5 Day Pouch Test Bulletin
Rule #2 - Lots of Water
We're supposed to drink lots and lots of water - but not with meals.
How do we do it? What counts for water?  

2012 Is Your Time:
Shine Like the Star You Ar

October 2012  

Today's Bulletin
Inspired Quotes
Hold the Ice
I'm Confused! Drink lots of water, but restrict liquids?
Recipe: Lemon Ginger Iced Green Tea
WLS, Dizziness, Dehydration
Free Downloads
Lots of Water

The Cold Wet Truth: Even with WLS Lifestyle Changes Are Necessary

"The truth is, in order to lose weight and maintain the resulting healthy body weight with weight loss surgery (gastric bypass, gastric lap-band, gastric sleeve) one must make significant lifestyle changes that include a following high protein diet, the elimination of processed carbohydrates and carbonated beverages, and avoiding or at least controlling snacking or mindless eating. In addition patients must engage in daily physical activity beyond the physical motions of the routine day. Patients must exercise. A lapse in adherence to the dietary or activity requirements of bariatric surgery will cause weight loss to cease and may potentially cause weight gain."
~Kaye Bailey
Day 6: Beyond 5DPT

of WLS

Protein first.
Lots of water.
No snacking.
Daily exercise.

Back to basics means a refusal to return to the eating patterns and habits that caused your obesity in the first place. Back to basics is about dedication and hard work and stubborn determination."
You Have Arrived Newsletter
September 5, 2007

Understand the Four Rules of Weight Loss Surgery Before Going Under the Knife

Featured in  

5DPT Article Collection:


"Weight loss surgery is frequently perceived as an easy means to weight loss that requires little or no effort by the patient. However, patients who undergo bariatric surgery are prescribed Four Rules of dietary and lifestyle management that they will follow for the rest of their life if they wish to lose weight and maintain a healthy weight. Here is what you need to know about the Four Rules of weight loss surgery before going under the knife."   Full Article 


Losing weight and staying sane in a world where
 it's easy to be fat.

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General Store

No Ice Water for Me Please!
Ice Water

We have all read this conventional diet tip - and we've heard it before:

"Burn away fat with ice cold water! Ice cold water is calorie-free and fills you up so you can eat less. Drink ice-cold water and you'll even burn a few extra calories as your body warms it up!"

If you are in the phase of rapid weight loss or have lost quite a bit of weight you know exactly why gastric bypass patients don't drink ice cold water - we're already freezing - even in the heat of summer. The last thing we want to do is get colder!

People who experience the massive weight loss associated with weight loss surgery experience feeling cold for two reasons: loss of insulation and less energy generation.
Fat is a highly efficient insulator. When gastric bypass patients follow the rules: eating protein and exercising, the weight lost can only come from fat or stored energy: insulation. Less insulation increases the likelihood of feeling cold.

The second reason for feeling chilled is that the metabolic cell processes are not working as hard as when you were heavier; it takes fewer calories and less energy to maintain and move a smaller body. A heavier body must generate more energy to operate, as a result more heat is generated.
Most weight loss patients report that their body temperature regulates after their weight is stabilized, usually eighteen to twenty-four months after surgery. Patients who incorporate exercise in their weight loss program experience less chilling than patients who do not exercise.

Serve a cup of herbal tea instead:
Herbal Tea
LivingAfterWLS General Store
Herbal Teas


In Case you missed it:
5DPT Bulletin
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Protein First:
We are falling short
September Bulletin
How much protein have you had so far today? "As a group, we are not eating enough protein and this shortfall is putting our health at risk." We know that after weight loss surgery we should follow a high protein diet. We call this "Protein First" - the first of the Four Rules of WLS. Mainstream studies of people managing their weight without bariatric surgery continue to indicate a diet high in protein supports weight loss and weight management in addition to promoting health.
Go to Bulletin

Back to School:
August Bonus
I am capturing the spirit of back to school in this special edition 5 Day Pouch Test Bulletin and reviewing the EUREKA! fundamentals that keeps this WLS working for me. I hope you'll join me in this review and take some time to go back to school - the University of LivingAfterWLS - right this way - I saved you a seat basics.
Back to School

Review Top FAQs

February 2012:
Today we take a look back at the most frequently asked 5DPT questions in the last year. As the 5 Day Pouch Test has become more widely known information about it --both accurate and inaccurate-- abounds.

Is this Dangerous?
March 2012:
Answering the tough question - Is the 5DPT dangerous to my health? Link

Help! I'm Stuck!
May 2012:
If you are frustrated with a plateau give the 5 Day Pouch Test a try. Get that scale moving again and renew your confidence in your pouch, your personal power, and decision to have surgery in the first place! This month's 5DPT Bulletin is all about using the plan to boost your metabolism, bust a plateau and get back on track with your weight loss surgery! Link

Days 1&2 are Hard!
June 2012
This month's 5DPT Bulletin takes a look at some of the pitfalls that derail us on Days 1 and 2. I then give solutions and suggestions to avoid these pitfalls so we all may successfully get back on track with our health and weight management using the weight loss surgery tool in the manner that serves us best. Little things make a difference and I think if you give Days 1 and 2 another try a pleasant surprise awaits you come Day 3.


Greetings Neighbors!
In the September 5 Day Pouch Test Bulletin we discussed Protein First, the first of our four WLS rules. As reported, many of us are not getting enough protein. I was pleased to hear from so many of you who were inspired to increase your protein intake and you noticed the results on the bathroom scale. Congratulations to all of you! Even if we do not need to do the 5 Day Pouch Test, we almost always can do a little something different that improves the results we are a getting with our healthy weight management. If you missed last month's bulletin you can check it out here: September 2012 5DPT Bulletin.
Coffee Protein Smoothie
Does coffee count?

This month we move to Rule #2 - Drink Lots of Water.  The advice to drink lots of water is universal across the diet spectrum. Water flushes toxins, including the body fat we shed, improves circulation, promotes skin health, brain function, kidney function -- the list is long. With all the great benefits that come from drinking lots of water you'd think it would be easy to get it done. But drinking lots of water every day can be very challenging.  The more we drink, the more we eliminate (not always convenient). Water is tasteless and can seem tedious. There are many other better flavored beverages tempting us. And then there are the liquid restrictions: no water with meals; no water for 15 to 30 minutes before and after meals. And what actually counts as water?

It is really confusing!

It seems like almost everyone has their own standard for what counts as water and what doesn't.  Even from one bariatric center to the next it is difficult to get a consistent answer about how much water we need and what counts as water. Over the years I've come to my own conclusion about what "counts" as water for me. First, water counts. Next, if there are nutrients in the beverage such as Green Tea or a protein drink, I count it toward my fluid intake. One glass of red wine with its health promoting antioxidants counts -- four glasses of red wine do not count. Coffee with protein powder blended in counts; black coffee doesn't (because of the caffeine).  I aim for 60 to 80 ounces of water or countable fluid a day. This puts me in the bathroom about every 2 hours and I am able to maintain my weight without frustrating water weight gain or false weight loss.

I imagine that is the real bottom line regarding water intake is answered with this question:  What does it take to help us feel our very best? It will be different for each one of us but it certainly helps to learn what is working for others traveling this not-so-easy WLS terrain. I hope you will find some nuggets of helpful information in this month's 5DPT Bulletin. Thanks for joining me!

We are all in this together!
You are more powerful than you think and
You Can Do This!


"Keep learning. Use the 5 Day Pouch Test and beyond to continue your education about health, nutrition, weight management, and living after weight loss surgery. Continued education works to keep us informed, trying new things, and renewed hope that lasting remission from our medical disorder is achievable. Seek knowledge from reputable publications and from peers. This process of support and learning becomes a self-fulfilling prophecy as we benefit from the give-and-take of a generous spirit. Learn, teach, and share. We are in this together."
~Kaye Bailey - 5DPT Owner's Manual 2nd Edition, p.29

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Drink lots of water, but restrict when you do it.
for the rest of your life......  but how?
From the 5DPT Articles Collection
In a country where food and drink go hand in hand weight loss surgery patients are challenged to follow the liquid restrictions as instructed by their bariatric center. But understanding and following the liquid restrictions plays a key role in long-term weight maintenance following gastric bypass, gastric sleeve, or adjustable gastric banding (lap-band) surgeries.

In general, bariatric centers instruct weight loss surgery patients to avoid drinking liquids for thirty minutes before a meal, during the meal, and for thirty minutes following the meal. This easily adds up to 90 minutes of no liquids three times a day: four-and-one-half waking hours. It is easy for patients to become frustrated with these restrictions because another rule of weight loss surgery is to drink lots of water, at least 64 ounces a day. Understanding why the liquid restrictions are necessary and how water intake affects weight management will increase the likelihood a patient will follow the guidelines.

When a person undergoes any of the currently practiced bariatric and metabolic surgeries for weight loss the size of the stomach is reduced significantly to restrict the amount of food which may be eaten at a given time. The size of the restricted pouch varies by procedure, surgeon and patient. What is consistent, however, is that the smaller stomach pouch fills quickly and the patient experiences a feeling of fullness andsatiation, which must be sustained following the meal to avoid hunger and cravings later.  This is to keep the patient from over eating.  In addition, the longer food is kept in the digestive system the more opportunity the body has to absorb and metabolize nutrients. The best way to sustain this fullness is to eat lean protein and low-glycemic complex carbohydrates in a ratio of two bites protein to one bite carbohydrate.

For many weight loss surgery patients the feeling of tightness or restriction that results following eating is unfamiliar and uncomfortable. In weight loss surgery street talk these patients learn to "eat around the pouch". In many cases that means drinking liquid with solid food which relieves the tightness as the chewed food (chyme: semi-liquid mass of partly digested food) mixes with liquids to form a more fluid liquid slurry which passes through the new stomach outlet more rapidly. The result is increased food intake because patients can eat more food during a planned meal and they are likely to eat again later because they are hungry and the slurry meal failed to satiate hunger for a reasonable amount of time.

As important as it is to follow the liquid restrictions it is equally important to drink adequate water. The body is made up of about 60 percent water. Water assists with the transport of nutrients and waste products throughout the body. Water is present in every process of human biology. Most centers recommend a minimum intake of 64 ounces a day. Others suggest morbidly obese patients drink one ounce of water for every two pounds of body weight.

Organized planning is helpful when following liquid restrictions and drinking lots of water. Begin the day with water and enjoy water between meals, which will also help keep cravings away. Keeping a glass or bottle of water at arms reach is a steady reminder to sip often and stay hydrated. Newly post-operative patients report drinking tepid or room temperature water is easier on the pouch thus making it possible to drink more.
Kaye Bailey (c) All Rights Reserved


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Lemon Ginger Iced Green Tea
 I use this recipe often but seldom serve the tea over ice for myself; however others enjoy it with ice. Your choice. There is a certain clean feeling that comes from drinking tea - I think if you are not already including green tea in your healthy weight management plan that once you do, you'll be hooked. Give it a try!
Not the Queen's Tea
Herbal tea counts towards water intake and provides many health benefits.

LivingAfterWLS General Store

2 cups water
1 teaspoon ground ginger
2 teaspoons grated lemon peel
6 green tea bags
juice of 1 lemon
low-calorie sweetener of choice, to taste

Add water, ground ginger, and lemon peel to medium saucepan and bring to boil over medium heat. Reduce heat to where it sustains a gentle boil and cook for about 7-8 minutes. Remove from heat and add the green tea bags. Steep this tea mixture for 10 minutes, stirring or dunking the bags often.
Remove tea bags and stir lemon juice into the tea liquid. Cover and refrigerator for up to 1 to 2 weeks.

To make a cup of iced tea, pour 1/4 cup of the concentrated tea mixture into a tall glass and stir in 3/4 cup of cold water, add sweetener as desired.  Add ice cubes and enjoy!


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Weight Loss Surgery, Dizziness, Dehydration:
How to prevent chronic lightheaded woozies
Stop Spinning!
Many weight loss surgery patients report frequent spells of dizziness. In general they are using the word dizzy to describe everything from feeling faint or lightheaded to feeling weak or unsteady.  

Research indicates a state of chemical imbalance can lead to temporary bouts of dizziness. When a bariatric patient feels dizzy it could very well be related to the restricted diet. Most commonly going too long between meals or not drinking enough water causes bariatric patients to become dizzy or have a mild electrolyte imbalance. Many patients self-treat dizziness by drinking water or little sips of a sports drink such as Gatorade. I use Emergen-C energy booster for the vitamins and electrolytes, and I like the portability of the drink mix in a sealed portion-perfect envelope.

Dizziness may occur when too much time passes between meals, or as an early warning sign of dehydration. Lack of food or loss of bodily fluid interrupts the body's physiological process; the electrolytes get out of balance.

Potassium, sodium and chlorine are the three dominant electrolytes in the human body. Beneath our conscious awareness the electrolytes are very busy jumping in and out of cells making it possible for nerve impulses to travel from one nerve cell to the next. When we are eating correctly, staying hydrated and pursuing a healthy lifestyle it is likely the electrolytes will stay balanced and we can enjoy a dizzy-free existence.

It is extremely dangerous when electrolytes become severely imbalanced. Infants suffering from dehydration have died from electrolyte imbalance. So have sufferers of anorexia.

If flu symptoms cause dehydration to the point of extreme dizziness and disorientation one must seek medical help. Dehydration will force a greater loss of potassium, which raises the sodium level in all muscle tissues. At greatest risk is the heart muscle where an increase of sodium may cause arrhythmia and death.

The sports and nutrition industry's guideline for water consumption is one ounce of water for every two pounds of body weight. Carefully monitoring fluid intake will help weight loss surgery patients avoid chronic dizziness.


Free Downloads from LivingAfterWLS
Rainbow of Ribbons downloadsBuild Your WLS Toolbox
LivingAfterWLS offers several free download worksheets (.pdf format) to assist you in keeping records and setting goal in your weight loss surgery journey. May we recommend:

Quarterly Personal Self-Assessment Worksheet

5 Day Pouch Test 2-Page Journal

Fit Is It Exercise Log

Day 6 Menu Planner & Shopping List

LivingAfterWLS Downloads Page

5 Day Pouch Test Tools
Four Rules

Rule #1 - Protein First:
 LivingAfterWLS Weekly Digest January 20, 2011


Rule #2 - Lots of Water

  LivingAfterWLS Weekly Digest February 2, 2011 


Rule #3 - No Snacking

LivingAfterWLS Weekly Digest February 9, 2011  


Rule #4 - Daily Exercise

LivingAfterWLS Weekly Digest February 18, 2011  


The Four Rules: Should this be Rule #5?
LivingAfterWLS Weekly Digest February 24, 2011.




The health content provided by LivingAfterWLS is intended to inform, not prescribe, and is not meant to be a substitute for the advice and care of a qualified health-care professional.

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