Hypoglycemic Episodes - MUST READ!

Studies are being done - some pointing to real danger for post-ops experiencing these. Here are two articles, very dense but try to read and make sense of it - and SHARE WITH YOUR DOCTORS!!!

http://content.nejm.org/cgi/content/full/353/3/249

http://jcem.endojournals.org/cgi/content/abstract/92/12/4678

Will have to read them. I finally got my blood work done yesterday. Will wait for the results. I'm nervous about it. I fasted and everything so hopefully I'll have accurate results. I DID forget to ask her about the vitamin d. I will in 2 months when i have my full physical and check up. of course if my levels are bad she said she would call me. Well I  have heavier meds. Percocet and was STILL in pain last night on precocet. It worked great while i was awake but when i hit the bet oh man oh man... i didn't sleep a wink last night...well maybe half an hour. I was up at 2 up at 3 up at 4 and up at 5. it was awful. But i do feel a little better today. Still hurts to swallow but not as bad. Still cant turn my head left and right very much but it was a liiiittttle better than before. and the aching isnt as bad. So my fingers are crossed. Keep me in your prayers. I'm gonna read that tonight. its quiet in here. you're right. Everyone is preparing for the holidays, its hard to find time to go on the computer when you are doing so much to get ready for christmas or whatever you celebrate. about what you said about how you are feeling, how we lost track or got off track...know whats been helping me? reading all the newbies that are preparing and JUST had surgery. I read about this one guy who was on liquids and protein for a month and dropped 50 pounds. I was like OH YEAH! thats right... then i read 3 months out... then 6 months out and i was constantly like.... shoot ! i forgot about that! you start to notice all the things you did wrong. well...i guess we already know what we did wrong....but we forget what we did RIGHT. because its been so long. I find reading those newbie posts very helpful and gives me that extra...reminder... ((hugs!))

Hey you, good to hear from you today ... I'm feeling really, really lonely so I am glad to see your pretty little face!   Percocet is hard stuff - man, if you're still in pain on that stuff - have you had your neck x-rayed or maybe you need an MRI??? This sounds like it could be more serious than a muscle sprain, which I would think would have eased up by now. Feel better, kiddo. I haven't done a thing for the holidays - nothing. We don't have a tree up, not a single present has been bought ... Jillian got home last night for a week's stay and I just don't know her anymore - she's changed into this very ah-nat-ur-al, take-a-shower-once-a-week, I-don't-drink-milk, I-only-drink-soy-milk, kind of person - vegetarian, real earthy - you know, grow the hair all over the body - kind of woman. I'm not complaining, I'm all for living naturally but she's complaining about everything in terms of the way WE'RE living - we are so out of synch, I just feel like we're total strangers. I just don't have the strength for any of it anymore.....give me chocolate.

Thank you Reenie for your thoughtfulness and trying to find the info that we need. I tried very hard to understand the articules you sent but it is so far over my head that I can not make sense of it at all.
My problem with low blood sugar was somethinjg that I had before surgery but it wasn't as bad. I ate all the time so if I went without eating I'd have a minor issue. The bad issues that I get now have alot to do with me being stupid in august and abusing myself by not eating. what a dum bunny i am. it is also combined with my menopause and yes the gastric bypass put all three together and i upset my apple cart big time.
i'm feeling much much better but not totally myself. if i skip or am late with a meal i know it.
the things that happen are scarey to me. i keep food with me at all times.
truthfully i'm to the point where i find that i am afraid to leave the house for long periods of time. i go to work and do a good job. i have always carried my lunch box so i always have things with me. what scares me is after work at home alone,. i worry that somethinjg will happen to me and no one will find me.
silly isn' tit? this stuff never bothered me before and i've been alone for many years now.
as i feel better those feelings of terror aren't as strong. its right after an issue that i get anxious. ive got an appointment with kim daniels in january. ive never looked forward to an appoointment so much!
so for me it is getting markedly better. will it go away tottally? i do not think so it is here to stay. i need to be very viligent in how i care for myself.
why did i have my head in the sand thinking that i could do what i wanted that i woudln't be the one who would have problems? HA!
guess I got taught a good lesson huh?
happy holidays.
i've got decorations done, presents bought. have to do the wrapping but my heart is not in th eholidays im just not into it this year. maybe next year.

Pam, you are blaming yourself far too much for this. What you are experiencing is a very serious medical and health consequence for a pretty significant percentage of gastric bypass post-op patients who begin to experience severe symptoms at anywhere after 2 years out of surgery. This is nothing to take lightly - and blaming yourself is ... well, if not taking it lightly, it certainly is detracting from what you need to be doing - making sure your medical doctor is aware of these complications, becomes educated, and knows how to treat the problem! People are having surgeries to get their livers and pancreas's partially or wholly removed!!! Please stop blaming yourself. Yes, these articles are very dense and hard to read but there are others. Please take care of yourslef! Love you, Reenie

Hi reenie,

I agree that we must take care of ourselves. we need to not only educate ourselves but our doctors.
But I can not totally blame the surgery on me having this issue. I had low blood sugar before. Now I have it worse. The worse is not totally due to the surgery. The worse was brought on by me not eating and using laxatives daily.
Could I, would I, have had the problem brought on as strongly? *****ally knows. If it was already there and triggered by what I had done then my thoughts are hey i brought this on to myself.
Its kind of like when they started to do heart transplants. No one knew what could really happen but the choice to have it or not was made. The early ones were the ones who paved the way.
While I'm amazed at how long they have been doing some type of stomach reduction surgery they are always making changes to it to improve it. each improvement is going to have its own set of new issues.
No I do not want to lose my liver or pancreas. Yes I am doing what I am suppose to do to make things better and right.
I think what we will see in the future is a new set of doctors who specialize if patients who have had stomach reduction surgerys. they will be the ones that we will need to visit to get the information we need. Dr A is a great surgeon. He is not an edonocronologist, dietician, or shrink. Lets face it we need all of those and maybe some more!
We didn't get to be our previous sizes by not having some kind of issues mentally. I think that all goes along with before and after surgery just like eating right and excersizing.
The surgery is a done deal for me. Now its the moving positivly forward.
Would I still do the surgery? yes. I would. I would also still have Dr A for my surgeon. and if I needed more types of surgery I would go to him too. He's good as a surgeon.
I'm not keeping my head in the sand. No ostrich here but I can not dwell on the negative that could happen. That would jsut mean I would need even more mental health visits! LOL
Thank you for caring so much for all of us. we all appreciate the reseach that you do. It is a help. I try to read those but it is to technical for me the language I can not understand but I do go and google alittle bit more after trying to dispher them. I bet cha the doctors even have a hard time with them.
take care,

Only you know if you are on top of your game and it sounds as if you believe you are - so that's all I care about! But people are blacking out, becoming increasingly disorientated, confused, even while driving, which puts other people on the road in danger - because of these hypoglycemic issues. And it's an alarming consequence to post-ops at around 3 years out and beyond - that's all I'm saying. We need to be aware and if we are experiencing these episodes, we need to be working with our doctors. As for Dr. Aranow, well I was at the last post-op support group meeting when it was announced that he would no longer be seeing post-op patients; that he had hired a full-time RN who would be seeing post-ops, he was only going to be seeing pre-surgery patients up to and through their surgeries. He is a surgeon. I have waited in his waiting room for close to 2 hours for a 5 minute face-to-face annual appointment, during which my concerns were completely dismissed. My opinion of him is completely different than yours. The very real, very serious hypoglycemic issues are medical - absolutely not psychological (as you suggest in your post) - I've never thought I needed to see Dr. A as a shrink, but dammit, he carved me up like a turkey inside, he re-routed my guts that have forever changed the way my body will matabolize nutrition, or deal with what it recognizes as sugar overload (with insulin) - and as the industry learns about the medical ramifications, I should trust that I can turn to my WLS surgeon to tell me what I should be doing to stay well and healthy. But he's not available to me - I now am relegated to his RN. There's a great difference between 'being negative' and being pro-active in one's own healthcare. I'm on a lot of different boards and learning that a very high percentage of post-gastric bypass patients beyond 3 years are in trouble, either having gained most or all of their weight back, or having these medical issues that have them very scared.  Knowledge is power, not negative thinking. Be well, Pam. M.

Hi Reenie,
Gee I'm sorry if I gave you the opinion that my issues were phsycological and not medical They are medical. I thought I had been clear as to how I had gotten ill. They have been brought on by a combination of the surgery, my menopause and what I had done to myself phsycally by not eating correctly and using laxatives. The laxatives issue was the part that I do blame on physicology. Head issues. My feeling of being fat.
Thats what I need the shrink for. I am not fat. I look in the mirror and see fat. when I weigh myself I do not see what the scale really says but I see 300 pounds. I am not 300 pounds! thats what I need the head doc for.
I do believe that I am proactive with my healthcare. If I do not understand what they are telling me I repeatedly ask questions not only of them but of others in the medical field. Until I understand.
Yes we both agree Dr A is a surgeon. Could be that the RN might have more info for us than he would especially if she is the one who is talking to all the other patients. Next year for my yearly phsical I will give the RN a chance. I dont want to decide until I meet and speak with the RN if I am going to like them or not or if the info they have is going to be what I need.
I hate waiting in a doctors office forever! do you know after I had seen him I was waiting at the desk for copies of my blood work and the receptionist at the desk was talking to one of the nurses there. They were discussing how he double books during the same hour! that did not make me happy. Its the same thing at all the other doctors that I've ever gone to. You get a good doctor then everyone else finds out about them so that the next thing you know they are double booking and not giving anyone the time that they deserve.
We have had major surgery that has made major changes in our lives. Some positive some negative.
I feel I did mega research before my surgery over the course of years before I decided which to have. I also met and talked with 3 doctors before I decided which doctor to use. I had good friends who before me had the surgery and did not choose their doctors. I chose the one that I liked and wanted. they might have thought I was wrong but it was my choce.
Seems like no matter who I talk with who have had the surgery at work, my friends in the town I live in and my customers along with the people on the boards no matter the type of surgery that they have had,there are always questions or issues.
One of the women I work with had the banding. Her band slipped and she almost died. They had to surgically repair everything she was out of work for 4 weeks.
When someone who is thinking of the surgery asks me what I think I tell them to do their research. I tell them what I have gone through, my thoughts and how I feel. I tell them they need to make their own decision but they need to base that decision after they talk to many different people, doctors, the works. they can not make the decision quickly. Theres no turning back with this.
Are you still happy that you had the surgery Reenie?
God bless, Pam

Hi Pam - maybe this is the best way to answer your question - of course I am happy that I had the surgery. But I hold the medical professionals in the WLS industry ACCOUNTABLE for our continued success, well being, health, and education - as they learn more (and they are learning every day about how this surgery is affecting us - their guinea pigs - in our bodies and in our lives), it is a moral imperative that they be committed to keep us informed and educated. Surgeons like Dr. Aranow, who carve and release without so much as a backwards glance toward individualized personal follow-up care, are doing the entire WLS industry a great diservice. He doesn't need to be my daddy, my friend, my shrink, my anything - other than the single most knowledgeable person I can and should be able to go to if something goes wrong - and he is not available that way. Our regular doctors, our PCP's are generally pretty clueless about the physiological consequences of WLS. My doctor says I've taught HIM a tremendous lot so that he feels much more informed and capable to research and to treat people who have come after me having the surgery. I'm happy about that. But it shows how little the general medical world really knows about what this surgery does to our bodies! Negative??? NO!! Dealing with reality?? YES. But look at Nic, and Connie, and YOU, and so many of us and the PHYSICAL problems we're having. You keep saying it's because of the laxatives you took but I don't think so, Pam. I've researched your problem and I can find absolutely NO CONNECTION between laxative use and the extreme hypoglycemic episodes you've described - but TONS of connection between these episodes and post-WLS! Surgeons are not Gods. I feel pretty passionate about this right now, so sorry if I'm coming across stronger than I should or need to - have you noticed Connie has been absent from the board for a very long time? I'm betting it's because she's really dealing with some medical **** That's my guess. Time to get real about this surgery - be grateful for the weight loss, sure... but there are things happening to our systems because of the surgery that are potentially very serious. And that doesn't even take into consideration the fact that MOST PEOPLE have gained most or all of their weight back by 5 years post surgery!!! Attention must be paid. Here's a post I made a week ago in response to a post on the Revision Board - it was applauded, virtually speaking: 

"If I had one wish for the entire WLS community, especially for people considering weight loss surgery, it would be that every single surgeon and associated caregiver would utter these words as their opening remarks:  "YOU WILL FEEL HUNGER AGAIN. YOU WILL BE ABLE TO EAT REGULAR FOODS IN WHATEVER QUANTITIES YOU ASK OF YOUR POUCH. YOUR POUCH WILL STRETCH TO THE EXTENT YOU ASK IT OVER TIME. TO SUSTAIN YOUR WEIGHT LOSS WILL REQUIRE HURCULEAN EFFORTS ON YOUR PART. FOR THE REST OF YOUR LIFE, YOU WILL BE REQUIRED TO COMMIT TO A DAILY REGIMEN OF VIGOROUS EXERCISE AND HEALTHY EATING CHOICES IN MODEST PORTIONS AT NO MORE THAN THREE MEALS A DAY.  IF YOU CAN DO THIS, YOU MAY STAND A CHANCE TO KEEP MOST OF YOUR WEIGHT OFF FOR MANY YEARS TO COME. THE SURGERY IS A TOOL, IT IS A JUMP START TO HELP YOU LOSE THE WEIGHT. IT IS IN NO WAY A MAGIC WAND THAT WILL GUARANTEE THAT YOU WILL BE FOREVER NORMAL SIZED. THAT IS ENTIRELY UP TO YOU AND YOU WILL HAVE TO WORK AS HARD AS YOU HAVE AT ANYTHING YOU'VE EVER WANTED IN YOUR LIFE BEFORE TO ACHIEVE IT.  GOOD LUCK."  Look, you are 10 lbs. from your goal weight. That is an incredible accomplishment. Eat healthy foods that taste good. Stay away from crap food. Move your butt, hard, every day. Do these things and you'll be fine. Get out of your head and you'll get out of your own way - redirect this energy toward giving yourself away to other people or causes who need help. Make a difference in your community and in your world. This is the true secret to successful weight loss, staying healthy and fit. Sorry you're not hearing what you want to hear. But this is the truth. Let us know how you're doing, ok? Best, Maureen"

That was my post to the Revision board. Pam, I just don't want any of us, myself included, to waste a minute of our lives blaming ourselves for anything - ill health, weight regain, failed ANYTHING. There are many REASONS for much of what is happening. Not all, but much of it.  When my beautiful horse, Laela, is behaving badly I always start from the physical in trying to figure out what's wrong - and I'm always right. She's never 'behaving badly' out of choice, there's always a (physical) reason. I need to accord myself that same respect. There are reasons I do what I do. I need to love myself that much to stop, listen to my body, and try to help it. Our surgeons need to do likewise for their patients. Maureen

I will have to puzzle over this posting that you have made its alot to think and read about from a tiny computer screen.
One thing I will say Reenie is that the laxative use that I did was daily several times a day for a month. I was basically heading down anorexic drive. I caught myself but you have to admit that it DID do and WAS part of the key to pushing my already low blood sugar issues that i had BEFORE the surgery into mega bad lands.
I don't think of Dr A as being the bad guy who forced us into this surgery. I agree we need doctors who are aware of what is going to happen to us down the road. Yes we are guinea pigs just like the ones who had the surgery before us and  who are now having revisions or the surgery you had to make the opening smaller.
More to come
have a great day.