Hi all first I wanted to share a pic of me and my kids from Thanksgiving! I am truely thankful!!! Ok my Q is since the past year and half (Bout 10 mths out of surgery) I have episodes of shaking, sweating but cold, just feels awful, makes me wanna lay down and sleep and I can't even think straight when I have these. I notice if I eat something with real sugar in it, just a small piece of chocolate or something it will go away gradually. Have I formed some sore of sugar problem? I was insulin resistance b4 surgery and that has straightened itself out, this is different. My mom says I am hypoglycemic it sounds........and ideas or suggestions??? I mean it only happens like 2 to 4 times a month.......no matter how I eat. I can eat exact same time everyday andsome days are good some are bad. Is this a form of dumping or what????

Thanks!

Hi Paige,
Go to your doctor and get a fasting blood sugar test done...and share this experience with him/her. You should get an answer to your issue pretty darned quick.

I have done that time and time and it comes back ok. Even when Iw as insulin reisistance they had to do more evasive test to find it! My glucose has always been good.........

Have you done the two hour test at the lab...where you drink the syrup and they test you every 30 minutes? That is what my doctor suggested for me.

Sounds like a good idea Kim. Paige, the pic of you and the kids is great! You are a lovely family. Get to the doctor and INSIST that something be done.

Paige,

What you've described sounds like a hypoglycemic attack to me... what I call a crash... I get them very frequently now, only 1 month out, and used to get them really badly before I learned what my triggers were... This is very hard to get a diagnosis for if it's what's known as "reactive hypoglycemia" because it doesn't react the way "traditional" hypoglycemia does... It took me years to figure out what the deal was. And my PCP told me about 10 years ago that sometimes you'll even get a negative on a GTT (Glucose Tolerance Test) which is what Kim is recommending...

What I can tell you is that it is VERY controllable, if you get a handle on your triggers. Start making note of what you eat when this happens, when you ate it, and how long after you get this reaction. If you can, if someone close to you is diabetic, have them take your blood sugar levels when you feel one coming on. And whatever you do... if you start to feel one happening, don't answer it with more sugar! Chocolate is about the worst thing you could do... well... next to fruit juice, anyways! The best remedy, for me, is a banana and two pieces of cheese. You eat half the banana, and 1 cheese stick. Then then other cheese stick. Then wait. If you don't feel better in ten minutes, you eat the other half banana. Then you get up and make yourself a nice protein rich meal. Works like a charm. and the next time, you plan better what you ate, and when you last ate... it's a two pronged fork. It's not always about what you ate last... sometimes it's just about when you ate last... and that's a hard part to deal with when you're trying not to eat!!

I started having these even worse after the surgery because I wasn't getting enough protein, and none of my tricks were working. I even crashed after having a pure protein meal, simply because my body needed more fuel, and there wasn't enough to be had! The body is weird, and it won't always burn a fat deposit when it needs fuel... Sometimes, it makes you feel really weak, sweaty, cold, and dizzy... like you're gonna pass out. And it's demanding some fuel. Right NOW!! I have now learned that if I don't provide three protein shakes, I'm gonna crash, plain and simple, no matter what I eat...!

I've been dealing with this particular monster for years, so if you have any questions I can help with, I'm more than happy to answer... By the way, talking to your doctor is always a good plan - don't misunderstand me... mine was able to give me the basics I've outlined above... but, the rest was up to me.

I found that I had some issues while on the 5DPT. I can't remember which day it was...maybe day three...that I seemed to be losing my brain function. I added a few carbs to my meals and things leveled out.

Here is the thread that I started after I got the news that I was probably hypoglycemic:
A wake up call...

Thanks all especially Darrie. I have noticed since I am not making sure I get my protein in I havent been having them I was having them worst when I was depending on carbs. So I havent had one since NOV 8th til this morning which is why I posted, but you know I am sure thanksgiving is still in me and I had carbs. But I got up this morning and worked out, then ate a boiled egg b4 I drank anything and then it came on. I had my protein coffee and it went away......and it was a small one. They do seem to get better now that I am def getting in protein first........I use to have em real bad.....I mean I couldn't function! Especially when I was eating beakfast bars.....which were high in carbs....

Thanks for the info and help!

Kim, I get a "not permitted" message when I click on your link...?

Paige, at this point, if I eat ANY carb - including ones that used to be "safe" I find I'm crashing... so I have to be very careful. My surgeon says he's never seen anyone as sensitive as I am, and yet I test negative on the GTT. Go figure!

It's a balancing act, and the more you stick with the proteins, the better off you'll be. For example, I've found that if I maintain my protein levels at or above 100 g per day, then I can eat whatever I want and I'm fine. If I let my proteins drop below 100, I'm gonna crash, sooner or later. It's a new experience for me, because I used to just need to avoid the simple sugars, and I was fine. A mashed potato didn't ever send me into a tailspin... until now. It's a pain in the butt. plain and simple!

Anyway... just push the proteins, avoid the sugars... and pay attention when you feel a crash coming... don't let it go, it probably WON'T get better... and it's too easy to fix... Sometimes, the first symptoms feel like you're about to have a cranky PMS fit... but, it's really about your sugar levels. If you can afford it, getting your hands on a blood glucose monitor is a great way to help you figure things out faster than just by your moods. Sometimes you can't identify it until it's so obvious you kinda feel like you got hit in the head with a 2 x 4...! Like I've said, it's annoying, but, once you figure out the puzzle that are your triggers, it's very easy to control... and the most important thing to remember is to avoid the roller coaster ride of sugar levels You want your blood sugar level to be as level and constant as possible. Not too high, and not too low either.

Another thing is that you may have to switch from 3 meals with no snacks to 6 smaller meals in order to keep your levels even. I've not been able to stick to 3 "squares" for years... It can be difficult if you're not a planner, but, you sound like you plan pretty easily, so, you should be fine! And, please feel free to either PM or E-mail me directly if you have any questions you'd rather not post up here... I'm happy to answer what I can...!

Paige,

I agree with Kim see your doctor again. It sounds like an extreme drop in blood sugar. I had this happen to me when I accidently took my wifes diabetes med and thought it was my pain med, my blood sugar dropped somewhere around 30. It was real scarry and definately something I dont want to go through again.

Hey Darrie...it is under the Maintainers Forum...you might have to be a paid member to get in there. I'm sorry! I know that some of the forums are restricted to the free memberships.

Your words here are great! Paige, Darrie is one smart cookie! I've switched over to six small meals after talking with my doctor and WLS nutritionist, and feel much better, but am having issues with keeping the "small" part under control. I'm working on it...

Hey Darrie that has to be my problem cause I always had them up til I started making sure to get in 100G protein aday and thwat was just since DAY 3 of the 5 DPT........I had a lil one then I went to look at my journal I only had like 50 g protein on thanksgiving must be what caused it. SO I will def keep an eye on and watch what I am doing. I feel like I get ins 6 small meals........normal daily diet consists of say a boiled egg at bout 6 am , 30 mins later I have my protein coffee, 10 am a 12 oz protein shake, noon say tuna (bout 5 ozs) with a couple sugar free bread and butter slices and tsp FF mayo, 2 to 3 pm 12 more ozs proteins shake (has PB in it also yummy), dinner say 4 ozs ham with some few greenbeans.......sometimes I dont get to the vegtables. This usually gets me alottttttttttt of protein and I am good......and I notice that as lon as I work out 1400 cals a day I lose weight, when I was at 1000 a day i just maintained so im going down the scale again lol...............

Anything I should chage to keep from crashing???
Thanks,
Paige

Wow, thank you Paige for starting this thread. I didn't realize it, but this has been happening to me too! I'm always really careful to make sure I get my protein in first, never have high glycemic carbs on an empty stomach and never go too long between meals. This seems to keep the shakes at bay for me, but sometimes when I'm out hiking for a long time I've gotta be really careful. Now I always carry a little hunk of jerky in my purse/day pack (as Kim would say, "Isn't THAT sexy?"). Good info everyone.

HI Paige

I hope you get your answers soon!

I was thinking about what Sandi said...its weird because I have never really gotten the DUMPING like most ppl mention.....LIke I can eat a WHOLE snickers bar and not feel a thing (which sucks) but at times I do get some shakiness like Sandi mentioned.

Sandi....I noticed that I get the shakies when i'm doing my morning walk.....but not always...dont know why....and of course lately I have been getting the POWER SURGES! lol.. I believe these are hormonal again...better GET THAT WISDOM OF MENOPAUSE book out again! lol...

GOOD LUCK PAIGE! Keep us posted!

Julie

Yea it has to just also be out new systems adjusting and all, even if its been years out! And When I dump it's not as severe as the beginning. I still do but its different and I just stay away from anything that does. If I ate a whole snickers I would so dump! I wuold be sweating and feeling it coming while I was eating it. Like my body is saying WHAT ARE YOU DOING WOMAN! lol IF I crave chocolate real bad I just eat a caclium chocolate chew LOL Sugar free of coarse.....But at first dumping was really bad, like I had PARVO lol now it makes me wanna vomit and I to this day can not throw food up! I think once I threw up some color that was bout it. And I have a small hernia, if I go to vomiting, which for me is dry heaving it pops out and hurts like h*ll! So I just def avoid anything that causes that. i did it last bout 2 mths ago on some red velvet cake lol one of my weaknesses and it was my b'day cake.....I noticed I had a hernia bout 10 mths ago, it just came out from nowhere. If I shave my legs a certain way it pops out and it hurts like apulled muscle, then I have to stretch out to make it roll back in. Doctor said it was pretty small and not to worry bout it right now, if I ever get a tummy tuck I will then. But it just sucks. They went in my belly button when they did my RNY and then 3 mths later to get my gallbladder out. So guess thats why I have it. About the shaking, I think also if you get up and workout before breakfast is on sets it. So I usually work out in afternoons or evening, which I know isnt as affective but if I get up first thing and workout b4 I eat I get shaky.........

You're probably not gonna believe this - but, I want you to stop using Fat free products. I know... I know...! Fat is the enemy... but, I need to be sure you know this too: when they take out fat, they put in sugar. You can sometimes switch to the lighter versions and not get all the sugar, but, you've gotta read the labels... (Now, where have I heard that before???) For example: Hellman's Regular Mayo has 11grams of fat, 0 grams of sugar - and all of the 100 calories are from the fat, (but, who didn't know that?) Now, by comparison, Hellman's light Mayo has 5 grams of fat, 50 calories (45 from fat) and only 1 gram of sugar. I can't remember which brand it was, but, there's a fat free mayo out there that has 5 grams of sugar per tablespoon. (Of course, it has no fat, so it's ok, right? )

The (not so) wonderful nutritionist that my surgeon recommended I use tried to give me the usual speech about avoiding fat, and tried to steer me toward all the wonder fat-free products available now... When I asked her how my system would handle all the sugar that replaced the fat, she asked me what I was talking about. When I then pointed to her list which included Fat-Free Half-n-Half for my coffee, I asked her if she knew what that stuff was made of... the answer was "No." (Amazing!) I then asked her if she'd recommend I use Coffee-mate's liquid creamers for my coffee. The answer again, was "No. They have too much sugar."

No!! Really..?!! My response was..: "Fascinating. The ingredients listed for Fat Free Half-and-Half are the same ones listed for the Coffee Mate Creamers, minus the flavors. And the number of grams of sugar per serving is identical."

That was the last time I spoke with that particular "nutritionist" (and I use the term loosely!)

Personally, I try to maintain a level of around 40-50 Carbs per day. And I've been doing that for years. Atkins recommends you strive for less than 30 grams of Carbs with little or no concern for fat or protein levels. If I go above these levels, I find myself dealing with the roller-coaster ride again. There's a great deal of evidence that you can switch your body over from burning glucose for energy to burning fat for energy. It's a wee bit on the controversial side, but, I believe, for me, it's accurate.

I know someone out there's gonna say that fat is worse than sugar, and they may well be right in certain circumstances, but, not when you're hypoglycemic. This is just another side of the Diabetes coin, and for us, sugar, in all it's forms, is absolutely the enemy. Complex carbs are certainly much better, but, if they're not paired with protein, you're still setting yourself up for a problem. It's a tradeoff, but, the fat will help to stabilize your blood sugar levels, and the sugar's gonna send you crashing.


I want y'all to think about what you were taught when you were a kid about why you were supposed to eat breakfast before you went to school. Your body has just been through an 8-12 hour fast - sometimes more, depending on when you had dinner, and whether or not you ate anything afterward (Who said that?? US??? Indulging in after dinner snacking?? NEVER!!!)... That long fast translates into a very low blood sugar level. If you add exercise, which means your body is looking for glucose to burn, your blood sugar level is going to go down. Get below a certain level, and here come da shakes...!

Now, I'm not anywhere near any of your stages of post-op... in fact, I've still not been able to do any exercise because I've not gotten past the "twist the wrong way and see stars" phase yet... But! I AM hopeful that this will end soon... I'd love to hear what Judy, or one of the other exercise fiends around here have to say on this subject, but, for now, I'd probably recommend that you have a protein shake or the equivalent before you set out on a long walk... and take a banana, and a couple of cheese sticks with you. If the shakes start, eat the banana. Then a cheese stick. Then another cheese stick. ( I use the Polly-O Part Skim Mozzarella sticks. 7 grams of protein, 80 Calories, and NO carbs. This will hold me for better than an hour, or until I can get a meal prepared, whichever comes first...! )

The thing is, just like in a diabetic, the goal is to maintain a blood sugar level that remains fairly constant. No extremes in either direction... Too high can be just as bad as too low... or at least, if you go too high, you know you're going to go just as low - and it's just NO fun when ya crash! Ya know?

I'm not sure I've said this before, so let me say it now: If there are any underlying health conditions (most especially anyone who was diabetic pre-op...!!) PLEASE! I am NOT a healthcare professional...! I'm just a long term hypoglycemic and I'm passing on what works for ME... If you have any questions, please feel free to ask me, but, also talk to your doctors, nutritionists, see what they think... I don't believe that anything that I'm suggesting could harm anyone, but, I'm really not qualified to make that call either...!

FWIW... Found this list of symptoms of Hypoglycemia, and thought it might help anyone who's not sure if they're in the right category...

Symptoms of hypoglycemia include

* hunger
* nervousness and shakiness
* perspiration
* dizziness or light-headedness
* sleepiness
* confusion
* difficulty speaking
* feeling anxious or weak

Hypoglycemia can also happen while you are sleeping. You might

* cry out or have nightmares
* find that your pajamas or sheets are damp from perspiration
* feel tired, irritable, or confused when you wake up

Normal blood glucose levels in people who do not have diabetes
Upon waking (fasting) 70 to 110
After meals 70 to 140
Hypoglycemia (low blood glucose) 70 or below

If your blood glucose levels fall below 70, you can start to feel the symptoms of hypoglycemia.

A blood glucose level of less than 70 mg/dL at the time of symptoms and relief after eating will confirm the diagnosis.

The oral glucose tolerance test is no longer used to diagnose hypoglycemia; experts now know that the test can actually trigger hypoglycemic symptoms. (Well... duh!!!)

Causes and Treatment
The causes of most cases of reactive hypoglycemia are still open to debate. Some researchers suggest that certain people may be more sensitive to the body's normal release of the hormone epinephrine, which causes many of the symptoms of hypoglycemia. Others believe that deficiencies in glucagon secretion might lead to hypoglycemia.

A few causes of reactive hypoglycemia are certain, but they are uncommon. Gastric (stomach) surgery, for instance, can cause hypoglycemia because of the rapid passage of food into the small intestine. Also, rare enzyme deficiencies diagnosed early in life, such as hereditary fructose intolerance, may cause reactive hypoglycemia.

To relieve reactive hypoglycemia, some health professionals recommend taking the following steps:

* eat small meals and snacks about every 3 hours

* exercise regularly

* eat a variety of foods, including meat, poultry, fish, or nonmeat sources of protein; starchy foods such as whole-grain bread, rice, and potatoes; fruits; vegetables; and dairy products

* choose high-fiber foods

* avoid or limit foods high in sugar, especially on an empty stomach

Well Darrie, Diane (aka Bamagal) is going to NOT disagree with you about fat. She is the queen of it and low carb living. I'm sure that when she gets back to regular posting, she'll chime in here.

My fasting blood sugar was 102 and my PCP said that was "high". This is why she wanted me to test for hypoglycemia. She said that another WLS patient of hers (the only other besides me that got to a healthy weight) recently had a 15 pound regain and had developed this. I can't remember what sort it is, but basically, my body...for no reason...will process some things well and other things will cause it to go wonky. She suggested dropping these extra pounds, eliminating white carbs, eating six small meals, dropping coffee and wine. My other blood sugar test...A1C or whatever it's called was normal.

I'm getting used to the six small meals. It is difficult with a workout, as I'm pretty darned hungry about an hour following. I've just got to figure out what is the best thing that will satisfy me for about 200 calories. That is my target. Six meals that are 200 calories. Today has been very good for me.

Darrie---I love you---really girl I love you......

Kim was right about me chiming in here---I'm not back in full but this post caught my eye

Paige--

hypoglycemia is not uncommon after WLS---some such as myself have a terrible time with it--I have to avoid carbs like the plague---some have had to go so far as to have some of their islet cells--they make the insulin--- in the pancreas surgically removed---

Fat is used as my energy source and the little glucose my body requires is made from protein so some days my carbs are near zero---but generally stay less than 30gms---I also use coconut oil every day---it is a fat but acts like glucose in the body without the insulin spike

eating frequently each day will keep these symptoms at a minimum

best of luck to you.....

WOOHOO!!! Sarge likes me and Bamagirl LOVES me!!! Life is great!!


Now, y'all just remember that when I say sumthin' stupid, 'k? Promise?

It's especially nice to hear that I won't be the only voice for this... it's a little intimidating considering I'm so new to WLS, although I am NOT new to hypoglycemia.

I gotta tell ya... I had to look up the A1C test because I've never had one, and until I did, I was scratchin' my head trying to understand why she'd give you such a vague plan if she thought your BG levels were high after fasting... If this was me - Kim... I'd have walked away shaking my head from the lack of substance in all that info she gave me. I am shaking my head at the lack of substance in all that info she gave you...!



How about this? You're targeting 1200 calories.. plan three snacks of 100 calories or less. Plan three meals consisting of a more or less even breakdown of 300 calories apiece. You certainly can have one meal that's 200 calories, and another that's 400... as long as the three add up to no more than 900 calories, you should be fine. You should find it much easier to workout after a 300 calorie meal, and have a 100 calorie snack to hold you over til your next meal. If it doesn't work, then you can try to plan a workout that can be more closely followed with a larger meal. Personally, I look for a total daily calorie content of 1000 or less, 100 g of protein, 30 g of carbs and let the fat just fly!! It doesn't always work out in the calorie department, but, it doesn't seem to matter... the weight's coming off... slowly, slowly, but still coming off...! and I'm not crashing either... The surgeon wants me to limit my calories to less than 400 a day, but, that's just not possible!

Well thanks for all the info and it's nice to know I am reading my body right and I seem to have the hypoglycemic straight....and I will def swtich to light instead of fat free.........I been taking in about 50 to 80 g fat a day is that enough or to much???? bout 30 - 50 grams carbs, and 90 to 130 g protein.........

Thanks so much!

that's a promise.....



The A1C is the standard test right now but it does come under fire---it really is not an accurate account---but Dr Mary Vernon explains it well on her blog---she is the president of the American Academy of Bariatric Physicians and a long time supporter of the low carb lifestyle

here is how she explains A1C





so even if your A1C is normal you may be having many hypoglycemic episodes---see why it is controversial now

a glucose tolerance test is the only real way to see what is going on--and that is not completely accurate--but if you have been doing low carb for awhile---even those are thrown off---depends on your own level of insulin response

if you have a meter of your own check your own blood sugar at home---30 min before you eat, 30 after then 1 hour after that, then an hour after that keep repeating for up to five hours---just make sure what you eat does not have fructose in it( like fruit and many processed foods have)---meters do not register those---the highest level you want to see is 140---that is the level where organ and cell damage occur---and no lower than 70-80 depending on your machine--you can do this a couple of times a week and take the info to your doc---

Well, I love everyone, always say the STUPIDEST stuff, and everyone just ignores it Darrie, so don't fret...

I have to say, I've never worried about fat grams. I kind of look, but I really don't spend much time on it. If I get too much fat in my food, I get sick. And it's a much different kind of sick than if I get too much sugar. I'm still learning. I always take a protein bar with me when I'm hiking or out running in the woods now. I've been at the half way point and just kind of crashed with fatigue. Part of mine must be the anemia though. I'm pretty sure of it.

So far, at this point in my journey, I know that I feel my best with small meals (about 200-350 calories per meal) with the majority of the calories coming from protein. I don't necessarily count the fat, or decide to not eat something because of the amount of fat it has, but I do listen very closely now to how I feel as I eat something. I eat one bite at a time and pause and feel how it's going down. If it's too rich, I quit. If it's too sweet, I quit. If I hit it right and everything is good for that meal, I get absolutely euphoric, like someone gave me drugs. I get giddy and silly from it like a high. It's the weirdest thing. I love it though. I kind of live for that high of finding just the right bites of things.

The kicker is that it's a different combo every day. That's the fun, and the frustration. A part of me just wants to eat and be done. But I am learning that eating is a major pleasure to be enjoyed. It's a sublime experience and it should never be taken for granted!

I'm learning how significant the phrase, "Bon appetite!" really is!!!

Hey there Darrie...my doctor gave me more info...I just summarized here. Bottom line was that she wanted me to take the two hour lab test just to be sure. I didn't want to take it and said that I'd rather just treat things as if I WAS hypoglycemic, as the solution seemed to be condusive to the post-op WLS life.

I NEED to get rid of these extra pounds. I NEED to stop eating white carbs. I NEED to cut back on my coffee...maybe even give it up...as well as wine. All of these things are important to the long term success of my WLS.

I'm not satisfied with 100 calories for a snack. One Atkins bar is 200 calories. Could I eat half and save the other half for later? Sure. Do I? No. It's just easier to keep it 200 per meal. Now, if I go out to dinner, then clearly, I'm going to be taking in many more calories than that and I'll adjust accordingly. When I was in the early stages of being post-op, it was very easy to manage all of this. Year number two hit and then the hunger gates opened up for me. I'll find my happy place soon...like Sandi! BTW, I've been there when she's had this perfect meal...she mentally checks out and really does go to her happy place!

[/color] [color="#800080"] THANK YOU PAIGE AND DARRIE!!!!!!! Paige for starting this topic and Darrie for all the info!!!!


Oh my gosh, Darrie I just love you!!!! I have been having these "episodes" for about 3 years (had wls in 2003) and I keep forgetting to mention this to my PCP b/c it is soooo sporadic! However, I have found that if I eat unsweetened peanut butter or almond butter it tends to do the trick for me...but OMG when it comes on I feel like I am gonna pass out and almost speechless (if you knew me, you find this; OH, SO VERY AMUSING!...I am never speechless!) Also, I have noticed that I tend to have them most often either just before my period or during the beginning of it.




AND I DO ALMOST ALL OF THESE THINGS...with a couple of exceptions, but definitely gonna make better effort to do all of these!!!!! Thank you, thank you, thank you all for your honest and candid responses!!!! This web-site never ceases to amaze me!!! Blessings!

Well I am very happy for the answers and responses. I guess I been kinda keeping this to myself, and sometimes pretending like everything was ok, bein 2 yrs out you just assume everything is fixed. But when I crash reality sets in alot that I will never be the same again. Sayin that i still remind myseld how lucky I am and even thought this is about my only challenge in life other than not puting the weight on I find myself lucky, because if I didn't get the surgery, with my insulin and rapid weight gain due to it (insulin reisistance) I would be prov 300 or moe pds and I was heading to be put on high blood pressure pills. It was running 180/120 resting and last I checkes its 91/60. I count my blessings everyday!
Again Thanks And I am glad I started this thread not just for me but for all of you also!

I am happy to help, happy to share, more than happy to be able to spare someone else the worry I felt when this first started happening to me...

But I'm even happier to add another member to the Darrie fan club!! Do I get dividends from the membership fees soon??

No? Dang it all anyways!!

Oh well! I guess I'll just have ta keep on keepin' on...! I can do that!!!