blacking out / dizziness / fainting post-op

I am 14 months out and yesterday I left the house before I could eat anything, and spent about 3 hours on my feet at Wal-Mart (I had lots of pictures to scan at the photo center). After about an hour and a half I had tunnel vision and I got sick to my stomach and really fatigued and dizzy all of a sudden. I thought I was going to faint so I went over to a bench and sat down for a few minutes, then I thought I might have to throw up so I ran to the bathroom (I still had only partial vision), where I didn't throw up, but I looked at myself in the mirror and I had no color in my face, even my lips were white. I went back out to the bench and sat down for a while until I felt strong enough to stand and finish with my pictures. It would be one thing if this had only happened once, but it has happened a couple of times. Other times my vision narrows until I can't see anything and I get dizzy when I stand up (this happens at least a couple of times everyday) and another couple of times I fell down because I was so dizzy. My surgeon, the last time I talked with him, told me it was bouts of low blood sugar and I believe that is what happens sometimes, but it really happens more than just normal low blood sugar should be able to account for. It happens when I've eaten well, when I've had plenty of water and when I have taken my vitamins and exercised, as well as when I'm not sticking to my plan as well as I should be. I am going in on Thursday to talk to him again and get my labs done because I need to figure out how to make this stop happening. Any suggestions or experiences like this that I could learn from?

It does sound like hypoglcemia. Maybe you should get a meter and start checking your blood sugar when you have one of these episodes. Does eating make it go away? You can get glucose tablets at the pharmacy. They are cheap, taste good, and hit your blood stream quickly. I want to stress to you how important it is to get to the bottom of this. You don't want this to happen while you are driving! I'm having the same kind of problems only I haven't passed out. I can recognize the symptoms and I start to eat right away. I keep a baggy with dry roasted peanuts and raisins with me at all times as well as the glucose tablets. It doesn't seem to matter how I've eaten. One day it will be oatmeal that sets me off, the next day it won't bother me. One time it was hamburger and corn. Then I'll eat something that should, like cookies, and it won't. I've had tons of lab work drawn. You need to see an endocrinolgist. They should want to draw your blood when you are having symptoms. When I did mine, my insulin, proinsulin, and c-peptide were all very high. But after fasting for 18 hours, everything was normal. That rules out an insulinoma (small tumor of the beta cells). I could have just reactive hypoglcemia, meaning my body's response to what I eat, or it could be the beta cells themselves are putting out too much insulin. To properly diagnose that, you need a calcium stimulation test. I don't know where you are located, but here in Iowa the only place to have that done is at the Mayo Clinic in Minnesota. The key is to eat numerous small meals consisting of protein and some fat. The fat helps keep the body metabolizing any carbs into sugar as fast. I try to eat about every 2.5 to 3 hours. If I do that, and watch what I eat, I do much better most days. I'm in a holding pattern right now. I have more labs in 2.5 weeks and we'll see where we go from there. Hope this info helps. There is another person on the board, Karyn, who is going thru the same thing as I am. She may be able to offer some input also. Keep us informed. Lyn

This did happen to me last week while driving to work. I was amazed how quickly I went south. Thank God I called to ask work to have someone help me in the hospital. I am a nurse. The person I spoke to told me to pull over and park the car. I was so confused I didn't think of that I just knew I was close to work! I had an EMS ride to the hospital and never did go into work that night. My blood sugar was 50 and I was really feeling awful. I have been testing 2hours after meals and in the morning when I get up. I have really had a time of it. I am back to shakes and low carbs. I am afraid to eat and to drive by myself. I got the symptoms, dizzy, week,jittery etc but from that until confusion during this episode was only about 7minutes. I had glucose tabs because this has been happening more and more and I took two of them. My glucose was 107 after two tablets. I then seem to have come up and then rebounded right back down again before stabelizing and being sent home from the ER. The thing I find most upsetting is that I seem to be having these reactions without changes in my diet. I am two years out this month and my weight has been stable for about a year at 148-150 lbs. I see the endo on the 17th and am so curious to see what he has to say. I moved from Maryland to Florida in June and I am nervous with getting all new docs. I'll keep you all posted. Carolyn

I am terrified of this happening while I am driving! I have to make the 3 1/2 hour trip down to see my surgeon on Thursday, and it looks like I'll be going alone, and I can think of nothing worse than having an episode while driving. I get all disoriented too and it is really scary. One of the times I fell I was alone in my apartment and my husband wasn't coming bac****il the next day. It is so scary to think that I might pass out alone in my apartment with no one around to even know there is something wrong. I was type 2 diabetic pre-op, and day 1 out of surgery I wasn't anymore. I haven't tested my blood sugar in a while, I don't even think I have my tester anymore, so maybe I'll start doing that again. *sigh* I thought I had left all of this behind. Let me know if you figure out what is going on. Amy

OK..saw the endo on 17th he seemed to understand exactly what was happening. I am very relieved. Here are the key points: I was probably insulin resistant prior to wls I have dumped insulin in response to carbs entering lower in my gut than normal after surgery I then release too much insulin and bs goes down When I treated with glucose tabs it was too much and I then rebound with the whole cycle again treatment: when blood sugar is low treat with food products...dairy...milk with protein powder etc if time allows and not too low...so if you feel it coming on don't ignor it treat right away of course eat small freq meals (duh) and high protein snacks throughout day (nuts etc) monitor how you feel...exercise allows body to use glucose and reduces the issues with insulin resist. I am having labs tomorrow to see if my cortisol and insulin levels match my glucose levels. If not he is going to try me on medication...smiliar to glucophage or metformin (spelling could be off) His theory is that the genetic predisoposion to obesity for me is linked with insulin resistance and that now that I am thin this is still a problem. He thinks that diet, exercise and medication may even things out. as far as driving.. I take my blood sugar before getting in car. I have quick absorbing foods/glucose tabs etc handy and I will pull over at first signs of any issues and treat /eat/wait until I am safely able to drive again. Symptoms can progress from annoying to crashing very quickly so you are right to be concerned but... you can handle this...just pay attention. I ignored symptoms while I was chatting with a freind on the phone...bad idea...I wont do it again. Quite an eye opening experience. Good luck and take care Interesting articles on line regarding hypoglycemia/insulin resistance/bypas surgery if you do google searches... I hear NIH is doind some kind of study but haven't been able to get information on it. Carolyn

hey Lyn ... I realize I'm a day late and a dollar short here on this conversation ... but I thought I'd update since I met with the endo this morning. For the past month we've monitored my blood sugar after meals (I did some before meals as well as when I wasn't feeling "well") ... and it did get below 50 a few times. Their original recommendation was for me to get more fats in (as you mentioned, they do slow absorption of sugars / carbs, etc.). Mind you, I have NEVER intentionally tested myself with sugar and try to avoid carbs (although that's not completely possible). Some of my low sugar levels (even the 46) was after eating ... protein & carbs (we are NEVER supposed to eat carbs alone ... we can have protein alone, but should never have carbs alone). SO ... they've now prescribed something for me that slows absorbtion even more (therefore hopefully minimizing insulin output) ... there are actually a few meds they mentioned trying, and we're going with Acarbose and see where that gets us. I still need to monitor my food (carb intake) and blood sugar levels after meals ... I'm just hoping I don't have another seizure (my sugar level was at 23 when that happened). So, we'll see how this goes ... let me know where you're at ... Karyn

I think we should start a new forum for hypoglycemic!! Wow, I just can't believe how many of us are going through this. I am also hypoglycemic and have dropped to 14! I am starting on Precose on Monday to slow the absorbtion of carb. My cortisol is also low so I have to have somemore labs tomorrow. Kourtney