My numbers haven't gone that low yet, I think 45 is the lowest I recorded.  I had to stop eating shredded wheat wirh protein powder and almond milk on it because I regularly tanked on that

When I reported it as part of my four-year checkup, the registered dietician said there are many cases reported.  She didn't indicate that a reason had been found, just that the data was increasing.

I have seen it discussed on several boards and blogs as well.  The street wisdom seems to be small high-protein meals.  Many, but not all folks have mentioned a corollary between lots of artificial sweeteners and the big drops.  Except for Pure Protein bars, I avoid most sweet stuff most of the time, except for fresh fruit.  I haven't tanked for a few months now.

Keep me informed!

 I went with Grand Health Partners after much research.  My insurance also requires a COE facility and so I restricted my search to those particular facilities but I would have considered going out of state if that was what it took to find the right surgeon for me.

I attended the GHP orientation to find out more information because at the time I was still a little reluctant to consider surgery.  I was only aware of the Lap Band and RNY surgeries but saw that other surgeries I'd not heard about were being performed at GHP and I wanted to find out more (I KNEW I didn't want a lap band and had some misgivings with the RNY).   Dr. Foote was the surgeon that did the orientation and I was VERY excited when I heard about the VSG and the DS.  I originally chose to go with Dr. Kemmeter because of his experience and sat down with him for my first consult.  I only had about 100lbs to lose and he didn't feel that the DS was necessary for me and stated that I would probably do very well with a VSG.  

Although Dr. Kemmeter does all the surgeries he said that if I was considering VSG that I might want to consider going with Dr.Foote as Dr. Foote was their practice's go-to guy for VSG and so I transferred over to Dr. Foote for my surgery.  

I'm VERY happy with my aftercare and am thrilled with my surgery.  Dr. Foote tends to create tight sleeves so I have PLENTY of restriction and although these ending stages of my weight loss are going slowly (I'm within 15-30 lbs of goal - my final goal hasn't really been determined since I'm much smaller than expected at my current weight and I may not be able to make it to our original weight goal) it has been steady and I continue to lose.

Really, I would trust any of the surgeons in the GHP practice, but that is my personal view.

I had initially chosen to go with Dr. Gluck in Muskegon.
After finding this site and reading about VSG & DS I decided to go only to a surgeon that performed all 4 surgeries.
I have chosen Kemmeter based on what Guate Wife has already stated.
Due to my higher BMI I have chosen the surgery that will give me the best results long term.
I am not going through this twice..  DS for me!

I made alot of my desicions based on collective studies and all of the forums and blogs on OH.
I researched the Surgeons I was looking at (Foote & Kemmter) and chose due to history & number of surgeries performed.
I get along with just about anybody and have a very upbeat attitude and got along with Kemmeter very quickly. He does ecpect you to know what you are talking about and he was SUPER releived and pleased that I had already done my research and knew what he was talking about.

Dr H did my surgery and I will tell you if he does yours you will not regret it.  His staff is so supportive and so nice and he is right to the point.  I would get another PCP

I just totally lucked out, but if I knew than what I knew now....

1)  I would ONLY consult with a surgeon that is capable of performing ALL FOUR of the major WLS options.  It is scary to me how much faith people put in a person because of the "M.D." after their name, and don't connect the financial incentive to convince people that what is the best for them is limited to what the surgeon can provide for them.  At the practice I used (Grand Health Partners in G.R.), people tend to go with the surgeon who gives the orientation, and almost without fail, the "perfect surgery" for that person is the one the surgeon prefers or is capable of.  In that office, Dr. Kemmeter is the ONLY surgeon I can recommend.

2)  Geographic proximity to my surgeon seemed so important pre-op, and post-op I realize how that should not have even been a consideration.  My surgical practice was recommended to me by my PCP, and it is less than a mile from my home, and so is the hospital where my surgery was performed.  While I see my surgeon often (he is very involved in supporting post-ops), I have yet to have any  *reason*  to see him.  Like you said -- the surgeon is the cutter.  Post-op, you are really the one responsible for your after-care needs.  I would now travel anywhere for who I consider the top three surgeons:  Kemmeter, Rabkin, and Keshisian.

3)  Some people really feel the need to "click" with their surgeon.  I happen to, but in reality, I wanted a brilliant surgeon, and could have cared less if he were an asshole.  I checked out my surgeon via hospital staff that I knew --- if they won't let someone touch them, than you know it isn't someone you want touching you!  Turns out my surgeon is extremely highly regarded from nurses to other surgeons, and on top of that he is the go-to guy for abdominal trauma.  Made me feel really comfortable that if he got in there (which he does Lap, as an open surgery was out of the question for me), and there were issues while I was on the table, he would not only know how to handle the issue, but also he wouldn't freak by the pressure.

4)  I wouldn't consider any surgeon who doesn't perform WLS laparoscopically  There is no reason, in this day and age, to go in knowing that the surgery will be performed open.  Surgeons who do this are out of date, and their reasoning for sticking with open is strictly because they can't do the procedure lap, even though they will tell you otherwise.

5)  Being a COE means jack squat as far as surgical skill, but it is often required by insurance that you use a COE.  Just don't be fooled into thinking that just because it is a COE that you are in superior hands.

If you haven't considered the DS, please do so.  It is the most effective WLS at keeping your weight off LONG TERM  --- many people seek the DS after another WLS has failed them.  Revisions are risky, so think twice & cut once.  You can get a lot of information on the DS on my link to DSFacts.com on my signature, and also by visiting the DS Forum here on OH.