I hesitate to post this, but I need to hear, so I will.

Please be honest with me - I'm not looking to be coddled or agreed with here. I need to hear the straight truth.

I'm scheduled for surgery the 29th. My surgeon has a pre-surgery diet that is 14 days of Clear liquids, no calories. Water, diet soda, coffee, tea, SF Jello, SF popsicles, flavored water with no calories, etc.

No Protein shakes, no soups/broths. Basically, 2 weeks of NO nutrition.

I understand the fatty liver concern. I could not possibly be more serious about wanting to succeed here, both before and after surgery.

I have thus far dropped 32 pounds. I'm on the verge of dropping into the next bracket of BMI (a few more pounds, and I'll be in the 39.XX range). I am exercising every day, nearly - averaging 5-6 hours per week.

I am not doing so well following the "all clear liquids" order. I already talked to the nurse at the surgeon's office about it and she was sympathetic.

I need to function. I have a job, five kids, a house, 2 dogs, a husband, a life. I have to DRIVE my kids around and make decisions at work.

I know it's a short amount of time, but this restriction seems SO dire.

So while I do want to take my surgeon's instructions very seriously, here I sit second guessing them. So many other surgeons seem to do Protein shakes, or low-carb, or a very restricted number of calories per day. Those things seem to be effective at shrinking the liver, right? Some surgeons don't put any restrictions on at all.

If thousands are having surgery without such dire restrictions, then are they THAT necessary? Doesn't my 32 pounds and my committment to daily exercise count in my favor here?

I have been allowing myself 1 small meal a day - low carb. Am I making a horrible decision?

What I am leaning toward is continuing this approach for a couple more days - small meal tomorrow evening, small meal Monday evening. And THEN going all-clear-liquids for Tuesday-Friday.

I'd like to hear opinions and input. I keep thinking that I surely have shrunk my liver considerably with all the recent work over the past few months.

Am I being irresponsible? I may be taking 500 calories in a day.

Edited May 24, 200917 yr by LindaD

You're definitely not being irresponsible, honestly if my surgeon did what yours is, then I would eat a small meal as well. I had to do my preop diet 3 times and the first time was the worst, mainly because I had absolutely no energy at all, which totally sucked. If your surgeon says you can't have surgery because you ate one small low carb meal a day then you should tell him it is impossibly for you to function on that small amount that is, no energy, no proper minerals and no proper vitamins when you have to look after 5 kids, a husband, 2 dogs etc.

I'm not going to give you advice - but my surgeon had me on a protein and a few green veg's diet. He was concerned about the liver thing... and I did it religiously. That seemed to do the trick for me. Good luck.

I think this: if you don't "trust" your surgeon to guide you through the preop phase, how can you trust him to band you? To effectively give after care? He may or may not be right: I honestly don't know. I know that I had a big liver, I didn't follow MY doc's diet, I "cheated" but in 3 weeks lost 15 pounds and did NOT get the band because my liver was too large, so I came to in recovery with the scars but no band. I then, chagrined, did EXACTLY what my surgeon said, lost 17 MORE pounds, and got the band 19 days later.

What are you going to do post op when you have to have only liquids? It isn't a matter of "need to function" but a matter of "need to heal properly". My surgeon required a week of liquids only....no Protein shakes, no supplements, nothing. What if yours requires that? IF you eat ahead of yourself, peristalsis and the concurrent movement of your stomach can literally rip your stitches loose. Worse, actually, it can loosen things so that you don't know it happened, but in 6 months, or a year, or down the road you'll have a slip or erosion and wonder "WHY ME?"

So while I feel your pain I think you need to really question this. If your doc is wrong (and he may be?) why do you trust him to operate on you? If he's right (and he may be) why don't you trust him to guide your diet? You said his nurse is "sympathetic". Does that mean she said "you're right; you must eat" or "I know it's hard but hang in there"

And what good is 500 cal a day actually doing you? Why can't you just stick? Why didn't you tell him "I can't go 2 weeks on just water; I have kids; I need to function"

Only you can answer these questions for yourself. I don't really know the "right" answer. I hope you find it.

I think my doctor, like many, prescribe a one size fits all solution.

I sat in the seminar with people who were 100 and more pounds more than I was. I'm sure there are many who have not worked as hard in the months leading up to surgery, as I have.

I don't distrust his surgical skill or his track record.

I am questioning the necessity, given that so many doctors don't require anything quite so extreme. If I had a surgeon who said "Eh, eat what you like up until the day before - go crazy!" I'm sure I'd question that too. These appear to be the two extremes. There appears to be a lot of middle ground.

From everything I've read, the process AFTER surgery is quite different. I've had open surgery before where my intake was significantly restricted for a period after and I did fine. I'm sure I will do fine here too. I UNDERSTAND the necessity of it after surgery.

What I'm questioning is the necessity of it before surgery. Why a ZERO CALORIE routine for 14 days when this seems so uncommon?

I'm nearly into the 240s for my weight range and will surely be going into surgery with already having 40+ pounds off my body, not to mention the physical fitness I have worked up to these many weeks. I believe those are important to factor in here and I don't think they are being factored. This 2 weeks of zero calorie liquids is what is asked of EVERY patient, regardless of situation or circumstances.

I'm merely questioning other views on it. Thanks for those who are contriubting to my thought process.

When I did my pre-op diet, starting 3/29/09, I had Protein shakes and green vegetables for 10 days, then clear liquids the day before surgery and nothing by mouth after midnight the day of surgery.

HOWEVER: much more important than what I did is what you should do. TALK to your surgeon, or his/her nurse (might be better, frequently has more time to talk.) Be calm and reasonable and lay out what you've told us. If your surgeon has specific reasons why this regimen is being suggested for you in particular, then follow it. Perhaps, upon hearing your concerns, the recommendation may change.

If there doesn't seem to be a valid rationale for this plan, though, then perhaps you need to reevaluate your choice of surgeon. Communication and trust are vital to this process. If your surgeon's office (or associated hospital support such as a clinical weight loss program or the nutrition department) isn't providing that, then you may need to seriously reconsider your plans.

Good luck, whatever the outcome, and keep us posted.

If you don't agree with, or want more explaination, then you should talk to your surgeon about it. You can always find someone on here with instructions that you'd rather follow than the ones given to you by your doctor.... you can also find some on here that make you glad you have the surgeon that you have. I don't think any of us would tell you to do what you think is best - you need to do what your surgeon tells you to do. He knows what works best for his patients. I know it is hard - most pre-op diets are.... but you are putting your trust in him to operate on you, and I think you should trust that he knows what is best for you before surgery. I do wish you luck - hang in there - you can do it. Take care. Becky

Linda,

I think it sounds too drastic. You need nutrition. You need the protein shakes to keep your nutrition up. My shakes were only 120 calories. The main purpose of the pre-op diet is to "rest" your liver. Not giving it anything to work through. So by eating popsicles, broth, and diet drinks you are resting yourt liver and allowing it to "shrink" by not giving it fats. You need to drink nutrition. I had 3 protein drinks a day, ate all the sugar-free popsicles I wanted and all the broth I wanted. It was very tough but we have that goal in mind(surgery) so thats what got me through it. Its not easy. I have 3 kids and one of them is disabled so I hear ya about keeping up energy. So I ate a TON of popsicles and did my protein drinks and made it through the 10 days. I wish you all the best on one of the hardest parts of this process. Good luck.

WOW- that sounds so tough. I don't think I could do all liquid. Seriously talk to your Dr. about options to get a little more nourishment. I'm lucky that my hospital just dropped the pre op diet to just the day before surgery because they had done research that showed they were not that effective(you have to love research hospitals). Hopefully you can get some Protein shakes added to your diet.

Good luck!

I'm doing clear liquids (not broth or anything with calories) and I've added about 4 ounces of Protein at around 5PM. That is getting me through. And I did talk to the nurse on this topic.

I don't give 100% blind trust to anyone. Yes, I know I'm letting him operate on me. I have done my homework and verified his background, track record, etc. I have met him multiple times and assessed my "gut" feeling on him as someone who can take care of me. But I do and will continue to question the medical professionals I engage directly as well as to seek information from other sources.

Here, I was merely trying to collect input from multiple people. I wasn't going to accept or reject anything just because it did or didn't agree with me. I wanted a sampling of opinions, simple as that.