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Patient Problems with Hypoglycemia from July 15, 2007 Newsletter |
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Barbara, you asked about problems with hypoglycemia. I spent about one year trying to find out what was wrong with me, Thousands of dollars in tests and doctor bills. One visit to my gastric surgeon with my symptoms and he told me what was wrong. My symptoms started out with seizure like activity. I also had An episode with my blood sugar level going down to 27. I don't have any problems as long as I get enough protein. If I don't start the day with protein and eat something with carbohydrate my blood sugar drops around 10am. I didn't start having these problems until approximately 5 years after my surgery. Maintaining contact with your surgeon is very important because the general practice physicians and even the gastroenterologists aren't aware of all of the problems that a person that has had gastric bypass surgery can have. Thanks for listening to me and thanks for your newsletter. Debby Stonestreet.
I had the pleasure of meeting you in Pittsburgh at the weight loss seminar 2 years ago. I am a member, and sometimes moderator of the Simply Support Group in Parma Ohio. I am a Nurse Practitioner, and had gastric bypass surgery in January 2003. I suffer from Reactive Hypoglycemia. It happens if I eat too many carbs, and not enough protein. I still am very sensitive to sugar. I do not eat more than 15 grams at a time. The surgery still works for me that way. I do not eat refined sugars at all. If I eat "Mexican, or Italian" foods and don't pay attention to what I am eating, my blood sugar will bottom out approximately 2 to 3 hours later. I must always concentrate on eating enough protein at each meal. It also helps to eat more frequently. I try and eat my 3 regular meals and have a midmorning snack, and evening snack. I try to eat protein at every meal and snack. I keep orange juice on hand at work, and at home. In my purse I keep my emergency glucose gel. A small squirt is just enough to get my sugar up until I can eat food. You can loose consciousness if your sugar goes to low. I start having symptoms if my sugar is in the low 60's. I have symptoms of weakness, diaphoresis, dizziness, and hot flashes type feeling. I originally thought I was having hot flashes associated with menopause since I am 51. I started checking my blood sugar during those episodes and found that my sugar was usually in the 40's. I now recognize the subtle signs sooner if I haven't eaten, or have eaten too many carbs, and not enough protein. I hope this helps. Barbara Gabel
I had gastric bypass surgery Sept. 23, 2003 and have lost 280 pounds since then. I was diagnosed last year with reactive hypoglycemia. A nutritionist, advised to eat more often, 6 small meals a day and that my carbohydrates should be complex such as whole grain bread. I am having a hard time eating the 5 to 6 small meals a day since I never experience hunger pains. Also, I always get headaches after I eat, and my doctors don’t seem to understand why.
Anyway, I hope I've been helpful. Thank-you, Deena Tjartjalis
I was formally diagnosed with hypoglycemia last year. I had gastric bypass surgery in 2003. An episode sent me to the ER during a family dinner that included ice cream for dessert. I continue to have episodes if I am not careful to balance every processed carbohydrate with protein. Peanut butter is my constant friend especially on long trips. Sheila, In Virginia
Within the past several weeks I began to notice that I would feel nauseated, tired, dizzy, overheated, weakness, the urge to vomit, and have a racing heart and/or palpitations after nearly everything I ate. I had also been experiencing night sweats and nightmares. My husband and I did some research on the internet and discovered hypoglycemia seemed to account for a number of the symptoms, if not all of them. Through some trial and error I have found that if I eliminate the majority of carbs and stick with protein and vegetables I generally feel fine after meals. We have found the glycemic index and have so far had some luck with working with that diet system, using whole grain food items to replace the refined versions, like spaghetti. I’m a bit wary to eat things right now because I don’t know how I’m going to react to it, things I used to be able to eat I can’t now; it seemed to happen overnight. I have gone to the doctor just this week and he issued me a prescription for a glucose monitor that I have been using before meals and then testing either one hour after eating or as soon as I experience symptoms. He wants to send me for a glucose tolerance test but I have thus far refused since I know that it will cause me to dump. I’m really not sure how else I can be diagnosed though. So I will just stick with the glycemic index diet Diane Dooley Denton, TX
I was just diagnosed this month with reactive hypoglycemia. I now have to carry a blood sugar monitor with me 24/7 and also glucose tablets for those dangerous low levels. I am 4 years out from gastric bypass surgery and after surgery had minor low blood sugars from time to time. I averaged maybe one a month now I average 3 to 4 a week. They have done a peptide test to confirm whether or not there are benign tumors in my pancreas. My fasting glucose is fine and stays pretty stable if I don't eat anything. Apparently my pancreas shoots out too much insulin to counteract certain foods and not enough on others. My low readings usually come about 2 1/2 hrs after I eat a meal and it does not matter what I eat it still happens. Eating anything with sugar causes a very substantial drop. My lowest reading was a 35 and I had just a funny shaky feeling before I tested. The doctors are talking about going in to remove part of my pancreas to stabilize my sugar levels. They range from 204 down to 50 in any given day. After losing 185 pounds and maintaining my weight loss after 4 years without even 1 pound gained back this is very frustrating. I am healthier by far but now I have a whole new set of medical problems to go with the new me. Still I wouldn’t trade the obese person I was for the problems I am having. Ramona
I have been told I have reactive hypoglycemia. My sugar levels drop really low sometimes without much warning. It has been as low as 35. Sometimes I can catch it when it’s starting and get it when it’s in the 60’s or 50’s. I carry hard candy in my purse at all times for when it’s really low to get it back up in a hurry. I also carry peanut butter crackers in my car and purse. If I’m at home I get something good with protein to eat, but seem like I’m not usually at home. It usually happens about 3 hours after I have eaten my meal. I have also gained weight trying to keep it under control because I’m eating more often trying to keep it from happening. I feel like it’s a losing battle and often wish I didn’t have surgery. Sincerely, Susan Cauley
Dear Barbara, Annette Eaton
I was just at my surgeon's office for my four-year checkup and he told me that what I've been experiencing is probably reactive hypoglycemia. He said he's been seeing a lot of it with patients who are several years out. What happens to me is that I'll get jittery and sweaty and sometimes even feel faint or have tunnel vision and have trouble walking. I'll feel like I have to eat something now, though I'm not necessarily hungry.
The worst time was when I had a drink of Bailey's Irish Cream at about 9 pm about 3 hours after my last meal. This was unusual for me. I usually don't drink alcohol and if I do it is just one glass of wine. I went to bed and woke up about an hour later with that jittery, sweaty, unsteady must eat feeling. The doctor explained that made complete sense since it is a result of the pancreas putting too much insulin into the blood to deal with simple carbohydrates in the system, and alcohol is turned into a simple carbohydrate quickly. Once those carbohydrates are used up the insulin is excessive and needs to be fed more carbohydrates or you risk going into insulin shock. The doctor suggested having a piece of candy around just in case. It also happens to me sometimes if I'm working hard, like doing yard work, and it may just have been a long time since I've eaten.
I'm glad you're asking about this; I had never heard about it before I went to the doctor in April.
Best regards,
My name is Traci Woolard. I'm 34 years old and will be 3years post-op from my lap gastric bypass surgery this July 21st. I had the pleasure of hearing you speak when I was just 2 to 3weeks out when you came to the Twin Cities. Hearing you was very inspirational.
You asked about reactive hypoglycemia. While I do know that I was mildly hypoglycemic prior to my surgery, it became more pronounced after surgery, and I was diagnosed as having it. I periodically check my blood sugar and have found it as low as 30 before. For me, my signal is that my hands get shakier than normal. I know that if I check my blood sugar then, it will be around 40-60 just depending on how long it took me to notice. It's rather hard sometimes as my hands normally shake quite a bit. I keep glucose tablets in my van just in case, but try to get in protein as fast as I can. That was the biggest recommendation from the head of my obesity program, and I must say it really helps! I was 2years post-op when Dr. Hartley determined my issues were due to reactive hypoglycemia. In general I don't have problems with it often, but I do have a tendency to forget to eat especially in the morning. If I go too long without at least snaking on something, then I'm in trouble. Traci Woolard
I have had several episodes of reactive hypoglycemia, or what my endocrinologist called insulin dumping. I would be feeling fine, even just eaten a high protein, low carb meal and 20 or 30 minutes later my blood sugar would be around 40 to 50.
The first time it happened I did not know it was happening and fortunately my husband realized something was wrong and took charge. Since I had gastric bypass surgery I cannot have orange juice or candy, so he gives me milk and Ritz crackers.
This happened several times in a 3 week period of time, and I began to see some symptoms, I'd get cranky, restless, then begin feeling a bit confused. We did some tests, and I even wore a machine that kept track of what my blood sugars were for a 72 hour period of time. Since my problem is so random, of course when I was being tested there were no abnormal results.
I can go weeks, even months without it happening and then all of a sudden I will have one or more episodes in a month.
I now have to test prior to driving, as I never now. It's rather scary for me, but I try and keep myself focused on how I am feeling. I carry a test kit and a high protein, low carb meal bar with me at all time.
Prior to my surgery I weighed 285 pounds. I was border line diabetic. When I was pregnant with my son I was on insulin as I had been diagnosed with maternal diabetes.
The doctors are puzzled with my condition, and I do keep a food log at times, but we have not found yet what food combination I am eating that causes this to happen. Sebrina Brown RNY 2/11/04 110 lbs lost
I am responding to your news letter in reference to those diagnosed with hypoglycemia.
I had my weight loss surgery August of 2004. I have had no complications from my surgery. But at about 1 year after surgery I started having a rapid heart beat, sweats, trembling, and a crashing, weak feeling. I would eat something and start feeling better. At first I thought I was dumping but couldn't trace it to anything I had eaten, i.e., sweets. I talked to my surgeon about it and he said I was hypoglycemic, that I should carry mints or crackers with me to eat when I felt these before mentioned symptoms. When I get like this I have to eat something immediately and will quickly feel better. However, if I can't eat or put off eating I seem to spiral downward quickly and it takes me longer to feel better after eating. I asked what the worst case scenario would be if I didn't eat and he told me I could pass out. My solution seems to be to eat smaller meals very often, even if it is something simple like bread or cheese.
Being hypoglycemic is a small trade off for the tremendous gift I have been given by having the surgery and I wouldn't change a thing. But I do wish I had been told before surgery about this possible condition, only so I wouldn't have been caught off guard and alarmed at its onset. Sincerely, Cathy Sanderson
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