Reactive hypogycemia and losing consciousness

on 9/4/18 2:55 am
VSG on 06/28/17

Okay, I will ask this question by explaining the best I can.

Most of you know my situation but for those who don't, I had some complications after bariatric sleeve surgery that required a revision to a modification mini gastric bypass. My GI anatomy is not a full RNY bypass and not like a mini gastric bypass due to the nature of my complications. My stomach was "sleeved", i.e reduced about 70% a year ago and then about 6 weeks ago, "bypassed" using the billroth 2 and omega loop technique of the MGB (mini gastric bypass), bypassing a stricture in my sleeved stomach; however, my surgeon's goal was to restore a route for nutrition NOT weight loss, so my bypass is about 3 feet/1 meter, to try to reduce the risk of bile reflux we didn't go shorter (I realize no guarantees here), and we didn't go longer.

I will be 6 weeks post op tomorrow. I can fully hydrate now, take my vitamins and eat some things which leads to my question. I do experience dumping syndrome from time to time, which for me is a racing heartbeat or a very lethargic feeling to the point I almost pass out sleeping. I do everything I can to avoid this.

2 days ago now before leaving for the store/to run errands before dinner time, I ate some graham crackers for the first time. I ate them slowly and I didn't notice any immediate negative symptoms but hours later I couldn't stay awake. My heart rate was okay but I could not stay awake! I was passing in and out of a state of sleep and wakefulness. Looking back, I don't think I was falling asleep. It wasn't like going to sleep. It was like one minute I was forcing my eyes open and then no awareness until my eyes opened again and time had passed. Prior to this I felt waves of nausea and headache briefly enough to tell my BF I didn't feel well and to move to the couch to lay down right before I lost awareness. I felt very very odd, but it came on suddenly and swiftly and we were just starting to watch a movie. Thank god the kids were already in bed for the night and I was at home.

In hindsight I think I just was so excited to tolerate the crackers I probably overdid it there. I had some peanut butter for protein and thought I would be okay as far as balancing out the carbs with protein...guess not? I think it was too many hours after eating to have been dumping but it was very very scary. My BF left and I felt so weak but I remember getting to the fridge and getting a cheese stick before falling asleep for good around midnight and then I was up around 4 and started my morning routine.

Has anyone else experienced anything similar to this?

on 9/4/18 4:36 am
RNY on 08/21/12

If what you were actually experiencing reactive hypoglycemia, you can control it. Just don't eat simple carbs. If I eat too many graham crackers, or regular crackers, etc., I'll get the same symptoms. Ice cream, because it's liquid , is the worst . A small serving of ice cream would knock me right out.

Concentrating on protein and fat should keep your blood sugar stable.

6'3" tall, male. Maintaining a loss of 280 pounds.

Highest weight was 475. Consult weight 04/12 was 411. RNY on 08/21/12 at 359 lbs. Current weight 195.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

on 9/4/18 4:43 am
VSG on 06/28/17

Thank you for the feedback. I definitely will be more cautious. It was hours later so I was really surprised but I want to avoid this happening again

on 9/4/18 6:48 am
RNY on 08/21/12

Dumping always happens fairly soon after eating. 20 minutes or so. Reactive hypoglycemia can be 10 minutes to a couple of hours.

6'3" tall, male. Maintaining a loss of 280 pounds.

Highest weight was 475. Consult weight 04/12 was 411. RNY on 08/21/12 at 359 lbs. Current weight 195.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

on 9/4/18 1:05 pm
VSG on 05/12/14

I'm going to disagree on your timing for RH, Grim. Because of the mechanism, true RH will never happen that quickly. I'm sure you know this, but RH happens when blood glucose spikes and then falls below baseline (in a normal person, eating sugar will cause a spike, but then it falls to baseline. RH sufferers fall below baseline and that's what causes the symptoms) 10 Minutes is not enough time for that to happen. I have pretty bad RH and the fastest it's ever happened for me is 45 minutes after consuming sugar. My typical time period is 90-120 minutes after eating the offending (but often times delicious) food.

on 9/4/18 6:13 pm

i also agree- its about 2 hours for me.

HW 295 SW 278 Surgery weight 225 CW 160 GW 150 LW: 118.8 RNY 12/15/2015, GB removal 09/2016, Twisted bowel/hernia repair 08/2017

M1 Dec 2015-13.0, M2-7.0, M3-14.5, M4-9.4, M5-7.1, M6 9.8, M7-7.6 ,M8- 7.6, M-9 5.5, M10-6.4, M11- 2.2, M12 Dec 2016- 5.8

on 9/5/18 4:10 am
RNY on 08/21/12

I start getting sweats and horrible overheating about 10 minutes after a little too many simple carbs. RH hits me pretty quickly.

I figure if I'm ever trapped outside in a blizzard I can just eat a big piece of chocolate cake. I'll melt everything around me.

6'3" tall, male. Maintaining a loss of 280 pounds.

Highest weight was 475. Consult weight 04/12 was 411. RNY on 08/21/12 at 359 lbs. Current weight 195.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

H.A.L.A B.
on 9/6/18 7:54 am

I'll agree and disagree with you. I have severe RH happened after 1-2 hours, but I also had episodes when it happened very quickly, like 15-20 min after eating.

The difference between those 2 - one was caused by eating too many carbs, getting my BS up then my body released too much insuIns and my BS crashed.

The second one - when RH came on very fast was when I ate/drank foods that caused a Insulin response, but the food did not have enough carbs to offset the protein induced insulin response. That happend to me often when I drank whey isolate protein shakes. My BS was normal, or low normal before I had the shake, then I drank the shake and my body released Insulin, and without carbs in the shake, and low carb diet I was in - there was no glycogen stored in my body to increase my BS.

I had to make sure my meals include carbs, and I took time drinking any low carb low fat shakes, to prevent RH.

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

Donna L.
on 9/8/18 9:35 am - Chicago, IL
Revision on 02/19/18

Mine starts between 40ish-60 minutes, but 30 minutes has happened with protein powder which causes a huuuuge insulin spike. The more digestible the carb or protein, the more likely you are to have a higher insulin spike quickly. For me, protein powder seems to be a huge trigger. The staff said that if I ever experience it much quicker it's more likely to be dumping due to the glucose spike, as the RH and dumping have similar symptoms and can even overlap together.

I follow a ketogenic diet post-op. I also have a diagnosis of binge eating disorder. Feel free to ask me about either!

It is not that we have so little time but that we lose so much...the life we receive is not short but we make it so; we are not ill provided but use what we have wastefully. -- Seneca, On the Shortness of Life

on 9/25/18 1:27 pm - Douglassville, PA

I agree with you on the timing. Same for me. 90-120 min.

Teresa O

RNY 4/1/2008