Whatchu talking about ... Enlarged Fatty Liver?

levittown_loser
on 3/18/08 12:35 pm, edited 3/18/08 12:36 pm - Levittown, PA
DS on 07/02/08 with
OK I had an Abdomenal Ultrasound as part of my pre-surgical testing this morning.  I got my results back already and it says I have an Enlarged Fatty Liver.    It looks like obeseity is one of the main causes.   Is this pretty normal for us?   Will this cause a problem for my surgeon?    Thanks!! Tom
goodkel
on 3/18/08 12:56 pm
DS on 08/20/07 with
It DOES get in the way during surgery. This is why it's VERY important that you follow your surgeon's pre-op diet, to shrink that fatty liver to give him more room to maneuver.
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DS SW 265 CW 120 5'7"



Jackie W.
on 3/18/08 1:14 pm
DS on 08/25/08 with

From what I've read in the binder, Dr B puts his patients on a liquid diet for 5 days before.  That way it shrinks the liver, he has to lift the liver to get to the stomach.  When doing it lap, if the liver is too big, it could give him reason to go open!!

There are never any problems, only solutions.  quoted by a dear and special friend!!!

My stats:
Starting weight 234 lbs    Height 5 ft 6 in
Goal in 7 months (127 lbs)
Currently: 120-123 lbs
Tops Small   Bottoms size 2!!!!
UPDATED: 11/11

levittown_loser
on 3/18/08 1:18 pm - Levittown, PA
DS on 07/02/08 with

Thanks. Yes I am aware of needing to be in a losing state before surgery so the liver is smaller.  I was just wondering if others have had this "diagnosis" and if it should cause me worry.    I'm at least 3 months out from surgery so I will be losing a bunch of weight before on my multi disaplinary prep diet.   Thanks Tom 

stormy918
on 3/18/08 2:07 pm
I had a biopsy at the time of surgery and the report said I think, stage 4. Mine was bad. Sorry I dont have the report in front of me.  At 18 mos post op I can say that my liver blood tests now have gone back to just about normal. So, try not to worry, do the liver shrinking preop and wait for the DS to do its thing.

Darlene    DS ..9-19-06
OFFICIAL ANGEL
Kryst.......6-27-07
KellyKirk........8-6-07  now our DS FOREVER ANGEL....I will always remember
BettyBoop.....2-26-08
Jewel506...5-26-10
Ragamuffin...9-29-10
185# gone forever

 




Ample Beauty
on 3/18/08 2:59 pm - central, VA
Yea, it's pretty common with the obese.  My surgeon routinely does a liver biopsy during surgery and my initial one was abnormal.  I don't remember the details.  Point is, my second surgery it was NORMAL.  YEA Follow your doc's instructions and don't freak out about this.  It is common.  The doc just wants to know what to expect!
Ample, the Hybrid Caddy -- 488 (76.4)/146(22.8)/140-ish
12/11/2005 Hit by a truck - wt 435/BMI 68     
1/24/2006 VBG w/sleeve - Dr. Elariny
   
12/5/2006 Revision to D/S and Adjustable Band - Dr. Elariny,
wt 286/BMI 46
7/30/2008 LBL; 10/13/2008 UBL; 12/29/2008 Lipo: Dr Krieger
(deactivated member)
on 3/18/08 3:02 pm - TN
DS on 11/03/03 with
It's called NASH and it is very common in morbidly obese people, but it is reversible, Your liver enzymes may actually go up right after the surgery but over the first year or two they should slowly decline to normal. You should strictly limit your use of alcohol and acetaminophen and avoid statins until your liver enzymes are normal. Milk thistle supplements may also help.
LadyDi9080
on 3/18/08 4:57 pm - Tallahassee, FL
Carolyn, you are so smart! Have I told you how much I like you?? Come to Jackson next year! Dianne from FL

SW / GW / CW  5'10"
306 / 165 / 140
With the DS: there is no stoma, so no stoma strictures; there are no limitations (other than volume) against drinking before, during or after meals; 80% of ingested fat is malabsorbed; 98.9% of type II diabetics are CURED of this devastating disease, with data showing stable cure over 10 years out; there is the best average weight loss and most durable (average 76% excess weight loss going out 10 years) of all of the bariatric surgeries.  That's why I had a DS!

(deactivated member)
on 3/19/08 5:01 am - TN
DS on 11/03/03 with
I am already planning on Jackson next year--y'all had way too much fun without me!
gwbp
on 3/18/08 3:13 pm
Yeah, fatty enlarged liver is very common in MO. it's (was) true of mine too!
Down 165 lbs. as of May 21.
LadyDi9080
on 3/18/08 4:56 pm - Tallahassee, FL
Hey Tom! Is your surgery going to be open or lap? I was careful to take off some pounds before surgery just for the liver reason. I wanted it healthy and did not want to complicate anything!! So..shrink that liver and YES, we all had them at one time or another. Dianne from FL

SW / GW / CW  5'10"
306 / 165 / 140
With the DS: there is no stoma, so no stoma strictures; there are no limitations (other than volume) against drinking before, during or after meals; 80% of ingested fat is malabsorbed; 98.9% of type II diabetics are CURED of this devastating disease, with data showing stable cure over 10 years out; there is the best average weight loss and most durable (average 76% excess weight loss going out 10 years) of all of the bariatric surgeries.  That's why I had a DS!

Jupiter6
on 3/18/08 5:13 pm - Near Media, Pa- South of Philly, NJ
You want to get that puppy as small as you can by surgery day, Tom. I lost from 368 to 300 pounds pre-op in order to insure a safer surgery--- and I am told my liver was STILL huge and hard to manipulate!  Do whatcha gotta do!

 "Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert  Lap RNY 7/07-- Lap Gallbladder 5/08--  
     Emergency Bowel Repair
6/08 -Dr. Meilahn, Temple U.  
 Upper and Lower Bleph/Lower Face Lift 
12/08 
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA  Mastopexy/Massive 
     Brachioplasty/ Extended Abdominoplasty 
(plus Mons Lift and Upper Leg lift) / Hernia Repair
      6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10
 - Dr. Ivor Kaplan VA Beach
      
Total Cost: $33,500   Start wt: 368   RNY wt: 300  Goal wt: 150   Current wt: 148.2  BMI: 24.7

Valerie G.
on 3/18/08 5:57 pm - Northwest Mountains, GA
If you're having laproscopic surgery, they'll likely have you diet like crazy to shrink it so they can maneuver the tools around it.  If it's open, it doesn't matter, really.

Valerie
 9 years post op DS 
There is room on this earth for all of God's creatures..next to the mashed potatoes

levittown_loser
on 3/18/08 6:44 pm - Levittown, PA
DS on 07/02/08 with
Thanks everyone!    I want Lap so I will do anything to get that bugger normal. Sounds like my plan to lose a bunch of weight during my 3 month insurance wait is going to benefit me in more ways than I had planned.  A smaller more healthy liver :) In other news, my gallbladder was in great shape so it's not coming out during the DS.  I'm kinda bummed cause I wanted it out... but will focus on the positive. Tom
(deactivated member)
on 3/18/08 11:13 pm - San Jose, CA
1)  This is just me -- I would insist on getting my gall bladder out at the same time. 2)  Dr. Robert Rabkin told me that he doesn't believe that the "liver shrinking diet" does anything much at all, and that bariatric surgeons should expect to find an enlarged liver, and to expect to have to deal with it.  The Pacific Laparoscopy practice has done many many patients with BMIs >60, without a pre-op diet. In my opinion, the pre-op liver shrinking diet isn't worth the stress and torture it puts patients through.  Dr. Rabkin said he would prefer his patients arrive on his operating table hydrated, well-nourished, rested, and as unstressed as possible under the cir****tances.
levittown_loser
on 3/19/08 4:58 am - Levittown, PA
DS on 07/02/08 with
Thanks Diana.   I'll have to see about the gall bladder issue.  Not sure how to attack that.  I guess I have time and could find some data to support taking it out and ask it be submitted with my WLS approval documents along with a letter from me.  Cost benefits of one surgery vs. two etc. As for the liver, that is very interesting.  I can see Dr. Rabkins position for the 1-2 week preop liquid diet for liver shrinking.    I'm thinking with a normal diet regime between now and surgery I should be able to improve the liver.   Might be intersting to ask for another ultrasound and have my liver measured again right before surgery! Thanks again. Tom
(deactivated member)
on 3/19/08 5:13 am - TN
DS on 11/03/03 with
Tom--I am about to agree and disagree with Diana in the same post. First, I too would want my gallbladder out. The odds that you will have problems with it during the rapid weight loss phase are very high. Secondly, I didn't lose weight like I was supposed to before my surgery,my liver was still quite enlarged, and my surgery took 5 and a half hours because of it, rather than the more typical 3 and a half to four hours. So I would do what your surgeon asks you to do in that regard.
levittown_loser
on 3/19/08 5:57 am - Levittown, PA
DS on 07/02/08 with
I will follow my surgeons instructions!   I am not getting this surgery because I can't lose weight.  It's because I can't keep it off and then gain back more then I lost.  Now that I'm started on the process I am going to lose as much as I can before surgery.  I'm going to increase my protein intake and begin a workout regime to build muscle, stamina and increase my lung capacity.  Since my insurance covers the DS I don't have that fight ahead of me.  I guess I should fight for the gall bladder removal.  I don't want a second surgery. Thanks for the reinforcement. Tom
Jupiter6
on 3/19/08 6:18 am - Near Media, Pa- South of Philly, NJ
Make sure you get in DOUBLE your usual fluid volume-- and tell your surgeon you'd prefer to have the gallbladder out if possible. Most surgeons would accomodate this, I think.

 "Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert  Lap RNY 7/07-- Lap Gallbladder 5/08--  
     Emergency Bowel Repair
6/08 -Dr. Meilahn, Temple U.  
 Upper and Lower Bleph/Lower Face Lift 
12/08 
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA  Mastopexy/Massive 
     Brachioplasty/ Extended Abdominoplasty 
(plus Mons Lift and Upper Leg lift) / Hernia Repair
      6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10
 - Dr. Ivor Kaplan VA Beach
      
Total Cost: $33,500   Start wt: 368   RNY wt: 300  Goal wt: 150   Current wt: 148.2  BMI: 24.7

Jupiter6
on 3/19/08 6:14 am, edited 3/19/08 6:20 am - Near Media, Pa- South of Philly, NJ
I'm gonna second Rabkin's opinion there about the pre-op diet--sorta. True story: I lost 68 pounds in the 4 months before surgery-- and still had a huge and hard to manipulate liver. My surgery was supposed to be at 9:30 am--- and at 4pm they were still trying to get a line in me, because I was so badly dehydrated, and my blood pressure was very low (90/45 when it was previously 120/80). I attribute this to pre-op dieting: I have always gotten much of my fluids through food, never been a great drinker. Additionally: the huge fatty liver meant that I had to keep my gallbladder (which already had sludge and stones in it!). I begged to have it removed-- my doctor said he would do it "if there was time." In part because of my liver, surgery ran very long, and it wasn't possible. I still have gallstones today-- just finished my Ursodiol, and expect a gallbladder attack any time now. Grr. Flip side is that if I hadn't lost the 68 pounds, it would have possibly been larger still, and certainly would have been harder to manipulate. Another piece that's not gonna be too popular: in my experience losing weight before surgery doesn't really speed things up. Sure, you do get closer to your goals faster--but the initial large losses one has while pre-op dieting don't "re-happen" after surgery-- so post op, you will find yourself losing slower than your peers who didn't diet-- and it all turns out to be a wash. I don't believe that significant pre-op weight loss is necessarily all that necessary or beneficial, except in that I am 8 months out and already down 157 pounds...but I would have gotten here either way. The biggest pre-op dieting benefit to me (as an RNYer) is that I had never dieted before (I know, I know!) so my pre-op started getting me in a mindset regarding measuring and accountability that's made the transition a little easier.

 "Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert  Lap RNY 7/07-- Lap Gallbladder 5/08--  
     Emergency Bowel Repair
6/08 -Dr. Meilahn, Temple U.  
 Upper and Lower Bleph/Lower Face Lift 
12/08 
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA  Mastopexy/Massive 
     Brachioplasty/ Extended Abdominoplasty 
(plus Mons Lift and Upper Leg lift) / Hernia Repair
      6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10
 - Dr. Ivor Kaplan VA Beach
      
Total Cost: $33,500   Start wt: 368   RNY wt: 300  Goal wt: 150   Current wt: 148.2  BMI: 24.7