difficult 12 week pre-op liquid diet & weight dump

PatientEleventyBillion · February 23, 2017

Hello fellow bariatric patients,

I'm in Canada, my surgeon wanted a 12 week liquid diet pre-op. Before I get into the details here's my story in highlights:

- 34 Male, 5ft11in (180cm)

- Severe weight gain over a few years (from 180 to 360 peak in 5 yrs)

- Caused a number of sudden issues (stage 3 liver fibrosis, pre-diabetes/diabetes, increased GERD, L5/S1 compression fracture, high bp/pulse, depression, etc.)

- S3 Liver fibrosis: initially diagnosed cirrhosis w/fibrotic scan but after biopsy (which they did after I told them I'm not an alcoholic) revealed stage 3 fibrosis&no cirrhosis - prior ultrasound suggested 19cm or larger, not sure

- Diabetes (5.4 1 year ago to peak 7.9, down to 6.1-6.4 now and likely will drop again w/March 1st A1C workup)

- Everything is currently contained w/meds (10mg forxiga, 2x metformin tabs 2 times a day, hydrochlorathiazide (1 small tablet a day), cipralex (1x tablet a day), metoprolol 75mg 2x day, 1 capsule of prevacid generic, 2 Vitamin D tablets because Canada) - resting hr 50-80 (previously 80-110), bp 110-130/60-80 (previously 150-175/100-115)

- Initially suggested bypass but because of age (34) had my surgeon and two second opinions all suggest sleeve so I wasn't gonna argue, they said if I didn't like results of sleeve could get bypass after 1 yr

- 12 week liquid pre-op diet started Feb 1, OR date April 20

- Dietitian was pissed off at 12 week diet saying she will talk to surgeon, obviously didn't convince him

- Weight changes: (ignore the column to the left, I haven't figured out how to change it)

∙ Feb 1: 350

∙ Feb 4: 336

∙ Feb 15: 322

∙ Feb 17: 319

∙ Feb 22: 314

Daily Pre-op diet plan (1400 cals):

- 6 bottles of Glucerna (<- yech)

- 1 serving of sugar free Jello (4x per container)

- 4-9 cups clear fluids (i.e. broth) w/extremely low cal/carb

- 2 scoops Beneprotein

- 3.7L Water

I have to say, this has been the hardest thing in my life. Not so much the sticking to diet part, but keeping down this Glucerna stuff. It's so disgusting! I couldn't help but regurgitating the stuff in the first few days. I had 1-2 Glucerna for the first few days, resulting in being extremely calorie deficient.

Even with my wife helping trying to flavor w/spices (i.e. cinnamon) for berry/vanilla I just couldn't take a few flavors, wound up settling on chocolate, making sure the stuff never touches the front of my tongue, otherwise I'll upchuck.

Stomach was going nuts w/hunger the first few days, since then haven't been able to stomach more than 1-3 Glucerna a day, eventually it stopped bothering me so much - but has resulted in first couple occurrences of "lows" (low blood sugar). Have been eating more broth though closer to the 9 cups, and taking Multivitamins, and having daily amt of Jello. Body seems to do fine.

Haven't had a normal stool the entire time, all liquid.. (I assume thats normal?)

The concern of mine is my paranoid dietitian freaking out and nearly wanting to call off the surgery because I wasn't having the amount of Glucerna she wanted. To the point where I had to lie to her about how much I was having a day, as I've waited 1.5 years to get to this point. Can't see how going nuts on me is productive. Already have my wife nagging at me.

Has anyone had an issue w/not having sufficient calories not causing liver to shrink going into surgery? Or light malnutrition affecting whether or not surgery was done? Pretty much everyone I read has like 2-6 weeks and I'm stuck with 12. This is absolute misery, but I'm perfectly ok doing what I'm doing as long as the end goal is met and nothing causes my surgery to be cancelled (i.e. liver not shrunk enough).

Steven

Edited February 23, 2017 by PatientEleventyBillion