the muscle activity is at rest. Remember, the stomach made of vertical and horizontal muscles that work in waves to massage (digest the food). Just like we pre-warm our muscles of motion to avoid injury, pre-warming the stomach muscle (with a beverage or warm food) you can avoid injury (discomfort) when the muscle is abruptly put to task. We would never jump out of bed and run 2 miles without first getting the blood flowing and warming our muscles and joints. The same is true for the tummy. Most days, for me, a cup of coffee is a good warm-up. Dilute herbal tea is even better and more comforting. I need to remember that.

Now maybe we (ME!) need to work on an evening warm-down routine to put pouchy to rest for the night!

What's up with your surgical stomach pouch? Is it as moody as ours?

If Your Pouch IS Broken: New Procedure

As reported at ClinicalTrials.gov

Incisionless Treatment for Patients With Inadequate Weight Loss Following Roux-en-Y Gastric Bypass

This study is currently recruiting participants.

It is estimated that up to 20% of patients who have Roux-en-Y Gastric Bypass (RYGB) surgery will not meet their weight loss goal, or may even regain some of the weight they initially lost. One possible explanation is that the opening between the stomach pouch and the intestine becomes stretched. If this opening becomes too wide, food may be able to pass from the stomach to the intestine too quickly - causing patients to feel less full after eating.

For some patients, doctors may recommend additional invasive surgery to tighten the opening between the stomach pouch and the small intestine. Although this may help patients resume their weight loss, the risk of complications during a second surgical procedure is significantly higher than the risk during the original gastric bypass.

The purpose of this study is to evaluate an incisionless procedure for patients who have either had inadequate weight loss or have regained weight following gastric bypass. The procedure is designed to tighten the opening between the stomach pouch and the small intestine, which may slow down the passage of food to help patients feel full longer after eating.

Locations: Denver, Colorado; Baltimore, Maryland; Boston, Massachusetts; St. Louis, Missouri; Lebanon, New Hampshire; New York City; Cleveland, Ohio; Philadelphia, Pennsylvania; Dallas, Texas; Milwaukee, Wisconsin.

Read more and get contact information

After the 5 Day Pouch Test

What happens after the 5 days?

After the 5 Day Pouch Test is when things get exciting. Having successfully broken a carb-cycle, regained a feeling of control over the surgical gastric pouch and possibly losing a few pounds one is ready for re-entry into a compliant way of eating. This means focusing on protein rich meals, observing the liquid restrictions and avoiding starches, particularly processed carbohydrates and slider foods. Three meals a day should be two-thirds protein, one third healthy carbohydrate in the form of low-glycemic vegetables and fruits. Consumption of whole grains is not forbidden, but should be limited to one serving a day.

5 Day Pouch Test Plan

If necessary, due to hunger, between meal snacks should be protein dense. Natural food protein is great including hard-cooked eggs, lean low-sodium deli meats, and limited servings of nuts or low-fat cheese. In addition, protein bars or beverages may be used for between meal supplementation. Liquid restrictions should be observed.

5 Day Pouch Test Recipes

Patients should drink at least 64 ounces of water a day and take their prescribed supplemental vitamins. Caffeinated beverages should be limited to one or two a day and carbonated drinks are discouraged. Alcoholic beverages should be limited to one per day or less.

Patients should commit to this way of eating for their lifetime.

For more Q&A's visit: 5 Day Pouch Test FAQs

Lifetime Weight Control

Published today in the You Have Arrived Newsletter.

This is the bullet list of guidelines provided by my center. Again, I realize they may differ from other programs and present them here as an example of one center's counsel for LIFETIME weight control. I know personally that when I follow these rules I feel terrific, my weight is stable and I feel confident and proud of my tool ownership.

Chose foods high in protein, moderate in carbohydrates and low to moderate in fat
Eat slowly in a relaxed setting. Chew all food well.
Eat no more than three small meals per day. The first 1/2 of each meal is protein.
Stop eating when you first notice the sensation of fullness!
Do not snack. A snack is any food consumed between meals or eaten in a hurried fashion.
Drink at least 64 ounces (2 quarts) of water every day.
Do not drink liquids 30 to 60 minutes before or after meals.
Avoid/limit sugar. Sugar will only sabotage your success.
Avoid/limit milk and milk products. Think of milk as a liquid form of sugar.
Avoid greasy, spicy and fast foods.
Avoid carbonated beverages and alcohol.
Take the nutritional supplements as prescribed.
Exercise for 20 minutes, aerobically, every day.

Gastric Bypass Dumping Syndrome

Hello Everyone - Welcome to Monday!

Lately I've received several letters from people who are suffering from dumping syndrome or constant feelings of a low-grade dump. It's hard to pinpoint the symptoms but can be described as simply feeling "off". A return to the high protein diet that worked for weight loss will often diminsh the symptoms of dumping. Several people have successfully returned back to basics of WLS eating by following our 5 Day Pouch Test. It concentrates on the elimination of processed carb snacking, focuses on high protein and quickly advances through the post-op eating stages to help one feel a tightening of the stomach pouch.

Below is a previously published article the describes the feelings and causes of weigth loss surgery dumping syndrome:

By Kaye Bailey

Weight loss surgery patients who have gastric bypass can suffer from what is called dumping syndrome. Dumping syndrome is described as a shock-like state when small, easily absorbed food particles rapidly dump into the digestive system. This results in a very unpleasant feeling with symptoms such as a cold clammy sweat, pallor, butterflies in the stomach and a pounding pulse. These symptoms may be followed by cramps and diarrhea. This state can last for 30-60 minutes and is quite uncomfortable.

A small percentage of long-term post-operative patients build a tolerance and do not dump on foods that would normally cause dumping syndrome with the malabsorptive gastrointestinal system. However, most patients learn to avoid the foods that cause dumping because it is so unpleasant.

Foods that typically cause dumping are sweets, fats and processed carbohydrates. If a person is dehydrated the symptoms of dumping will be exaggerated.

The most efficient way to avoid dumping is to maintain the strict regimen practiced during bariatric infancy: follow the four rules. Eat protein first making sure it comprises one-half of every meal. Avoid snacking. Avoid all sources of simple sugar; and yes, this includes cookies, cakes, candy, sodas, ice cream and sorbet. Sip water throughout the day. When you practice this eating behavior your blood sugar will not fluctuate and you will not dump. Most patients, who crave a taste of something sweet, have learned they can tolerate a bite of fruit at the end of the meal. Each person must proceed with caution and discover what works for their body.

It is important to note that the dumping experience is different for every person. Some will always have extreme dumps and others more mild episodes. Individuals will notice dumping episodes will vary by incident. No two people experience dumping syndrome the and no two dumping episodes are the same.

Dumping is a bittersweet result of the malabsorptive gastric bypass surgery. Because patients are challenged daily to retrain their eating habits an occasional dumping episode is likely to occur. Adherence to the four rules will prevent dumping in most cases. However, every now and again we will be blindsided by a dump caused by a food never suspected. Keeping a list of poorly tolerated foods will help you avoid them. The acutely dramatic event of dumping is a convincing motivator to follow the rules and avoid the foods that have trigged a dumping episode.

New! 5 Day Pouch Test Website.

For You: The 5 Day Pouch Test Website

The response to Kaye's 5 Day Pouch Test has been amazing! Around the world people are taking control of their weight loss surgery tool to lose regained weight, to take control of their eating habits to succeed with weight loss surgery. The test works.

Now you have a one-stop destination for all things related to the 5 Day Pouch Test.

Visit: www.5daypouchtest.com

--Learn the Plan
--Get the Recipes
--Be inspired
--Take Control!

You can succeed with surgical weight loss, no matter what.

"During the past five days my pouch and I renewed our friendship. My body rewarded us with a 10 lb weight loss."
--Kressy, LivingAfterWLS Neighbor


5 Day Pouch Test

Another quality product from LivingAfterWLS, Ltd. Liability Co.

Pouch Test: One Neighbor's Story

Hello Everyone! I hope you had a nice long weekend full of LIVING and wellness. It was a busy weekend in my world and more than once I was grateful for my health and physical fitness as we engaged in numerous activities without respite. I realize that as a morbidly obese person I would have sat on the sidelines on such a busy weekend - but as a healthy weight fit person I played first team and loved every minute of it.

By now you know that I believe in the 5 Day Pouch Test. We first published it here on August 13, 2007 and since that time numerous LivingAfterWLS Neighbors have taken the challenge to reclaim their pouch and get back to the basics that support surgical weight loss. Today I present to you (with permission) the posted notes of one woman who completed the test last week. Backtracker, AKA Lisa, joined our Neighborhood on August 22. She started the pouch test on August 28 and five days later was celebrating a tight pouch, a sense of accomplishment -- and she had lost 6 pounds. I think you will be inspired by her story - I know that I am.

Forum Link: Have I broken my pouch?

On August 22, 2007 Backtracker introduced herself, "I'm new to this site, but not to Kaye's newsletters. I'm a little over 2 years post-op and her newsletter asking if the pouch is broken caught my eye. I've been guilty of the slider foods, and yes they do go down more easily than protein. I've decided to backtrack and get back to basics and that's why I've joined." The following are Backtracker's posts chronicling her 5 Day Pouch Test:

August 25, 2007
Grazing has been my downfall, but all that is changing. I have resolved to get back on track and Monday I'm starting the 5 Day Pouch Test. I've also grown lax in exercising, so I'm getting back into that as well. It's back to basics for me. I've changed my mental attitude and have stopped feeling sorry for myself. Getting active in the Neighborhood is another tool for me.

Reading about JudyPetite's experiences has truly been inspirational for me. The tool will always be there. It also brought home the importance of sharing our experiences with others because you never know what will help someone else. After all we are in this together!

August 28, 2007
I need to check in and give a report on my progress, but first I want to say something to Robin. I have gotten nauseated before from protein drinks too. What helps me is to drink some hot tea. Yesterday I drank green tea if I felt that little rumble starting to happen and it worked great. I bet chicken or beef broth would have been acceptable too. (Am I right, Kaye?) ((Yes – broth is a good liquid, and sugar-free Jell-o is also good at this stage of the test.))

Read more about dizziness and dehydration after weight loss surgery

I just finished my 30 minutes of exercise that I committed to do as part of my plan. I must confess I did have a mental conversation with myself to convince me to do it, but I'm a Gemini, so I can get away with it. Anyway I did it, and I felt great afterward. I discovered a need for a second exercise: not to watch real-time television these first two days as there are so many food ads. I just don't want head hunger to enter into the equation.

Easy Walking Program

I didn't feel physically hungry at all. I swapped tea for coffee as I find tea to be soothing to my pouch. I drank lots of water, pretty much sipping it all day. I had three protein drinks.

For those of you thinking about doing this, it helps having a buddy. If you don't know someone, post to the list and I bet you'll have a taker. Deb asked me if I'd be her buddy and I was thrilled. It really does help because you don't want to let your buddy down.

Support: Another LivingAfterWLS Power Tool

August 29, 2007
My buddy and I are on day 3. I'll let Deb share her progress with you. I got confused and bought salmon for dinner only to discover (thankfully in time) that it will be for tomorrow's dinner. Back to the store in a bit to find a softer fish.

I got my exercise in, which came easier today than yesterday. I have a recumbent bike that I'm riding so I don't have to deal with the hot Texas weather.

This has been a good experience for me. This program works on the mind every bit as much, if not more, as it does on the pouch.

August 30, 2007
This is day 4. My pouch literally has tightened up! I hadn't expected it. I guess I expected more of an awareness that the pouch still worked. I can never eat as much in the morning anyway, but right now I really don't want to eat. I'm sipping hot green tea to coax my pouch a bit, because I know how important it is to get in my protein.

This has been a very important Aha Moment because now I realize how I slipped into the carb pattern. As I found to be true with near death experiences, it's one thing to read about them and comprehend, but it's so much more to gain the perspective from having had the experience. I'm so glad I'm doing the Five Day Pouch Test.

September 1, 2007
I was so focused on working the plan that when some pretty heavy duty obstacles came my way this past week, I didn't let them affect my food. I think the length of the plan had a large part to play in my ability to overcome the obstacles. So now I have to think about what I can do for the long term so I don't cave when obstacles come my way.

One of the things I'm tossing around in my head: Is there a way of working the program for five days at a time and then renewing on an ongoing basis? Maybe changing up the program a little from week to week would be involved. Any input would be appreciated.

((Kaye's Note: Back to Basics will be the topic of discussion throughout September here at the LivingAfterWLS Blog, the Newsletters and the Neighborhood.))

I neglected to mention that I lost 6 pounds while I was on the 5 Day Pouch test. Felt like the good old honeymoon days! If that's not incentive, I don't know what is.

September 2, 2007
In encouragement to another LivingAfterWLS Neighbor Lisa wrote, "I just finished the pouch test. How much of your hunger is head hunger? Are you drinking as much water as you should? Try sipping it throughout the day. Something else I found helpful was drinking hot green tea. It was very soothing to my pouch. Activity is the other thing that can get your mind off of food, be it exercise, housework, gardening, or perhaps a hobby you enjoy."

5 Day Pouch Test Journal: Useful Tool

Hello!

Yesterday in the You Have Arrived Newsletter we presented a new LivingAfterWLS Tool: The 5 Day Pouch Test Journal. This is a downloadable worksheet for use during your pouch test. Our servers were overwhelmed with requests for this tool - if you were unable to get it please click the link below and download your free form:

Download the 5 Day Pouch Test Journal

Using the Pouch Test Journal:

This simple two-page form is divided by days and asks you to record your weight, your energy level throughout the day, food intake, activity and motivation. For your convenience the daily food recommendations are included on the journal sheet. Record keeping should be honest, but brief. You don't need another burden in your day, just a visual record of your progress.

Energy level should be ranked 1 to 10: 1 is low energy, 10 is extreme energy and 5-6 is neutral. We will talk more about energy level and food intake as we continue this discussion in the newsletters, blog and Neighborhood, so please keep track while doing the Pouch Test.

With the Pouch Test we are not focused on losing weight, but we ask you to record your weight as an observation. In most cases it will go down, but if it does not please remember the scale is not our focus here. The focus is on quickly moving through the post-op diet, rediscovering our pouch and breaking a snack or processed carbohydrate cycle.

Use the margins to note water intake, vitamin intake, monitored steps or anything else you use in your individual program to optimize your health. This is your worksheet and we hope it is a meaningful tool on which you can build a strong case for getting back on track.

Kaye Answers Questions About Pouch Test

Here are some questions about the 5 Day Pouch Test that I answered in today's You Have Arrived Newsletter:

Kaye, Is this something you came up with yourself or did you get it from your doc?
This is a plan I developed based on the post-op stages given me by my center. Over the years I've done it 3 or 4 times to get back on track. When I first did this plan it was for 7 days, but it seems like 5 days works better for me. After all, we can do anything for five days, right?

Is the idea behind this that we "allow" our stomachs to shrink down a little and thus get that full-feeling sooner again?
The plan is first intended to allow your pouch to rest, just like right after surgery, to break the slider food habit and gradually work up to firm proteins that worked in the beginning to help us feel full and lose weight. It will work to help your pouch feel tighter.

I don't like protein shakes - What can I do for days 1 and 2 of liquids?
I know many of us became sick and tired of shakes early after surgery. If you wish to omit the liquid phase skip days 1 and 2; do day 3 twice, day 4 twice and day 5 once (or twice for 6 days). This program should not feel like a punishment, so work it for your personal taste.

Recipe Suggestions

Eggs don't sit well with me. Can I use cottage cheese on day 3?
Cottage cheese is a good soft protein, but we did not include it on the list for Day 3 because many consider it a slider food. If you use cottage cheese measure your portion (1 cup volume) and do not exceed that. Practice mindful eating to know when you are full.

Is there a time a day I should be eating each meal?
Again, this is your program. Work it to your schedule. The program allows that you can eat protein whenever you are hungry so try your best to respond to your body's signals.

The program is working so well, can I just stay with it?
If you are enjoying the program then we recommend you stay with days 4 and 5 alternating between the two. Day five is actually the plan that most centers recommend during the phase of rapid weight loss.

Read the ongoing discussion in the Neighborhood

Fixing Broken Windows

I am posting this essay from the July 10, 2007 You Have Arrived Newsletter. We have so many new members who may have missed this - and it talks about some key steps to attacking a stall or weight gain. I hope you enjoy and would love to hear your thoughts.

Fixing Broken Windows

by Kaye Bailey

There is a popular theory in urban renewal that suggests fixing broken windows as they happen is the key to reducing crime and preventing urban decay. The theory is based on a 1982 Atlantic Monthly article by George L. Kelling. He writes, "Consider a building with a few broken windows. If the windows are not repaired the tendency is for vandals to break a few more windows. Eventually, they may even break into the building, and if it's unoccupied, perhaps become squatters or light fires inside."

Perhaps it's a stretch but I believe it is possible to apply the "Broken Window" theory to our post-weight loss surgery health and wellness. The broken window, of course, would be a lapse in compliance with our program: eating unhealthy foods, the absence of exercise and so forth. If we break a window one day and do not fix it the next then we risk breaking another window. But if we practice self-renewal and fix that broken window promptly we can avoid the intrusion of vandals and squatters who would break more windows pollute our healthy new body.

The challenge herein is that if we allow the broken window to go without repair we then become the vandals to our own building (body). At times it is far easier to give permission to the squatters than it is to kick them out. One day of missed exercise leads to another and another and pretty soon the sloth-squatter has set-up camp in our building. I know for me all it takes is three missed workout sessions and my sloth-squatter is quite at home enjoying the broken windows. But when I saw the pattern I came to understand that one broken window (missed workout) could be repaired without struggle. Repairing three broken windows demands a forceful and determined self-renewal to fix my building.

In cities and in life there will always be broken windows. A broken window is not a sign of failure or neglect. Windows are made of fragile glass that sometimes breaks. And though we may pretend to be tough as steel we are more like glass: fragile and prone to occasional breakage. Windows can be fixed. Fix your broken windows promptly and forbid the squatter's entry. You've worked hard for your new life; give yourself the gift of self-renewal.

More essays by Kaye Bailey

GDL: Grit Determination List

Since we are focused on getting back on track, rediscovering our pouch and empowering ourselves with success now is a great time to make a Grit Determination List. (grit: indomitable spirit: pluck)

A Grit Determination List?

Absolutely! This is a list of your Grit Priorities - the things in life about which we are unyielding; the things you will accomplish without regard or acknowledgment of life's barriers. Your list can include weight loss surgery rules and/or goals, healthy living concepts or just stuff you need to fix so you can thrive. Life has few absolutes - the GDL (Grit Determination List) is one of them. It can be a list of one or a list of one hundred. Just write it down. Hold your GDL close to your heart or share if you must. Either way, get hell-bent and uncompromising with your list.

Own it.
Live it.
Love it.

I share mine with you as a pledge to myself. After all, if my GDL is public then I have got to make it happen, right? Feel free to share your list in the comments here, on your blog or in the Neighborhood. Or, if it feels right, write it, learn it and burn it. This is your tool - use it in the most comfortable manner you know.

Kaye's Grit Determination List:

On this day, August 18, 2007 I vow to myself that I shall employ my personal powers of GRIT DETERMINATION to do the following:

1. Take my full vitamin cocktail - daily.
2. Engage in kindly self-talk with myself - daily.
3. Laugh at myself - daily.
4. Engage in "living" activity 40 minutes per day (this in addition to my scheduled exercise - 50 minutes per day).
5. Call my Dad every week.
6. Manage and clear my incoming paperwork/email - daily.
7. Empower others with positive talk even when I question my own capabilities.
8. Nap when I'm tired.
9. Manage personal guilt so that I neither feel like a failure, nor disregard life's lessons. i.e.; acknowledge that I am indeed, human.


There you have it, in the raw, my GDL. Have you started your list yet?

Recipe Suggestions: 5 Day Pouch Test

Many of our LivingAfterWLS Neighbors are enthused about trying the 5 Day Pouch Test and a few have written to ask for recipes. As we explained in the original post, lean and clean protein is the best way to work this plan. But you can be flexible and cook recipes with more ingredients to enhance flavor. Remember, the objective is to give your pouch a two day rest, then progressively "tighten" it by increasing the density of your protein over the next three days.

Here are some recipe suggestions from our LivingAfterWLS Recipe Collection. Work the plan the best way you can and rediscover your pouch.

Days 1 & 2:
(liquids, protein shakes)
Healthy Chocolate Smoothie
Orange Dream Smoothie
Strawberry-Banana Smoothie

One of our community members suggested this:

"I have come across a great protein smoothie called 'Naked' All natural protein juice smoothie. I get it from SAM's Warehouse. Each bottle (32 fl oz) has 38 Grams of Protein or 19 grams per serving (16 fl oz) along with other nutrients like Potassium, calcium, Vitamin A, Vitamin C and Iron. It tastes great!

The web site is... www.nakedjuice.com ... Check it out. There is a store locater on the site too."

Day 3: Soft Protein
(canned fish, eggs, soft fish)
Healthy Deviled Eggs
Oven Scrambled Eggs
Crusted Fish Recipes
Cheesy Salmon Loaf (omit green peas)

Day 4: Firm Protein
ground meat, shellfish, scallops, lobster
Turkey Cheeseburgers
Grilled Garlic Shrimp
Tender Shrimp
Baked Citrus-Herb Salmon

Day 5: Solid Protein
(white meat poultry, beef steak)
Basic Sauteed Chicken Breasts
Lemon Herb Chicken
Bamagal's Thai Peanut Butter Burgers

Remember, keep your food selections as simple and basic as possible for the best results. But it is OK to be flexible. This plan is to help you rediscover your pouch and boost your confidence in your ability to work the tool.

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.