[Continuation. Website editor deleting the end of my post. Will try again]

In a small percentage of cases (3%), the hypoglycemia can be due to overgrowth of insulin-cells in the pancreas (called nesidioblastosis). The diagnosis is difficult - CT scans and ultrasound don't help. It takes an arteriogram (like a cardiac cath) to diagnose, and treatment involves removing 90% of the pancreas (no small deal).

Reference article for more detail: http://www.ncbi.nlm.nih.gov/pubmed/18656831
Hope this helps. Say hi to Stacy & Erin for me.

Dr. Castellucci's a good endocrinologist, but the problem of post-bypass hypoglycemia is poorly understood, and not an easy one to diagnose and treat.

That being said, most cases (>95%) can be helped by diet modification: eating the proper foods.  The big enemy: CARBOHYDRATES! IE the high-glycemic foods that Atkins & South Beach diets tell you to avoid.

I've experienced this in my bypass as well, and without exception, all of them admit to a starchy meal before their hypoglycemia episodes, and reverting back to a HIGH-PROTEIN meal always takes care of the problem.

So the solution (for the vast majority): eat PROTEIN FIRST at every meal (ever heard that before?) - chicken, fish etc; nonbreaded, nonfried. Then green veggies - broccoli, green beans, spinach; complex carbs are okay. Avoid hi-glycemic carbs like crackers, chips, potatoes/fries, bananas, fruit juices like OJ, even milk. They're absorbed quickly, cause a spike in insulin, then your blood sugar bottoms out. Bingo: hypoglycemia.
 
Talk to your dietitian to get a list of hi-glycemic carbs you should avoid. Sometimes, a drug called Precose, prescribed to prevent carb absorption in the intestine, can help.

This is different from dumping, but some of the same foods can cause both reactions.

In a small percentage of cases (

NO DOUBT I WOULD DO IT AGAIN IN A RED HOT SECOND!

Lisa,
REALITY CHECK!  10lbs?  You're doing fabulous.  I know scale stalking is hard for us when we see a gain but you are doing great.  I agree with gwen.  *insert my typical go "back to the basics" schpeal.

As for the handbook, I re-requested mine and after a re-read knew what my protein, vitamin and etc. goals were...again (always good to re-read and know and follow!)  :)  Contact your surgeons office and requestit.

U mentioned pouch test, liquids, etc.  I don't feel that 10 lbs warrants that.  Relax a bit.  TRY.  SERIOUSLY.  And this is coming from a scale stalker!  :)

Good luck in TX and hope you keep visiting us here.  I have been away from the VA boards for a long time too.  But we are all still here even though we check in...infrequently.

Feel free to contact me/email me privately.

Hugs babe!,

Lauren

Dr. Mann...beach area?   I'm in RVA.  Welcome to the board and hope we can help!  :)

Grats on the surgery coming up soon!

Lauren