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"Liver Shrinking"- the pre-op diet?



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I'm aware that the pre-op diet is typically in place to shrink your liver- does anyone know why this is so important? Is the liver typically "in the way" during surgery?

What is it about the diet that causes the liver to "shrink"? My surgeon is having me do a pre-op diet that consists of 2 small Protein Shakes and a green salad with "clear" dressing (Italian, balsamic etc.) I know for certain, this will have me very very hungry all week. I intend to do my absolute best and follow all instructions, but going from eating (I'm not a huge eater actually) to a diet that's roughly 600 calories a day is intimidating.

I worry a bit, because though I am stopping drinking now (surgery is November 8th) I drink fairly regularly (4-5 drinks a week). I wonder if I have some giant liver! I have had my liver checked, and my function is healthy- but I am a bit fearful.

I am "low" BMI (32) so my surgeon only requires this diet for a week.

How did you deal with the pre-op diet?

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The liver sits somewhere on top of the stomach and has to be lifted and shifted suring surgery. The smaller the liver is the more out of the way it will be during the surgery. I doubt your liver is huge, especially if the test was fine. Most people have to go thru some type of pre-op diet to shrink the liver. I have been on mine since September 26th lol. I won't be having surgery until November or December, so don't worry you are fine. I get 4 Protein shakes a day and non-caloric liquids. You will be fine. The better you do on the diet, the easier time the surgeon will have with your liver.

The diet should be low to no carbs and high Protein. It is meant to put your body into ketosis and flush out the toxins. This is what my surgeon told me. Dealing with the pre-op diet is super hard. You have to only do it for a week so I recommend to just to stay busy busy busy.

Good Luck.!

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My understanding of it is that is less a matter of shrinking the liver (you're not going to do a lot in a week or two) but more of removing some of the slimey coat that can be present with fatty liver which is very common with us obese folks. Some docs require the pre-op diet while others don't. My doc doesn't require one, other than the day before purge, and he's a liver specialist who does transplants aside from his bariatrics (go figure!) Presumably he has specific skills from that where our typical liver condition isn't a big deal for him.

Irrespective what other surgeons do, you should do whatevery your doc wants you to do - he's is the one who's digging around inside of you and it's in your best interest to make him as comfortable as possible when he's doing so! I would agree with Felicia - try to stay busy and keep your mind off of it as much as possible. The Protein helps as it's usually very satisfying even if it isn't "real" food. The VSG didn't cure me of hunger as it does some, but it has become less of an issue as I recovered and became busier with normal life.

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It is true that the pre-op liquid Protein diet is intended to shrink the size of the liver. Yes, it does interfere with the surgery, the dr. has to 'tuck' it out of the way and there's not much room up against your diaphram. Please do keep to the diet and increase the chances of an easy surgery! And yes, with your low BMI you probably got a shorter pre-op diet and the added salad+dressing.

I am home from the hospital (early am surgery last Wed. 10/19, Thurs in a fog, and home on Friday with drain out. Doing well physically, too) and counting the pre-op I am down 20 pounds. Hang in there friend.

Thoughts and prayers go with you!

Mary

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Thank you for all the great replies!

I was confused as to if immediate sudden weight loss was what shrinked the liver, or if it was specific to being "low carb".

My surgeon typically has patients do a 2 week diet of 2 Protein shakes and a green salad each day. I was cut down to a week due to being a "light weight".

If it was just straight up "Atkins" (very low carb, but eat normal portions) I would not be worried about hunger- I LOVE eggs, Protein etc. I'm not actually a fan of sweets or bread. I know I can do it, I've done far more extreme diets in the hope of losing this weight (I'm sure we all have).

I want to make sure I do all I can to make the surgery as easy as possible for him, and me. I'm just about 2 weeks a way (yay!) so rather than enjoying the final week of no pre-op diet too much, I think I may be smarter to start cutting out sugar, bread, and Pasta now.

Ever since my surgery was scheduled, I've been quite motivated and been more active (I do 45 minutes of cardio a day, I started walking every where). It has not helped me lose any weight, but it's helped me be stronger and more prepared to be active once I recover from surgery. I think success is dependent on how I use this new "tool"- sure, I'll only be able to eat small amounts, but if I'm not working out and making those small portions unhealthy food, I'm not taking full advantage of this new tool. I do wonder if this process will "cure" me of emotional eating in any way, but I figure that will always be something I'll have to struggle with and address.

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I was told that the liver shrinks signifincantly in just 2 weeks of doing a low carb/low cal diet.

Besides making it easier for the surgeon, I am told it decreases the risk to your liver - a little less jostling around. It seems standard with most, but not all surgeons. I don't know why I wasn't asked to do this when I was banded, or had the band removed.

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The liver really does shrink considerably with a low-carb diet in a short amount of time. My surgeon explained that when our body consumes carbs, it first goes to the liver. When the liver is "full" it is THEN converted into stored fats. The opposite is true as well. When our body needs carbs, it takes it from the liver storage first before it touches the stored. SO, if you aren't adding carbs into your diet your liver will shrink because your body will use up all the stored carbs in the liver. I actually did low-carb for four months before my surgery and my surgeon said that my liver was "tiny and perfect"... about the only thing that can be said was tiny about me lol!

Shrinking the liver is important because it makes it easier for the surgeon to get to your stomach. In really big people the liver can completely cover the stomach. When it is easy for the surgeon there are less chances of complications. I know some surgeon's don't bother with the pre-op diet. I'm not sure if they are just exceedingly confident in their skills or they don't think it will help enough to make a difference, but I was very glad I went through with mine in the end.

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I did not do a pre-op diet, as my doctor did not require it. He never mentioned the shrinking of the liver as something I needed to do. I went through surgery very smoothly and never had a problem. My BMI was 40. It was really cool to watch the dvd of my surgery as they put in the little tool to move the liver out of the way. biggrin.gif

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Thank you for the replies!

You really explained it well Emily- I now get why so many people are simply instructed to do an Atkins phase 1 diet.

I am hoping my liver will be nice and shrunken after me week of this torture diet ;) Anything to make the surgery go as easily as possible.

Did your surgeons have you do two days of Clear Liquids only prior to the diet? I am required to do this.

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I missed chewing so badly on the pre-op diet that I took to making Jello Wigglers... you know... cut the Water by 75% and you get hard little Jello squares (I mixed two large size Jellos with just 2 c. boiling Water then poured it into an 8" sq, pan. Sets very quickly, cut into squares) Gave me something to chew on & I lost 14 pounds on the 3 wk. pre-op. You might try that!

The very best wishes to you! I am 6 days post-op and have lost 21 pounds total. Into a blouse I've not worn for at least 5 years. Hang in there, you can do this!

Sincerely, Mary

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You should watch a video of the surgery. There are several on youtube. Get one that has voice with it and they will explain what they are doing and why. I watched it like 5 or 6 times.

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Thank you for the replies!

You really explained it well Emily- I now get why so many people are simply instructed to do an Atkins phase 1 diet.

I am hoping my liver will be nice and shrunken after me week of this torture diet ;) Anything to make the surgery go as easily as possible.

Did your surgeons have you do two days of Clear liquids only prior to the diet? I am required to do this.

I'm glad I helped! I was not required to do clears before the diet, but I was required to do two days of clears before the surgery.

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I am same as bikerchick519.

Surgery in 16 days!!

Julie

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My surgery is in 6 days and i am going nuts! I was told i had to lose 10% of my intial weight prior to my surgery date and i have 6lbs to lose. Dont think i can do it but i will shoot for 4lbs by Nov 9th. My coordinator told me i am fine and i just need to do a clear liquid diet the day before surgery. I was not told about the liver shrinking however GOOD LUCK with your operation :aureola:

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