Long Term Post Op: Alcohol Observations

Ok, first of all I'd like to say that no I do not drink alcohol regularly. I drink on occasion during social events and I know that a "simple" solution would be to not drink at all. I'm 3.5 years post-op RNY. Nevertheless, I had an episode that happened this weekend. I went out to dinner and had a salad as well as a Hypnotic Martini (which is basically a sugary liqueur). My date actually ordered me another but I only drank maybe two sips of it. Afterward we went elsewhere and I had a malibu and cranberry, of which I drank half. This was all in the course of 2 hours or so. I started to feel sick and threw away half the drink. I sometimes get that way after i have too much sugar (however MUCH more than simply 1-2 drinks) and start to dump...feel sweaty/hot and dizzy. I usually sit down, drink water, and feel better. But this time I remember feeling that coming on, and the next thing I knew my friend was picking me up off of the floor. He said I was talking to him and all of a sudden my eyes dilated completely and I passed out. I sort of woke up however passed out another 2 times within the next minute or so as he was holding me. Finally the bartender gave me a glass of water with a sugar packet in it (I suppose he thought it was diabetes from my sugar being too low) and I took a sip and woke up. After that we went outside and I was still kinda shakey but was basically fine and it had passed. The paramedics did come and checked my blood sugar, which was on the high level of normal (and if it was from low blood sugar shouldn't it have been the opposite??) I'm just wondering if anyone has ever experienced this before? I usually don't drink sugary drinks because on occasion they make me feel sick, however I have NEVER passed out from that (and I have drank much more than that before). I spoke with my doctor and basically he just said, "don't drink." I'm kinda looking for an explanation. I feel like I need water, but if it was hypoglycemia I would need sugar(such as juice). Has anyone else experienced this, or what do you feel like if you drink alcohol? My experiences with it are very erratic, some nights I could have one drink and feel drunk and others I could have 3 and be completely sober and fine. I might add that I had RNY when I was 19 and (to the disbelief of many...) I never had a drink prior to it. So my experiences with alcohol have ONLY been post-op (I did not drin****il 1.5 years after surgery) and I do not have anything to compare them to, pre-WLS. Any thoughts/advice/commentary?

Your post hit home in a BIG way. I went out this weekend to what we call a "drunk bus." I know some lawyers in a rock band and they rent a motor coach for about 40 of their friends to go to whatever bar they are playing in. We party on the bus for a couple of hours before going in. I drank no more than I ususally do. Like you, I drink socially but am VERY social. I probably overdo a little too often. I am certainly not an alocholic, but I enjoy a good party and a good buzz. So anyway, Something happened after about a half an hour into the bar. I got so sick I thought I was going to die or hoped I would. I made it back to the bus with my husband where I stayed all night. Now I am not talking just drunk sick, but sicker than I have ever been in my whole life. I have been a partier for many many years as well. I dry heaved for 3 1/2 hours to the point I could not stand. The worst part is I never sobered up. Now, normally if I stop drinking I am pretty sober after an hour. It never got better and I never stopped vomitting. I could not even make it to the car once we got dropped off. I was vommitting in the snow with no coat and could barely walk. This was several hours after my last drink. I did not drink any more than I have on other nights as well. I am 3.5 years post op. I have no desire to drink again any time soon. I thought I was going to have to go the ER that night. I cannot figure out what went wrong. I am fine having some diet pop for now. Terri

First of all, HELLO TERRI!! Nice to see you! Secondly, yes I have had an episode or two similar to these....I think it was alcohol poisoning to be perfectly honest. I didn't feel like I drank very much, and had also drank more at different times and didn't feel that way. I think it all depends on what you ate prior that will help absorb things, and the spacing out of the drinks. I had two or three in a short period of time...not paying attention...just basically thirsty and sucked them down within probably 45 minutes. I was sitting there with some friends watching someone sing (I was hosting karaoke at the time) and all of a sudden I had to put my head down, and from that point on I could not lift my head. I was sweating profusely (my hair was sopping wet), didn't feel sick to my stomach, but had no control over my body! Thank God my son was there and he pretty much led me out of there and put me in his BACK SEAT....HOW EMBARRASSING!!! I have NEVER had to be led out of ANYWHERE in my life, let alone in front of my son! He understood that something wa****ting me wrong, so he took over my karaoke and I layed in the back seat til the end of the night. He would come out and check on me every other song, just to be sure I was okay. I could hear everything perfectly and understand everything perfectly, but could not move or even lift my head. He drove me home afterward (about 2 1/2 hours later) and I still could not get out of the car...he basically pulled me out of the car and carried me to bed! I was never so embarrased in all my life. He knows me and knows I'm not a "drinker"...but wow, what a horrible reaction. I didn't drink for quite a while after that, but now have drank since then, ... NEVER alot in a row though. I space it out. I also asked the bartender where I work karaoke to be sure whenever I order anything to drink, cut the alcohol in HALF. (I don't have to pay for drinks when I'm working) So they do this for me, and it works for me. It was scary though so I can relate! Theresa

I have never experinced that while drinking alcohol, but I had a very similar episode drinking about 2 oz of Orange juice at Church one morning. You said you had a salad - I simply cannot function with even a hint of sugar (even

My surgeon told me pre-op he thought the orange juice was evil and I should never drink it, dont even mention grape juice LOL

I am also a social drinker so that's maybe once a month (or could be even less). I have not had any problems like you've described, but I do not drink sugary drinks. Even when I go out I take Crystal Light lemonade packets with me, order a glass of water and a shot of Absolut Vodka, mix it myself at the table and enjoy! The only problem I've had with drinking since having wls was my own fault~I was in a stressful situation and drank WAY too much vodka~I literally can not remember 4hrs of my life, which is very scary to me, but thank goodness my husband was with me and made sure I was safe. I'm sure I was close to alcohol poisoning after drinking 3/4 of a bottle Absolut all by myself. I wasn't that hung over the next day either~just tired, but never threw up or anything. Alcohol in wls patients can have different effects so we should all be very careful when consuming alcohol of any kind. Tracy B 328/150 5'9"

Hi Natalie ... I wish I could explain it. Last May I was in Dallas for work. Our group rented out a nightclub, and I had 3 drinks over a period of almost 4 hours (2 mango margaritas and one shot) ... I did have some finger food (chicken/veggie appetizer skewers) ... and about 11pm they found me on the floor of the bathroom. The paramedics just thought I was intoxicated, they didn't even check my blood sugar. They left me there. I was sick for the next 24 hours ... dry heaves, horrible pains (note: my gallbladder is also dysfunctional, so that may have been the source of some of the pain?) ... I had to miss my flight home the next night (still sick), and had to fly out the next day. In August, I had a grand mal seizure (it was 10:30am, and I had NOT been drinking), and the paramedics tested my blood sugar at 23. My docs all pretty much think I may have even had a seizure in Dallas (my blood sugar gets pretty low). I also had another occasion in December of 2005, I had 2 glasses of wine and ended up on the floor in the bathroom (another work event ... I'm sure they all think I'm a lush by now) ... BUT, I have also been able to drin****asionally (social drinker - rarely) without incident (oh yeah, I did dump from 4 sips of a kahlua and cream about a year ago), so I have found no pattern to date. I wish I had advice ... guess its best to limit alcohol, make sure you have food prior, and maybe have a glass of water in between each drink? Karyn

My guess is you had a rebound hypoglycemia or late dumping. and that low blood sugar in addition to the alcohol made you pass out. if you drank sugar water and were then tested by the paramedics the sugar water is why you were high - being a liquid it essentially poured through your pouch, into your small intesitne and directly into your blood stream. I know that when blood sugar is low, after having some sugar it will rise in minutes. I think your Dr. gave you excellent advice - But it sounds like you want a loophole around that advice. No judgement - I do the same thing. I was advised no alcohol too, and did drink but only a little. After a couple of really scary incidents involving alcohol I dont think I will ever drink again. A Mango Margarita made me feel like I was dying between the severe drunken state 3 OZ put me into (could not walk on my own - DH had to assist me to the car) and dumping with nausea, cramping, bloating followed by diarrhea, I decided a social drink for fun really was not much fun at all. so now I get plain club soda over a lot of ice with a slice of lime and stir it to flatten it so Im not belching all over the place and that is my ****tail. here is an article about dumping syndrome. I have another much longer one from a nutrition journal if you want it email me. [email protected] Under normal physiologic conditions, the stomach and pylorus (the opening of the stomach into the small intestine) control the rate at which the gastric contents leave the stomach. That is, the stomach, pancreas and liver work together to prepare nutrients (or sugar) before they reach the small intestine for absorption. The stomach serves as a reservoir that releases food downstream only at a controlled rate, avoiding sudden large influxes of sugar. The released food is also mixed with stomach acid, bile, and pancreatic juice to control the chemical makeup of the food that goes downstream and avoid the "dumping syndrome." Dumping syndrome occurs with the Roux-en-Y Gastric Bypass patient only and is divided into early and late phases. Early dumping syndrome happens when the lower end of the small intestine (jejunum) fills too quickly with undigested food from the stomach. Patients can develop abdominal bloating, pain, vomiting, and vasomotor symptoms (flushing, sweating, rapid heart rate, light headedness). Other patients may have diarrhea. Since with the Roux-en-Y Gastric Bypass the majority of the stomach is not being used and a new, small pouch that directly connects to the small intestine is created, there may be dumping. Early dumping syndrome is due to the now-rapid gastric emptying causing bowel distension plus movement of fluid from the blood to the intestine to dilute the intestinal contents. These symptoms usually occur 30 to 60 minutes after eating. Late dumping is related to the blood sugar level. The small bowel is very effective in absorbing sugar, so that the rapid absorption of a relatively small amount of sugar can cause the glucose level in the blood to rise rapidly. The pancreas responds to this glucose challenge by increasing the insulin output. Unfortunately, the sugar that started the whole cycle was such a small amount that it does not sustain the increase in blood glucose, which tends to fall back down at about the time the insulin surge starts. These factors combine to produce hypoglycemia (low blood sugar) which causes the individual to feel weak, sleepy and profoundly fatigued. Restricting simple carbohydrates (rice, pasta, potatoes and other sweet tasting foods), eating more protein and not drinking liquids during a meal can reduce the symptoms of dumping. Further, avoid foods that are very hot or very cold, which can also trigger symptoms. Obviously, surgeons consider dumping syndrome to be a beneficial effect of Gastric Bypass surgery. It provides a quick and reliable negative feedback to eating the "wrong" foods. In practice, most patients do not experience full-blown symptoms of dumping more that once or twice. Most simply say that they have lost their taste for sweets. Be aware that late dumping is the mechanism by which sugar intake can create low blood sugar, and it is also a way for patients to get into a vicious cycle of eating. If the patient takes in sugar or a food that is closely related to sugar (simple carbohydrates like rice, pasta, potatoes) they will experience some degree of hypoglycemia in the hour or two after eating. The hypoglycemia stimulates appetite and the patient will want to eat again.