My doctor didn't insist on a pre-op diet but did recommend it and explained the advantages in terms of liver reduction, etc (with comparative videos to make the point!) However, he didn't give me any specific instructions and I didn't have time to see the dietician before I had to fly back to work. I've been trying to stick to it with some adaptations, thinking that I had a bit of leeway because the doctor hadn't insisted

I bought the vanilla Optifast option which has 152 cal, 2.3g fat, 15g carb, 17g Protein. The recommendation is 3 x Optifast + salads/low carb veges, giving a total of about 500 cal, 7g fat, 60g carb and 51g protein. This seems high in carbs and low in protein to me. I've been substituting the evening drink with a small meal of very lean meat and low carb veges and putting my daily intake into Fitday.com. It comes out at around 550 cal, 12g fat, 50g carb and 60g protein. While the fat content is a little higher, the carbs are lower and the protein higher and it is MUCH more satisfying to eat! A couple of days I've had a slightly bigger piece of meat and its gone up to 650 cal, with similar rises in the others.

So my question is, am I blowing this by not sticking to pure liquids? What is the purpose of liquids in the pre-op stage? If the point is simply to lose weight quicky, then surely 550 to 650 cal should do the trick? The carb/protein balance on the Optifast is much more carb heavy than the Atkins diet, so I don't think the aim is to get into ketosis (I'd need to get my carbs down under 30g for that I think - not sure).

If I've stuffed this up, I have another week to go before the op to correct it, but I have had to guess as best I could, as I am 3000km away from doctor's advice at the moment. Can you folk help?

My doctor explained it to me that shrinking my liver would help me have less pain because he has to touch, flip my liver to put in my port.

I wanted anything to help with pain.

I had such a small amount of pain it was fantastic.

I slept the first night after coming home a 4 pm.

The next two days it just felt sore when I would lean over to pick up something. I would remind myself let it lay. I would forget and lean over again.....

The pain made me think if I HAD (lol) ever done too many sit ups (never) this is how my stomach would have felt.

I did take advil every 12 hours for 5 days per my surgeon. I sure that helped.

So on the 4th day I had no pain.

I did not walk my first 1/2 mile until the 7th day. I went back to my dog grooming job on the 8th day. I lift dogs of course with this job.

edie

Yes, my doctor did explain about the advantages of reducing the liver, and I am keen to do that. However, I don't know if the "liquid" part is necessary for that, or if it is just the calorie restriction and weight loss that is necessary. Any ideas?

My doctor does not require a pre-op diet for people under a certain bmi. As I am considered a low bmi'er for surgery I am not required to. What he explained to me was that once you reach a certain bmi your liver starts to add fat-hence they refer it as a fatty liver and it tends to be heavy and bothersome when performing surgery. It can become dangerous as they have to keep flapping it, pushing it and moving it around in order to perform the surgery. In order to avoid that and assist to a faster recovery they place those candidates who are believed to have and enlarged liver on pre-op diets. He informed me it was up to me, but that yes it would help for a faster recovery if I opt to do a liquid diet.

I choose to. He recommended until I have a surgery date to start replacing 1 meal a day with Unjury protein shake. Once my record is sent to the insurance to replace 2 meals. And 1 week prior surgery to replace the 3 meals per day. Add only green vegetables that are low glycemic index.

And that is what I will do. I have purchased sample packets from unjury and to my surprise they taste great. (thank goodness)

Welcome to the UNJURY Homepage

hope this helps!

Liquid diets are composed of "foods" with low residue. This will minimize the load of food needed to be digested by the stomache and intestines. solid food can take approx. 30 hours to complete it's travels through all of the digestive system. It depends on the amount of food and other factors like fat content and so on. Liquid takes a considerable less amount of time. I'm not exactly sure but i think it's something between 4-6 hrs. The digestive prsocess is also very different from liquid and solid.

My Dr. recommended a low sugar low carb. liquid diet 10 days before surgery to deplet glycogen (fat) stores around the liver. *I think* the reason most Dr. put patients on a liquid diet is due to it working much better. It's easier to control your sugar and carb intake and prob. works faster at getting rid of the extra glycogen stored around the liver. Carbs., when not used will basically turn to sugar in the blood and stored.

As far as you not needeing to be in ketosis... If you have weight to lose before surgery you DO need to be in ketosis. Ketosis by definition is a stage in metabolism occurring when the liver converts fat into fatty acids and ketone bodies which can be used by the body for energy.

Under everyday conditions, the carbohydrates you eat are

converted to glucose, which is the body's usual source of energy.

Whenever your intake of carbohydrates is limited,for

a long enough period of time, you'll reach a point where your body draws fat stores, for fuel.

That's just what I know about it. I can't tell you exactly why. I can only speculate. I hope it helps in your choice. Good luck on your surgery.

My BMI was 35 so my doctor also said he wasn't too worried about my liver. For that reason, he just put me on a low-carb, low-fat diet. Then I was on clear liquids the day before surgery with no bowel prep required. I got the feeling that he has a different diet for his higher BMI patients.

I do think you're right to be worried about the Protein and carb levels. I'm on a liquid low-carb diet now for my surgery on Tuesday (12.11.07 - yippee!). And I have to keep my protein above 70 and my carbs below 50, while my total calories must be under 900. I too love the unjury Protein powder (chocolate mixed with hood calorie counter milk and strawberry sorbet mixed with crystal light lemonade) to help me stay within those guidelines. I supplement the shakes with Soup, sugar-free Jello, and sugar-free popsicles - all on my doctor's approved pre-surgery diet list

HTH!

Kris

Thanks everyone for their advice. I fly home this afternoon and I guess I'll have to look around for another Meal Replacement drink, as I don't see how I can get under 60 carbs a day using the Optifast. This doesn't quite make sense to me, because why would it be the recommended one on the list if it isn't low enough in carbs? However, I really want this to work and to give myself the best possible chance, so I'll see what I can do to find a better substitute.

MrsJiggles: Thanks for you comments re solids/liquids. That was what I really wanted to know and what you say does make sense. I guess I was just wondering if I wouldn't be better off just doing the steamed veges on their own and skipping the liquid meals altogether, as this would give a lower carb count, but I suppose there's more to it than that.

The most used pre-op diet in australia is Optifast. You need to have it 3 times per day - unless told otherwise by your Dr and it does actually take you into ketosis on about day 3. I followed this as instructed by my Dr and had an uneventful surgery. If this is the diet you Dr has told you to do then you should follow it - he does know what he is doing.

Good luck for your surgery.

Danna

My Doctor was Dr. Horgan of UCSD in San Diego. He explains it like this and he does require it. The liquid diet shrinks the liver. This in turn allows them to give you less anesthesia and shorter recovery time. This also as previously said allows them to more easily retract the liver when doing the surgery. I was waking up as I was leaving the surgery room and was home relaxing by 1pm. (Surgery was at 9am) things went perfect. I included things like sugar free fudgpops, sugar free pudding and Jello, soups and broth. Good luck.

Oh by the way, the reason that Optifast is top of the list is because it is the only one in Australia to be medically supported in having all the daily requirements of Vitamins etc. this is why a lot of Dr's don't allow you to use TF or Celebrity Slim.

You have to remember also that different countries and Dr's have different ways of doing things.

Danna

I had a BMI of 35 too and just by chance had had a liver ultrasound a few weeks prior to first meeting my surgeon, courtesy of a very zealous gp who gave me my referral but also sent me for a barrage of tests, which turned out to be good as my surgery was able to be done very quickly as I didnt have to redo many of them for the surgeon. So I knew for a fact my liver was not fatty and enlarged.

Like I said to you in the PM, Optifast is well formulated for presurgical fast weight loss and is probably the most nutritionally safe way to eat that few calories, but then again, its only a few weeks.

If it were me and the doc hadnt insisted on it, seriously, successful as I've been with weight loss with the band, I didnt have and I still DONT have the kind of willpower to stick to an Optifast diet unless someone's holding a gun to my head. I thought I'd try it, made it 3 days and started passing out - it happened about 4 times over the next 2 days. I called my doc and he said I was an idiot for doing that to myself when it wasnt in the least bit necessary and to "eat something for pete's sake", lol. In hindsight, if I had the chance over again, I'd still try it but I think 2 meals a day, some fresh fruit, a green salad and a small sensible Protein and vegetable dinner would be the way to go with it. And dont worry about having coffee, or the odd meal that wasnt scheduled kind of thing.

I think anythign is better than the last supper syndrome, I dont think people who do it are "weak" or morally inferior, its just that I felt strongly I'd made the choice to start a new life and I wasnt going to begin that new life by saying Oh surgery's in 2 weeks, I'm going to have whatever I want till then. That's the kind of behaviour that got me fat in the first place -you know, I'll start the diet on Monday so I'll have McDonalds today. It feels WAY better to show up for surgery with that clean break already made - so its still worth doing to some degree but I"d say that when the surgeon's not fussed by whether you do it or not, then if you prefer low calorie food rather than liquids, there wont be a drama.

Not all docs prescribe preop diets and as long as you know the risk that if you DO have a large liver and dont shrink it you may end up with open surgery or no surgery, then it's up to you what you want to do.

I was able to forget about a really strict preop because I KNEW I didnt have a large liver.

I weighed 208 pre-op and weight 201 at surgery. I had a few false starts with attempting to do the liquid diet. At the end of the day...for us lower BMI folks...they just don't want you to gain any weight before surgery and they want you to get mentally ready for life Post-OP.

~Holly

My Dr insisted on Clear Liquids for 8 days. That is right CLEAR liquids and it was 5 days before surgery and 3 days after. It was indeed very hard at first but after the first two days it got easier. Once the stuff starts leaving your system you do not crave it is what I found.

I am glad that I did it I lost 10 pounds in 5 days. It was a great way to start my life as a bandster. I also know it made the surgery easier. Everyone who is being banded should watch one of the surgeries here on this site.

I watched 3 different ones before I was banded and was glad I did. It gives you a perspective on what is being done to you and why things feel as they do afterwards.

It is very important to shrink the liver, and most Americans who are overweight have fatty livers. It is because the diets that we eat of red meat and fat.

I hope this helps you some.

My surgeon rang me at work this morning because there'd been a cancellation at the hospital on Monday, and he offered me the earlier surgery date. I told him about what I'd been eating/drinking for the past week and asked him about the liquid vs solids issue. He was very happy with what I have done and said that the main reason doctors recommend the liquid diet is because it is far more accurate than when choosing solids. With solids, it is easy to underestimate quantities and go over-budget on calories, etc, but essentially if the numbers were the same, there was no great advantage to liquids.

Soo... SURGERY IS ON MONDAY NOW!! (And I'm doing the strict liquids for the weekend, just to push it as hard as I can).

That's awsome! At least you know what he wants from you now. You are getting off a lot easier than me. Then again, when I started my BMI was 51. I have to do the liquids for 10 days. I start Monday....pray for me. I have a feeling I'm going to need it. :nervous Let us know how it goes.