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So I didn't know I wasn't able to blog on here on my phone. Totally frustrating. I don't have a computer at home so taking two weeks off work for the surgery; I was unable to get on here. Pooey. I tried to recap the last two weeks quickly as possible. So it's now been two weeks since my gastric sleeve surgery on 07/17/2017. I arrived at the hospital at 9am and didn't get taken back to surgery till about 2pm. Boy that was a long wait. ugh ***My surgery was performed by Dr.Dyer at Centennial Medical Center in Nashville TN. Surgery went well. Minimal pain. I was on the pain pump and used it for a bit. I'm allergic (severe itching) to morphine so I only used the pain med for the first two days since they gave me a drug related to morphine and of course I was miserably itchy. I had a drain on my right side. (I attached pics of the incisions.) I had a total of 10 marks – a couple you can’t see. One was in my belly button and another on my left side. It wasn’t real visible in the photo. Some were small incisions, some punctures (needles where the gas was inserted), and the largest where they took the stomach out was near the drain. It still hurts a bit today, but not much. I was up walking pretty quickly. No problem. Drinking was bit hard. It felt like swallowing a rock. And it hurt went it hit the stomach. But I just sipped sipped and it got better each day. The second day I was given a bowel suppository of some sort to help reactivate my bowels since they freeze up due to surgery and anesthesia. I had a small movement the next day. Same stuff each day, walk , drink, sleep, walk , drink sleep. I was released early Thursday about 10am. I still had the drain and had it taken out that following Tuesday. I felt pretty good. I was probably ready to go back to work Wednesday but already had put the time in so just took the rest of the week off. So the worst part of everything was the clear diet. Ugh ugh. I couldn’t stand Nectar, Isopure and started to have trouble with the Unjury. I don’t throw up, but just hated the tastes of the water based proteins. I was only getting 40 grams in a day. So I started the stage 2 a few days early. I was suppose to be on the clear diet for two weeks then start stage 2 liquid diet. This just adds the Premier protein drinks. I drink two a day right now. I did have my first “too full” feeling yesterday when I drank my shake. I think I just had too much at once. It was like a large burp that couldn’t come out stuck just below my sternum and I was nausea's. Because of course my gag is broke (wink) I don’t throw up. So I just didn’t move for a bit till things moved on through. I only drink a bit at a time now. Much better So I’ll be on this Stage 2 liquid for three weeks. It’s only suppose to be two, but my doctor doesn’t want me changing stages till I see him and the nutritionists and he is on vacation the week I’m suppose to transition, so I get an extra week of liquids. Oh Joy. We’ll see how this goes. LOL Other than that I’m back to work today. I have my schedule with my vitamins and drinks and will see how it all goes. I listed my schedule below case you were interested. I’m suppose to add a third shake if able when I can. But doc said doesn’t have to be everyday. Hope everyone is doing well in Bariatric Land. GrInS ***this is just a layout to try and help me get everything I am suppose to in. Awake – 4am – take thyroid pills (crushed) Start first 24oz cup water At Work – 6am – take multivitamin Start second 24oz cup water 8am – drink ½ protein shake 9am – drink ½ protein shake – take first calcium 10am if not completed – finish second 24oz water Start third 24oz cup water 12pm – walk 30 min (lunch break) – take second calcium 2:15 off work 3pm – drink ½ protein shake 4pm – drink ½ protein shake – take third calcium – biotin and D3 ( I take B12 once a week on Sunday) Make dinner for family Have another 24oz water available as I want ( I don’t feel pressure to finish it since I’ve hit my goal of 64 ounces already) but drink as I want so I’m not thirsty. 6pm – yummy sugar free Popsicle. 7pm – Bed time Oh my states right now are highest weight 315 - DOS 286 (I think- they weighed me in Kilograms ) - today 273.8 (42 total lost)

There are probably several potential causes for your condition - as others have said. These include: A lack of B12 vitamin. Orthostatic or postural hypotension. https://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/symptoms-of-heart-and-blood-vessel-disorders/dizziness-or-light-headedness-when-standing-up Reactive hypoglycemia. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass Vertigo. Dehydration.

You'd think she'd get hypoglycemia from candy too though.. (not saying it ISN'T a blood sugar problem, just that it's weird ). Personally I can taste the baking soda in cakes and the like, so then I start thinking maybe there is another ingredient in the second list that you have developed a sensitivity to (my daughter is sensitive to vanilla! Can you imagine?) I was kinda assuming you are dumping.. but maybe taking a blood sugar reading when you feel that way could answer whether it's the reactive hypoglycemia. (The other way to tell, if you don't have a monitor, is to see if you feel better after you eat something).

Some patients experience a condition called reactive hypoglycemia. It sounds like you are experiencing periods of low blood sugar after you consume foods high in sugar content. Here is a link. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass You can search the internet for more information on this condition.

Ok, so now you know you are prone to blood sugar problems, and what it feels like when yours gets too low. Make sure to keep "emergency" juice on hand (individually packaged singles are great since they can just stay in your cabinet or fridge until you need them). Try to eat more often through the day to help keep things stable. And always follow your juice with a protein based meal so you don't develop the reactive hypoglycemia. Your doctor will want to know you are having this issue, and can help you know what else you should be doing (changing meds, start testing blood sugar, etc.). Good luck!

It might be related to low blood sugar, especially since you drank some orange juice and it stopped. If you had diabetes prior to surgery and were taking prescription medicine prior to surgery, it may be time to scale back the use of this medicine. It might be signs of a condition called reactive hypoglycemia. Here are a couple links. https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/

The following abbreviations are commonly used on this website: ACL = Anterior cruciate ligament AGB = Adjustable gastric banding AMRAP = As Many Rounds As Possible (crossfit) BB = belly button bc = because BCBS = Blue Cross/Blue Shield BED = Binge Eating Disorder bf = best friend BM = bowel movement BMI = Body Mass Index bp = blood pressure BPD = Borderline Personality Disorder or Biliary Pancreatic Diversion bs = blood sugar btw = by the way C25K = Couch Potato to Running 5K CBT = cognitive-behavioral therapy CC = common channel c diff = clostridium difficile cos or cuz = because CPAP = continuous positive airway pressure CRNP = certified registered nurse practitioners cw = current weight CXR = Chest X-Ray DDD = degenerative disc disease Dr. = doctor DS = Dumping Syndrome or Duodenal Switch EGD = Esophagogastroduodenoscopy EKG = Electrocardiography ff = fat free GERD = gastroesophageal reflux disease GI = gastrointestinal GNC = General Nutrition Corporation store GP = general practitioner or family doctor HBP = high blood pressure hr = heart rate hw = highest weight ICU = Intensive Care Unit Idk = I don’t know IMHO = in my humble (honest) opinion IMO = in my opinion IUI = Intrauterine insemination LAP Band = Laparoscopic Adjustable Gastric Band LES = lower esophageal sphincter lol = laughing out loud LSG = Laparoscopic Sleeve Gastrectomy med = medicine MFP = my fitness pal msg = message NASH = Nonalcoholic steatohepatitis nf = non fat NG = Nasogastric NP = nurse practitioner NSAIDS = Non-steroidal anti-inflammatory drug NSV = non-Scale victory (“scale” means “weight scale”) NUT = nutritionist OA = Overeaters Anonymous omw = on my way Onederland = a magical place or destination for those trying to lose weight. It might correspond to attaining a weight in the hundreds or losing a hundred pounds. op = operation OSA = Obstructive Sleep Apnea Oz = Australia PB = Productive Burps PCOS = Polycystic Ovary Syndrome PCP = Primary Care Physician PICC= Peripherally Inserted Central Catheter PM = private message (email) PMS = premenstrual syndrome POSE = Primary Obesity Surgery Endolumenal postop or post–op = post-operation or post-surgery PPI = Proton Pump Inhibitors ppl = people preop or pre-op = pre-operation or pre-surgery PTSD = Post-Traumatic Stress Disorder PVC = Premature ventricular contractions RA = Rheumatoid arthritis RH = reactive hypoglycemia RN = registered nurse RNY = Roux-en-Y RTD = ready to drink RYGB = Roux-en-Y gastric bypass SADI-S = single anastomosis duodeno–ileal bypass with sleeve gastrectomy s/f or sf = sugar free SG = Sleeve gastrectomy SIPS = stomach intestinal pylorus-sparing surgery smh = shaking my head, scratching my head SO = significant other SOB = shortness of breath sw = weight at surgery tmi = too much information TPN = total parenteral nutrition TT = tummy tuck TTC = trying to conceive Ty = Thank you. [but according to the urban dictionary “Ty” is also an abbreviation for “a total stud with a massive carrot”.] u = You UGI = Upper Gastrointestinal VSG = Vertical Sleeve Gastrectomy Vit = vitamin wks = weeks WLS = Weight Loss Surgery WOD = Workout of the Day w/o = without wt = weight

Hello John, Did I read right? Your surgery has been delayed by 2 weeks? I'm on the home run, surgery on Tuesday,11th July. As I'm diabetic I'm the 1st patient on the day,I resent the 7am show up, but then its better this way isn't it? I won't be stressing the whole day waiting for my time I've been given. Good luck with the diet they've given you as you have another 2 week wait. Incidentally,what are you consuming on your diet ? I suffer from diabetes and hypertension's,thats why I want gastric bypass surgery, i have 6 brothers,4 of them have had heart attacks, my father died from a heart attack thats why I want the op. Its a shame I'm vegetarian, easier way to get protein if you're a meat eater. Im feeling better then I was last Saturday when I started the preop diet. Last night wasn't good as I got a hypo. My diabetic meds will definitely have to change after the op. Yes I'm set for Tuesday,ive bought my M&S cotton dressing gown ;-)''.

I have done my thinking and thought I was prepared. My appts have been done for the past 6 months which i think were definitely worth the wait. I eat and think totally different. I thought I was good before but jumping into something so quick would not have been good for anyone of us. I am preparing myself. i just have to get the endoscopy and chest xray and I will get my date. I do try my best to get protein in all the time and try to stay low card for the most part. I am down 27lbs since i started nearly 300lbs. My worst nightmare was to go over 300. I am a mom of 3 and i just turned 40. I do not want my kids to be embarrassed of me being over weight although they have never ever felt that way that i know of. they kind of brag about me to their friends for the most part. We are all pretty unhealthy in my house. I am trying to show them all what good nutrion and health look like. I have hit a plateau for the past 3 months and started exercising. still have not lost a thing. weight is still 270lbs. Body is changing a little as far as gaining strength and flexibility so i am greatful for that. I look forward to getting my sleeve dispite what my family is saying. my parents ans sibilings are against surgery for weightloss. Bad knees and diabetes run in my family. All the woman in my family for the past 3 generations are all 300lbs or more. I dont want to be like them! I watch my aunt struggle everyday with bad knees. I watch my sister take diabetes medicine. oh i also have Hypo thyroid disease so I think this may play a part in my weightloss but how does that work with Surgery???

Some patients that undergo weight loss surgery experience reactive hypoglycemia. The following are a few links to this condition. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ http://www.todaysdietitian.com/newarchives/060415p48tip.shtml https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf

I know this conversation started a few months ago but I thought I'd add my piece. I recently got diagnosed with spondyloarthritis. It's basically ankylosing spondylitis but they couldn't diagnose AS officially because my lumbar spine is fused. I started humira about 5 weeks ago and it isn't helping yet. I also have autoimmune thyroid but we aren't sure if it's hypo or hyper because my test numbers are all over the place. I could possibly lose the weight on my own because I workout like a total maniac but losing weight will help my joints and reduce my other symptoms. Plus, I'm borderline on several other diseases and my GI thinks I'm basically "pre-crohns". I also have a worsening incisional ulcer that my doctor can't fix till my BMI is below 30.

Recently I had similar issues, from eating protein bars. http://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/reactive-hypoglycemia/faq-20057778 I gave up protein bars, no issues.

Thanks for the info. I'm not sure I fit into that category because I was on clear liquids the first two times, and I have been following my liquid protein diet to a tee since coming home. It sounds like reactive hypoglycemia happens when someone eats the wrong thing and spikes their blood sugar, which then falls rapidly as well. It's definitely good information to have though, for when I'm further down the road I will keep it in mind when tempted!

Some patients experience a condition called Reactive Hypoglycemia after bariatric surgery. But generally this condition appears much later than a few days after surgery. https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf

Non SF pops are so laden with simple carbs (sugar) with no nutritional value, it would be utterly disastrous to have these. Pre-op: Your liver will not shrink. Post-op: You're setting yourself up to gain weight and have reactive hypoglycemic episodes, even if you're not diabetic. Liquid carbs go right through the body, get absorbed right away, they hit the bloodstream very quickly. This causes the pancreas to dump insulin into the bloodstream, but in all likelihood what you've had will already have passed through. It'll lower your blood sugars dramatically to a point of danger. If you're post-op, the liver is already under extreme stress trying to help supply the body with enough energy. Pre-op, you want the liver to shrink. The mechanism works the same when it comes to losing weight and liver shrinking. If you're consuming so much sugar so quickly, and it doesn't take much to overdo it, the liver takes in all the carbs, converts it to sugars for storage, then if it has too much, which happens easily, it converts to fatty acids, that infiltrate the liver itself and get sent around the body. Fat infiltration makes the liver larger and more slippery, at first. Thus, it will work against you both in pre-op and post-op stages. You won't lose weight, and you'll make your surgery more risky, possibly even causing the surgeon not to go through with it if your liver isn't shrunk.

For post WLS patients the hypoglycemia after booze would be reactive, and it can cause you to pass out. Alcohol is extremely carb-dense, and its liquid so it will be absorbed very quickly, your body will respond in kind by releasing tons of insulin into the bloodstream. The booze will past through your digestive tract extremely quickly and the insulin will lower the glucose in your bloodstream by far more than you can handle. This problem gets compounded if you haven't had much to eat or drink, as in water, not booze, in the prior few hours. At any decent concert one can be there for hours.. even worse if they're burning off energy standing, walking, moshing, etc., and not sitting, out in the heat, it only gets worse. Sometimes people need to learn the hard way that their bodies can't take much post-op.

This is common even for those who were not diabetic prior to surgery. It is called Reactive Hypoglycemia. Here is a link. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass

Had my surgery dec 16 and dropped the weight quite quick. I was 85kgs now 65kgs. With high BP and medicated with two lots of meds and hypothyroidism.. Off one lot of bp meds and halved the other bp med. hypo hasn't changed still on 200 micros a day Unfortunately I have developed reflux after the op which is ****...

Here is a list of some of the abbreviations used on this website. ACL = Anterior cruciate ligament AGB = Adjustable gastric banding AMRAP = As Many Rounds As Possible (crossfit) BB = belly button bc = because BCBS = Blue Cross/Blue Shield BED = Binge Eating Disorder bf = best friend BM = bowel movement BMI = Body Mass Index bp = blood pressure BPD = Borderline Personality Disorder or Biliary Pancreatic Diversion bs = blood sugar btw = by the way CBT = cognitive-behavioral therapy CC = common channel c diff = clostridium difficile cos or cuz = because CPAP = continuous positive airway pressure CRNP = certified registered nurse practitioners cw = current weight CXR = Chest X-Ray DDD = degenerative disc disease Dr. = doctor DS = Dumping Syndrome or Duodenal Switch EGD = Esophagogastroduodenoscopy EKG = Electrocardiography ff = fat free GERD = gastroesophageal reflux disease GI = gastrointestinal GNC = General Nutrition Corporation store GP = general practitioner or family doctor HBP = high blood pressure hr = heart rate hw = highest weight ICU = Intensive Care Unit Idk = I don’t know IMHO = in my humble (honest) opinion IMO = in my opinion IUI = Intrauterine insemination LAP Band = Laparoscopic Adjustable Gastric Band lol = laughing out loud LSG = Laparoscopic Sleeve Gastrectomy med = medicine MFP = my fitness pal msg = message NASH = Nonalcoholic steatohepatitis nf = non fat NG = Nasogastric NP = nurse practitioner NSAIDS = Non-steroidal anti-inflammatory drug NSV = non-Scale victory (“scale” means “weight scale”) NUT = nutritionist OA = Overeaters Anonymous omw = on my way Onederland = a magical place or destination for those trying to lose weight. It might correspond to attaining a weight in the hundreds or losing a hundred pounds. op = operation OSA = Obstructive Sleep Apnea Oz = Australia PB = Productive Burps PCOS = Polycystic Ovary Syndrome PCP = Primary Care Physician PICC= Peripherally Inserted Central Catheter PM = private message (email) PMS = premenstrual syndrome POSE = Primary Obesity Surgery Endolumenal postop or post–op = post-operation or post-surgery PPI = Proton Pump Inhibitors ppl = people preop or pre-op = pre-operation or pre-surgery PTSD = Post-Traumatic Stress Disorder PVC = Premature ventricular contractions RA = Rheumatoid arthritis RH = reactive hypoglycemia RN = registered nurse RNY = Roux-en-Y RTD = ready to drink RYGB = Roux-en-Y gastric bypass SADI-S = single anastomosis duodeno–ileal bypass with sleeve gastrectomy s/f or sf = sugar free SG = Sleeve gastrectomy SIPS = stomach intestinal pylorus-sparing surgery smh = shaking my head, scratching my head SO = significant other SOB = shortness of breath sw = weight at surgery tmi = too much information TPN = total parenteral nutrition TT = tummy tuck TTC = trying to conceive Ty = Thank you. [but according to the urban dictionary “Ty” is also an abbreviation for “a total stud with a massive carrot”.] u = You UGI = Upper Gastrointestinal VSG = Vertical Sleeve Gastrectomy Vit = vitamin wks = weeks WLS = Weight Loss Surgery WOD = Workout of the Day w/o = without wt = weight or :-) = = smiley face or :-( = = sad face

3 years out. I feel like I eat small to normal size meals now. I still take a long time to eat a meal and usually just take leftovers home and eat in "chapters" as my other WLS friends say. The amount of restriction varies, sometimes I can only get down a few bites and sometimes I can eat almost a full meal. I've only had actual dumping once or twice. If I eat a few bites too much or something too carb heavy I will feel a little bit sick for maybe half an hour. It's nothing serious, but it's enough to make me think twice about taking that last bite of something. My biggest challenge is protein intake and blood sugar management. I don't eat meat much anymore, so I try to eat a lot of legumes. I have some instances of hypoglycemia and I have more frequent occurrences of reactive hypoglycemia after I eat. My body still makes too much insulin and drops my blood sugar. I keep a lot of juice boxes and small snacks around.

Does having no thyroid at all = hypo? I've wondered about that. I'm losing pretty well so far on pre-op diet. 9lbs in 10 days. But thats on all liquids except a lean dinner. 9lbs is a big deal since it would normally take a year to lose 5 just to gain back 15. The struggle is real with no metabolism. I gained 70 my first year after having it removed. I'd give anything if modern medicine would figure out how to do a transplant.

I was hypo and I never wanted to take Synthroid, I didn't want to put my thyroid to sleep. Now I'm 10 weeks pOP and I'm thyroid healthy, don't be fooled by taking synthroid, especially when you're overweight and that's causing it. Went from 5.9 to 3.9.

I'm hypo as well and take 200 micros of thyroxine a day. Reduce on weekends now though due to my weight loss after vsg. I had no issues losing and was nearly at goal weight around 2-2.5 months after my op. Being a low BMIer. But have been stuck for ages at my current weight. Sleeved 5/ dec 16. Thyroid getting tested again this week

Keep your head up and stay positive. I experienced a couple of setbacks too. I started my quest for wls in March of last year. I was recovering from sudden cardiac arrest that I suffered in October 2015. I had an emergency tracheostomy while in ICU which I had several setbacks to have removed months after being discharged from the hospital. I had to have surgery to remove scar tissue around my vocal cords. Also had a DVT which left me on blood thinners temporarily. By June, I had all my requirements completed to have weight loss surgery and was waiting for medical clearance. My second setback occurred my employer switched insurance companies from Blue Cross Blue Shield to Aetna. Aetna's requirements were different from Blue Cross Blue Shield and I had to start the whole process all over again and this time I had to do the documented weigh-ins which with Blue Cross Blue Shield I did not have to do. My third setback occurred this past October. I completed everything that was required of me by Aetna. By that time I had medical clearance and had my surgery date set for early November. I then received the worst news of all, I was told the policy that my employer provided did not cover bariatric surgery even after I was told that they did when they first changed to Aetna. As you can imagine I was really upset even after Aetna covered the visits I had with the dietitian and surgeon. I also lost money with those visits as I had to pay a $50 copay for three visits with the dietitian and my surgeon. While I was very frustrated, I stayed focused and determine to have my surgery. I dropped in during open enrollment switch back to Blue Cross Blue Shield. I had to wait until January for of the new policy to go in effect. This time I made sure that the policy I had chosen covered bariatric surgery. Luckily for me all the lab work that I had done and October was good for 6 months. My chart with my surgeon was reactivated and I just had minor documentation that needed to be submitted to Blue Cross Blue Shield and I was approved surgery. After 13 months of starting my weight-loss Journey, I had gastric bypass surgery on April 11th and I'm out a week out from surgery. So I'm here to tell you to keep your head up because sometimes obstacles do get in your way but you have to stay focused in order to reach your goal.

gpmed wrote This is interesting. I'm not currently having any trouble, but this sparked a question. I'm 19 months out from RNY and I've had to deal with reactive hypoglycemia. I find it helps me to eat smaller amounts throughout the day instead of three meals and no Snacks. So what's the difference between this and grazing? Or how does one do this without falling into the pitfalls grazing presents? Grazing is more akin to snacking. Consuming 5 smaller meals a day is not grazing.