Can someone explain something about the pre-op diet to me?

I am on day 6 of my 10 day liquid diet. Tonight my husband and I were talking about it and he asked why exactly it was that some doctors require a liquid diet for a specified time and others require no pre-op diet at all? I honestly wasn't sure, guess I hadn't thought about it too much, but now I'm interested to know! My doctor told me it was imparitive that I stay on the liquid diet for 10 days to shrink my liver as much as possible. He said especially for the VSG where you are particularly working right under the liver to do the surgery. Ok, I get it, but how come other doctors don't require it? At first I thought probably a big part of doing the diet is to psychologically (as well as physically) prepare you for what is to come in the next few weeks instead of hurling you right into it. What do you guys think? Anyone have a good explanation? Thank you!

 I'm not sure exactly why. The only thing I can come up with is that if they "make" you do the pre-op diet it might put so much pressure on you to set you up for failure. My doctor said to "try" and lose 10-20lbs before surgery to shrink my liver. Knowing it was for the best I made it happen. Oh don't get me wrong, I had many bad days......but I got the 20 off.  =)  Good luck !

 I'm also waiting to be sleeved July 28 and my doc and nut both said to me that losing extra weight just before surgery, especially on the restrictive liquid, low carb, hi protein diet will shrink the liver reducing the risk of damage when they are working laparascopically. But the nut also said that since this is the diet you go on after surgery for some weeks (length of time depends on doc) that it's good to get into the swing of things as it's so very important not to damage or overstress the new sleeve.
Why other doctors don't insist on it is a mystery to me. Maybe they just have better malpractice insurance incase of a damaged liver??
Lynn

  I'm also waiting to be sleeved July 28 and my doc and nut both said to me that losing extra weight just before surgery, especially on the restrictive liquid, low carb, hi protein diet will shrink the liver reducing the risk of damage when they are working laparascopically. But the nut also said that since this is the diet you go on after surgery for some weeks (length of time depends on doc) that it's good to get into the swing of things as it's so very important not to damage or overstress the new sleeve. Why other doctors don't insist on it is a mystery to me. Maybe they just have better malpractice insurance incase of a damaged liver??
Lynn

It is purely about what surgeons learned in school and what they have seen aand learned since they have been practicing. Just as in every other instance,they have formed an idea of whAt works for them and what they want to see their patients do.

It depends on your weight / bmi.  For those who are REALLY obese, we are going to have very fatty livers.  If your liver is still too big and fatty when the surgeon gets in there, he will have a very difficult time operating around and under it and may nick it with his instruments.  That could very well be fatal!  You MUST do what your doctor says!  This is no time to be messing around with your surgeon's instructions.  Please follow his requirements to a tee, both now and at least for the first few months post-op as your stomach heals.  Your health and life may very well depend on it.
--Dorothy  

But my surgeon requires the 10 day liquid diet for all of his patients no matter what their weight or bmi. ...And I understand that is his protocol and it's probably just easier that way if he insists that all his patients do the same thing, but still doesn't answer my original question......if it is so imparitive that the liver must be shrunk sufficiently before surgery, then why isn't it a requirement of ALL surgeons performing WLS? I'm not questioning the validity of the diet, just trying to understand why.

The deal is- for the most part "liver shrinking" is a misnomer.. what they are doing is making you use up all the stored glycogen in and on your liver by putting you on a strict almost no-carb pre-op diet. The liver stores glycogen and it makes it snotty slick. When the glycogen has been used up it's a lot less slippery and less floppy.. now, the liquid diet is the surgeons call entirely.. and not all insist on it. I was on a no-carb full food diet a week prior and it accomplished the same exact thing. I agree with the poster about that it's partly what they learn, and partly what they desire.. either way, it's your surgeons plan, so stick with it so things go smoothly for you. 

I didn't know that, makes sense! Now, a diet like yours (high protein, no carbs) vs. a diet like mine (all liquid except 2 cups or less of very specific vegetables and a couple fruits)....what is the reason for that? Is that a psychological thing too? I wonder if the patient has a high rate of success with the diet if it is more/less drastic? Hmm....

I am also wondering because I have done really well so far...except 2 slip ups. I was feeling really guilty about them, but then I started thinking that even though I was 'cheating' my choices weren't really 'bad' ones. I have been having a raw spinach salad for dinner every night, but last night my husband grilled some salmon burgers for himself and the kids. I was weak and I took one and crumbled it up on my salad. I went back and looked at the nutritional info on the box  and it said one salmon patty had 21grams of protein and 4 grams of fat. That's pretty good. Then tonight I did it again....I know, I know.... this time it was with grilled chicken on my salad. I know I shouldn't .....but at least it wasn't a Big Mac or anything.

That explanation makes so much sense to me. If only I'd had that explanation I'd have made better choices. Some of the protein drinks (including diabetic Boost and Glycerna which were recommended by the NUT) have 16-20 grams of freakin carbs per serving! So I was feeling virtuous about drinking those and horribly, miserably guilty about the night I fell off the wagon and had a small serving of grilled steak and grilled salmon with a homemade no sugar coleslaw when in reality those were better for me than the protein drinks (well, maybe not the coleslaw...lol)
I'll stick to liquids for the rest of the days until surgery, but only the low carb protein drinks and not with the berries mixed in (as also permitted thank you very much) by the NUT.
Sigh.... live and learn. Well, I still have until Thursday at the crack of dawn to get rid of more liver snot. Here's hoping!
Lynn