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Day One – Eat fruits and lots of Fat Burning Soup (recipe below). Eat all fruits you want. Any kind except bananas. Canned fruit juice or fresh is OK.
(Note: Watermelon and Cantaloupe are lower in calories than most other fruits.) Drink unsweetened tea, unsweetened fruit juices and plenty of water.

Day Two – Eat Vegetables and lots of Fat Burning Soup. At dinner time help yourself to a huge baked potato with butter along with your soup. Eat any and all the vegetables you want. Canned, fresh, or frozen (without added sauces). Green, leafy veggies are especially good. Stay away from corn, dry beans, nuts and peas.

Day Three – Eat all the veggies and fruits you want and lots of Fat Burning Soup. Do not have a baked potato today.
Note: If you have eaten as directed above and have not cheated you will have lost 5- 7 pounds already!

Day Four – Eat lots of Fat Burning Soup along with three bananas for potassium and 5 -6 glasses of skin milk for calcium. Drink plenty of water.
(Add miller’s Bran to your diet if necessary to keep bowel movements regular.)

Day Five – Eat lots of Fat Burning Soup along with beef (Broiled fish or Skinless Chicken) and tomatoes. You can have 10-12 oz. of beef and a large can of tomatoes or as many as six fresh tomatoes. Be sure to drink 6-8 glasses of water today to wash away the uric acid in your body.

Day Six – Eat lots of Fat Burning Soup and beef and vegetables today (no potatoes). You can have two to three steaks today if you like and all the veggies you want. Go for the green, leafy veggies if possible. Remember, the Fat Burning Soup is the bases of your diet, so eat lots!

Day Seven – Eat lots of Fat Burning Soup along with unlimited brown rice, fruit and vegetables (except potatoes). Stuff yourself!

Note: At the end of Day seven. If you have not cheated, you will have lost 10 to 17 pounds. If you have lost more 15 pounds, go off the diet for two days before starting again at Day One.

Since everyone’s system is different, this diet will affect everyone differently. However, it is guaranteed that after just three days you will have more energy than when you begin.
(If you don’t cheat) Bowel movements will change after a few days on the diet. Add one half to one full cup of bran to your diet, if you like.

This Seven-Day diet eating plan can be used as often as you like. It actually cleans your system of impurities and gives you a feeling of well being and energy.

Absolutely no bread, alcohol, or carbonated drinks, include diet drinks.

FAT BURNING SOUP

6 large onions – yellow or green
2 green peppers
1 or 2 cans of tomatoes (stewed, crushed, paste or combinations)
1 large head cabbage
I bunch celery

In a large covered pot, place soup mix and medium cut vegetables. If you desire, add additional seasoning suck salt, pepper, curry, parsley, bouillon or hot sauce. Cover with water and simmer for approximately 45 minutes or until vegetables are tender.
Note: Should be used in conjunction with the Seven Day diet and not alone for indefinite periods.

Vocabulary :

Diversion –  an act of rerouting or diverting the flow from normal pathway to create a new way

Anastomosis -  the surgical union of parts and especially hollow tubular parts
Ileal –  or ileum is the final section of the small intestine in most higher vertebrates, including mammals, reptiles, and birds. The ileum follows the duodenum and jejunum
Ostomy -  A surgically-created opening in the abdomen for elimination of waste products (urine or stool).
Stoma -  an artificial permanent opening especially in the abdominal wall made in surgical procedures
Reservoir –  pouch, a space (as an enlargement of a vessel or the cavity of a glandular acinus) in which a body fluid is stored
Cystectomy -   the removal of all or a portion of the urinary bladder
Neurogenic bladder -   refers to dysfunction of the urinary bladder due to disease of the central nervous system or peripheral nerves
Neobladder -  a pouch or false bladder which mimics the normal storage function of the urinary bladder.

Urinary Diversion Surgery

Urinary diversion is a way of surgically rerouting or diverting urine flow from its normal pathway in order to treat the condition of diseased or defective ureters, bladder or urethra, either temporarily or permanently. Using the surgical method of urinary reconstruction and diversion a new way is created for the patient to pass urine.
For all of the procedures, a portion of the small and/or large bowel is disconnected from the fecal stream and used for reconstruction.

Purpose

The bladder creates a reservoir for the liquid wastes created by the kidneys as a result of the ability of these organs to filter and retain glucose, salts, and minerals that the body needs.

When the bladder must be removed; or becomes diseased, injured, obstructed, or develops leak points; the release of urinary wastes from the kidneys becomes impaired, endangering the kidneys with an overburden of poisons.
Reasons for disabling the urinary bladder are: cancer of the bladder; neurogenic sources of bladder dysfunction; bladder sphincter detrusor overactivity that causes continual urge incontinence; chronic inflammatory diseases of the bladder; tuberculosis; and schistosomiasis, which is an infestation of the bladder by parasites, mostly occurring Africa and Asia.

Radical cystectomy, removal of the bladder, is the predominant treatment for cancer of the bladder, with radiation and chemotherapy as other alternatives.

Common Indications for Urinary System Diversion

• Cancer of the Bladder • Bladder Dysfunction due to Neurogenic Sources • Bladder Overactivity that causes Continual Urge Incontinence • Chronic Inflammatory Diseases of the Bladder • Neurogenic bladder conditions that threaten renal function • Severe radiation injury to the bladder • Chronic pelvic pain syndromes

Three Types of Urinary Diversion Surgeries

1. Ileal Conduit Urinary Diversion

The ileal conduit urinary diversion surgery is used in patients who have had their bladder removed and is usually used in conjunction with radical cystectomy in order to control invasive bladder cancer. In this procedure, the ureters are surgically unattached from the bladder and a ureteroenteric anastomosis is made in order to drain the urine into a detached section of ileum (a part of the small intestine). The end of the ileum is then brought out through an opening (a stoma) in the abdominal wall. The urine is collected through a bag that attaches on the outside of the body over the stoma. The bag must be periodically emptied of urine.

Procedure

Ileal conduit surgery consists of open abdominal surgery that proceeds in the following three stages: • Isolating the ileum, which is the last section of small bowel. The segment used is about 5.9–7.8 in (15–20 cm) in length. • The segment is then anastomosized, or grafted, to the ureters with absorbable sutures. • A stoma, or opening in skin, is created on the right side of the abdomen. • The other end of the bowel segment is attached to the stoma, which drains into a ostomy bag.

Ileal Conduit Urinary Diversion Surgery (A). In a cystectomy with ileal conduit, an incision is made in the patient’s lower abdomen (B). The ureters are disconnected from the bladder, which is then removed (C). They are then attached to a section of ileum (small intestine) that has been removed and refashioned for that purpose (D). A stoma, or hole in the abdominal wall, is created at the site to allow drainage of the urine

2. Indiana Pouch Reservoir

In this form of urinary diversion, a reservoir (pouch) or a “false bladder” is constructed out of the right colon (large intestine) and a small segment of ileum (small intestine). The ureters are connected to the pouch and a short piece of small intestine is brought out to the skin as a small stoma. A one way valve mechanism is created so that urine is kept inside the reservoir (pouch) and will not leak out to the skin. Urine is removed by inserting a thin tube (catheter) into the stoma when the pouch is full. A bag is not required and the patient simply wears a bandage over the stoma. The patient is then taught to catheterize the reservoir to drain urine at regular intervals during the day. Although a continent diversion is not suitable for every patient who requires urinary diversion, it is an option to be considered.

3. Neobladder to Urethra Diversion

With the Neobladder to Urethra Diversion procedure, the intent is to create a new bladder that mimics the storage function of a normal urinary bladder. The surgery makes a reservoir or pouch by utilizing a small part of the small intestine and connects the pouch to the urethra. The ureters are repositioned to drain into this pouch. As in normal urinary system, urine is able to pass from the kidney, to the ureters, to the pouch, and through the urethra out of the body.

Alternatively, a similar pouch called a neobladder may be created, attached to both the ureters and the urethra, in an attempt to preserve as close to normal bladder function as possible. In some patients, it is possible to safely connect a reservoir (pouch) made of small intestine to the urethra, allowing the patient to void in a manner similar to before surgery. The reservoir (pouch) is made to mimic the normal storage function of the urinary bladder. The patient is able to pass urine through the urethra, although there is a period of incontinence (leakage of urine) that all patients go through following this surgery. It may take some patients 12 to 18 months to regain control of their urination. A small but not insignificant percentage of patients will have persistent incontinence.

Rarely, a patient may not be able to empty this reservoir (pouch) well and will require intermittent catheterization (placement of a small tube into the urethra) in order to empty the reservoir (pouch). Some patients will be required to do this several times a day for a prolonged time period and in some cases permanently.

In order to be considered for this sort of reservoir (pouch) there must be no evidence of cancer at the urethra at the time of surgery, and patients must be willing and able to pass a catheter into the urethra to empty the reservoir (pouch) if necessary.

Vocabulary :

Artificial Urinary Sphincter -  is the only device that closely simulates the function of a biological urinary sphincter.

AMS 800 artificial urinary sphincter -  is the most commonly used device and is the criterion standard for the treatment of incontinence caused by intrinsic sphincteric dysfunction. It is composed of a pressure-regulating balloon, an inflatable cuff, and a control pump. The balloon has a dual function as a pressure regulator and a fluid reservoir.

Postprostatectomy Incontinence -  which is the most common indication for placement of an artificial urinary sphincter after a prostate cancer treatment

Intrinsic Sphincteric -  dysfunction following pelvic fracture, spinal cord injury, or urethral reconstruction.

Neurogenic Sphincter -  with associated sphincter or bladder neck incompetence.

Recurrent disease -   (eg, stone disease, bladder or ureteral tumors) that requires retrograde endoscopic instrumentation is a relative contraindication. Such instrumentation can predispose to cuff erosion in patients with an artificial urinary sphincter.

Inflatable Cuff – part of AUS which fits snuggly around the urethra and compresses the urethra except during voiding. The cuff applies pressure to the urethra to keep it closed.

The Pump -  which is placed inside the scrotum and controls the deflation of the cuff. It facilitates transfer of fluid to and from the cuff.

The Fluid Reservoir (balloon) –  part of AUS which is implanted in an inguinal incision and controls the amount of pressure exerted by the cuff.

ARTIFICIAL URINARY SPHINCTER

The artificial urinary sphincter is considered an alternative to urinary diversion. Artificial sphincter insertion surgery is the implantation of an artificial valve in the genitourinary tract or in the anal canal to restore continence and psychological well being to individuals with urinary or anal sphincter insufficiency that leads to severe urinary or fecal incontinence.

Since complications have the potential to occur, this is a treatment technique that generally is reserved for people for whom all other treatment options have failed. This includes conditions that result in the removal of the sphincter. Sphincter deficiency can result directly from pelvic fracture; urethral reconstruction; prostate surgeries; spinal cord injury; neurogenic bladder conditions that include sphincter dysfunction; and some congenital conditions.

However, the use of AUS with women has declined with advances in the use of the sub-urethral sling due to its useful “hammock” effect on the sphincter and its high rates of continence success. Women with neurologenic incontinence can benefit from the AUS.

Procedure

The artificial urinary sphincter is made of a silicone rubber material. The surgical process consists of a doctor placing a small balloon in the lower abdomen, an inflatable cuff around the urethra, and a pump in the scrotum.

When the cuff accumulates fluid it compresses the urethra so that urine will not be released. Patients simply squeeze the pump a few times when they want to urinate. Once the pump is activated the fluid flows from the cuff to the balloon.All fluid will flow into the cuff after urination is completed. Similar to most minor surgical procedures, there is a slight risk of bleeding or infection.

Some doctors have reported cases where patients have experienced urinary retention and a malfunction or breakage of the device.

The artificial urinary sphincter is not suitable for older men, for men who have undergone radiation therapy, or for those who have vascular disease.

Three Components of The Artificial Urinary Sphincter (AUS)

1) The Inflatable Cuff - which fits snuggly around the urethra and compresses the urethra except during voiding. The cuff applies pressure to the urethra to keep it closed.

2) The Pump - which is placed inside the scrotum and controls the deflation of the cuff. It facilitates transfer of fluid to and from the cuff.

3) The Fluid Reservoir (balloon) - which is implanted in an inguinal incision and controls the amount of pressure exerted by the cuff.

The three parts are connected by tubing and filled with saline solution or a contrast medium. When a man wants to urinate, he squeezes the pump 2 to 3 times until is it completely dimpled, which pulls fluid out of the cuff releasing the pressure around the urethra. The man voids and then in 3-5 minutes the cuff automatically reinflates.

To empty the bladder, squeeze and release the pump, located in the scrotum. This moves the fluid out of the cuff and into the pressure-regulating balloon. Because the empty cuff is no longer pressing the urethra closed, the urine can flow out from the bladder.

Several minutes after the bladder is empty, the fluid automatically returns from the pressure-regulating balloon to the cuff, once again squeezing the urethra closed.

Tuna Carbonara in Penne

Ingredients:

1 tbsp butter
2 tbsp olive oil
1 tbsp garlic, chopped
onions, chopped
red bell peppers, sliced
2 cans of tuna flakes
1/2 c parmesan cheese
1 c beaten eggs (4 eggs)
1/2 c cream (optional)
pinch of sugar (optional)
pinch of MSG (optional)
pre-cooked penne noodles

Procedure:

Mix the butter and olive oil over low heat.

Sauté the garlic, onions, and bell peppers.

Add the tuna flakes, cheese, and eggs, then mix well.

Add sugar and/or MSG, both of which are optional.

Add the penne noodles then mix thoroughly.

Lower heat then transfer the mixture on a plate.

Image Source : www.juvela.co.uk

Ingredients

Servings: 6-8 persons

* 1 kilo pork liempo (pork belly), sliced into strips about 1 inch thick
* 6 cloves garlic, chopped
* 2 pcs onions, chopped
* 1/4 cup minced ginger
* 6 cups coconut cream
* 1 cup green finger chilis (seeds removed), cut horizontally into strips
* 1/3 cup red chilis
* 2 Tbsps. turmeric
* 1/2 cup bagoong alamang (shrimp paste)
* Cooking oil

How to prepare Bicol Express

1. In a pan, heat a small amount of cooking oil. Saute garlic until fragrant and add onions. Cook until onions are tender.
2. Add shrimp paste and continue cooking for about 5 minutes.
3. Turning the stove to high heat, add meat and cook for another 10 minutes or until the meat releases its natural oil.
4. Put in the ginger and cook for few seconds.
5. Add in the coconut cream and chilis.
6. Cook for another 15-20 minutes or until the sauce has been reduced and thickened.

Serve with steamed rice.

* Amount of chilis may be adjusted depending on your tolerance for spicy dishes. However, chilis are said to help in clearing the nasal passages.

* Shrimp paste may be omitted since it can cause allergic reactions in some people. For saltiness, you may add fish sauce while cooking the meat (before adding coconut cream) or you may use salt as an alternative.