Bariatric Surgery Patients Pre-operative indications
Please follow the Liver shrinking diet. The porpoise of this preoperative diet is to decrease the size of your liver, which can be markedly enlarged do to excess fat accumulation.
No Hormone, hormone replacement or supplements (birth control pills or estrogen etc.)
No Aspirin, Ibuprofen , coumadin or heparin-type of anti-clotting medication for 7 days priot to surgery (ex,Alive,Advil,Plavix, Celebrex,Vioxx,Ultram, Mobic.,) regular Tylenol is okay.
Clear liquids for 1 day prior to surgery (ex water, broth, clear juice , gingerale, kool-aid, Gatorade, strained fruit juices with out pulp, apple juice, white grape juice, lemonade, low sodium chicken broth etc.
Desserts: Jell-O (lemon, lime or orange; no fruit toppings, Popsicles-no sherbers or fruit bars.)
Nothing by mouth, no food or beverage, after midnight in the evening prior to surgery.
Liver Shrinking Diet:
The Liver Shrinking Diet (LSD) applies for all patients scheduled for bariatric procedure with a BMI >50:
Liver shriking diet
In the obese, the liver is a huge, fatty organ. It is "in the way" of the surgical area during band surgery, and must be held back with surgical instruments. An enlarged liver is very fragile and bleeds quite easily when touched or manipulated during surgery. This bleeding can be difficult to control, and the extra care required with an enlarged liver increases surgical risk, as well as surgical time. Longer surgical time and extended time under general anesthesia can make both immediate and longer-term recovery much more difficult for you. An especially large and fragile liver has even caused some band surgeries to be cancelled, for the safety of the patient.
For those with a BMI of 45 and over, it has been found that a special high-protein and low-carb pre-op diet has been extremely effective in shrinking and strengthening the liver, so that the risks of bleeding and extended surgery times are greatly decreased. Those with lower BMI's may also choose, if they wish, to follow the liver-shrinking diet to further decrease their surgical risks.
Please follow the prescribed diet very carefully (usually about 2 weeks' time). We want you to have as easy, safe, and uneventful a surgery and recovery as possible.
Following this SPECIFIC DIET PLAN is extremely important. The goal is not to lose weight, necessarily, but to enter a temporary period of dietary ketosis, which is not harmful to you at all. However, many do lose a good amount of weight, which will jump-start your Band weight loss as you begin to regain and improve your health. It is this dietary ketosis that results in liver-shrinking and the normalizing of your metabolism so that you can do well with banding.
LIVER-SHRINKING DIET PLAN
1. There are NO CALORIE LIMITATIONS on the LIVER-SHRINKING diet. You may eat/drink as much as you wish of the allowed things to feel satisfied, although we suggest reasonable limits to assist your weight loss.
2. A maximum of 40-50 grams of carbohydrates (carbs) a day.
3. You may have as many high-protein/low carb Protein drinks a day as you wish. No limit!
4. You may add low-carb protein bars up to the max of 40-50 grams of carbs a day.
5. You may have any type, brand, and quantity of protein drinks and protein bars that you wish, as long as you read the labels carefully so you are getting a MAX of 40-50 grams of NET carbs a day.
6. Count only the NET CARBS that are on the label, not the "total" carbs. Please eat and drink NOTHING that is not clearly labeled as to net carb content. With some products, the "Net Carbs" are called "Impact Carbs" or "Effective Carbs".
7. You may have as much water, Crystal Light, herbal or regular teas, or coffee as you wish but please remember, NO sugar, and NO milk/creamer with high carbs. You must count any carbs here in your daily total of 40-50 grams maximum.
8. Your local GNC or other nutrition store will have a variety of drinks and bars to try. We suggest getting one each of several kinds to try before you buy a larger quantity, so you can find some you really like.
9. Many find that the UNJURY brand of protein drink is the best tasting and among the least expensive. It is available only online, but ships very quickly. www.unjury.com
Do a web search for "low-carb protein bars" and compare costs, grams of protein, and grams of Net carbs. Online sources are often much less expensive than those found in local stores, and the shipping is often free.
We feel that the Atkins ADVANTAGE and ENDULGE bars are excellent, with about 3-4 grams of Net Carbs per bar, but there are several other brands that are fine.
10. PLEASE eat *only* solid protein! Choose only a piece of chicken, a lean steak, a hard-boiled egg, or some low-fat cheese. PLEASE: NO mayo, BBQ sauce, ketchup, sweets, junk food, cereals, or anything else. Even the smallest amount of non-protein, carb-laden food can take you out of ketosis and easily negate many day's worth of the low carbs that are so greatly decreasing your surgical risk.
11. Watch out for things that you would normally not consider food! You must also have NONE of the following things that are full of sugar:
· chewing gum with sugar or carb sweetener
· breath mints
· cough syrup
· hard candy and cough drops.
Examples of good High Protein, Low-Carb drinks and bars:
· Isopure Clear Protein drinks - strawberry, grape, blueberry, Alpine punch 0 carbs
· Zero-Carb Isopure Mix strawberry, vanilla, chocolate
· UNJURY protein powder vanilla, chocolate, non-flavored - mixed with skim milk 20 gm protein, 3 gm Net Carbs.
· PRIA Carb Select bars 10 gm - very tasty!
· EAS Myoplex protein bars 29 gm protein, 2 gm "Effective" carbs
· Atkins Advantage protein bars 17 gm protein, 2 gm "Net" Carbs. Berry Granola, many other flavors
· Pure Protein Bars 30 gm protein, 5 gm Net Carbs
· Nitro-Tech Protein Bars 35 gm protein, 4 gm Net (Impact) carbs
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1-617-418-3436
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