Question:
3 months out, experiencing major hypoglycemic episodes after I eat (I think)...

Hi - I am 3 month out from Lap RNY, and have lost 64 lbs. I'm very happy about this, but I've noticed that for about the last few weeks, after I eat in the morning and early afternoon, I get dizzy, shaky, and so sleepy that I can barely keep my eyes open. I don't so much have this issue in the late afternoon/evening. I'm not really eating any carbs to speak of other than a little fruit or well cooked veggies, but usually in the morning I wake up and have a protein shake (8AM-ish) and have some breakfast around 10 or 10:30, typically a scrambled egg w cheese. By 10:45 or 11:00, I'm getting the major "sleepies". Then, around 1:00 when I have lunch, the same thing happens. On Monday, I woke up and started to make my protein shake before I left for work (no food yet) and I got so dizzy and shakey that I had to sit down and drink a shot of cranberry juice and eat 2 bites of a banana. I was better 15 min later. I called my surgeon who referred me to my GP. My GP was a waste of time - I told them what was up, and they scheduled me to come in at 4PM. I explained that I have these issues in the morning but never in the afternoon, but they wouldn't give me a morning appointment. Well, at 4PM, my blood sugar was at 92, perfectly normal. Based on that, my GP said, "Well, it's obvious that you are having reactive hypoglycemia, but I don't know what to do from here", and that's where it ended. Yes, like, you, I'm shocked at my doc's response, but that still leaves me here in the lurch. The last thing I want to do is have my blood sugar start plummeting and be behind the wheel of my car, or driving my son around and pass out because it's bottomed out...or end up having seizures somewhere because I didn't recognize the signs early enough to have some sugar. I am in communication with my surgeon, but I was wondering if anyone else out there might have been through this and has any suggestions. I've never had any history of diabetes (even when I was pregnant) in my life, and while I've heard of people developing this reactive hypoglycemia a year or more out from RNY, I've never heard of anyone doing it at 3 months out. Thanks so much!    — stellarsan (posted on August 14, 2009)


August 14, 2009
It sounds to me like you are experiencing "dumping" because that is what happens when your food passes through your intestines to fast. You get dizzy, shakey, and very sleepy and or sick to your stomach. I don't think it has anything to do with being 3 months post op. Look into "dumping syndrome".
   — Kristy

August 14, 2009
check this. You probably experiencing reactive hypoglycemia. http://www.news-medical.net/news/2005/10/12/13727.aspx http://www.fred.net/slowup/hcauses.txt
   — H.A.L.A B.

August 14, 2009
Sounds like dumping to me too. There are many different phases of the dump. The shakey weak, heart pounding one. Almost like an anxiety attack. Then theres the foamies, where the spit keeps coming and you keep swallowing to try not to throw up, sometimes you do, sometimes you don't. Then theres the severe, your out of it rooms a spinning like a hangover and u get sick and feel like you might die phase. I myself have only had the latter twice. The most memeorable time I had an icecream bar. Have I eaten anymore of these? uh huh! nope! If you really think you are having hypoglycemia, you need to have a blood screen ran with your doc. Hope you feel better. P.S. I avoid eating out much unless I am going right home after, because you can dump on a thing that you could once eat with no probs. Sugar is not the only culprit. Greasy food can make me dump. My body doesn't know how to process grease. Good luck to ya! Lesleigh
   — lesleigh07

August 14, 2009
Hi there: I am so sorry you are going through this. Your GP's attitude concerns me. Sounds like he is just out of his striking zone, but it is not acceptable to blow you off. I would ask your Weight Loss Surgeon to recommend a nutritionist. They have lots of experience with this very thing and can help steer you in the right direction. I had a similar experience. It started happening for me at about four months out. Each time I went to the doctor, my blood sugar was in a normal range. They were perplexed. During one episode, I became shaky, was sweating profusely, incoherent. Like you, could hardly keep my eyes open. My husband, who had a glucose monitor due to his diabetes, took my blood sugar. it was 50. Too low. It is important to have a monitor so you can figure out if this is indeed your issue. I found that animal protein, helps staves this off somewhat. It is hard at your stage, but how about some soft fish? I know chicken and beef are tough at your stage...Animal protein keeps me at a normal level much longer. I am sure there are some vegans out there who have ways of coping with this too, but it is always my best bet. I have had it happen when I was out, and it is incapacitating and scary. I ALWAYS carry a Pure Protein Bar with me before I go out, in case I start to feel the effects. I also have something in my system about every 3 hours, even if it is something small. Dumping syndrome for me is different. Yes, I sweat and shake, but I almost always get sick to my tummy. I get sick, and then magically, I am better. This is different, and the fact that you feel better after drinking juice or eating fruit does point to hypoglycemia. I never know when it is going to strike, I hear you on that. However, we do start to recognize the symptoms early on. That shaky feeling, the sweating, heart pounding. I had it happen the other day, and acted quickly. I stopped the episode from going too far. Keep searching for answers. Don't give up. WIshing you luck and strength. Fond wishes, Pam You have every right to be scared. especially when driving. However, if you are not getting the help you need, change doctors or raise a fuss until you are heard.
   — pjwilsen

August 14, 2009
Definitely sounds like reactive hypoglycemia. You need to meet with your NUT and alter your eating plan to incorporate more frequent small, protein rich meals. This is the best way to treat hypoglycemia. Keep cheese, peanut butter, hard salami or jerky on hand to nibble on between 'meals'. Glucose tablets are fine for emergency situations but PLEASE get protein into your system immediately after you take those to stabilize your sugar. The glucose alone will just have you repeating the same sugar drop in 30 minutes. Seriously, you need tiny snacks about every 2 hrs. Trust me, been there, done that and that was before surgery. Best of luck to you.
   — Arkin10

August 14, 2009
I used to suffer from Hypoglycemia, but I had a difficult time convincing my DOCTOR of this. The way that I did it was to get a cheap blood sugar testing kit and test myself when I felt the episodes coming on and at other times. I then took the MONITOR (which stored the time, date, and blood sugar level) to my doctor and SHOWED it to him. Of course, I got the question,"are you sure that you are testing correctly?" At this point I showed the doctor how I was doing it. It was proof positive that I was having problems. This is probably not going to help your doctor figure out what to do, but at least he will know. What you may want to do is take a bit of fruit (let's say half a banana) when you eat breakfast and lunch. I used to mix a frozen banana half into my protein shake and make a smoothie. It was tasty, and it gave me a few carbs to stave off the shakes. Hope this helps.
   — hubarlow

August 15, 2009
Before my wls, I was borderline hypoglycemic, about 5 months after surgery I started having similar attacks after I would eat say "toast" for example, I have found the same happens after other types of food, I thought it was hypoglycemia again...but when I would take my blood glucose test it was in perfect order,..To the others who answered, I never knew that could also be a symptom of dumping but now that its mentioned and I thought back that is probably in my case exactly what it was, I have noticed a lot of breads have a ton of sugar in them even one slice, and I have learned that anything over 7 grams a day will cause me to dump... i agree if you think its your blood sugars have a tester handy next time to show the doc..otherwise maybe start watching the sugar contents a bit closer, more than one banana will cause the same feelings with me,..Good luck and sorry your going thru this..wish I could be of more help, but your question has probably helped me too...Hugs and good luck
   — gaydria

August 15, 2009
I had the same problem, and I was told to carry a couple sugar packets everytime I felt the epesode coming on. It worked just fine for me. And it wasnt too much sugar to hurt my pouch. Good luck!
   — bostonkid33

August 15, 2009
I have this issue too. It happens mostly when I drink strong coffee in the morning and then eat something with more carbs than protein, like toast. I have gone as low as 36. I went to an endocronologist this past week. She told me to stay away from the sweet creamers. I don't really know if that is my problem. She did give me a meter and told me to check when I feel it coming on. I dumped this morning and then my sugar crashed. You could be feeling a combination of the two. It certainly happens to me. I was told to drink sim or 1% milk. It has sugar and protein in a more natural form. good luck. Deb
   — Debbi S.

August 16, 2009
Thank you all so much for your insight and suggestions. I'm meeting with my surgeon next and will certainly discuss with him as well as outr nutritionist ( part of the program). I wasn't eating many carbs (if any) at all with my meals, and I have actually started adding just a little ( a little smaller than a 1/4 piece of wholegrain toast w/ my scrambled egg) and that seems to actually help a lot. Also, I started eating a little bit more frequently (now I'm eating something every 2-3 hours)and this combo has really helped out a lot. I also bought some hard candy for when I really start to crash. I know there is no substitute for Dr.s, but so many of us have been through similar things that it's great to hear about everyone's experiences and get your suggestions. A lot of GPs out there still don't have a clue how to treat us and like many of you I take full responsibility for my health -I read, I learn about my "new anatomy". It will only benefit me in the end, right? Just a quick update and thank you to those of you that responded! It really helped!
   — stellarsan




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