Pre-op diet questions

Was your liquid diet protein shakes or meal replacements w/carbs?

My surgeon has me on a 21 day liquid diet, starting tomorrow - got a couple extra pounds to lose after the last couple days )

 

I can't remember if I assumed my liquid diet was protein shakes or the doc specifically told me that my liquid diet was protein shakes. I do remember him telling me I'd go ketonic and no drinking calories (i.e gatorade, coffee, etc.. was okay)

 

I got confused with with my final pre-op NUT visit (3 days after my surgeon meeting). She has me drinking meal replacements like ensure (800-1200 calories). Those meal replacements have a lot of carbs.

 

I thought the idea of the pre-op was to shrink the liver by removing carbs?

 

I don't have the most confidence in my NUT as she had me on a 10 day diet. (obviously didn't talk to the doc). She also said the point of the liquid diet was to limit calories and it was no different than eating smaller amounts but people can't seem to eat smaller amounts so they put patients on liquid diets.

(She also believes in eating more to promote weight loss (starvation mode believer), had no semblance of an educated answer about how reduced calorie intake changes our metabolism long term, and took about 5 min explaining how to fill out a pen and paper chart to track my weight/bmi/measurements. I thought filling in my weight under the heading that read "weight" and bmi under "bmi" was self explanatory. Good thing she clarified that next to the prompt that said 1 month I would enter my results 1 month out and at the prompt for month 2... good thing she had the time to "teach me". Sorry for turning this into a vent. This process feels a bit to "cookie cutter" and several parts of my COE cookie cutter approach are a waste of time/insurance money.) 

 

Thanks for the help with your pre-op diet and liquids/calories/purpose/carbs/etc..

I would call your doctor to double check. All preop diets are different and you definitely want to start off on the right foot.

My doctor told me to find a protein shake with the following guidelines: No more than 200 calories, no more than 5 carbs, and at least 15 grams of protein.

But trust your doctor he knows what is best for you.

I would definitely call your surgeon and ask these things.  And let him know you're getting conflicting info from the nutritionist!  

And this is a good article -- http://authoritynutrition.com/how-to-win-an-argument-with-a- nutritionist/

The shakes are meal replacements and also a liquid diet.  Sounds to me like he actually said both to you which would be pretty standard in this process.

Generally, you're looking for shakes with no more than 10 grams of carbs per container and 15 grams minimum of protein.  Ideally, you're looking for closer to 5-6 grams of carbs and 20-30 of protein.  Most of what you see of the shelves at Walmart, Target or other chain stores, does not fit this profile (regardless of advertising).  You need t read the labels and dismiss and product (no matter how well it's "branded") that doesn't fit.

Following most physicians rules should drop you below 60 grams of carbs initially and Willet you in ketosis for sure.  Your objective is to stay there until you reach a normal BMI.  Be prepared, this will take many months and you may have to decide whether to deviate from your NUT's advice or not.  That's a personal choice and depends on what you NUT might be telling you.

Sugar = carbs, even a little sugar is more carbs than you need and will kick you out of ketosis.  That's why he cautioned you about Gatorade, etc.  If you must, use crystal light or MIO flavoring with ice water.  Any sugar-free option here probably works.  The coffee caution is another issue (except for the sweeteners and creamers) and subject to some debate on it's pros and cons.  I was never a coffee drinker, and figure just plain water is best, so I stay out of it.

Generally, they are guiding you toward a 1000 calorie diet pre-surgery with no more that the 60 carbs.  Different physicians will vary, but that's the general idea.  Obviously, you won't be eating fast food, chips, soda or ice cream and be able to maintain those numbers.  Following the guideline on carbs will shrink the liver.

NUTs tend to give out broad spectrum guidance that's going to (a) work for more people in general, (b) provide at least a minimum level of success for everyone, and (c) provide for a steady controlled function over time.  So, with that said, they aren't "wrong", but there are many paths that will get you there and you aren't strictly required to followed the NUT's advice.  A lot of what they teach will make sense, and remember, they are often educating people with little or no real understanding of nutrition.  You just have to decide what works for you and be able to objectively evaluate your process as it goes along.

BTW: I'm one (of many here) who believe that "starvation mode" is absolute BULLSH@T.  The simple truths are (1) your body needs fuel and will use what it has when not provided enough by way of food, (2) the "math" won't always work smoothly, and make sense day to day, but it will function correctly over time, and (3) your body will get much more efficient, and totally blow the math formulas out of the water, once you get to a normal BMI.  By the time you reach this point you focus should be on calories consumption relative to exercise, and nutritional balance.

 

Well, there is a lot going on in this post.  Your doc seems to want you on protein shakes, but low carb.  But it does not appear he gave you a carb target, and consequently I wonder if perhaps you may have partially misconstrued the instructions.  It is entirely possible to use shakes with hardly any carbs- premier protein and Eas low carb are two examples that have a good stat profile with protein, carbd, and vitamins.  What your Nut described to you matches what was prescribed for me.  The incongruence between the doc and Nut though is more stark than most.  I would call and check in with your doc. 

As far as shrinking the liver- it is not low carb that does it, it is the caloric restriction.  So your Nut is not off base in her plan.  On the doc's plan due to the super low carb approach it will cause you to burn off the glycogyn faster though, and initially a jumpstart to weight loss.  

Anyway, good luck.  Call and get the clarification you need.  

Thanks for the help...yes a call to the doc is planned for monday morning :)

When I did the pre-op diet it was mainly protein shakes, even though I would have other shakes that weren't protein shakes but still fit the liquid diet. Be careful with Ensure, there are 2 types of shakes, the one you've been drinking is the high calorie/carb one, drink the hi protein one, it is about 210 calories and 23 carbs. Glucerna hunger smart shakes & other low carb shakes (butter pecan) were good too, but pick the low carb one, the kind made for diabetics. I also had swansons chinese hot & sour broth, they make a mexican tortilla too. Pre-op diet is to shrink the liver, period, you'll cut back on carbs if you choose low carb options, but I don't know how low on carbs you have to be to get ketogenic.

I had no preop diet. I just started eating right on my own. Made sure my protein was up to 80-100g and calories at 1200. I lost 28 pounds in 2.5 months and got used to tracking