A fellow I know is/was scheduled for surgery tomorrow with my doctor. He is getting the lapband.

Dr. Cudjoe's assistant called yesterday and told him he might have to postpone his surgery date while he loses more weight. She told him that Dr. Cudjoe had to stop a procedure on a man of about our same build because he couldn't place the band through all of the fat.

Now it's just hearsay, and I'm sure much was lost in the exchange from the man's wife to him to me, but does this sound a little goofy to anyone else? I mean losing weight to have weight loss surgery sounds kind of counter productive. It's like telling a person with a hernia that the surgery can't be performed unless they heal up and don't need it.

Catch 22 anyone?

Waiting for my next visit with the good Doctor so I can get some clarification.

Anyone else heard of this?

Ryan there are several doctors who if you have a BMI over 50 will ask you to lose weight prior to surgery. It makes it easier to place the band when someone has a BMI over 50 losing weight reduces fat around the liver and makes it easier for band placement. Most docs will have you do a low carb or liquid diet 2-3 weeks prior to surgery. It is true..there was a man who had surgery with my doctor whop had a BMI over 50 and had to do 3 weeks of liquid protein drinks and a very low carb diet prior to surgery...so when you see your doc get clarification or plan on starting this process 2-3 weeks prior to surgery but it is true I'm sorry to tell you. ( I have heard of it more with men then women however)

Yes, sorry, Ryan. My dr. had me eat "low glycemic" foods before my banding. That included vegetables low in sugar content, no organ meats, few fruits. I didn't have to diet or do liquids, just watch the types of food. He said it helped to shrink the liver before surgery. I don't know if it's true, but I didn't want to take any chances so I heeded his advice. It was worth it to have a noneventful laproscopic surgery.

Just to add to everyone else's info. In addition, some facilities just do not have the instrumentation that is required for the larger BMI. It takes longer trocars for those with a high level of tissue/fat to go through to get to the place where they need to insert the band. Some facilities have it readily, some do not. You will hear of some physicians saying they will not do anyone over a certain BMI. I definitely think it's a good question to ask up front as you may need to be seeking another physician or another facility to have your surgery in.

Just my 2 cents..

Leatha

There was a girl almost exactly the same size as me when I had surgery. She had Ortiz, I had Lopez. She had to do 3 weeks of protein shakes to lose weight prior to her surgery. I was supposed to do one week of low fat. Well, I screwed up and wasn't able to stick to low fat, but they did the surgery anyway. So yes, Whipple, they will ask you to lose weight to shrink your liver. Blah, blah, blah, rules, rules, rules.. I hate 'em!

I've read that too. That it's necessary to shrink the liver of higher BMI folks to facilitate lifting it out of the way, to try and lift one that is too fatty increases the risk for liver injury.

I agree that instruments would probably play a big part in that. I've read that those who need to reduce BMI are asked to go on the liquid diet for as much as up to a month in advance of surgery.

I'd think that if you did a reduced diet carb/fat diet for a week, alternating with a liquid diet for a week, so that you end up on the liquid diet the week prior to surgery you might get pretty good results without starving to death. You should check with your doctor on that though. He may have a better plan, or one more necessary for what you need.

I wish you luck!

Hi Ryan -

I have heard the "shrinking of the liver" excuse as well. I don't know if I buy it - my BMI was 48 when I had my band placed, and I was never told to go on any special diet prior to my banding, nor was I required to lose any weight.

I think it mostly has to do with the doc's experience, and the availability of the special trocars needed for the larger patients. If your BMI is 50 or more, I would look into this Yahoo! group:

http://health.groups.yahoo.com/group/ExtraordinaryBandsters/

They have exclusive membership, restricted to those of 50 BMI and greater, so if you fall into that category I'm sure you will get a lot of good info on what to expect and what your options are in regards to docs/pre-surgery diets/etc.

Hang in there!! You'll get this done, one way or another!!!

**hugs**

This particular article refers to a liver injury in banding surgery abuot 3 paragraphs down. it was too long to post here. sorry.

http://www.obesitysurgery.com/ARTICLES/391.html

Whip, maybe this will make you feel better. I was really worried that they wouldn't do the surgery because I was supposed to do lo-fat for a week, but I porked out (imagine one of us doing that, unheard of!)

But when I told the doc how I ated, they just said, "don't worry, honey, this surgery is going to help you." From your picture, you don't look as large as many people who have been banded. Listen to these smart people and do some more research & talk more to your doc. If they told me to liquid Protein for a week prior to weight loss surgery, they would have had to lock me up.

My surgery was kind of scheduled last minute (a bit less than two weeks out) and I had a BMI of 62. I asked if I should do any special pre surgery diet and they said no and managed to do surgery. Best of luck to you whippledaddy. Teresa

Hi Ryan... I am with Donali on this one...

I was not required to go on a special diet prior to surgery ... I asked my surgeon about the liver issue and he stated the the short-term dietary changes do not significantly reduce the size of the liver enough to make it worthwhile. I think that I have to agree in regards to the experience of the surgeon with band placement. I hope that you will not have to go through the dietary changes... but I can tell you it will all be worth in in the longrun.

My dietician did have me keep a food diary and when I turned it in... she said... "Hmmm... I think we will have to have you keep a food diary for another 4 weeks prior to setting up an appointment with Dr. CHua... you are still eating too much... too often." DUH. Like someone said here... that's like telling somebody to quit smoking... and give them the nicotine Patches AFTER they are able to stick with it for 4 weeks.

Darcy

I was banded with 6 others, and each one of us received completely different pre-op instructions. A couple people got to pig out the night before surgery.

I was instructed to have only Clear liquids the day before my surgery. At first I was jealous of all the Mexican food they ate, but they were all jealous the next day when they had to poop and I didn't!

The surgery is a pretty huge ordeal (to me, anyway) plus you're hooked up to an IV on wheels. Getting around the first day or so is no picnic, so having a bowel movement the day after surgery simply can't be any fun. No, no, no. I'm glad I stuck to clear liquids the day before!

Geez guys thanks, you've sure given me something to think about.

I had already seen my doctor a couple weeks ago and he said then that I would have to go on a "liquid protien diet" to shrink my liver.

The fellow I was talking about goes to the same doctor, and he got his information after his two weeks of liquid protien and losing a whopping twenty pounds on the diet. Now the doctor is back pedaling about what to do.

I think he may not be as experienced at the lap band on men. There were only two men at the meeting we had to go to.

Unfortunately I haven't seen the man or his wife (who's getting banded as well) at work so don't know what happened. I'm taking a stoic attitude right now. I will do what is required of me, and I expect so will he.

Thanks for all the responses! I'm overwhelmed. You all are really the only people I can talk to who understand, and you'll never know what it means to me.

For over two years now, I've read the pre-op diet to shrink the liver stuff. I wrote to the doctors (in New Zealand) who were promoting the theory, to ask if they had definitive answers to whether their diet had any impact at all on the liver. One of them wrote back saying, essentially, that they didn't yet have results, that they'd publish when they had results and that if patients didn't want to cooperate they didin't want to do the surgery. Segue to the present...

I haven't found anything published anywhere that says that certain diets shrink the fat around the liver.

I asked Dr. Rumbaut about this diet and he told me, post-op, that my liver went this-a-way as opposed to that-a-way, and it wouldn't have made any difference in my case.

My two cents.

Ryan, a man I work with just got the band 3 weeks ago. His doctor told him he had to lose weight at the first appt. He weighed 450 pounds. He had to lose 50 pounds before surgery which he did with Optifast. I think your doctor would have told you already if he wanted you to lose weight before surgery. I had to be on lowfat 2 weeks before my surgery and liquids the week before. I would definitely question the doctor just to make sure.

Hi,

My doctor did not request a diet before banding, but he said that is advisable. I dieted for two weeks before the procedure. When he came in to see me after he stated that I had made his job a lot easier.

banded June 29, 2004

Port Huron Hospita, Mi.

297/252/185l

Dave T.