on 9/24/09 4:30 am
 Hi, guys -
I'll be four years out from open RNY on October 14. For about the past year I've noticed myself having the dizziness and lightheaded feeling I described above. It normally climaxes with shakey hands and I've felt like I'm about to faint on the rare occasion I let it go too far.

I can't pin-point exactly what is causing it, but a theme seems to be eating carbs. This happened just yesterday when I had some pretzels for an afternoon snack at the office. Then when I was running errands, I thought I was going to  pass out. The feeling seems to come on 45-60 minutes after I eat the food. 

Does anyone else deal with this? Anyone know what the heck it is? I would go to my doctor, but he retired, I moved and I don't have a GP here. I've never actually passed out, it just feels like it is coming on and it is very uncomfortable. Anything you might know would be very helpful.

Not the Same Dawn
on 9/24/09 5:22 am - BEE EFF EEE, CA
Reactive Hypoglycemia? Where the blood sugar rises because of the carbs that you ate but drops suddenly after about an hour...I get that so I have to have something with protein in it WITH the carb...like peanut butter with an apple. Cheese and a slice of deli meat..If you start to feeling shakey, have a small handful of peanuts...works for me.
Yes, RNY worked for me but it also requires a lot of work from me!

Before Surgery: 214
Highest Weight: 240
Now: 125.6
Goal: 130
on 9/24/09 11:37 pm, edited 9/24/09 11:37 pm - Random Lake, WI
I'm going to go with Reactive Hypoglycemia as well.  Especially since it comes after eating food.

My understanding of RH is that, because of your former Obesity, your body produces too much insulin for the size of the meal you are now eating.  You body is "expecting" you to eat a 1500 or 2000 calorie monster meal and produces that much insulin.  Then, you eat a bariatic meal of 300 to 500 calories and you're left with too much insulin which causes low blood sugar and the associated symptoms (light headed, shakes, etc.)

Here is what I would do:  Set aside some food from what you eat and eat it 1 or 2 hours after the meal.  That way, you'll give the body a little more food to use to sop up the excess insulin.  High glycemic foods would make excellent after meal "snacks"

I haven't found that carb heavy meals make the RH symptoms worse.  Regardless of what you eat your body still says, "Pour on the Insulin!"  In fact, very high protein meals (like just scrambled eggs) could worsen the symptoms since you don't have any high glycemic foods (like toast) to counter the excess insulin.

on 9/25/09 12:44 am
 Thanks to both of you! The treatment I've been using is to have some sips of OJ or a banana or, as you suggested, a few peanuts or peanut butter.

It is a relief to have both of you confirm what my initial thoughts were. 

on 9/26/09 12:53 am - Fresno, CA
 I get the same thing, and I keep a package of peanut butter crackers next to my bed at night just in case I wake up with this feeling.  It has happened before, and it can be scary....

on 9/26/09 6:53 am - Puyallup, WA
RNY on 10/05/94
reactive hypoglycemia. Seems to hit us around 2 yrs post-op. For those of us who are on the yahoo grads (so many are moe than 10 yrs out now), we all carry PB crackers and have them everywhere.

To eat more sugar just starts the cycle all over again.

For me, a baked potato or bread without some protein (meat) with it, is a guaranteed crash 1-3 hrs later. It can be very dangerous if it his when you're asleep.

The early studies simply blamed the patient, but more recent studies are suggesting that for some of us, the pancreas will actually grow more insulin producing ability. So, eat a small potato but produce enough insulin for a 10# bag of 'em. But nothing arrives, so the blood sugar crashes down very quickly. In some cases, they term it as nesidioblastosis and some experiments with removing various % of pancreas have been tried.

The ideal is to control it without having to do that. I have pretty good luck if I don't do bread and potatoes in the amount of "as much as I want", but trim those back to way small portions, and always eat a few bites of meat first.

I would hate to think that for all the marvelous things that WLS has done for me, that my already broken pancreas is now broken in some other way. But if it is and I can "eat around it", then I'd much prefer that to being one of the "cut a chunk of pancreas out" experiments. I know a few ppl have done it and have yet to meet one who's totally happy with the result.

In any case, if you were on yahoo grads, you'd see that about 98% of us experience this.

RNY, distal, 10/5/94 

P.S.  My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.

on 10/10/09 12:19 am - NH
I disagree with the "sop up the extra insulin" theory by eating high carb foods. The idea is to prevent the insulin spike and subsequent blood sugar drop in the first place. You don't want to perpetuate the cycle, you need to stop it.

Insulin spikes when sugar, starch and other carbohydrates are injested. While the insulin is doing its job removing the injested sugar from the blood stream, it may go overboard and take out too much sugar leaving us feeling yucky, and sometimes, ready to pass out. For example, that's what happens when we eat a candy bar - a gush of insulin to remove the gush of sugar we just stuffed into our mouths.

So the solution is to create a balance of carbs, protein, fiber and yes, fat, everytime you eat something. So...pretzels with cheese or peanut butter, celery with cream cheese or peanut butter, dried fruit and nuts, greek yogurt (not non-fat) and jam/fruit, a vegetable omelet, etc.

This will help steady blood sugar levels, prevent an over production of insulin, and subsequent drop in blood sugar. I believe that eating real whole foods are the best bet - whole fresh fruit, whole fresh vegetables, real meat, beans, real cheese and milk, and protein-packed whole grains like quinoa. To be dramactic, processed food is the curse of mankind!

Check out some info on low-glycemic foods. There are ga-zillions of books, articles and internet sites on low-glycemic foods and eating.

The problem is not knowing what to do, it's just doing it!

Good luck to all!