Treatment of Hyperinsulinemic Hypoglycemia After Gastric Bypass

Matthew's picture

Hyper-insulinemic hypo-glycemia is an important late complication of gastric bypass surgery that is increasingly recognized in patients who have undergone Roux-en-Y gastric bypass. It is a condition characterized by shortage of glucose in the brain (neuroglycopenia) and abnormal elevated insulin concentrations experienced mainly after eating a meal.

Cause

Hyperinsulinemic hypoglycemia is caused by unregulated secretion of insulin by the pancreatic beta-cels. The obesrved postprandial hyperglycemia is caused from the rapid digestion and absorption of ingested carbohydrates. This is a common phenomenon in gastric bypass patients and is related to the dumping syndrome—the result of food passing too quickly from the stomach to the small intestine.

Symptoms

Post-gastric bypass hyperinsulinemic hypoglycemia causes confusion, lightheadedness and loss of consciousness after a carbohydrate-rich meal.

Treatment

Although the treatment of the disorder remains elusive, a number of studies have investigated the following three approaches

  • Low carb diet
  • Pharmacotherapy
  • Surgical Removal of Pancreas

Low Carb Diet

Since the symptoms of hyperinsulinemic hypoglycemia are exacerbated by carbohydrate consumption, low carb diet has been investigated as treatment of the condition.

A recent study described the effect of high and low carbohydrate meals on plasma glucose in 3 patients diagnosed with hyperinsulinemic hypoglycemia 15 to 37 months after Roux-en-Y gastric bypass.

Although the fasting glucose levels of these patients were within the normal range (70-99mg/dL), when they consumed a high carb meal all three developed hypoglycemia with plasma glucose reaching as low as 28 mg/dL, 2 hours after eating. The high carb meals consisted of orange juice, milk, bread, toast or donuts.

In contrast, when the patients ate a low carbohydrate meal, they exhibited no hypoglycemia, and the change in their glucose and serum insulin levels was minimal. The low carb meals included black coffee, eggs, meat, and cheese.

The authors concluded:

Our data suggest that a low carbohydrate diet may be effective treatment for this disorder, and we have recommended such a diet to all our patients.

A similar and more recent study confirmed these results. Fourteen patients who had reported episodes consistent with hyperinsulinemic hypoglycemia were given a meal high in carbohydrates on one day and low in carbohydrates on another day. Both meals were equivalent in calories (410 calories).

Within 30 minutes following the high carb meal, the patients became hyperglycemic and hyperinsulinemic. At 2 hours, glucose levels reached an all time low and subsequently returned to normal levels.

Interestingly, after the low-carb meal, insulin increased only modestly and plasma glucose changed very little.

Todd Andrew Kellogg, MD, who spearheaded the project, commented:

The hyperinsulinemic hypoglycemia noted in some patients after RYGB … can be significantly improved through dietary intervention.

Pharmacotherapy

Medication has been successfully used in a few cases for treatment of hyperinsulinemic hypoglycemia. A 2009 study by Dr Spanakis, reports on the successful management of post-gastric bypass hyperinsulinemic hypoglycemia with Diazoxide. The subject was a 52-year-old woman who had undergone gastric bypass surgery 4 years ago.

Diazoxide has been successfully used in the treatment of a similar condition in infants and children.

Patients taking other medications after a gastric bypass procedure should express extreme caution as some may cause potential harm. For instance, patients with diabetes may commonly use medications such as Januvia. In fact, DrugNews.net has just recently focused the health spotlight on the cases of pancreatic cancer Januvia has been causing, which some diabetic patients fear. Glyburide, a common diabetes medication taken orally, is also worrisome to doctors as it can completely alter a diabetic person’s blood sugar.

Removal of Pancreas

Partial pancreatectomy has been used to control the symptoms of hyperinsulinemic hypoglycemia. In such cases, some patients benefited from partial pancreatectomy while others experienced recurrent hypoglycemia that required total removal of their pancreas.

In general, studies do not support the use of pancreatectomy as a treatment for hyperinsulinemic hypoglycemia because pancreatectomy causes diabetes.

Dr Spanakis, explains that although there is a growing tendency to treat hyperinsulinemic hypoglycemic patients with pancreatic resection, it is often unsuccessful resulting in total pancreatic removal. “The end result of this approach is to cause iatrogenic diabetes, necessitating lifelong treatment with insulin”

Conclusion

Hypoglycemia after eating a meal is being increasingly recognized in post-gastric bypass patients. While the etiology of this condition is not entirely understood, ongoing research suggests that approaches to treatment should involve a low-carbohydrate diet rather than pancreatectomy.

Unreal

Thanks for your reply....I guess my daughter did get a response from the endocrinology dept. at Mayo Clinic but they are trying to get an appt. with the neurology dept at the same time. I don't know why because they know what this problem is according to their information and she needs to be seen by an endocrinologist and 4 months later we still havent got an appt. She has had some help by going to Salt Lake City, Utah and saw an endocrinologist there which he knows about this hypoglycemia issue with bariatric patients. He was surprised that she got it at only 1 year post op. he said he usually sees it around 3-6 years post-op. he has ran some of his own tests and thinks that she has a tumor on the pituitary gland which might be part of the problem and could of been the problem with her health issues before the surgery. In other words she probably did not need the roux en y surgery at all. Her cortisol levels were off before the surgery when mayo clinic did their tests and they mentioned it but just ignored it and told us that this roux en y surgery was the only option. She is on cortisol now and if it helps some of her head issues then I guess the doctor will set a plan of action on what to do. We will find out this week. So now she has this problem and the hypoglycemia problem from the surgery. Then while she was down there she started getting sores on her head bigger than a quarter skin peeling off, oozing, and hair falling out, you wonder why she has to suffer so when all we wanted was an answer to why her immune system doesn't work and why she was putting weight on so fast and no diet or even trainers could get it under control. She started at 254 and is under 150 now so I guess the only good thing about the surgery is the weight loss but is it worth possible death? NO!!!
I have contacted The Dr. OZ show and also 60 minutes , I hope that they will do a show on this problem, it has to get out to the public. Will keep updating on anything that happens good or bad to try and help everyone out there that is trying to figure this out.

check this out

My daughter is being treated for Addisons disease and so far the cortisol that the Dr. put her on has helped the slurred speech and foggy head. He is waiting for a month before they go ahead and make a plan of action on what to do next. He thinks that she could possible have a tumor on the pituitary gland and that is why her immune system is not good and also her metabolism. The Cortisol levels were low before her RNY surgery and the when we asked the DR. about that he said that it was a fluke because she would of had a hard time keeping weight on. If you look into Addisons disease there are precautions that you take before any surgery and by the sounds of it she could of died, also she had all the other side effects after the surgery. This Dr. (DR's) should of never blown this off. I wonder how many out there had their pituitary gland tested to see if this was their problem and the RNY surgery was not necessary like it was not for my daughter. She still has horrible swings in her glucose levels and I am thinking that since it will swing high (175) and low (31) if diabetes is just around the corner. I am quickly losing faith in the medical world and we went to the "BEST" ????

Stumped

I want to update you on my daughters diagnosis.....she was put on hydra cortisol for 6 weeks and the first 3weeks it seemed to help the black outs but then it did not help so the doctor tripled the dose and still not much success. Now after seeing the doctor again he has decided that the low cortisol levels were probably from a steroid shot that was given to her a few weeks before for her throat swelling. He is weening her off of it and then retaking the test. He thinks that it is part of the side effects from the roux en y surgery. Her last episode was pretty bad, she had slurred speech then started falling asleep / blacking out, then a massive bloody nose. To function normal for even 4hours a day is pretty much very rare. The doctor told her that he is not giving up on her, lets hope he can figure something out at the next appt. here in 2 months. Still haven't heard back from either dr. Oz or 60 minutes guess I will write again.

Wanted to write to you about

Wanted to write to you about your letter, I just got out of the hospital 2 weeks ago. I have had 2 incidents within a month with my blood sugar dropping to 26.
I had a ROUGH-N-Y GASTRIC BYPASS done in Sept 1998 and up until this year thought it was the best thing I ever did. Please contact me about this we need to do something and spread the word about this surgery.
Thank you Susan Gomez

Nothing changed

Sorry to hear that you too are having hypoglycemia issues. My daughter thought that she found a doctor who said he could help her and he has no suggestions but that there is nothing you can do except try and figure out a diet that will work to keep the sugar drops in check. I met this doctor and thought nothing of him. He knows about this problem with this kind of surgery and I wonder if he made my daughter think he could help her because he saw the money coming in the door since people like her go in a lot because they need help. When I came out and started asking him questions and told him that he should go on this website and read what you all are dealing with, he then changed his tune. I asked him straight out "there is nothing that you can do is there?" And he said "no". My daughter had another gran maul seizure her levels were at 44. This does need to get out to the public but I haven't had any success with trying to get it on any talk show but will keep trying as I think everyone else suffering from this should. They just don't think there are enough people out there that suffer from this hypoglycemia from the surgery, I think they would be surprised. I do have a friend that is diabetic and has a lot of the same problems. She and her dietician have found to not completely take out carbs but eat small portions to keep the levels steady so that the body doesn't freak out when you do have a carb. Worth a try nothing else seems to help. Good luck and stay in touch.

Wow, so sorry to hear she is

Wow, so sorry to hear she is having such a terrible time. I feel for the both of you. Glad she has a dr that is working hard for her.

Is her blood sugar low when she is having the episodes? or is it related to her low cortisol levels?

Definitely keep in touch. Wishing you the best.

I got to 93 lbs and nobody took me serous

Hi all,
History bypass 2001 failed due to being done wrong. Starting weight 280 lost 100 lbs in year but had bile reflux due to surgery being done wrong. Revision scheduled 2005 to fix bypass Doctor got in there and found about a 1/2 ounce part of my stomach that wasn't ulcerated from bile. Did what is called sub totally gastrectomey. Took out all of my stomach. So did pretty good for a couple years stayed around 130lbs. All of a sudden I started feeling like I was going to die.sweating, fatigue , shaking, slurred speech and then the passing out started. I talked to numouros doctors all of witch thought I was in early menopause. I don't think so..... Anyway around the same times started dropping weight again and fast. I got down to 93lbs before I stumbled across this forum/website. SURE ENOUGH. I started testing and found like many others on here that after I ate carbs or anything that made my blood sugar spike it would then crash soon after. I've been as low as 19 and just started to get symptoms but then I've also been 70 and have been sweating and non verbal. I was sent to a diabetic dr whom I had to convince him to read the liditure on here and other web sites his answer. " eat every two hours" as many of you know sometimes were still full from our previous meal two hours earlier. I too have been battling one medical issue after another since getting the re do RNY. I have lupus, osteoarthritis, sever osteoporosis, Malnutrition, malabsorption, anemia and all the other fun stuff that comes with gastric bypass. I too take pain meds for the osteoarthritis and I vomit a lot so end up having to re take meds. Hard to explain to pain management that your not a junky your vomiting 3-4 times a day. I had a pain Managment doctor offer me a challenge she said since I wasn't able to keep down the ensures and proteins drinks that she dared me to try a kale, bannana and OJ smoothie for a week and tell her I didn't feel better and wasn't able to keep more food down so I figured what the heck at 93lbs what else did i have to loose. Sure enough 3-4 days later I started to ge more energy, I noticed my pain level wasn't as high. I could actually keep a little more food down then normal. Now I am not one to jump on These new fad diets and gimmicks. However, I did see an improvement. I am now 110lbs. I added veggie burgers and soy burgers and yes I'm gaining weight but I'm steal dealing with those nasty crashes. I've been averaging about 1-2 a day. I've started to stop becoming symptomatic until I'm in low 20's which isn't good. I'm thinking of getting a contentious glucose monitor has anyone tried this? Does anyone on here have anything that's been able to help them control this? I know there are certain meds that might help and surgery to take out yor pancrus I'd rather try diet or medicine. No more surgery for me!!! Any thoughts on glucose monitor or anything you think might help would be great! Thanks and best of luck to everyone on here its an awful thing to deal with.

So sorry for everything you've been through

Hi Apwell. What a story. You definitely need a good endocrinologist. It sounds like you haven't found one yet that knows about hyperinsulinism post-gastric bypass. Do some research and try to find one. I would suggest a teaching hospital as they tend to have better drs. I found mine at Johns Hopkins and they are wonderful. I have had 85% of my pancreas removed for this condition. It eased some of the symptoms but did not cure the condition by any means. They do not do this procedure anymore because it is a serious and invasive surgery that does not provide enough results to be worth it. Reversals have been tried on several at Johns Hopkins but again the results have not been good in those cases. There have been very good results with patients getting feeding tubes placed in their remnant stomachs. I attempted this procedure in Oct but they couldn't do it because they found my stomach had found its way into my chest cavity. I will need MORE SURGERY to repair it first. I was so disappointed because I was really looking forward to the relief from the feeding tube. I, too, suffer from daily hypoglycemia and no diet techniques that we have tried have changed anything. I do used a continuous glucose monitor which has proven to be a life saver to me as it warns me by an alarm when I am going low and even when I am dropping rapidly. Unfortunately, it goes off ALL NIGHT LONG so I do not get much sleep but I guess the alternative is not good so I must live with it. I do appreciate it and am so glad I have it. I also take Acarbose before each meal. It slows the absorbtion of carbs which helps with rapid rises and drops of BS. It helps but, of course, does not stop the lows. I hope this information has helped you. Please find a good Dr knowledgeable in our condition. My Drs at Hopkins diagnosed me with Nesidioblastosis of the pancreas after doing the pathology following my pancreatectomy although some prefer to call it hyperinsulinism post-gastric bypass. Either way it can be hard to find an Endocrinologist that knows anything about it. It took me five months to find a Dr after I started passing out and having seizures. Keep in touch and take care.

Jade-Sam

Hi Ladies,

thanks for the replies to my post. It's so sad to read all the stories on here of what all of us are going through do to a procedure that we all thought was going to improve are quality of life not hinder it even more.  I wish there was a way to get this information out there not only to the people who might be considering getting this surgery but also to the medical community. Jade you had mentioned that you were seeing doctors at John Hopkins. I too was being treated there before moving out of state. Even at one of the most world rebounded hospitals in the United States and they still seemed to know less about this condition then I did. I don't know how we can get the word out about this subject. I do feel that if I had all the information available to me prior to doing the surgery I would have made a different choice. I truly believe that my lupus, RA, osteoarthritis and severe osteoporosis is directly caused by this surgery. I also have thyroid issues, iron, malabsorption issues as well. Jade I too was going to get the feeding tube but since we were moving I opted to wait and I'm very thankful I did. I've gone from 93 lbs to 120 lbs as of yesterday. That's is huge for me because no matter how much I ate of what types of food I couldn't gain even a pound. But since going on a superfood type diet and eating a ton of soy and little to no carbs and of course eating non stop I am gaining and seem to be keeping my lows to just a couple a week now instead of 2-3 a day. I know a lot of you are un able to control your lows with diet and for a long time I couldn't either. Even with Adkins and low carb. It wasn't until I started doing the super foods and eating all day long was I able to get it some what under control. If you haven't tried the whole clean diet- super food maybe you might want to give it a shot. Like I said before I've tried changing my eating so many times and nothing worked. Why this is now working for me I have no idea. It all started to turn around when I intradouced those kale shakes. If any of you want to give it a try I can email you a sample of what I eat through out a day and maybe see if this works for you. Like I said before I am not into fad diets or any of that other BS but since it has worked so well for me I feel I should at least share the information if anyone wants it. On another note do any of you have any ideas how we can spread the word about this condition? I really believe that patients should have all the info before under going this surgery. I hope everyone is feeling well today and I appreciate the info and support from you ladies.   Take care Angela 

Gastric Bypass

I so glad I just saw this page. I have been battling this same situation for the past two years. I had gastric loss 100 pounds 3 years ago. Within the last 2 years, I have seen neurologists, psychiatrist, put on anti-depressants, spinal tap done - all because my sugar was dropping, memory loss, fatigue, etc. I knew something was going on but could not pinpoint it. I have seen my MD and she basically looked at me like too much carbs, my rheumatologist, I have lupus said too much carbs, the gastric doctor said you taken in too much carbs. I was literally driving one day and had to pull over to the side and the funny thing I did not eat anything. On top of all that I was going through premenoupasal. Labs came back fine but still have all kinds of stuff wrong with me. When I feel the onset coming I just take the glucose pills. I have gained 30 pounds and doctor just say carbs and hormonal. I see that I need to go to an endo and maybe I can get help. I have gotten so tired.

Would be interested to know what you are eating daily.

Angela:

I just am curious as to what the whole clean diet-super food is. I had my bypass surgery in March of 2009 and 20 years before that had hypoglycemia and then in 2010 I started having my sugars go in the teens and 20s, passing out, so I got very lucky and found great doctors who knew about the bypass issues and tried everything, every medication, testing, everything that was out there. They suggested the subtotal pancreatic surgery and as of 6/2012 I had the surgery at the UMC in Tucson. They removed 80% of my pancreas and to everyone's surprise, my sugars have remained within normal ranges without any medications. Just about 1 month ago the lows started again, without any variation on my diet..mostly protein and veggies. I too agree we need to let our voices be heard and share with Dr. OZ or anyone who will listen, it is life altering to go through this. So as I stated, I am curious to see what you are eating and maybe it might help me in preventing more low blood sugars. Also, what are the kale shakes?
Thanks and best of luck.
RB

I have sent an email to dr.

I have sent an email to dr. Oz website hoping that they take this on and put it on their show. I am waiting to hear back, maybe if several of us write they will consider this. I am also going to try and get with different shows that do investigating type shows on stuff like this. I got onto you tube and started replying to posts telling these people that are going to have this surgery to google hypoglycemia caused from roux en y surgery and telling them not to do it until they read these forums first and let them know that the doctors are not telling you this side effect before you have the surgery. I think if we can get enough people out there telling their stories then maybe someone will listen and get some help or even awareness out there.

dr.oz

amazing idea, I am an md and would be happy to appear as both proffessional an personal, great idea!
sam

Awesome! If you get any

Awesome! If you get any replies, let me know.

hyperinsulinemia

Hey Jade
man if we had only known what would become of us eh? I am currently controlling my lows with very low carb intake, like less than 20gm/day and it is awful. On the whole, it is ok for now but every year it gets worse so who knows what the future will bring...it freaks me out and I am a doctor! It has totally changed my life and not in a good way, I am anemic all the time, tired, and anxious about when the next low will hit. My doctors have never heard of this either...for now I will just continue with the atkin's diet and hope for the best!
keep in touch guys, sam

Atkins diet

Hi Sam,
Nice to hear from you. I wish the Atkins diet worked for me. It was one of the methods I tried but I experience lows with exertion and with so little carbs in my system, something as simple as walking in Walmart caused me to crash and quickly pass out. It happened too many times. I wonder if others have such issues with exercise and lows. If I go walking, I have to eat immediately prior to walking and unless I eat a glucose tablet periodically throughout the walk I will always crash by the end of the walk. I have more issues with exercise and lows than with food alone. The drs at Hopkins have been pressing me to have the remainder of my pancreas removed and just go on an insulin pump but when they described the surgery (10+ hrs, a lot of blood loss, 2 wk hosp stay) I am just too scared. I, like you, struggle with anemia already so the thought of going through that is terrifying. I have iron IVs on a reg basis and monthly B12 injections. I keep asking which is worse. My drs say that the damage to my blood vessels by the sharp rise/fall of my BS is doing silent damage daily and I will begin to experience the effects in a few years. Kidney failure, etc. I just don't know what to do. When they read my Continuous Glucose Monitor readings, I go as high as the 400s post meal and drop to the 40s or less in less than an hour. They say taking the rest of my pancreas out and having an insulin pump I would be able to control it much better. I am so scared of the surgery though. The artificial pancreas is 3 to 4 years away from being approved by the FDA and sounds so good and I am really considering it when the time comes. Thanks for listening. : )

atkins diet

Hey Jade
I have been wondering how u are. I've been to the endo dept at
MD Anderson. Had the cal stim test and two positive reactions and
now going to a surgeon there on the 9th to see whats the next best
step. My lows are better but the swinging isn't. If i go all protien my head is better but so tired it is unreal. So, added back
in carbs which shoots me up then down in 5-10 minutes. I so wish
I had not had the gastric bypass. I too have trouble with exercise
so don't do much which isn't good for me either. Im scared too-
don't know what to do---I know the toll on my organs can't be good
and I too have damages to blood vessels-I had an mri to confirm
the brain damage. Still working tho-this takes all I have to get thru the day. Good luck to u and good to hear from you.

hypoglycemia vs gastric bypass

My gastric bypass was performed over 10 years ago.  I had NO significant problems before, during, or after the surgery.  No hair loss, no vomiting (although undercooked rice was an issue), no real issues other than low iron but not low enough to actually call it anemia.  I lost 120 lbs and would do it all again in a minute if I could lose more (I have gained some back but that is strictly my fault ... I stopped exercising and began adding a little "junk" back into my diet).  My surgery was the best thing I ever did for myself.  NOW however I may have an issue ... I occasionally have CLASSIC hypoglycemic symptoms ... nervousness, cold sweats, stomach ache, dizziness, vision issues, hunger and I find I have to sit down before I fall down.  Usually sweet tea, a Snickers bar, or some other quick food snack makes the symptoms go away in about 15 minutes.  After my surgery, I was told to eat SOMETHING every two hours or so.  I did that for years but now my job makes that difficult.  Sometimes I go half the day or sometimes much more without eating anything at all.  Two days ago it was about an hour after a breakfast of coffee and a waffle ... still think it was breakfast that caused it but have been told I was probably wrong.  I think I am going keep some juice or snack handy and try to keep track of what I am doing diet wise to see if I can figure out what is causing it.

Please add me to our email

Please add me to your email list. Ghjr1948@yahoo.com

Just amazed

I had my gbp surgery may 17th 2010 was 362 pounds. I had problems from jump. 3 months into it I couldnt hold food down at all meaning liquids.Every time they did a endoscopy I would be able to eat. Then 15 months after surgery I was dropping weight to fast. Started to get numbness in my legs I thought it was because I had my neck fused. My feet go numb. Would get exhausted. Didn't know what was wrong with me. Complained to my doctor about mass headaches especially towards the back base of my head on the left side.
Then January I had whats called sorry for spelling inception my intestines folding back into each other. Found out I was malnutrition malabsorption vitamin b12 deficient. Went to a dietitian who explained I need to stay away from breads pasta and so forth I was like ok hard to do but I will. It helped a lot no more stomach problems yes have a bad ulcer lacking oxygen. I had gotten down to a size 5 way to small. So when i cut those foods out I started to gain weight. Got up to 130 yeah was happy was also able to eat salads was real excited. Then one day was bringing things out of the rain I had ate breakfast that morning then ate a chicken leg. Sat down said I feel like Im going to pass out. I had a grandma l seizure. Sugar level was 55 I couldnt remember things not right off took me awhile.
Stayed in hospital for two days. Got a monitor to check 4 times a day. My thing is my sugar doesnt have to be low. If it gets 100 or less I start going into a daze staring cant think my family forces me to take the tablets. This has even happened when it is almost 160.
To make matters worse because we live in 5th wheel and no power but use generator. A week later my little girl was taken from me.
Every one sees how skinny I am and I do look like a junky but I dont do drugs and passed the piss test. Now the want to do a mental evaluation. I hate not being able to control this. So I hardly eat last weight was 119 that was a week ago and my size 5 are getting to big. If I eat some thing sweet then the dumping starts if I eat to fast the sweating and nervousness starts and the staring daze or confused. Heart races. My doctor has scheduled me for a EEG next month. I will make it through this and my little girl will be back with me. I am 47 years old.

I had a modified Rouen-Y in 1978

I had a modified Rouen-Y in November 1978, and although I lost weight for the first couple of years multiple complications began and I've experienced almost all of the problems experienced by other contributors to this blog. I'm interested in keeping updated with what others are finding out about available treatments, and how people manage diet and exercise.

I haven't written in a while ...

Hello Everyone:

I haven't written in a while ... I have been struggling feeling seriously ill, from the various complications. That feel like one compounds the other 24x7x365. I have such regrets about having surgery on my stomach ... to fix one thing caused a host of other things to go dramatically wrong. The ongoing battle of severe, severe fatigue is taking it's toll. I can't explain to the people around me how sincerely ill I feel, the exhaustion is off the scale. Half the time I think I am going crazy ... from dealing with all the medical issues and the other half the time I think I am in a process of slowly dying. It appears to be a no win, I am feeling hopeless lately. Tired of the medical community they have no answers ... just plain sick and tired. This isn't the life path I ever wanted ... regrets, regrets ... jeanne

I Haven't Written in awhile - Jeanne

Hi Sorry to hear you have regrets . I am experiencing so many problems with my Y Bypass such as Malabsorption and many others ontop of my work accident that caused me to loose my job, friends and family. Also enslaving my eldest son to dedicate his life to me by becoming my carrer. I hurt my back and take many pain pills but more than usual because of the Bypass. But I was so large I had to do some thing but should have gone for the lap Banding. No-one told me of the problems it has caused.
Now I too feel like you but did start to get better after changing my doctor.I had many times had blood tests but they ignored them untill the new Doctor saw how low my Vit D levels were. The Levels were down to 21 which are supposed to be between 100-150. I was so tied and slept for days and felt like I was dying. Iwas taking vit D and calcium tablet but it was not enough dayly. The new doctor saved my life. I still have extreme problems that is how I came onto this site.

At the moment I am sweating profusely from my head only. It runs down my face off my nose. It is so embarasing when I go out. My body feels like it is boiling in side at times and it scares me but no one is listening.Or know what is causing it but now I will be asking to see some specialists in these areas.

I Hope you get better and take more vit D as listening on the news lately it has nothing to do with going out in the sun as its a epidemic of women all over the world are seeing the levels of Womens Vit D are extrewmely low and they do not know what is causing it. Lokk after yourself and try them as it wont hurt but may be a life saver. Thanks Dana

h

response

Hi Jeanne
Let me begin by saying I feel your pain! I too at am my wits end. I had surgery in 1986. Lost up to 90 lbs in 3 months. Then in the early 90's had issues with being able to eat they went in and I had scared badly. This happened twice more. In 2005 they had to reverse the surgery. I was able to gain some weight back, but experienced more and more hypoglycemia and dumping. Now I am constantly checking my blood sugar, and barely eating anything most days. One day I can eat an egg with no problem, the next day sugars will drop. I have been told my body is overproducing insulin. Also told by Vanderbuilt in Nashville TN that when you are heavy your pancrease is growing with you. As you lose weight the pancrease remains the same size and is producing as much insulin as when you were heavy. Anyway, my situation seems hopeless too. I have contacted the Mayo clinic who refused to see me. I also can not get any excercise between my mini meals without sugars dropping. There has to be someone out there who can help people like us.....hope you are getting some much needed rest as stress effects this to. Martha

feeling ill after RNYGB

I too felt very ill after my surgery. I could not keep anything down and had horrible dumping syndrome. i tried to drink all the water they advised, but I just could not tolerate the volume of liquid. I became malnourished due to not eating for fear of vomiting. I got so depressed. When I went to a support group, everyone had sucess stories and spoke of how wonderful life was post operatively, I did not share my feelings at the support group because I felt so out of place and like something must be wrong with me. I have never had diabetes, yet now I have reactive hypoglycemia. the more i eat, the lower my blood sugar goes.Calls to my surgeons office resulted in advise like "eat more, drink your water and have patience". That was 5 years ago. I have gone from 267pounds to a range of 140 to 148. size 24 down to an 8 or 10. I did eventually "outgrow" my feelings of constant nausea, incontinence and dumping syndrome. I still have physical consequences to eating the wrong things, and have learned the hard way what I can no longer tolerate. For me, the list of forbidden foods include fresh leafy green vegetables,grapes, raisens, anything containing sugar alcohol or aspertame. I sympathize with you and offer my encouragement.

new side effect

I not only can't talk right etc sometimes I don't process what others are saying. Last weekend I misunderstood almost everything that was said to me. This is so fustrating.

Will you see e I can e-mail Jade directly?

Thanks
Clia

I just found you

I was not sure , what was hapenning to me...so by paying attention to my body ...I found you...
I have all of the symtons that many of you write....Since I have my surgery in 2004 Feb...I been in antidepressants, since march last year a Dr diagnosed me with ADD, taking generic,derral 60 mgs a day...I feel so week, my insurance coventry does not pay for me to see my Gastric bypass Dr...Please I need help...if someone can inform me ...I am in Fort Lauderdale my email ccmantilla@yahoo.com
I appreciated any ideas, how to deal with it, what Dr to see..Thanks

i always feel strong for his work has giving me a change.

The spell worked in the prescribed time-frame but what really got me happy was
his proof of casting. I worked with countless others over the years. No one has
ever make my situation change . He really knows his stuff and he's ethical. He's simply the best. If you're going to have a spell cast of retrieving back your ex you might as well go to the best in the business freemercytemple@yahoo.com.

yesterdays news about the gastric bypass

Don't know if everyone heard but the gastric bypass was said to help people with diabtes 2-------we all need to e-mail all the major news people and the talk shows to get them to tell all that the bypass does so people can make an informed decision. As we know, this is not a cure all. This was so upseting to me as I'm considering have a gastric tube (feeding) put in my rememnt part of stomach to be able to function semi normal(my mind).

Clia

Seizures further info to above

Hello all,
I commented earlier up this page re seizures and sugar intake.
This is how I found this site in the first place. Unlike all of you I have not had gastric by pass surgery. I had cancer of the large bowel and had 2/3s of my stomach removed and about 6 to 8 foot of my bowel removed 30 years ago.
Have had seizures and was diagnosed with "possible dumping syndrome"
but having read most of your comments I believe we share something in common. First of all quite obviously radical gastric surgery.
The purpose of yours seems to be to turn highly effective digestion systems into very poor digestive systems. With mine I had no choice but can testify to the fact I have a very poor digestive system. I weigh between 7 and 1/2 and 8 stone.
I think one quite important thing we seem to share please correct me if I am wrong is that the muscle (valve) that controls the entry of food into the small intestine no longer operates for all of us.
Mine was removed with the bottom 2/3s of my stomach.
There is nothing really but a tube between my mouth and my small intestine,
Everything goes straight in. Without realising it I have controlled the seizures and rapid ingestion of sugars with my diet.
I eat a bung, block of solid food like bread or porridge before eating anything else, that is normal food.
This has only been recently been realised by myself and in no small part come from reading your comments.
To cut this long story short I am undergoing a barrage of tests;
EEG;MRI;Colonoscopy;Endoscopy;Blood tests and then referral to a dietician.
I will keep you informed. lucky for me I live in Scotland and this is all free probably the best thing the UK has ever invented that is the National Health Service.
No politics its just a fact I wouldnt be alive talking to you without it.
I feel incredible that you are all thinking about how to pay. Its bad enough what you have to deal with.
If i find out anything that may be of use, you will know about it here.
My personal theory is that they have underestiimated the importance of the control valve at the base of the stomach. This lets food in when the small intestine is ready for it I think and is not just some sort of pressure valve when your stomach is full. Think there must be some communication from the gut to brain to stomach that is quite critical for safe control otherwise everyone who just stuffed themselves with sugary food would be having seizures.
May whatever you believe in a God or Guardian Angels keep you strong.
Regards John

had to quit my joc...

Hi gang,
Nice to meet you all. I am a doctor previously working in a hospital. I am 11yrs post RNYGB. At first I had mild symptoms of dumping but as the years have gone by it has evolved into life threatening hyperinsulin hypoglycemia. I had the worst episode ever last week and ended up in hospital...my sugars drop to less than 1(thats about 20 in your measurement) I live in canada. I have very little warning of a low...I suddenly get confused, unable to speak or move,shaky, emotional and huge feelings of anxiety. I have now got into the process of diagnosis so that I can find some treatment. This is debilitating...i do find that I get most lows right before my period so I have been medically put into menopause.This really impacts your life...I get very anxious in social situations, I am unable to do my work as I become so confused that my patients are in better shape than me. Anyway, thanks for being here, we need to get the word out because at the increasing rate of the RNY being performed we are going to see this issue become very common.
keep in touch...sam

This Blog Site

Sam, sorry to hear about your illness. I have wrote in a couple of blogs recently which I am wondering if anyone is actually seeing as I cant. I am the skinny guy from Scotland who had 2/3s of his stomach and 6 to 8 foot of bowel removed 30 years ago through having cancer. Have just recently come to understand that the cause of seizures I have had is this "Dumping syndrome" that a lot of people here have been discussing. I know the surgeries are not the same but think we may all be sharing something worth looking at. Have you seen any of my Blogs?
Dont give up the good fight keep kicking Sam.
Regards
John Kirkwood

hi john nice to meet you...i

hi john
nice to meet you...i live in canada but i am from england, so i agree with the whole social medicine thing. thanks for your reply, sorry about your cancer, and congrats on surviving. I agree with the valve theory, the duodenum is actually more of a narrowing rather than a physical valve. it does signal the brain with the release of hormones and so missing it is likely the cause of all of our symptoms. also the three different parts of the stomach which release signals to the brain when we are full or empty. that is why most people with rny gb regain weight after a few years, the puoch stretches so larger amounts are eaten but the hormones are missing to tell the brain to stop eating. this surgery is so flawed in many ways. anyway, I am very anxious to hear what comes of your medical workup so keep in touch.
good luck to you, sam

Just a reply

Alright sam nice to meet you. Seems I am very healthy after all these tests. I am waiting on an appointment re one thing only apparently there is something unusual about my brain which they say is A.B. Normal. Not quite sure what they are getting at there!
Please tell me you get it. I,m not taking the piss there is something, but honestly am told nothing to worry about, I am in good shape and feeling bloody great, wish the same for everyone. All the best John K.

Takedown because of Hyperinsulinimic Hypoglycemia

I had a takedown 3 weeks ago; still recovering from the surgery and not eating much so don't know if it will help. I could no longer stand the thought of living with this condition any longer. The postprandial spikes trigger migraines and when you can only eat 4 grams carbs without a spike, believe me, you get a lot of spikes...then the crash. Unless you eat almost nothing and get down to less than 88 pounds, like me. Malnutrition and starving the internal organs a whole host of physical problems on top of the spikes & drops, migraines, TIAs, it has been ungodly. Hope that gradually the takedown and restored gastrointestinal tract help the pancreas get back to normal. I plan to use Acarbose to help as I attempt to gradually add back in complex carbs. But that will have to wait a few weeks for more healing. I will keep you all posted on my progress. I feel isolated as I attempt this and hope if I am successful and someone else reads about it, they will have hope.

Takedown

My fiend I like you have the same symptoms. You mentioned you had a takedown. I know your post was back in March 2012. If you don't mind me unquiriering who was your surgeon and where is he or she located? I hope you are doing well, and Evernote though you may feel like you are or have been, your never alone.
At this point I don't care how far I have to travel to get help. You can emal me at munchkins2125@aol.com.

In my prayers for you and everyone else,
Arzula

take down

Hi friend
I am so sorry to hear about your illness. I just wanted to reach out to you. I have recently been on a very low carb diet less than 20 gm/ day and my lows had been under control, i finally felt that it was going to be ok....so yesterday i had a couple of bran wafers with pnb and 2 hrs later, boom my sugar dropped! I told my husband, who tries to be helpful and he said, "well i guess you will just have to eat no carbs at all", no one knows how hard that is. so now i am affraid that it will continue to get worse where i cannot eat anything like you. I too see a take down in my future, please let me know how you are doing and feel free to contact me anytime you are feeling bad.
all the best, sam

Good news to come

Hello Samantha and everyone else,
Here is a quick roundup of my condition before going on. 30 years ago almost exactly I walked into hospital aged 17 with a pain in my gut. It was my appendix about to burst. By an amazing bit of good fortune a top surgeon here in Scotland had been at the hospital that day to give a lecture. He was stopped on the way out of the door by the junior doc who was trying to work out what was going on with me.
He looked and prodded for about 3 mins and told me he was going to remove my appendix. Looking back I know he spotted more. Anyway into surgery and coming round about 4 hours later I had a scar from the bottom of my rib cage to below my navel aswell as my appendix scar.
Turned out I had cancer of the bowel which had attached itself to my stomach and he had removed 6 foot of my large bowel and 2/3s of my stomach including the bottom valve. This I am sure is the muscle at the bottom of everyones stomach that keeps the food in, letting the acids of the stomach and enzymes produced by the stomach prepare the food and break it down, the food is then transformed into a more manageable "soup" for the super absorber the small intestine to do its work. Critically it also controls the amount going in. That is in small doses or packets that this super absorber can handle. I am guessing there must be some sort of communicator from the small intestine to this controlling entry valve to say its ready to accept this soup therefore avoiding "Dumping" otherwise everyone one be having the seizures and associated symptoms you are all describing and that I have experienced also.
Obviously my surgery was not really planned but I will tell you what 30 years of effectively not having a stomach has meant and means to me daily now. By the way this is sounding very negative stick with me here there is good news to come.
I am not really sure what this R n Y is exactly but it sounds like they are by passing the stomach taking away its ability to break down the food in the hope of turning what was quite obviously very eficient digestive systems into really poor digestive systems thereby aiding weight loss. Quite a radical bit of surgery then. It seems they maybe did not expect or appreciate what by passing the entry control valve aswell as the stomach would do.
As for weight loss I can attest to that but not happily I am afraid.
I have been between 7 1/2 and 8 stone the last 30 years.
I have on occassion stuffed myself stupid with food for a month and not put on a pound. Some of you might think that sounds great. But believe me Scottish blokes are not meant to be skinny rakes. We are meant to be like SHREK and settle things over a pint.
Hey I am well happy to be alive so really I should not be complaining.
Its just it would be nice to weigh a bit more, 10 stone would do me.
Back to the important stuff.
I have had 3 seizures in the last 10 years. Saw docs on occassion and was told this could be possible dumping syndrome.
I didnt know what that was which has led me to sites like this only recently.
Looks like they are taking me seriously now as the last time I went I explained to my gastro enterologist that I did not think I had dumping syndrome, because if I had that my stomach would have to be able to dump. And considering the fact I had no controlling muscle at the bottom of what is left of my stomach I had to have just the syndrome that is constant access from my mouth to the super absorbing small intestine.
How do I know that I had no valve at the bottom of my stomach? He asked.
Well my operating surgeon told me, I told him. I then told him how i Could relate all of my seizures back to sugar intake.
All 3 in the morning when I had been to the toilet (creating space}.
I had not had my normal routine of breakfast and had:
1st time, a large peice of carrot cake which was incredably sweet with coffee and sugar.
2nd time, on a very hot day 2 pints of cold coca cola (other branded drinks have as much sugar I'm sure)
and 3rd time about 4 or 5 cups of tea with 2 spoonfuls of sugar in them.
On all 3 occasions I had a seizure about 40 minutes later.
Why not all the time then?
What was my diet.
I then explained that just a few years after my surgery I had been at work and a cholesterol test had been arranged for all the employees. The nurse took mine and said that my result was not possible, she would have to take it again.
Again she said the result was not possible and asked "What the H*** do you eat?"
I explained that I took healthy eating quite seriuosly and grilled all my foods to get rid of fats, concentrating on fruit, fibre etc..
She then told me that my cholesterol level was 0.2.
I said "well thats good then"
She said no its really bad and explained that normal readings were around 4 or 5. That some of my work colleagues were 6 or 7 and one had been 8.5 and she had refered them to see a doctor.
Also that everyone needs some cholesterol and that I was off the scale for being so low.
You just cant win eh!
Anyway she told me that eating healthy was not for me and that I should eat as much stodge (high carb) fatty foods as I could lay my hands on.
Which I have pretty much done from then until now.
In doing this without realising it I have pretty much controlled this "dumping syndrome"
When I get up I have two slices of toast then porridge which effectively puts a block or bung in my gut. This stops immediate access to the whole super absorber at once. Throughout the day about every 2 to 3 hours I'll have potatoes, pasta: all stodge.
I have controlled this without realising.
On the 3 occasions I messed up I had a seizure.
I have told my doc if he wants me to prove it I'll set it up and have a seizure in front of him, but he hopes we wont have to go there.
I am now waiting on the results of about 20 blood tests.
I have had an MRI that is a brain scan.
I have had an EEG ,a brainwave scan.
I have had a colonoscopy.
I am booked to see a dietician.
I am booked in for an endoscopy on the 13th of April.
All results to follow and I'll keep you informed.
My Gastro Enterologist pretty much agrees with me so we are literally covering all bases.
It seems to me the critical thing here has been underestimating the importance of the controlling valve at the base of the stomach that controls entry to the small intestine.
And what it is that actually sends the message from the small intestine to the stomach that says let the food in and how much. And even watch out thats too much.
The small intestine is a tube covered with millions of absorbing "fingers" that if laid out would be the size of a football field. To let even a moderate amount of sugar access to this will allow super fast absorption. Dont let it happen, bung up the tube. Not completely just make sure the food you eat goes through slowly in manageable packets. A bit of stodge at the start of any intake of food may just do the job.
Anyway I'll keep you informed,
Regards to everyone,
Keep fighting the good fight.
John Kirkwood

add;l info for ryn bypass

Hey ya'll----I have run across a nutr in Ca that has worked with ryn gastric bypass patients that has reactive hypo. Search the web for
nutritionbycatherine. I'm in the process of trying to work with her. I've also run across sev articles that some of us have a feeding tube put on the part of the stomach that was bypassed and have their nutrients and carbs feed thru the tube and the majority of the prob go away. I'm not to that point(hopefully will never be) but it is good to know. I have improved some by taking acarbose(bad stomach now) with each meal---switched jobs so not much stress(paycut but thankful to be working). I'm now having to have iron infusions-just one more complication. Hope all is good as it can be with everyone.

Clia

Hi Clia, I'm glad to hear

Hi Clia, I'm glad to hear that Acarbose is helping you a little. Any little help is welcome, right? It helps me a little too so I keep taking it too, even though it has a few unpleasant side effects it is worth it.

Yes, my drs at Hopkins presented the option to me as well of the feeding tube as a possibility. OMG! The idea of never eating food again though seems like a torturous punishment to me. Am I being petty? Eating is one of lifes joys, even when you learn how to do it in moderation like we have. It scares me.

As far as my treatment goes, we (my drs and me) are waiting for the artificial pancreas to become approved by the FDA. Should be about another 4 years. The trials have been very promising. I already have 85% of my pancreas removed so I would have to have the rest removed which they already want to do anyway. The artificial pancreas consists of an insulin/glucagon pump that works in conjunction with a continuous glucose monitor (which I already use) and pumps in insulin as you need it (which could occasionally happen.) I have read of patients who participated in the trials in hospital that could eat anything they wanted while on the device and had no highs or lows because the insulin/glucagon was administered accordingly in the proper doses and they had no problems whatsoever. I CANNOT WAIT. I am trying hard to postpone my completion pancreatectomy until that time but I am having a terrible time right now controlling my lows. I am on Medicare now and they won't pay for the sensors for my continuous glucose monitor so now I don't have the luxury of a warning alarm for my lows esp during the night so I now have hypo unawareness again. My endo (she is a gem) has been working hard in my court and has found a different company that also makes CGMs that will advocate and fight Medicare and claims they can get approval through a appeal/denial process over an 18 month period...in the meantime they will let me use the device at no charge. I can't wait to get it. I need it to survive. To those of you that have never used one and that have medical insurance, I am telling you a continuous glucose monitor makes a monumental difference in your glucose control. Talk to your endo about it.

My tics have returned. They are caused by brain damage from severe hypoglycemia. When I have severe lows, the tics are NON-STOP. They are not seizures as you might think. The paramedics always ask that. My seizures are mostly grand mals or tonic-clonics. As far as the tics go, the EEG/MRI shows they are caused by "Metabolic Insult" or brain damage from severe hypoglycemia. They were controlled by medication but for some reason it stopped working. I have incontrollable jerks of my head, neck and face. So far we haven't found another medication that will help. My neurologist is great though. This week he tried Botox injections in the affected muscles in my shoulder, neck, scalp, and around my eyes. It takes up to a week to take affect but I can already see a reduction in the jerks. It is so unfair what this gastric bypass has done to my life. Not only has the brain damage caused tics but I have significant cognitive affects. I read slowly, my attention is affected, and OMG! my short-term memory is so shot, and forget about multi-tasking anymore...if I even try, I feel like going into panic mode.

I'd like to hear how everyone else is doing. If you have time to check in, feel free to do so. Hope you are coping well!! Take care!! : )

Terri

cgm sensors

hi terry,
will you please contact me reguarding the cgm you are waiting for. i to am on medicare and need this bad. usually my dog wakes me up when it gets below 40 but that is not soon enough to stop the damage it is causing.
donna
dmoorer1@hotmail.com

more prob

Hey Terri,

Good to hear from you again. I ran across a lady on e-health that has the tube and she eats her protien/veggies-gets her nutrient//vit//and carbs thru the tube. I e-mailed her but haven't back to see how she was doing. At the time of the post she had the tube for 2 yrs and doing great. Have you had any kidney problems? When I got my labs back Friday my gfr was low and the test said if you have two low reports within 3 months thats starting kidney failure. I got my labs from Feb 1st and it fell 5 points in two months-----at that rate its not good. I'm coping better-seeing a therapist. We are both in the same boat- seems like when one thing settles down another pops up. Thanks for the update and hope u are feeling ok.

Clia

Hi Clia, So nice to hear

Hi Clia, So nice to hear from you again. Wow those kidney levels don't sound good. I worry about that all the time too. So far so good for me. My endo told me about 3 years ago I had 10 yrs or less before my kidneys would go. I didn't know you could eat while on the g-tube. That is one reason I turned that option down. That's interesting.

I don't have my CGM anymore because I am on Medicare now and they don't cover the sensors so my sugars are crashing constantly. I have hypo unawareness again. It's so hard trying to get through each day. From the way your kidney levels are I am guessing you're not managing your glucose levels well at all either. If there was any consistency to the behaviors and tendencies of this thing, it would be easier but just when I think I have something figured out, it morphs into something else and changes completely. What works one day will not work the next. My seizures are much more frequent now. I have myoclonic jerks daily from hypoglycemic encephalopathy. I am on 3 anticonvulsant drugs and they are still not controlled. This thing is killing me. I used to like to walk 3 to 4 times a week but I can't do that anymore. After 10 minutes, I collapse in a severe low and start seizing even if I eat just before I leave. Please keep me informed on your condition. Tell me how you are coping and how you manage your diet.

10 years post RNY

So glad I am not the only one! Horrible palpitations and headaches and muscles that scream pain and the list goes on... I had a daughter almost two years ago and while pregnant my iron dropped so low I had pneumonia and my lung collapsed and I also needed iron infusions. My original doc was on vacation and the one covering told me I was tired and couldn't breathe cuz I "was pregnant. There is nothing wrong." I left his office and went to the ER where someone finally did a chest fray and some bloodwork on me. We almost died.
I have since then started with the spike and crash. I almost black out a lot sweat shake vomit & all the other fun stuff that goes along with it. I too have been brushed off by hematology an now I have no insurance so I am trying to deal with it all and work and take care of four daughters. It scares me that I can get down to a sugar level of 30 and still be up walking around, just feel crappy.
Anyone know what the complications and mortality rate are for this if it goes untreated? From what I have read it does not get any better :(
Best wishes and hugs to everyone.

4 yrs post-op RNY and having these same symptoms! I'm not crazy!

Hello all, my name is David. I am a 28 year-old male from Philadelphia and I had RNY gastric bypass surgery in Dec 2007 (at the Barix Clinic in Langhorne, PA - my surgeon was Dr. Lyudmila Pupkova). My weight before surgery was a little over 300lbs, and now I am at 172. I have been completely fine and have had no complications whatsoever up until just this past summer of 2011.

It first started with extreme fatigue. Then hair loss. I'm talking HANDFULLS at a time were just falling out during every shower (it still is happening). I constantly felt breathless. My heart always felt like it was racing, and I was having frequent violent heart palpitations, especially after meals and at night. I went to ER after ER, and I was always discharged and told to "follow-up." Well I have no health insurance, so it makes things extremely difficult for me, as doctors and specialists charge outrageous prices when you have to pay out of pocket...and that's not even counting any further diagnostic testing which can run you into the hundreds, if not, thousands of dollars. So that was this past summer.

CONVINCED there was something wrong with me, I took it upon myself to go to a private lab and have a whole range of tests ordered on my blood (cbc, comprehensive metabolic panel, iron panel, cardiac enzymes, vitamin b and folate levels along with a bunch of other vitamin levels, thyroid, etc etc etc). Well everything came back fine except for a few things: My iron was EXTREMELY LOW (ferritin was <10 and sats were down below range) and my hemoglobin was slightly low at 12.9 (normal range for a male is 14-16). Yay for finding the problem!!!..... (not really)

So my next step at this point was hematology. I figured hey, I finally got to the bottom of it...I'm iron deficient! That's easy to fix, right? WRONG! I saw the hematologist in October, and here we are 5 months (and 6 iron infusions) later, and my number have just hit the normal range...and I'm STILL FEELING BAD. I get the impression from my hematologist that he just doesn't want to get too involved in my case, so he basically cleared me from his standpoint, and at my most recent appointment with him last week, he told me to follow-up with him in 3-4 months, but "everything looks good for now." Meanwhile I STILL FEEL LIKE CRAP! Obviously the iron deficiency was NOT the cause of why I feel like this.

On top of feeling so poorly, I have recently noticed that I CANNOT...and I say CAN NOTTTTTT tolerate meals. It seems that NO MATTER WHAT I EAT, it throws me through a loop. After I eat a meal, about 45 mins after eating, I start with the rapid POUNDING heartbeat with intermittent palpitations coupled with shortness of breath. It is so uncomfortable that I am fearful to eat lately because that is what triggers these feelings. And don't get my started with sugar. I've also had a few episodes that people have described on here: confusion, flushing, sweating, racing heartrate, very shakey, and feeling like I "NEED" sugar. During these episodes I immediately grab candy, juice, peanut butter, whatever sweet I can find...and about 20 or so minutes later I notice the symptoms subside and I feel EXTREMELY DRAINED. It is a HORRIBLE THING TO GO THROUGH.

Since getting those episodes, I have went to see a cardiologist who ran EKG's, did an echocardiogram, and I wore a holter monitor. All of which were normal. So that was good. It's not a cardiac issue.

Next, I went to see GI, who sent me for a CT of my abdomen and pelvis. On my CT from January, it showed a "1.5cm peripherally enhanced lobulated lesion in the gastric antrum" of my gastric remnant (my OLD stomach). The doctors all agree that it is PROBABLY an ulcer, although they are not sure. They told me that because of my particular gastric bypass anatomy, this "old" stomach is no longer accessible by mouth, so they are NOT able to do a traditional endoscopy procedure to evaluate this abnormality. So they decided to treat it AS IF it is an ulcer. So I've been taking 40mg Prilosec every morning for 4 weeks in hopes that the reduction in stomach acid will allow this supposed ulcer to heal. I just had the CT repeated yesterday and I go on 3/1 to meet with my GI doc for the results. He told me last month that if the abnormality is still there after this repeat CT, they basically need to take me to the operating room to do a laproscopic endoscopy into that "old stomach" to see exactly what's going on there.

During this whole GI ordeal, I went 2 weeks ago to see my primary doc. Every ER I've been to keeps telling me YOU NEED TO GO TO A PRIMARY DOCTOR SO HE CAN REFER YOU IN THE RIGHT DIRECTION. Well, I followed their advice, and lo and behold, the primary doc was a waste of my time and a waste of my $75. He tells me that from a medical standpoint (meaning all my bloodwork), everything that HE CAN SEE looks fine. He then brought up the point that "maybe it is all psychological" which I find highly offensive, and an absolute cowardly cop-out. It is NOT psychological that EVERYTIME I EAT A MEAL, I FEEL HORRIBLE! These are actual PHYSICAL symptoms...NOT "manifestations" (as he put it). I don't know how many different ways I can say this to these doctors to make them understand!!!! It is incredibly frustrating, and every time I go to a doctor with hopes of getting answers and getting to the bottom of this increasingly debilitating problem, I am brick-walled... EVERY TIME! The emergency departments won't admit me to get to the bottom of it (because they see "nothing acute going on") and the specialists they refer me to, well they all have this very conservative approach, making me wait months and months in between appointments, all the while I am SUFFERING DAY TO DAY with this. I just cannot take it anymore, and it has caused me to lose my job, my unemployment just ran out last month so I have ZERO income now, and I have NO MEDICAL INSURANCE.

I tried signing up for Blue Cross Personal Choice insurance a few weeks ago, because I am willing to pay out of pocket for it (they quoted me something like $147/month)... and you believe they DENIED ME? Why, because they are calling my gastric bypass procedure a "PRE-EXISTING CONDITION." This is the same exact insurance company who PAID for this procedure 4 years ago in the first place...now they are denying me coverage based upon it. How is that even legal???????

I am just so fed up with it all. I am only 28 years old, and never did I imagine my life would have taken a turn in such a scary and uncertain direction. All I want is to just feel like myself again. I went from running 4 miles per day (before August), to barely being able to get out of bed. I'm afraid to eat because of how it makes me feel, and I'm scared that something awful is going to happen to me. I feel like none of these doctors are taking the time to actually listen to me. They are all worried about "what kind of insurance do you have?" And when they see you are a charity case, they order AS FEW TESTS AS POSSIBLE TO SAVE THE HOSPITAL MONEY. The GI doctor I'm seeing isn't even an attending physician. Because of the "charity care" program the hospital has me on (Thomas Jefferson University Hospital in Philadelphia), they threw me to some "GI FELLOW" (basically a student), so that's who I've been seeing. I feel like with my condition, I deserve a REAL SPECIALIST, not some student!!!

If there were a doctor out there who can guarantee me a positive REVERSAL of this RNY procedure, I'd have it in a HEARTBEAT. I'd much rather be fat and HAPPY than thin and sickly. This is horrible. I pray every day to just feel better again. I want to live a long happy and healthy life, that's all. That's the reason I got this surgery in the first place. Now I'm left, completely ALONE, to deal with the aftermath of the surgery.

Anyone can feel free to email me at keys2thebeamer@aol.com. This is so hard for me to go through, and my heart really goes out to all of you who feel the same frustration I am feeling. I really wish I can have this procedure reversed. :(

Same issues

I had GNY in October/2010 Recently I have had issues with low blood sugars. All the sudden I start feeling really weak and shaky my heart feels like it is doing flip flops in my chest. I take my sugar and i am usually in the 40 to 50 range. It hurts to drink anything cold, and there is no way I am able to dring 32 oz of anything in a day. I am lucky to drink 16 oz a day. When I eat I have this pain in my stomach that is nagging (is how I can describe it) I end up taking pain meds after I eat just to try and help with the pain. I started having pain in my right side and went to the doctor he did an ultrasound and a CT scan and said there is a mass in my liver and I am waiting on a MRI to be able to see what this is. But after reading some of these other posts maybe my liver is just not working as well as it should do to the surgery. I will have to see what goes on here. I am so "happy" to hear that I am not alone.

gastric bypass and reactive hypoglycemia

please add this to your e-mail notification. I was listed as
cguyans@yahoo.com but that e-mail was comprised.

thanks
Clia

Low Blood sugar with gastric bypass

I got the gastric bypass to help me do better at my job and now with these terrible drops in blood sugar it may ruin my career. Im upset and depressed now over this entire thing. Im glad to see this is being told to people now before they have the surgery, cause if I had known this was any part a complication I would not have dont this at all.

Seizures

I cant believe what I have just read. I have had 3 full blown seizures in the last ten years. The last one in August of last year. Was sent to a neuro surgeon on Friday there and am now booked in for an MRI (brain scan) and EEG?
The fact that I have told them that every time I can relate it back to sugar intake and I suspect this may have something to do with the fact I had the bottom 2/3's of my stomach removed and 6 foot of my bowel removed because of cancer 30 years ago. Dumping Syndrome is ticking a few of the right boxes now I think.

Seizures & blood sugar...

John,

I have been having seizures and can definitely related them to sugar intake. I cannot for the life of me get a doctor to address it as such. I've had a normal EEG and MRI. The only thing that was off was my sugar, which was 53 at the time of one of my seizures. I am frustrated at the lack of cooperation that I have gotten from the medical community.

-Theresa

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