I'm silently screaming obscenties at you.

Obscenties.

I really liked this entry at PostSecret this morning.  That's all.

But, what you're waiting for, is a reply to this:

"Do you think if you had stayed away from carbs better during these last few years you might have avoided these health issues now? In the year I have been reading you, your carb intake has always seemed higher and protein intake lower than it should have been for someone post wls"

From this post I wrote the other day.  (You must read that post first to understand.)

I'll be back with a reply very soon, if I didn't have a Certain Toddler typing ASDFJKL; over here on me.  BRB.

I'm back.  I even walked away from this, hoping to search online for information on this topic.  I searched on:

• nesidioblastosis after gastric bypass caused by eating carbohydrates?
• reactive hypoglycemia blamed on carbohydrates?
• how to provoke reactive hypoglycemia after roux en y
• what causes nesidioblastosis?

I can't find anything except everything I have already seen before.  I'm currently diagnosed as a reactive hypoglycemic, and The Cause IS my Roux En Y Gastric Bypass.  I do not know if I have nesidioblastosis, because that is tested by doing an arterial calcium stimulation test to the pancreas, which is probably in my future if my episodes of hypoglycemia do not improve with medication and diet, or get worse.

Seriously, though, do you really, truly, think that eating carbohydrates CAUSED this? 

It's a fair question, I guess, but, really?  If that were the case - everyone around me should be dead.  If my consumption of carbohydrates caused me to be a reactive hypoglycemic, very anemic, vitamin deficient and have seizures - - - my immediate family of three post op RNY'ers would, by the same reasoning - seriously - be (forbid the thought, just making a point!) dead. 

My diet, compared to the three of them?  You. don't. want. to. know.  I don't blog about it.  I sometimes poke fun at my husband, also post-op RNY, about his serious cookie habits Eating Choices, because I have to fight that Every Day Of My Life, but he's sorta healthy.  His daily consumption of super-carby laden food has not killed him.  The other two?  They're subsiding on A LOT of sugar-free sweets and stacks upon stacks of crackers, eating anything they want to, except regular white sugar containing sweets (ie regular candy, cookies or cake) because they are both TERRIFIED of dumping on sugar.

A typical "non-dieting" eating to maintain a level of consciousness day for me:

    -Protein Bar     -Cheese     -Greens, meat or cheese, fat free/cal free dressing     -Protein Bar     -Flaxseed/whole grain low carb bread or wrap/cheese     -Beans     -Naughty food, ie. handful whole grain tortilla chips/salsa/or cheese     -Protein Bar

Sure, there's lots of carbs, but they're usually complex if they're coming from actual food and not supplementary protein bars.  I pay harshly for inappropriate choices, like, a cookie, or pretzels, and I dump on them - - - and ALSO get a reactive hypoglycemia event, so that's a good way to learn, yes?

NOW - the thing is - this hypoglycemia OCCURS MANY TIMES WITHOUT any carbohydrate trigger. 

My biggest crashes were after a plain, low glycemic protein shake and cottage cheese.  I went to the ER after COTTAGE CHEESE. 

I thought I had a STROKE after COTTAGE CHEESE, four ounces of fiber-laced cottage cheese.

Last Thursday?  I had a GRAND MAL SEIZURE after a PROTEIN BAR + B-VITAMIN ENERGY DRINK.

IS that something I caused?  Did I EVER have things like this happen to me when I lived on chicken nuggets and Diet Coke?  HELLS NAW!

I don't think so.

PS.  I've dropped 35 mg. of blood glucose while typing this in 27 minutes.

I was at 107 mg - and now I'm 70 mg.  I'm sure you caught when it happened, too.  Read back.

Am I slow?  I missed it.  So, what the heck is reactive hypoglycemia and how does RNY cause it???  I am gonna have to google it now.  I am really bummed to hear that you have seizures and this dangerous sounding complication.  I sure hope that you are able to get control of it and not have to worry about having seizures and stuff for the rest of your life. Someone once said that cottage cheese is solely responsible for the obesity epidemic.... their point, "Ever seen a skinny person eating cottage cheese?"  Of course now after WLS the answer is yes... but before that, he may have been on to something! LOL  God help me, I love that stuff!

"Severe hypoglycemia is a complication of gastric bypass surgery and should be considered if the patient has symptoms such as confusion, lightheadedness, rapid heart rate, shaking, sweating, excessive hunger, bad headaches in the morning, or bad nightmares," says Mary-Elizabeth Patti, MD, investigator in Joslin's Research Section on Cellular and Molecular Physiology and Assistant Professor of Medicine at Harvard Medical School. "If these symptoms don't respond to simple changes in diet, such as restricting intake of simple carbohydrates, patients should be quickly evaluated hormonally," she adds.

The 3 patients—a woman in her 20s, another in her 60s, and a man in his 40s—all lost significant amounts of weight through gastric bypass surgery, putting them in the normal body mass index range. Each, however, developed postprandial hypoglycemia that failed to respond to dietary or medical intervention. As a result, all patients required removal of part or all of the pancreas. In all 3 cases, it was found that the insulin-producing islet cells had proliferated abnormally.

A potential cause of this severe hypoglycemia in these patients is "dumping syndrome," associated with a constellation of symptoms including palpitations, lightheadedness, abdominal cramping, and diarrhea, explains Dr Patti. Dumping syndrome occurs when the small intestine fills too quickly with undigested food passing from the stomach, as can happen following gastric bypass surgery. But the failure to respond to dietary and medical therapy and the worsening conditions over time suggested that additional pathology was the explanation of the symptoms' severity.

Other causes of postprandial hypoglycemia can include overactive islet cells, sometimes caused by excess numbers of cells, a tumor in the pancreas that produces too much insulin, or familial hyperinsulinism (hereditary production of too much insulin), which in severe cases can necessitate removal of the pancreas.

Is this something that is also known as  Alimentary Hypoglycemia?  Did you notice the symptoms right away after your surgery?   I had never heard of this before having my surgery... and I thought I had been pretty thorough.  There is such a wealth of  unique and mysterious  combinations of results when we tinker with our insides.  I certainly hope  they  can "fix" you and that no more people have to deal with that.  The idea of *possibly* needing to have our pancreas removed isn't a pretty one. I know you will keep us updated, and I eagerly await the outcome of our favorite melting mama!  Hugs to you, and thank you for sharing this information, and your adventures!

No, it's not alimentary hypoglycemia.  It's a condition caused by WLS, that causes bizarre hyperactive pancreas to push out way too much insulin in response to food, and that causes hypoglycemia 60 - 90 - 120 minutes after eating a meal.

WT_?  I guess this kind of thing scares people and it is easier to try to blame an individual then to believe that these things could happen to us.  I hope you get this crap figured out!  I can't begin to imagine how scary/frustrating it must be for you to deal with this every day without also having to hear it is your fault.  You are a bright enough person to know that you are doing what is best for you and you are doing what you can to take care of yourself to the best of your ability! SCREAM ALL THE OBSENITIES YOU WANT!! If anyone deserves to be able to do that, it is you!

I am sorry you are being made to feel this is your fault. I did look it up and found some info if you want and have time check out this site http://www.mayoclinic.com/health/reactive-hypoglycemia/AN009 34

Medical evaluation of reactive hypoglycemia initially focuses on confirming that symptoms are caused by low blood sugar and symptoms resolve once blood sugar has returned to normal. Further evaluation of reactive hypoglycemia depends on the severity of signs and symptoms.

Reactive hypoglycemia usually doesn't require treatment. When needed, treatment may include dietary changes such as:

• Eating several small meals and snacks throughout the day — no more than three hours apart
• Avoiding or limiting high-sugar foods, especially on an empty stomach

Thanks, Jeanne. I'm already doing those things, and I've been put on medication to slow the digestion of sugars that pass into my gut, and I'm being put on a continuous glucose monitoring system in my side that will warn me when I'm going too low - so I don't wait too long to treat a low sugar.

I hope the doctor can help you through this.  It sounds awful!!  I'm diabetic and I know how horrible those lows can feel, but I've never experienced anything like you've had.  I really do hope you get well quickly and can then live your life without this causing you trouble...

Listen, MM, nothing except prostitution is OLDER than blaming people for their own illnesses.  Actually, maybe the blame came first, who knows.  And nothing is more normal than trying to make sense of this hideous experience you're going through.   So, there's some f*cked up person or people blaming your behavior for your problem.  And as you are intelligently pointing out, if behavior were the issue, a lot of people would have this problem, which they (thank G-d) do NOT.  So, this is an horrible idiosyncracy of your body right now. And you, meanwhile, are doing the rational thing, which is to try to pull some sense out of a rabbit's hat.  Research.  More and more research.  Maybe-there's-something-the-doctors-missed research.  Taking-charge-of-my-own-body research.  Refusing-to-be-passive-when-it's-my-own-body research.  And all of that is good, up to a point.  Research can be empowering.  But it can also make you crazy.  I hope you find some good answers, roll them up real tight, and use them to soundly beat the doctors about the head and shoulders for letting you suffer. But the surest answer I know is -- **** sure does happen. I am terribly sorry it is happening to you. Charming