So, I completely understand why we have to drink liquids only after surgery. And I completely understand why we need to shrink our liver and how eating very low carb and low sugar can reduce it. What I don’t understand is why it has to be liquids only before surgery? Does anyone know?

Also today is day 7 of my 14 day liquid diet and I found a random scale (I don’t own one) and I’ve lost 5 pounds. I was probably going to hurt something if that scale hadn’t moved a bit after seven days of suffering.

BelleofBatonRouge, I am not exactly sure of the full reason why it has to be liquids only for 14 days however it is only 14 day and you can do it, you are already half way there.

When is your surgery date?

I have never found a satisfactory answer to this question (usually the liver shrinking thing is sited, but as you note, that only requires a low carb diet, not a liquid one.) I suspect that it is one of those "that's the way we've always done it" things. Sometimes we may hear something like "getting the patient used to their post-op diet" but that doesn't really wash, either, unless the program is specifying post op liquids long after they are necessary.

1 hour ago, Ed_NW said:

33

Let's take a look at these:

#1: most patients will lose 10-15 lb on any substantially low calorie diet, whether solid or liquid.

#2: liquid or solid is irrelevant to protein content, though lean meat and green veg will have better nutrition than most any protein drink.

#3: liquid or solid diet is irrelevant to change in liver condition - it's the carbohydrates, or lack thereof, that counts.

#4: how does one gain a /mental awareness of calories, portion sizes and ingredients when restricted to liquids?

#5: so this is just a test or challenge for the patient?

#6: it only takes a few hours for the stomach to be empty for surgery, not weeks. This is why most gastric scopes or surgeries simply require no eating after midnight prior to surgery.

#7: unless one has to buy a proprietary diet product from the surgeon!

Overall, I prefer bariatric surgeons who know their way around obese patients and who prefer their patients to be as strong and healthy as possible going into surgery - which multi week fasts don't do. If a surgeon is intimidated by fatty livers and needs help in working around them, then by all means do everything necessary to make him feel comfortable when he is rootin' around on your insides, but he should also do everything to help the patient feel comfortable with the process - at least let them have some steak along the way!

9 hours ago, BelleOfBatonRouge said:

So, I completely understand why we have to drink liquids only after surgery. And I completely understand why we need to shrink our liver and how eating very low carb and low sugar can reduce it. What I don’t understand is why it has to be liquids only before surgery? Does anyone know?

Also today is day 7 of my 14 day liquid diet and I found a random scale (I don’t own one) and I’ve lost 5 pounds. I was probably going to hurt something if that scale hadn’t moved a bit after seven days of suffering.

not everyone is on liquids only pre-op. This is per surgeon/site. I was allowed SF jello, watermelon and celery. So, the "reasons" might have some merit... but since this isn't an "across the board" situation, there is a *LOT* of personal preference based on what the surgeon likes to see when they start the surgery.

10 hours ago, BelleOfBatonRouge said:

So, I completely understand why we have to drink liquids only after surgery. And I completely understand why we need to shrink our liver and how eating very low carb and low sugar can reduce it. What I don’t understand is why it has to be liquids only before surgery? Does anyone know?

Also today is day 7 of my 14 day liquid diet and I found a random scale (I don’t own one) and I’ve lost 5 pounds. I was probably going to hurt something if that scale hadn’t moved a bit after seven days of suffering.

It's to ensure your intestines and colon are empty. The last thing you want is a dr accidentally nicking your intestines and having toxic waste flow through your entire insides contaminating and harming the other organs

And maybe to imprint in your mind " I am going to need a LOT MORE than a couple glasses of water or other fluid all day!" I personally believe we all do better on FLUID DRIVE than bumpty- thumpty our little jalopy? along Life's Road!

I'm allowed to have one frozen meal a day on my pre-op for 15 days. And then the day before surgery I am on liquid only. I guess it's just surgeon-specific.

17 minutes ago, mousecat88 said:

I'm allowed to have one frozen meal a day on my pre-op for 15 days. And then the day before surgery I am on liquid only. I guess it's just surgeon-specific.

It is definitely surgeon specific and it all depends on how their WLS plan is written for their practice. Ideally, you want your colon and intestines as clean as possible. I was asked 3 times on my op day when my last BM was. Fortunately it was the day before and I felt like I had emptied my bladder enough the day before and day of to ensure my bowels and bladder were free of excess

I also did not have to do an enema prior to surgery, unlike other past surgeries.

Edited October 10, 20187 yr by MargoCL

2 minutes ago, MargoCL said:

It is definitely surgeon specific and it all depends on how their WLS plan is written for their practice. Ideally, you want your colon and intestines as clean as possible. I was asked 3 times on my op day when my last BM was. Fortunately it was the day before and I felt like I had emptied my bladder enough the day before and day of to ensure my bowels and bladder were free of excess

I also did not have to do an enema prior to surgery, unlike other past surgeries.

I wonder if it would be beneficial to take a fiber supplement during the pre-op period, if you're still allowed to eat food. Wasn't mentioned or anything to me, though.

I know for a colonoscopy, the day before it's liquids only with a chaser of Miralax and Gatorade. That down rite cleans you out! I don't think 2 weeks is necessary but whatever the surgeon wants, I'm down for it.

30 minutes ago, Ed_NW said:

I know for a colonoscopy, the day before it's liquids only with a chaser of Miralax and Gatorade. That down rite cleans you out! I don't think 2 weeks is necessary but whatever the surgeon wants, I'm down for it.

Yes - what's typically done for a colonoscopy, or an endoscopy for the other end, is all that is needed to clean things out.

Our surgeon has a similar day before pre-op protocol as they specialize in the DS which slices up and rearranges the small intestine, so things need to be cleaned out for that - its a bit of overkill for a VSG that only operates on the stomach, but they always like to keep their options open. They have any other pre-op dieting requirements as the potential fatty liver problem doesn't seem to be an issue with them, but it can be intimidating for some surgeons (there was someone on here recently whose surgeon actually followed through the the common threat to "pull out and close 'em up" if the liver wasn't shrunk enough for them.) So yes, you want to do what your surgeon asks to make him happy (that particular poster had complied with all requirements, but it apparently still not enough for that doc.)

It's not even the carbs, though. I read a study, a while back (I can dig it up if anyone cares), that looked at liver sizes of people after low-carb very low calorie diets, versus standard very low calorie diets, and they were the same.

That said, once you make the transition into ketosis, you have a lot less hunger to deal with. So I see the "no carbs" thing as a kindness, rather than a medical necessity.

1 hour ago, RickM said:

.. you want to do what your surgeon asks to make him happy ...

or her

It’s not a liquid diet, it’s a keto/low carb diet. Most VLCDs used in the pro op diet just happen to come in liquid form or mix into a liquid form. My VLCD came in shakes, soups, mousse and bars, which is supplemented by lots of low starch veges. I liked the bars so that’s what I used. No liquid for me. When I mentioned to my dietician that I couldn’t mix the shakes properly, she offered instead that I could do a keto diet which was real food just low carb.