Hypoglycemia Doc waste of time.

Hi yall.  Long time since I have been on this board but wanted to ask about anyone here that has hypoglycemia.  I made an appt with who my surgeon suggested for the low blood sugars that I have been having.  The lowest has been 43. Dr. Castallucci whom is located in Richmond was who I went to yesterday.  First I went to his Dietician who was...stumped. Then I saw Dr. Castallucci and basically told me "I'm sorry I cant help you jus****ch what you eat". 

No testing, he didnt even touch me. Asked a few questions about the bypass and bascially told me well...sorry this is what happens with this surgery....deal with it. 

What should I do?  Just except it and do my best to manage it?  At this point I cant figue out my triggers, the dietician couldnt help me.  What we as bypass patients eat is how I eatand thats the same way of that those with hypo should eat...and im still bottoming out.

Or should I try to get a second opiniion.  Can someone please tell me the doc they use that is exeperienced with hypoglycemia in gastric patients?  Obviously the reason I asked my surgeon to refer me is because I figured he would give me a doc he refers all his people to but nope.

At this point I will make an appt and even if I have to wait6 mos to get in then thats fine. 

thanks

I personally struggle with this.  Figures I was pre-diabetic and now have low blood sugar crashes!  I keep glucose pills with me at all time.  NO JOKE.  PURSE, CAR, SIG OTHERS CAR.  Never know.  I just know when it   comes on it needs fixing.

Seek a second opinion.  DEMAND it to be investigated.  Have you talked to your surgeon about this?

I'm not going to lie.  I have self-managed this problem and have not seen a doctor about it.  BUT, I'm sure if I adjusted something it would help.

L

I have hypoglycemia too I am 8 months out, I went to My nut who is excellent, we sat down and went over what i can do. I have to eat 5 or 6 small meals a day. I always carry peanut butter crackers with me. At first it felt like i was eating all day long and with having surgery, I really don.t be hungry so I don.t think about eating so that was one of the things I had to get together on, but since I have been doing this, I have not had one hypoglycemia moment. I make sure i get all my liquids and protein in, I am feeling good. Sometimes I forget to eat something and I know my body enough to go get something quick, I usually get peanut butter and it will pass I hope you get someone who will take time with you and go over everything with you , so you wont bottom out. take care

Dr. Castellucci's a good endocrinologist, but the problem of post-bypass hypoglycemia is poorly understood, and not an easy one to diagnose and treat.

That being said, most cases (>95%) can be helped by diet modification: eating the proper foods.  The big enemy: CARBOHYDRATES! IE the high-glycemic foods that Atkins & South Beach diets tell you to avoid.

I've experienced this in my bypass as well, and without exception, all of them admit to a starchy meal before their hypoglycemia episodes, and reverting back to a HIGH-PROTEIN meal always takes care of the problem.

So the solution (for the vast majority): eat PROTEIN FIRST at every meal (ever heard that before?) - chicken, fish etc; nonbreaded, nonfried. Then green veggies - broccoli, green beans, spinach; complex carbs are okay. Avoid hi-glycemic carbs like crackers, chips, potatoes/fries, bananas, fruit juices like OJ, even milk. They're absorbed quickly, cause a spike in insulin, then your blood sugar bottoms out. Bingo: hypoglycemia.
 
Talk to your dietitian to get a list of hi-glycemic carbs you should avoid. Sometimes, a drug called Precose, prescribed to prevent carb absorption in the intestine, can help.

This is different from dumping, but some of the same foods can cause both reactions.

In a small percentage of cases (

[Continuation. Website editor deleting the end of my post. Will try again]

In a small percentage of cases (3%), the hypoglycemia can be due to overgrowth of insulin-cells in the pancreas (called nesidioblastosis). The diagnosis is difficult - CT scans and ultrasound don't help. It takes an arteriogram (like a cardiac cath) to diagnose, and treatment involves removing 90% of the pancreas (no small deal).

Reference article for more detail: http://www.ncbi.nlm.nih.gov/pubmed/18656831
Hope this helps. Say hi to Stacy & Erin for me.

Thank you all so much for your advice. I gets its back to the basics for me.  Dr. Elliot i will do everything you suggest and see how well I can manage this thing on my own. :-)


Thanks everyone!