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!

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