Surgery date approaching and really scared

My surgery date is in just over 3 weeks.  I need to be on Optifast starting on Monday.  I am really scared though for the surgery in general and because I think that I'm not what I was when I did all my testing.

A little backstory, I was supposed to have my surgery in November, but in October my dad died very unexpectedly so I postponed.  Afterwards I sunk into a pretty deep depression (that I'm still struggling to get out of) but I didn't want the year of pre-op prep I'd done to go to waste so I rebooked my surgery for mid-April.  While I was depressed I didn't really get out much and ate a fair amount and I feel like I undid all the hard work I had done beforehand and thensome, since now I'm heavier than I've ever been (I just crossed 400lbs for the first time).  I'm so scared that I should be on Optifast for longer than what I have or that I'm not as healthy as I need to be to survive the surgery.  My stomach and chest hurt from anxiety for the last week or so straight, ever since I started really prepping to get rid of all of my food and start Optifast.

I've put a call out to my bariatric clinic and hopefully they get back to me soon for advice.  They've been incredibly supportive, but it's still not people who have been through it themselves.

I guess I'm just really worried that I'm not as prepared as I could be, but I'm not sure how much of this is that I'll never be completely prepared.  I'm really scared for the surgery.

It is completely normal to be frightened by the surgery. It is, after all, a serious surgery, and it will change your life in many ways.  I was just excited up until the morning of surgery, and as soon as we arrived at the hospital, I got REALLY nervous!  By the time my surgeon came into the prep area, I was so stressed out that I burst into tears!  I assured her that I wasn't changing my mind about surgery, but that I needed something to calm my nerves.

I wouldn't worry too much about the weight you gained after your father died, or about not being as healthy as you could be prior to surgery (but I think it is good that you have contacted your surgeon's support team). Let's be honest, most of us who have a BMI of over 50 are a surgical risk even if we have no known pre-existing health issues. None of us is healthy simply because of our weight and the stress that it places on our hearts and lungs.  Your surgeon is aware of this, and will do everything (s)he can to ensure a safe surgery.

If your surgeon requires the Optifast specifically to shrink the liver, be aware that many surgeons doubt that just two weeks of a no-fat diet (whether liquid or not) is sufficient to significantly shrink a fatty liver (and someone who is SMO is very likely to have a fatty liver). Your surgeon also knows that.

Moreover, some surgeons (like mine) do NOT do a liquid pre-op diet because it places stress on the body and -- especially if they don't think it really helps the liver that much -- they prefer to have patients continue to eat a more normal diet so the body will be stronger for surgery rather than under stress.  It goes through enough stress from the surgery itself and the shock from the lack of nutrition post-op! My point is that it might actually be a drawback to being on a liquid diet for a longer period of time pre-op.

Try to focus on the positive side of things: on how much better you will feel physically as the weight comes off... of never again having to endure the embarrassment/shame of having people point and whisper about your size... of all the mundane things that will be SO much easier to do (e.g., tying your shoes or walking up a single flight of stairs)... of all the things you will no longer even think about (e.g., never again having to wonder if you will fit in a particular seat or restaurant booth)... of all the things you would like to do now but cannot because of your weight (heck, that could be anything from taking a bubble bath in a normal bathtub to parasailing/horseback riding/running a marathon!).

Try to do things that you find relaxing in this time leading up to your surgery.  (Finding non-food ways to deal with stress will be essential for long-term success, so you might as well start now!)  psychological stress takes a physical toll on our bodies, so eliminating/controlling the worry will make you stronger for surgery.

Lora