1. Beginning 1 week before surgery, DO NOT take any aspirin, vitamin E, herbal medications (including St. John’s Wort, Ginkgo Biloba, Garlic, Kava Kava, and Valerian Root), or NSAIDS (Vioxx, Celebrex, Bextra, Motrin, and Aleve). Tylenol or Tylenol Arthritis are safe.
  2. If you are on an antacid pill, continue to take it.
  3. Stop smoking – plan not to smoke for the rest of your life.
  4. Begin an exercise program before surgery. This should be the best you can do based on your weight. At the same time, plan for your increased exercise after surgery. This can be as expensive as buying a treadmill for your home or as inexpensive as driving your car a mile to see how far it really is. After you recover from surgery you will need to walk 2 to 3 miles two to three times a week. You could organize a group to walk together or find a shopping mall to explore or you could join a gym or exercise facility that will allow you to walk in water or on a track or treadmill. For the rest of your life, exercise will play an important role in your overall quality of life so pay attention to doing it right.
  5. Stock up on some liquid drink – there are many possibilities, so taste and decide. Examples are Boost High Protein, Ensure HN, Osmolite HN. You will drink 2 to 4 cans a day for the first 3 weeks.
  6. Beginning at least two weeks before surgery, change your diet to:
    • Eat more high protein, low fat foods:
      Lean meats, poultry, fish, seafood, eggs, lowfat cheese, light yogurt, skim milk, cottage cheese, tofu, beans/lentils
    • Eat less than 2 servings per day of these high carbohydrate foods:
      (1 serving = ½ cup or 1 piece of fresh fruit or bread) Fruit/fruit juice, breads, pasta, crackers, cereal, rice, potatoes. Avoid: sugary foods/drinks, desserts, and candy.
    • Limit these high fat foods and condiments:
      Butter/margarine, oils, salad dressing, sour cream, mayonnaise, cream, gravy, cream cheese, chips, high fat meats, bacon, sausage, fried foods, desserts
    • Try to substitute meal replacements for 1-2 meals/day to help pre-op weight loss

    This diet will help shrink your liver and make surgery safer. It will also introduce you to what
    the typical postoperative diet is like.

  7. AVOID the “last supper mentality.” Do not overindulge before surgery. This may increase the size of your liver and make the surgery more difficult and potentially more dangerous.
  8. On the morning of the day before surgery, begin a clear liquid diet. Also drink a full 10-12 ounce bottle of Magnesium Citrate (Citrate of Magnesia). This is a fairly strong laxative and will usually work within 2 to 8 hours.
  9. On the night before surgery, take a long shower or bath and clean your abdomen 3 or 4 times with soap and water. Pay special attention to cleaning your belly button area – use a q-tip.
  10. DO NOT EAT OR DRINK anything after midnight the evening before surgery. You may take those medications “Okayed” by anesthesia with sips of water as needed.
  11. Place the scopolamine patch behind your ear the night before surgery to decrease nausea.
  12. If you use a CPAP machine, bring it with you to the hospital. You