I passed out twice today and went to the ER

I passed out twice early this morning and ended up in the Hospital after a Black Tie affair for an organization I’m involved with. Let me start off by telling you what I ate for the day.

The Black Tie event was yesterday night it was the end of a three day meeting at a Hotel in Maryland.

Breakfast:  Muscle Milk Protein Drink, Bran Mini Muffin, Danon Vanilla Yogurt (added Pineapples & Blue Berries)

Lunch: 3oz Salmon, Spinach, chocolate gelato (ate ¾ of it).

Snack: Chobanni Greek Yogurt (Peach)

Dinner: Surf and Turf (little Lobster and Steak), Spinach

80 ounces of water

I didn’t count up all the protein but I believe I made my goal with ease. I should also mention that I did work out early in the morning. Ran a 15 minute mile on the treadmill and lifted some weights.

After dinner and the awards ceremony they had some desert. I admit I over did it on the chocolate and had about 6oz of dark/milk chocolate (11:00 pm).

There was an after gala party in the hotel lounge. Had a blast. I did have a drink Vodka and Pineapple juice. I had the drink about midnight.  Felt buzzed and decided that one was enough.  The buzz ***** off after about a ½ hour.

I left the party around 1:30 am. When I went down to the hotel lobby to go back to my room as the lounge was on the 18^th Floor (dedicated elevator). I noticed that one of my friends was in a wheel chair. She was complaining that she could no longer feel her legs and a severe headache. I decided to wait with her and comfort her until the ambulance arrived. Waited there about ten minutes. The ambulance finally arrived.

As the ambulance arrived I started to feel light headed and faint. Since there were other people and friends there to attend to my friend in the wheelchair. I decided to step into the background and lean up against the wall. I figured I was having a hyperglycemic reaction to the chocolate that I ate earlier. This has happened to me a few times before when I introduced a large amount of sugar into my system. In the past I would just sit down and the sensation would past.

The next thing I knew I was on the floor (on my butt) and people where buzzing around me asking me if I was ok. I asked what happened and they said I passed out.  I asked if I hit my head as I didn’t remember passing out.  I was told no, you slid rapidly down against the wall. (thank god I leaned up against the wall). The paramedics took my blood pressure and it was 74/50. Traditionally I have high blood pressure controlled with meds. I explained to the paramedics that it maybe a hyperglycemic reaction. They *****ed my finger and tested my blood sugar it was 115. They asked me If I wanted to go to the hospital I refused and said I would be ok. I just needed to sit a bit to get my bearings and sip some water. I told them to take care of my friend and get her to the hospital.  The ambulance left I must have sat for about 15 minutes.

I told my friends that I was ready to get up and go to my room. They told me to take it easy and they helped me to rise slowly. The next thing I knew I was being placed in the wheel chair. I passed out again. My friends called for another ambulance and told me that I had no choice I should go to the hospital.

I noticed that I broke out into a cold sweat as my shirt was soaked.  I remembered those times that I felt like this before I also broke out into a cold sweat then. I actually felt back to normal. The Paramedics took my blood pressure and it was normal 120/80. The Paramedics said that since this was the second call that I had no choice I had to go to the hospital. My friends agreed.

I really felt better at this point. I was able to get up and walk to the ambulance as well as climb into it on my own. They had me lie down on the stretcher in the ambulance and they strapped me in. A friend of mine came with me and off we went to Fort Washington hospital.

When we got to the hospital They asked me a ton of questions. I told them I had Gastric Sleeve Surgery almost two years ago. As well as Plastic Surgery 11 weeks ago.  The doctor asked me about my eating and drinking habits for the day. I told him and mentioned I thought it was a hyperglycemic reaction. He said he doubts it as I had several balanced meals throughout the day. He said I wasn’t dehydrated and that one drink of alcohol shouldn’t have caused me to passout. He told me that he wanted to do blood work,  Cat Scan of the Head and Chest as well as a chest x-ray. He said if the tests come back negative that his recommendation would be for me to be admitted into the hospital and have a Echo and stress test. He said that I may have to be transferred to another hospital depending if they had beds. I was surprised as the only other person that was in the ER was my friend who they were about to transfer to another hospital as this hospital had no trauma unit.  

They did all the tests and they all came back normal. The doctor wanted to admit me but I refused. I wasn’t impressed with the care of the hospital it looked like a dump and I really did feel fine. I went to the bathroom and walked there and back with no issue. I left the hospital against medical advice they made copies of all my records and I promised to follow up with my doctor. On Monday I will call my Primary as well as my bariatric doctor. Based on what they say I may also make an appointment with my cardiologist that cleared me for the sleeve.

I got back to my hotel room around 5:00am this morning and slept until 9:00. I got up took a shower went down to the hotel lobby for breakfast. Met up with a friend and he walked me to the Jos A. Bank store (two blocks from the hotel) to return the Tux I rented. I was able to move around pretty well today and felt good.

Hopefully my doctor can give me more answers. But truly at this point I feel back to normal. I really believed it was a hyperglycemic reaction.  But I plan to follow-up to see if I can determine the cause.

It turns out that my friend that loss feeling in her legs. Had an aneurysm. She had surgery to take care of it and the doctor said he was happy with her progress. She’s going to have a long recovery. All of her family came to support her.

 

 So sorry Mike that this happened to you. Please call your pcp and cardiologist first thing Monday...you need to figure out what happened.

Patty

 Wow, that must have been scary.  So sorry it happened to you.

I agree with you about the hyperglycemia.  I don't want to sound mean, but that was a lot of chocolate... we can't eat it like we used to.  Sugar is evil!!!  

I've been trying to cut down on sugar (and other carbs) for about a month... getting back on track after my sloth and gluttony during the Xmas/New Year period.  Last Sunday, I had about 1 oz of a caramel/macadamia slice... 1/2 later I felt so sick...weak, shaky and nauseous, I had to go home and lie down.  I put it down to the sugar.

You're a great role model, take care.

You're not mean. Quite frankly I was stupid

I got a little too comfortable and should have known better. It just goes to show you that even when you are successful you always have to be vigilant about what you put into your body. Sometimes you have to learn lessons the hard way.

Lesson well learned

Hypoglycemia is low blood sugar. His reading of 115 was not low, so doesn't quite sound like that...

I am hypoglycemic and I've never passed out and my blood sugar runs about 72 even just 1.5 hours after eating. I have to eat every 3-4 hours to keep from getting sick. I have come close to passing out after about 6-7 hours of not eating, but I got some sweet tea in time and was fine. Not the ideal solution, but it kept me upright until I could get food that day.

 Oh Dear!  Be careful Mikey.  Please keep us all posted.  We love you!

 Mikey, that's quite a story. Must have been scarey for you, particularly as you were watching your friend being taken in the ambulance as well.

How are you feeling this morning?  Let us know what your doctors tell you.

Mikey, I am so sorry that this happened to you. It sounds like Reactive Hypoglycemia to me, based upon the amount of sugar that you had, just before your symptoms happened. What happens is that the sugar triggers a spike in your blood glucose which causes the release of insulin into your bloodstream, which causes a dramatic drop in your blood glucose, and the symptoms that you experienced. A reading of 115 is just above normal, so I'm not sure about that, except maybe enough time had passed for your glucose to come back up a bit. Your blood pressure was on the low side, which can also cause dizziness and fainting.

Was your EKG okay?

What I was told by my bariatric internist, is that Reactive Hypoglycemia is being found in VSG folks, probably due to the increased gastric emptying that occurs. She has documented 3 cases in her own practice through medical testing.  When we eat sugar it goes through the sleeve pretty quickly, which triggers the release of insulin and the cascade of RH follows. So, RH can occur with us, although, it seems to be more common with RNY. Always, have protein with simple carbs. Having protein a few hours before may not be sufficient to counteract this cascade of symptoms, since the protein has already left your stomach.

Just a theory. I'm not a doctor, but as an RN, I have read about this a lot.

One other thing, alcohol enters our systems right away and is metabolized as sugar, so this can also contribute to RH. We are more sensitive to sugar and alcohol, since our sleeves are smaller than a regular stomach and simple carbs enter our intestines more rapidly, which stimulates the release of insulin and the cascade of RH follows.    


Gail

Thanks Gail,

At the OH conference last year my doctor said the same thing your internist said. So I really believe that was the cause. Since I'm not in serious distress and still away from home (in airport as I'm typing this), I decided to wait until tomorrow when my doctors office is open.

I've felt these symptoms before and I have always had protein around to take (as soon as i felt them) and it's never gotten to the point that I passed out. I had some Greek yogurt in my hotel room. My plan was to eat some protein as soon as I got there but didn't make it.

Think you're right about the alcohol as well. Typically I don't drink, but this was a social event so I indulged.

After about 1.5 years of not having any alcohol, I did indulge at Thanksgiving, Christmas, and a recent retirement party. I was careful each time to make sure that I had some protein with the alcohol and any sweets that I had. I was okay, but I found that the alcohol decreased my inhibitions about eating, so by the time of the retirement party, I only had half a glass with lots of water and only 2-3 bites of a chocolate cake. It's funny, but sweets just don't do it for me, like they used to. I think about them, but in reality, all I really want is a bite or two.


Gail

p.s. Ask your doctor if he can do some medical testing to confirm the RH.