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5 day pouch test

Discussion in 'Post-Op Diet' started by Jrichard, Jul 10, 2011.

  1. Jrichard

    Jrichard New Member

    Start Weight:
    21st10lb
    Current Weight:
    13st3lb
    Goal Weight:
    11st0lb
    Lost(%):
    8st7lb(39.14%)
    Surgery Type:
    Gastric bypass
    Funding Type:
    Private
    Consultant:
    Mr Ackroyd
    Surgery Date::
    16/06/2011
    I have read lots of people mentioning the 5 day pouch test, but I am confused......

    What is the 5 day pouch test?
    How do you do the 5 day pouch test?
    When do you do the 5 day pouch test?
    What are the benefits to the 5 day pouch test?

    I know, I know lots of questions but I am really confused.

    :confused:

    Julie
     
  2. BlueDiamond

    BlueDiamond New Member

    Start Weight:
    17st4lb
    Current Weight:
    9st7lb
    Goal Weight:
    10st0lb
    Lost(%):
    7st11lb(45.04%)
    Surgery Type:
    GASTRIC BAND
    Funding Type:
    NHS
    Consultant:
    MR KHOO
    Surgery Date::
    26TH JULY 2010
  3. Karlos

    Karlos New Member

    Start Weight:
    28st8lb
    Current Weight:
    10st11lb
    Goal Weight:
    14st0lb
    Lost(%):
    17st11lb(62.25%)
    Surgery Type:
    RNY Bypass
    Surgery Date::
    07.02.09
    It's a pouch reset rather than a test. It's only purpose is to allow you to break away from any poor food choices that you may have been making for five days. To give you a chance of getting back on track, and contrary to popular belief it will not shrink your pouch.

    It's also only for those people who are say 18 months plus post op who might have been slipping back to poor eating habits.
     
  4. Jrichard

    Jrichard New Member

    Start Weight:
    21st10lb
    Current Weight:
    13st3lb
    Goal Weight:
    11st0lb
    Lost(%):
    8st7lb(39.14%)
    Surgery Type:
    Gastric bypass
    Funding Type:
    Private
    Consultant:
    Mr Ackroyd
    Surgery Date::
    16/06/2011
    Thank you it all makes sense now. I was starting to think I must be the only person on here that doesn't know what it is.

    Julie
     
  5. shelbell

    shelbell Proudly maintaining

    Start Weight:
    20st9lb
    Current Weight:
    11st0lb
    Goal Weight:
    12st4lb
    Lost(%):
    9st9lb(46.71%)
    Surgery Type:
    Gastric Bypass
    Funding Type:
    NHS
    Surgery Date::
    16th July 2008
    It's designed for after 6 months post op ;)

    Sent from my iPhone using Forum Runner
     
  6. Karlos

    Karlos New Member

    Start Weight:
    28st8lb
    Current Weight:
    10st11lb
    Goal Weight:
    14st0lb
    Lost(%):
    17st11lb(62.25%)
    Surgery Type:
    RNY Bypass
    Surgery Date::
    07.02.09

    Really? :eek: :D:D:D You are kidding right? I've never read that on any forum, or heard any dietitian say that until now. In fact the medical advice given by a doctor on another forum I use said even twelve months out is far is too soon.

    Anyone who needs to do a pouch reset after just six months is unlikely to get much benefit from it. If you are already making bad food choices after such a short period of time you're in real trouble.
     
  7. shelbell

    shelbell Proudly maintaining

    Start Weight:
    20st9lb
    Current Weight:
    11st0lb
    Goal Weight:
    12st4lb
    Lost(%):
    9st9lb(46.71%)
    Surgery Type:
    Gastric Bypass
    Funding Type:
    NHS
    Surgery Date::
    16th July 2008
    That's according to the 5dpt book Karl. A lot of people need the kick up the backside earlier especially if they've fallen in to the 6 month carb and [email protected] trap, were you can get away with eating carbs and junk in the first 6 months and still lose weight, but then after the golden period it doesn't work so easily!

    I completely agree that you shouldn't need to do the 5dpt that early out, but unfortunately some do.

    Sent from my iPhone using Forum Runner
     
  8. Karlos

    Karlos New Member

    Start Weight:
    28st8lb
    Current Weight:
    10st11lb
    Goal Weight:
    14st0lb
    Lost(%):
    17st11lb(62.25%)
    Surgery Type:
    RNY Bypass
    Surgery Date::
    07.02.09


    I understand that view, I read of people on here wanting to rush the liquid or puree stage and I really dispair for them, they are future failures in waiting, but the general (Including medical and dietry) advice is 18 months is the earliest time that the 5DPT should be considered. Think about it, if your weight loss has stalled, then entering a period of relatively low calorie consumption is likely to enforce any stall.


    It also puts us right back on the futile cycle of eating crap then starvation dieting at a very early stage in our post op journey. Five days of strict dieting might cause some weight loss, (Though most of it would be fluid loss) so they celebrate with cup cakes and chcolate :D The same distructive cycle that got us huge in the first place.


    I would suggest that the type of person who feels they need the pouch reset (I hate the term "pouch test" as it really tests the willpower not the pouch) at just six months out is the last person who should do it, why? well because it puts them right back where they were pre op; Yoyo dieting and eating crap. If they have failed to follow the plan at six months out they need to get back to their NUT and talk it through. I have friends in the USA who go through the test every couple of months and they fail it everytime because it's not the pouch that needs to be reset but their heads


    My advice such as its worth, follow the post op plan, use the honeymoon period to break the hold food had on you and you will never need the reset. Not easy I know, in fact its chuffin hard, but its the key to lifelong success


    OK I'm getting light headed now so I'm going to step off this lofty pedastal before I fall off :D:D:D
     
  9. joffy01582

    joffy01582 New Member

    Start Weight:
    22st5lb
    Current Weight:
    16st9lb
    Lost(%):
    5st10lb(25.56%)
    Surgery Type:
    gastric bypass
    Funding Type:
    NHS
    Consultant:
    Mr PS Jambulingam
    Surgery Date::
    30 august 2011
    safe landing karlos............................ i thought we all had our heads checked before our surgeries (mines acoming) so that we know our assocation with food and the we think or am i missing something
     
  10. Karlos

    Karlos New Member

    Start Weight:
    28st8lb
    Current Weight:
    10st11lb
    Goal Weight:
    14st0lb
    Lost(%):
    17st11lb(62.25%)
    Surgery Type:
    RNY Bypass
    Surgery Date::
    07.02.09
    The pre op psychological assessments carried out in the UK are a joke. How many times do you see people on forums asking is it ok to eat eat pizza three weeks out if they only have one slice, or can I drink alcohol at week four :D

    We had one idiot at a support group meeting who was boasting that he had eaten KFC crap at week three :eek: WLS is littered with people who are simply not mentally equipped to handle the rigours of post op life
     
  11. joffy01582

    joffy01582 New Member

    Start Weight:
    22st5lb
    Current Weight:
    16st9lb
    Lost(%):
    5st10lb(25.56%)
    Surgery Type:
    gastric bypass
    Funding Type:
    NHS
    Consultant:
    Mr PS Jambulingam
    Surgery Date::
    30 august 2011
    my other half has a friends whos husband forked out for a stomach band for her and she eats more than me and i'm pre op ..................she'll eat till shes sick and its not a nice sight seeing her reaching and then laughing it off
     
  12. Jrichard

    Jrichard New Member

    Start Weight:
    21st10lb
    Current Weight:
    13st3lb
    Goal Weight:
    11st0lb
    Lost(%):
    8st7lb(39.14%)
    Surgery Type:
    Gastric bypass
    Funding Type:
    Private
    Consultant:
    Mr Ackroyd
    Surgery Date::
    16/06/2011
    Only NHS patients have the opportunity to seek advice from a psych. Private patients can choose to have the op and actually have the op within a month of that decision.

    It's not a perfect system, but until the NHS acknowledges that bariatric surgery is life and money saving, that is how things will stay.

    I went to two different trusts, with a BMI of over 50, but high cholesterol, high blood pressure and insulin resistance meant nothing so I had no choice but to go private.

    I agree that the pouch test should not need to be completed early on, however I am certain that there are post oppers out there that would benefit from a proverbial kick up the butt.

    Personally I know why I overeat and am lucky to have a low threshold for sugar. I physically cannot tolerate anything naughty. However I am not naive enough to think that this may not change.

    Additionally I am not naive enough to assume that the bad habits that I have developed and used for over half my life will magically disappear following surgery. Therefore having a safety net such as the pouch test is a valuable tool in anyone's weight loss journey, if only for the aforementioned kick up the butt!

    Sorry Karlos I thought I'd join you on the soap box.

    Julie
     
  13. shelbell

    shelbell Proudly maintaining

    Start Weight:
    20st9lb
    Current Weight:
    11st0lb
    Goal Weight:
    12st4lb
    Lost(%):
    9st9lb(46.71%)
    Surgery Type:
    Gastric Bypass
    Funding Type:
    NHS
    Surgery Date::
    16th July 2008
    I think that part of the problem is that people see it as just 5 days. Then back to 'normal' with, at best, good intentions. The point of it is that every day afterwards is day 5, but most people don't get that. Unfortunately a lot of people attempt it without having researched it and not really understanding the process.

    Sent from my iPhone using Forum Runner
     
  14. Sambucca

    Sambucca New Member

    Start Weight:
    20st7lb
    Current Weight:
    11st7lb
    Goal Weight:
    11st0lb
    Lost(%):
    9st0lb(43.9%)
    Surgery Type:
    Gastric Bypass
    Funding Type:
    NHS
    Consultant:
    Mr Amir Khan
    Surgery Date::
    30th August 2009
    Hear hear karlos, chuffin well said.

    Ive missed your wise words around here.
     
  15. Stellap

    Stellap At goal at last.....

    Start Weight:
    16st13lb
    Current Weight:
    10st0lb
    Goal Weight:
    10st7lb
    Lost(%):
    6st13lb(40.93%)
    Surgery Type:
    bypass RNY
    Funding Type:
    NHS
    Consultant:
    Mr koak, Homerton, London
    Surgery Date::
    4/12/09
    Unfortunately the psychological side of wls is sorely lacking. I had absolutely no psycho assessment pre-op apart from a few questions about the way I eat with the dietician. I paid privately for cbt and that helped a lot and has enabled me to stay on track 18 months post op. Most of our problems are in the head with old patterns well established that need breaking and to not deal with this is like having an op without a pre-op assessment.
     
  16. sydenham

    sydenham New Member

    Start Weight:
    20st0lb
    Current Weight:
    15st6lb
    Goal Weight:
    11st0lb
    Lost(%):
    4st8lb(22.86%)
    Surgery Type:
    Roux En Y
    Funding Type:
    Private
    Surgery Date::
    7/4/11
    I paid for my surgery and never once were the psychological issues touched upon.
    What I would say is that unless someone has "special needs" and then the surgery wouldn't have been performed - we are all mentally equipped for post op surgery but not everyone does the equipping in the same way.
    The way you write Karlos and its admiral, its clear that you are equipped with the Tenacity, Resolve, Drive and Determination needed to succeed but not everyone can be compared to you.
    I'm sure no one starts a weight loss journey with the idea that they want to invite failure but the mentality that got everyone fat in the first place is a difficult one to lose.
    Just like one drug addict fails on a detox programme where 10 others succeed and one smoker fails on a smoking cessation course where 10 others succeed, you have to appreciate everyone's strengths and weaknesses.
    That " idiot " although maybe seen as a failure by you, surely still deserves a chance - they are just weaker than you. Every human being has a right to help and support and shouldn't be dismissed as an idiot.
     
  17. Karlos

    Karlos New Member

    Start Weight:
    28st8lb
    Current Weight:
    10st11lb
    Goal Weight:
    14st0lb
    Lost(%):
    17st11lb(62.25%)
    Surgery Type:
    RNY Bypass
    Surgery Date::
    07.02.09


    I made no distinction between private and NHS patients as that was not the point in question. I guess there is a case for checking if the £12,000 plus of publicly funded money is a worthwhile investment, but I firmly believe that ALL surgeons have a duty of care to assess that the person whose guts they are going to re-route is equipped with the faculties to cope with post operative life. Post op life carries with it a number of rules that failure to follow may result in serious illness or even death, so surely it is prudent to assess if that person is prepared/capable of doing it?

    What “Special needs” would you say should be considered? On what basis are you claiming that we are ALL mentally equipped for WLS? Because if we were then surely there would be no reason for pre testing of attitude, or psychological assessment. Your premise is at best flawed and at worst dangerously ignorant of the impact that having someone’s main source of emotional support (Food) removed from their grasp might and does have.




    I am no saint, nor do I compare my maxim to anybody else’s, but I can follow instructions that we are all given and I would expect any post operatives to at least do the same



    Thanks, by missing the point completely you just made my point for me. The issue isn’t whether they want to fail; it is whether they have the mental capacity, determination, and attitude to want to succeed. Can they take this golden chance of potential lifelong success and make it work with them to change their lives for the better.

    Too many see this as a miracle cure, they turn up, get chopped, and the weight is gone forever, it’s easy. I read threads entitled 100 lbs gone forever!! And I cringe, it’s only gone forever if you have changed your lifestyle to ensure it. Unless we do our bit it will fail, we will fail.




    The failure rate for WLS is far greater than 10%. Average failure to maintain without regain for two years or more is I believe closer to 40%, but again you miss the point.

    The idea should be to assess if the potential patient has the capacity to succeed. My mate in America had to sit a two hour questionnaire that assessed her suitability for surgery. She also had a sixty minute interview with a psychologist who checked that her attitude was right, and that she was mentally equipped for the rigours of post op life. Her surgical team have a 95% success rate for their patients maintaining a healthy weight up to three years out. That success rate is superb and is based upon the level of assessment that is employed to make sure only those who are right for surgery get it. This is the norm for the USA mate not the exception; they don’t have the NHS in America, someone has to pay be it the individual or the insurance companies.

    All should receive help with managing their weight. That is an absolute given and I have no problem with that. My point is simply this; WLS is not a cure for obesity. Unless you deal with the root cause first then far from helping the individual WLS might actually make matters worse. If you have someone who is mildly depressed, addicted to the comfort that they get from food, and you strip that crutch away from them without prior or additional psychological support and you have a recipe for disaster.

    They should carry out better testing to find out if the person is actually going to do their bit and benefit from WLS. If they are not ready mentally then help get them ready first, then when they are prepared to change for life great; at that point let them have the chance, until that time spend the money more wisely on those that are. That really is my point in a nutshell.

    As for me calling some idiots! Well when your surgeon tells you that eating solid food before you’re ready for it could cause you serious medical consequences maybe even be fatal, and despite that they are still eating pizza or bread or meat or chuffin KFC at week two, then they my friend are friggin idiots. Someone who is told not to drink booze for six months who ignores that advice and is drinking at week two, three, or four etc is an idiot, or has a drink problem that should have been dealt with pre op. Banders who blend chocolate bars so they can have them at week two are idiots. You call them what you like and I’ll call them idiots

    I like to think I do give support to those who genuinely deserve it. If someone makes a mistake and learns from it then I will back them all the way, I am no saint and have never professed to be, but I have little tolerance for those who display a total lack of respect for the chance that they have been given.

    I see too many people who abuse this chance when there are people desperate for WLS who I know would do all they could to make it work but because of a lack of funding or the postcode lottery they are denied, to have much sympathy for these idiots mate.

    Have a good week x
     
  18. sydenham

    sydenham New Member

    Start Weight:
    20st0lb
    Current Weight:
    15st6lb
    Goal Weight:
    11st0lb
    Lost(%):
    4st8lb(22.86%)
    Surgery Type:
    Roux En Y
    Funding Type:
    Private
    Surgery Date::
    7/4/11
    I rest my case Karlos, Just because you are so Resolute, you wont consider another opinion.
    You make it very clear that it is your way or no way. I am fully aware that you weren't making comparisons between NHS or Private, I was merely stating my case. I don't consider having missed any of your points, would you consider perhaps you have misinterpreted my comments?.
    By Special Needs I mean for example "Downs Syndrome" - surgeons do not as a rule operate on a patient with Special Needs.
    You hold great stead in psychological testing and its benefits - are you so naive to believe that those taking part in these sessions actually say what is true or what they have learnt that they should say. Completing these sessions isn't such an achievement but changing lifestyle for a prolonged period of time is.
    I consider myself human with many flaws and couldn't possibly complete with your flawless attitude to life and WLS.

    Have a nice week too!
     
  19. Karlos

    Karlos New Member

    Start Weight:
    28st8lb
    Current Weight:
    10st11lb
    Goal Weight:
    14st0lb
    Lost(%):
    17st11lb(62.25%)
    Surgery Type:
    RNY Bypass
    Surgery Date::
    07.02.09


    Your case? What case? Your opinion seems to be that everyone apart from Downs Syndrome etc is ok to cope with post op life and you are dead right, I cannot agree with that premise. I have been involved with forums and several support groups for nearly three years and I have met a number of people who were simply not equipped or capable of coping with the rigours of post op life. Not just my opinion, their results and post op mental and medical issues proved it




    What absolute complete and total rubbish. It’s not my way it’s the instructions and advice given by my and every other surgical team, successful members of a number of forums, and the medical and nutritional profession in general. I chose to follow the professional medical and dietary advice that I was given, if you or anyone else wants to stray from that path that is your choice. It’s your pouch, your surgery and your ultimate success or failure. Just don’t expect me to have too much sympathy for those who choose to fail by the choices they make






    I struggled to work out what point you were trying to make to be honest, and I thought comprehension was one of my strong points, go figure! Are you saying that private patients shouldn't be tested? are less likely to have undiscovered mental health issues? that they don't need to follow the rules? what exactly is your point here?

    There are numerous cases of people being treated for mental health issues on medication for these issues who have received WLS on the NHS. I personally know of at least five people who are being treated clinically for mental health issues that should have called to question their suitability for surgery who have received it. So apart from the extreme case you allude to you have failed to make it clear what you would consider to make someone unsuitable for surgery.




    I thought that I had made it clear that the level of psychological testing in the UK is the problem not testing in general. I have actual experience of the level of testing, you appear not to have any so I'm unsure what you are basing your argument on. The tests carried out here are a joke and yes very easy to bluff your way through. Proper psychometric testing that is designed to look for consistency and honesty in answering is used daily in other areas, we use it at work when selecting new key staff, and when carried out by a trained professional it is extremely accurate and very hard to cheat. Backed up with an interview with a trained professional rather than a nurse or clinical assistant, and more people who need it would be able to get mental health assistance prior to surgery; giving a greater chance for them to have lifelong success, surely even you can see the benefit of that? Maybe not.

    "Completing the tests isn’t an achievement but changing lifestyle is"? At the risk of repeating myself, you seem to have missed the point once again, the point is that failure to assess the suitability of WLS candidates prior to surgery means that many more that are not prepared or not equipped to make these very changes receive WLS and ultimately fail. If we tested effectively then fewer of these WLS mistakes would take place, and more people who need a different type of help would receive it. I’m far from naive but I too am human and as such I too am flawed. As for your final comment well I’ll just treat that with the contempt it deserves, it says much more about you than I
     
  20. Jrichard

    Jrichard New Member

    Start Weight:
    21st10lb
    Current Weight:
    13st3lb
    Goal Weight:
    11st0lb
    Lost(%):
    8st7lb(39.14%)
    Surgery Type:
    Gastric bypass
    Funding Type:
    Private
    Consultant:
    Mr Ackroyd
    Surgery Date::
    16/06/2011
    Ok, when I started this thread I didn't anticipate an all out row. If we could focus on the subject and perhaps leave the scrapping to personal messages or just respect each others differences of opinion that would be great.

    Julie
     
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