Tuesday, April 22, 2014

Results of my first 5-day Pouch Test

I started my 5-Day pouch test a week ago, on the first evening of Passover.  For those who aren't familiar with the concept, the pouch test condenses the eating restrictions given to us as WLS post-ops into 5 days. Instead of being on liquids (mostly protein shakes) for two weeks, I was on them for two days.  Then instead of being on pureed/ super soft foods for 2 weeks, I was on them for the next 2 days.  The fifth day I returned to my normal post-WLS diet.  My surgeon said he has no problem with people doing the 5 day pounch test occasionally.  Of course, all WLS patients should check with their programs before they change their eating habits, even temporarily.

The reason for people doing the pouch test are two fold.  It is called a pouch "test" because after RNY/ Gastic Bypass post-ops have been over a year or two out, many start eating more food.  This can lead to pouch and stoma stretching, which starts to defeat the purpose of having such a baby-sized tummy (helping us get full quicker and stay full longer, also slowing digestion so that we can absorb as much of the nutrients as possible with our jejunum being bypassed).  Much like starting to eat after being very ill from the flu or other GI illness, after being on fluids for a while, you "feel" the food in your stomach more, and can become re-sensitized to cues of being satisfied before you over-eat.  This way you know that your pouch and stoma size are still working appropriately.

The second reason deals with the main problem most of us have - our heads.  Being restricted to protein shakes and the like forces us off the carbs that sneak back in to our diets.  Anyone who has tried to dramatically restrict flour, sugar, and other carbs from their diet knows that the first couple days are the hardest, but then you don't crave them as much after that.  It's both a physical and mental detox in some ways.  Being on protein shakes reminds us that we no longer choose what to eat based on taste - we choose it based on fuel our body needs.  Believe me, nobody would choose whey protein shakes for the taste.

Day 1: I drank 3 Syntrax Nectar Fuzzy Navel protein shakes over the first 24 hours.  While I am more tired than normal, the first thing I didn't anticipate was the return of the chills due to my greatly decreased caloric intake.  While I only eat about 1200-1300 calories on a given day, this took me down to about 750.  I also planned to use the Syntrax vanilla shakes to make the fake "Shamrock Shakes" recipe from the helpful website www.theworldaccordingtoeggface.com that I enjoyed as a post-op.   However, I was so cold I couldn't stand to make an iced drink, so I tried heating it up instead.  Ugh.  Predictably gross.  So, I used another packet of the vanilla to make some protein pudding (sugar free) with skim milk.  I had another 12 grams of protein from the pudding that first day.  First psychological observation: I don't feel hungry AT ALL.  If I'm going to feel hungry while getting all my protein in, it's when I'm only drinking the protein so it isn't staying in my stomach for long.  That means that if I'm getting in my protein when I'm eating my regular diet, any "hunger" I feel isn't real.  It's head hunger (feeling like you should be eating due to habit, emotional eating cues, etc).  Since I always get my protein in, ALL of my "hunger" sensations are fake/ unreliable.  Wow.

Day 2: I again drank the 3 Fuzzy Navel protein shakes and had some sugar-free protein pudding.  Note to others - Jello Sugar Free Lemon Pudding mix worked well.  I was down a couple of pounds already, which was not surprising.  No hunger, still.  Something I noticed more was that I was needing to watch myself very carefully to make sure I wasn't licking my fingers or taking a taste of something that I was preparing for the rest of the family.  I remember doing that a lot the first few weeks post-op.  Now I realize how much I have been licking off the spoons and knives, not to mention taking a bite of pasta to check if it's done, etc.

Day 3: I began my puree/ super soft foods with ricotta cheese mixed with some garlic salt, spaghetti sauce, and some mozzarella melted on top.  Ahhhh, the joy of savory flavors after two days of sweet is wonderful!  I'm down another pound, and still cold most of the time.  I had another eye-opening experience.  Last night I had a dream that I used to have frequently as a recent post-op.  In it, I find myself finishing off some cereal/ other non-bariatric friendly food that my kids have left over.  Then I wake up thinking I have really done that and feel awful.  As I realize it was just a dream, I feel a sense of relief and joy.  I am doing it.  I AM resetting my brain to it's original post-op state.  This is working.  I also enjoyed some runny scrambled eggs.

Day 4: No additional weight loss today.  Eating my runny scrambled eggs I realize that I'm perfectly satisfied with them.  For over a year I have been eating my scrambled eggs with sliced tomatoes, garlic salt, and melted mozzarella on top.  Those things are unnecessary for me to feel satisfied, and just add more calories, sodium, and fat than just another egg worth of egg beaters.  I'm no longer as cold.  Real food starts again tomorrow, and I'm looking forward to it, although I'll just stick with the plain scrambled egg beaters for breakfast.

Day 5: Down another 1/2 pound.  I'm back to my regular foods.  Lentils and onions with greek yogurt and cheddar cheese, sauteed julienned zucchini with vegetarian "meat" sauce and mozzarella, scrambled egg beaters.  Everything tastes great.  I'm eating a little less than I used to (my dogs are getting more leftovers).  I feel recommitted and renewed.  I am DEFINITELY going to make this an annual thing - probably on my surgiversary from now on.

Two days later, and my weight is still down, even though I'm eating regular foods.  What I'm not doing is licking spoons, tasting my kids food, etc (all stuff I shouldn't have been doing).  I'm not feeling very tempted by cravings, either.  For me this pouch test did exactly what I was hoping it would - reset my mind and help me reconnect with my commitment to staying healthy.  I didn't think my pouch or stoma had stretched, and feel confident that it won't if I keep following the rules.

Happy Earth Day!

Monday, April 14, 2014

Lots of pics! Starting my first 5-day pouch test/ My 2nd Surgiversary/ My 2nd Triathalon

I haven't posted a new entry in a long time!  I started this one in February and finally am posting in April.  I think that I have been have a lot of negative old-way-of-thinking thoughts - things like "I'll write a post when I have something cool to write about".  But, that's not why I started this blog.  I started it to motivate myself.  I started it to explore what was going on in my head on this journey.  And I've learned that you can't wait for life to hand something to you, you have to go out and make things happen.  So, I did my second triathalon in spite of the negative self-talk that was spinning around in my head, and it helped turn me back around.  Without further ado, here's a long delayed update.

I can't believe I've just celebrated my second surgiversary!  It seems to have gone so quickly, but at the same time it feels like I've been living this new life forever (and that's a good thing).  I celebrated with my family, and having a date night with my husband :)  And, I decided to splurge and bought myself a Fitbit Flex.

This year has been harder than the first - when they say that honeymoon period ends and it gets harder, they're right!  Your cravings come back stronger - that head hunger that you've been battling is still there AND you actually can tolerate more food (and probably more carbs without dumping, but I'm trying not to find that out).  My weight has fluctuated a lot more in the last year.  I was at 142.8 the morning of my surgiversary, which is 0.2 pounds less than I was on my 1st surgiversary and seems to be a stable point (also below my original goal of 150 so it feels great).  However, I have been lighter (down to 140.6) and I have been heavier (up to 148).  What has changed?  1) I'm not jogging right now, although I just signed up for my favorite 5k - The Color Run in May!  2) Part has been the weather/ deep freeze in Ohio and getting a tiny little dog that can't handle the speed and distance of jogging, and part has been dealing with the physical symptoms of pelvic organ prolapse.  But, part of it is 3) being lazy, being at my goal, and not trying as hard.  I have lost some muscle tone, although my size has stayed pretty much the same.  This is due to decreased intake to balance the decrease in calories burned.

My eating has stayed very good for the most part. I usually eat the exact same breakfast, lunch, and dinner every day.  It is boring, but it helps me remember that I'm eating for fuel not fun and it makes sure that I'm eating things my pouch tolerates well.  Being vegetarian and post-WLS, there aren't that many appropriate entrees that my pouch tolerates. Sometimes I find myself eating something I shouldn't as I'm preparing food for my boys (a bite or two of pasta, a pretzel, etc).  And, when I see the scale heading up north of 144 I have a "eat CLEAN d*** it!" moment.  Sure enough, as soon as I start catching myself, the scale starts to head back down.  I have also recently started rewarding myself with my favorite water flavoring drops (Dasani pineapple coconut) in my evening water if I have done a good job staying clean for the day.  That's been a good incentive.

My labs have continued to come back wonderful.  My hemoglobin A1C (blood glucose over an extended period of time) = 5.1  Anything 6 or below is considered normal for non-diabetics, and below 7 is normal for diabetics, so I am definitely still in remission and plan on keeping it that way.  Getting rid of my diabetes was my #1 motivation for having the surgery, and I was blessed to be part of the 75% to go into remission.  It doesn't mean it can't come back though - so I must remain vigilant.

In general I feel great - lots of energy, lower needed doses of anti-depressants, enjoying my job and (most of the time) my kids.  I love having the feeling of control over my health.  It used to feel like my weight controlled me.  Now it feels like I can us my brain to control my health - although it still has moments of poor judgement.  It's very empowering.

I've got the Color Run 5k coming up! I'm going to do a refresher course of Couch 2 5k to get my race legs on.

I just completed my second indoor triathalon, and that felt great.  I almost bailed on it - I haven't been jogging and didn't know the date for it until 2 weeks before hand.  I was worried that I haven't been jogging, and didn't want to injure myself.  But you know what - that was all negative thinking.  The fact is, nobody was going to force me to jog if I wasn't able to.  Nobody was going to make me finish it if I didn't want to.  Plenty of people just walk the track instead of jogging.  In other words, I needed to stop making excuses and just do my best.

I had a little bug a week before hand, and my husband was very nervous about me doing the race, but I reassured him I was back to normal and wouldn't push too hard.  To me, I realized that I can not let myself make excuses that allow me to be sedentary.  Races are motivating for me, and I enjoy the social aspects.

Here are some pics from the day:


Last year I won the gold medal for my age group - but that was only because I was THE ONLY WOMAN 40-49!!!  I enjoyed the medal, don't get me wrong, but I would rather lose and have competition.  This year my age group was the most competitive - I had 4 other women in my age group!  I'm proud to say I came in second!

So this is a great reminder to all of us not to let our own self doubts, or negative self-talk stop us from trying to do our best.  Did I run as far in 20 minutes as last year?  No, but it was very close.  And, it turns out I was able to swim, bike, and run farther than a lot of other people so I got a medal!  Most of all, I got a reminder that I am fit, and have good abilities from my daily living, even without really training.

As a psychological reboot, I'm starting my first ever 5-day pouch test tonight with the beginning of Passover.  The idea of a 5-day pouch test is that you re-boot your mind and your pouch sensitivity by reproducing the eating plan you went through right after surgery, only compressed to 5 days.  For the first 2 days, you drink fluids only.  Protein shakes, water, crystal light... The third and fourth day you eat pureed soft foods.  And the fifth day you eat regular food again.  It's to help you remember how to use your pouch as a tool, to think of food as fuel, and reconnect you to your commitment that you've made.  I had been thinking of doing it every year on my surgiversary but a family crisis made that difficult this year.  So I thought that Passover would be a good time - after all, I should be unleavened all year round, but the idea of making a sacrifice, much as people do for lent, seemed to align with the concepts of Passover.  Pushing through, doing what you need to do, walking towards freedom and your future, finding strength and renewing faith...  I'll let you know how it goes!