update:hospital work

Hey all, I miss coming here often, but am enjoying the summer chaplaincy internship at Erlanger Hospital in Chattanooga.  It's hard every day, but also great every day.  The 24 hour on-calls are not the funnest experience in the world, but are 'doable.'   I wanted to come and tell you all about one of the perks of working there.  It is a teaching hospital connected with University of Tennessee.  As such, they have medical residence on staff.  They have to provide a medical library for these residents on site.   As a member of pastoral care, I have access to the medical library.  Oh, they should have never let me in there.  I found one of the new leading textbooks on surgical weight loss!!! It is really cool.  Another book I found was on Hypoglycemia syndromes.  I know a lot of us here have varying degrees of low blood sugar issues post op and so I picked it up.  The book was written in 1978 so I was skeptical.  However, as I read, it made me more and more angry that more surgeons do not add reactive hypoglycemia to their list of possible complications.  THe book clearly lays out that there are five known causes (as of 1978) for reactive hypoglycemia (or subcatergories).  One of them is partial or subtotal gastrectomy or its medical equivalent.  Ummmmmmmmmmmm.................................................hello....what do people think has been done in gastric bypass.  I learned a lot about this specific type of reative hypoglycemia and all and it's really interesting that if you didn't know you had gastric bypass, they could still tell if you had reactive hypoglycemia and would ask if you had any previous abdominal surgery.  Yet when I went to see MY surgeon, it was all me bringing on dumping syndrome.   Just venting.  Anyway......cool books!   Hope all is well Rachael

so glad things are going well for you!! How are you managing your self care? I gotta agree with you on your research and I TOTALLY advocate for people to educate themselves about their medical concerns and not ASSUME their provider is fully knowledgable on the condition/treatment.  My baby's family dr was still pretty convinced her delays were due to her prematurity and medical difficulties, but I wanted more of an assessment, now we know she has cerebral palsy and several other problems, has seen 12 drs and 6 therapists and has had over a dozen diagnostic tests including a brain MRI and a sleep study.  What would have happened if I just took his word for it?

You are so right about us not being informed about hypoglygemia.  And even today when I've researched RNY, it isn't mentioned.  I called my PCP about a blood sugar of 36.  He told me to make an appointment with the nurse educator so she could tell me how to eat!  Imagine that?  I'm 3 years out, never had any problems until a year ago.  Didn't change the way I was eating.  Suddenly foods I could previously eat dropped my sugar like a rock. 

A year later, 4 endocrinologists, 2 hospitals, and a surgeon now have it figured out after I found the research and insisted on being sent to Mayo for it.  I'm having part of my pancreas removed in a week and a half.  It's producing 5 times it's baseline in insulin.  Mayo considers twice significant.

I'm just sure "learning" what to eat would have taken care of this problem.  NOT!  I haven't been back to my PCP either. 

 

Lyn

 

I am on Octreotide injections that are not helping any more. I feel horrible and have had blood sugars as low as 34 with total confusion, can walk and my body is dripping in cold sweats. I have to change my clothes and then I sleep for hours. I feel sick to my stomach all the time and nothing is helping. Please email me, I am feeling pretty hopeless. [email protected] Any help from anyone would be greatly appreciated. Thanks

Alimentary hypoglycemia occurs from a mismatch of insulin and carbohydrate and insulin which is usually due to having an abnormality of the stomach. Ordinarily, a meal sit in your stomach and is slowly released, so the carbohydrate absorption occurs over a prolonged period. For people who have stomach surgery to remove part of the stomach or who dumps most of the meal into the small intestine immediately, there is a very rapid absorption of the carbohydrate. This rapid carbohydrate absorption can be followed by a very brisk insulin release. The big insulin release can drive the glucose level very low. Of all the causes of reactive hypoglycemia, this can be the most dangerous. Alimentary hypoglycemia has been reported to cause coma and seizures. Characteristicly the hypoglycemia from this cause occurs 1/2 - 2 1/2 hours after eating. It usually does not occur without a history of partial or total gastrectomy (stomach surgery).

Oh my gosh, I am blown away. I have been dealing with this for 2 years now. I am on injections of Ocrtreotide and they are not helping anymore. No one in CA. including my Endochronologist knows what to do. I don't know how to get help. Do you? Please reply.  Thank you

I am nearly in tears as I read your notes.

I have been having this too. 

Am having it right now. It is such a scary thing to me when it happens.