dani2728

I was approved through BCBS as well, but I had to do 6 months of nutritional dr. visits. I went through allllllllll I was supposed to only to get approved for $5000 LIFE MAX!!! I still would of had to come up with $6000 out of pocket. Well my job changed to United Healtchare in Jan 2011 and I didn't have to show them anything but my approval from BCBS and they approved me in no time...covered at 100% with no max!!!!!!!!!!!!!!!! Make sure you get specifics from you insurance carrier. Just a lil' FYI!!!

Here's the information my doctor gave me for pre op diet:
Pre Op diet
In the obese, the liver is a huge, fatty organ. It is “in the way” of the surgical area during surgery, and must be held back with surgical instruments. An enlarged liver is very fragile and bleeds quite easily when touched or manipulated during surgery. This bleeding can be difficult to control, and the extra care required with an enlarged liver increases surgical risk, as well as surgical time. Longer surgical time and extended time under general anesthesia can make both immediate and longer-term recovery much more difficult for you.
For those with a BMI of 40 or over, a special high Protein low-carb pre op diet has been extremely effective in shrinking the liver, so that the risks of bleeding and extended surgery times are greatly decreased. Those with lower BMIs may also choose, if they wish, to follow the liver-shrinking diet to further decrease their surgical risks.
Following this SPECIFIC DIET PLAN is extremely important. The goal is not to lose weight, necessarily, but to enter a temporary period of dietary ketosis, which is not harmful to you at all. However, many do lose a good amount of weight, which will jump-start your weight loss as you begin to regain and improve your health. It is this dietary ketosis that results in liver-shrinking and the normalizing of your metabolism so that you can do well with weight loss surgery.
LIVER-SHRINKING DIET PLAN
There are NO CALORIE LIMITATIONS on the LIVER-SHRINKING diet. You may eat/drink as much as you wish of the allowed things to feel satisfied, although we suggest reasonable limits to assist your weight loss. This does not have to be a liquid diet.
Start a low carb (30 grams or less daily), high protein (minimum 60-70 grams daily), keep a close eye on the fat intake (don't over do it) and at least the minimum required daily amount (64 ounces) of plain Water intake diet prior to surgery.

If you chose to drink a Protein shake. Please read the labels. You should get at least 15 grams of Protein & less than 6 grams of total Carbohydrates per serving. Protein shakes are NOT required, but are very convenient.

You may have low fat yogurt, lean meats, grilled chicken, green vegetables. We recommend checking the carb content on your food. You can find a very useful carb counter on Atkins.com
http://www.atkins.com/Program/FourPhases/CarbCounter.aspx

So my surgeon requires a 2 week all liquid diet prior to surgery to shrink the liver. Given that it is for my safety as much as his convenience, I am following it to a "T." I think that I have been more stressed about the 2 weeks than anything else. Well, here I am day 4 and have lost 6 lbs so far (and actually feel pretty good). I thought I'd share some things that have helped me...
I didn't eat like a pig (my normal style) and then go cold turkey.
I tried 1 shake a day, 2 a day, 3 a day leading up to the full fast. I felt weaning myself off food and especially sugar helped me.
I bought a 1 liter water bottle and set mini goals for intake through out the day
I bought a range of shake flavors (pretested them all)- sweet, savory (chicken flavored) and plain protein. I find that I get sick quickly of having the same thing for every "meal" so I switch it up
My surgeon allows you to mix with water, milk or yogurt...so I switch that up to so I feel like I have some variety of texture
This may not be for all as it is expensive...but I bought myself a VitaMixer. This thing is AMAZING! I make coffee ice cubes then mix a chocolate powder with milk or water for a yummy frozen treat as well. I am actually saving a lot of money on food...so I splurged. I figure it will be good too for after surgery during the mushy stage

Yes, NASH damages the livers ability to break down fat because it is engulfed in fat. I started taking milk thistle and probiotics, who knows...good news is that. NASH improves as you lose weight. It might take longer but you are healing your liver in the process. NASH is such an unrecognized side effect of obesity. When I got my diagnosis I flipped, and needed to learn a,l that I could.