So I had my 1 yr visit last week. During which we talked about the fact that I have been having RH episodes more often the last month. So she said she didnt want to chance anything and is sending me to an endocrinologist that specializes in wls peeps.

So has anyone been to one? What should I expect. I know he is gonna do bloodwork again but nothing other then that.

yea... Most of us post op RNY get RH...  They can give you pills, or >???? run bunch of test.
In most cases it can be diet controlled. Sometimes severe diet control.
I need to eat every 2-3 hrs, and I do need to avoid sugars and starchy carbs (that also include milk)
My body function well on lots of proteins and fat and some carbs. 
I do need to avoid starchy carbs: grains and starchy veggies.  I can eat some fruits (not all).

Most likely your body makes too much insulin when you eat carbs.  I know mine do.


New Data on Weight Gain Following Bariatric Surgery

Gastric bypass surgery has long been considered the gold standard for weight loss. However, recent studies have revealed that this particular operation can lead to potential weight gain years later. Lenox Hill Hospital’s Chief of Bariatric Surgery, Mitchell Roslin, MD, was the principal investigator of the Restore Trial – a national ten center study investigating whether an endoscopic suturing procedure to reduce the size of the opening between the gastric pouch of the bypass and the intestine could be used to control weight gain in patients following gastric bypass surgery. The concept for the trial originated when Dr. Roslin noticed a pattern of weight gain with a significant number of his patients, years following gastric bypass surgery. While many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production.

The results of the Restore Trial, which were published in January 2011, did not confirm the original hypothesis – there was no statistical advantage for those treated with suturing. However, they revealed something even more important. The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs. Dr. Roslin and his colleagues theorized that the rapid rise in blood sugar – followed by a swift exaggerated plunge – was caused by the absence of the pyloric valve, a heavy ring of muscle that regulates the rate at which food is released from the stomach into the small intestine. The removal of the pyloric valve during gastric bypass surgery causes changes in glucose regulation that lead to inter-meal hunger, impulse-snacking, and consequent weight regain.

Dr. Roslin and his team decided to investigate whether two other bariatric procedures that preserve the pyloric valve – sleeve gastrectomy and duodenal switch – would lead to better glucose regulation, thus suppressing weight regain. The preliminary data of this current study shows that all three operations initially reduce fasting insulin and glucose. However, when sugar and simple carbs are consumed, gastric bypass patients have a 20-fold increase in insulin production at six months, compared to a 4-fold increase in patients who have undergone either a sleeve gastrectomy or a duodenal switch procedure. The dramatic rise in insulin in gastric bypass patients causes a rapid drop in glucose, promoting hunger and leading to increased food consumption.

“Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss," said Dr. Roslin.

http://www.lenoxhillhospital.org/press_releases.aspx?id=2106

can you believe that with all my complications, the one thing that most people do get and that is the one thing I dont get.  My Endocrinologist is amazed.  I am not complaining.  I am thrilled.  My Endocrinologist has me checked my sugar levels every now and then like 6 times per day for 1 to 2 weeks just to see what is going on so we can get on an idea if anything is changing and she does my A1C every few months to see if there is a change and nothing has changed. It is still 4.9 adn my blood sugars dont move - they are around 80 fasting, sometimes 90 and after eating they are usually 90 - 110 and very rarely go up.  when I was in the hospital and steroids were involved, they went up, not down

This is great. With allwhat is going on with you - at least that is going for you. I hate wwith passion the RH. It makes my life really challenging at times.  trying to eat enough and often enough to prevent low BS and not toomuch to prevent weight gain.  Glad to hear that you don't have that.
Hala

 luckily i haven't gotten this yet, i know many have said they started around 2 years so i'm definitely not in the clear, but here's hoping!

 I am just a yr out and it started for me a bit ago...I hope you are in the clear cause this sucks.

 Thanks for the Info. My A1C is 5 and they said it was normal but high normal. They asked if anyone in my family has diabetes as they are seeing a trend of RH in wls peeps with family histories of it. WHo knows tho. I will let you all know how the appointment goes. 

Oh man, that bites... I'm sorry you're having to deal with it and hope the endo can get to the bottom of it.  I guess I've been lucky so far... I can dump easily enough, but haven't noticed issues over an hour after eating.  Can't imagine how it would suck...

Anyway, wishing you luck with it Cheryl... (and everyone else with it!)...


tori