Dumping? (TMI sorry) I gotta know

[SoccerMomma73 1,867]

_{Thanks for the reply. Actually from my pre-op appt with surgeon on Thursday he only brought up my diabetes' date=' don't think he is actually too concerned about weight as I even continued to lose from having my band removed in May which all three of my doctors and Nut complimented me on. So I guess will discuss with the doctor either while I'm in the hospital next week, or when I have my post-op follow up the following week to see what I need to eat if I crash. I already have dumping episodes including just being on the liquid diet this past week, just don't crash. Again thanks.[/sub']}

_{I'll just tell you that I'm not diabetic and the first time I dumped I thought I was going to die....I don't have a glucometer so couldn't check my sugar but I was so weak and shaky I fell down on the kitchen floor and couldn't stand up for about 15 minutes....I knew what was happening but hadn't expected the severity of it and it freaked me the hell out (I'm a family practice physician assistant, I've been work in medicine in one capacity or another for 22 years....it takes a lot to scare me ). I can't imagine what would have happened if I was diabetic....as I said above, form an action plan with your doc. Don't accept 'drink orange juice', you need to know how much and what else to do so you don't just rebound and repeat the exact same situation....it is very scary when it's happening, you don't want to grab a tub of icing and just start going at it!!! Again, hopefully it will ever be an issue but be a Boy Scout and be prepared!!!!}

_{HW 312, pre-op (RNY) 255, current weight 199}

[DLCoggin 1,788]

I'll just tell you that I'm not diabetic and the first time I dumped I thought I was going to die....I don't have a glucometer so couldn't check my sugar but I was so weak and shaky I fell down on the kitchen floor and couldn't stand up for about 15 minutes....I knew what was happening but hadn't expected the severity of it and it freaked me the hell out (I'm a family practice physician assistant, I've been work in medicine in one capacity or another for 22 years....it takes a lot to scare me ). I can't imagine what would have happened if I was diabetic....as I said above, form an action plan with your doc. Don't accept 'drink orange juice', you need to know how much and what else to do so you don't just rebound and repeat the exact same situation....it is very scary when it's happening, you don't want to grab a tub of icing and just start going at it!!! Again, hopefully it will ever be an issue but be a Boy Scout and be prepared!!!!

HW 312, pre-op (RNY) 255, current weight 199

I'll second that - scared the hell out of me too and I knew what was happening as well.

[oldoneyoungagain 200]

Believe you me, I know what you both are talking about. My blood sugars are well controlled, but it doesn't mean we (diabetics) don't drop at times. And when I pulled my stupid mistake that totally freaked me out the minute I knew what I had done as there wasn't time to even start consuming sugar I had to get to the hospital immediately. I am quite certain within a couple or three weeks, my diabetes will become history and the surgeon is almost positive. But I'm still consulting with the doctor and will also post what I find out what to do if you dump and go hypoglycemia, even like you said soccermomma73 you have been in the medical field for 22 years and it scared the heck out of you. But for people who don't have diabetes, as you, need to know what they need to do if this occurs to them. Something like this probably has never happened to them so they haven't been educated, nor can they wait on the physician's office to call them back, so think people need to know how to bring up those numbers up because hypoglycemia can be more dangerous then being a diabetic. At least a diabetic knows what to expect and so does a hypoglycemic person, but a person who never experienced either/or, I feel needs help. In reading the websites DL put out there for us, I'll probably just eat six times daily, which is really what a diabetic should do anyway and in my case I already know "white process carbs" are an issue with me. I have convinced myself I am allergic to them . So you may be right I won't have this issue of dumping, but definitely will be safe rather than sorry. Thanks guys.

[DLCoggin 1,788]

Believe you me, I know what you both are talking about. My blood sugars are well controlled, but it doesn't mean we (diabetics) don't drop at times. And when I pulled my stupid mistake that totally freaked me out the minute I knew what I had done as there wasn't time to even start consuming sugar I had to get to the hospital immediately. I am quite certain within a couple or three weeks, my diabetes will become history and the surgeon is almost positive. But I'm still consulting with the doctor and will also post what I find out what to do if you dump and go hypoglycemia, even like you said soccermomma73 you have been in the medical field for 22 years and it scared the heck out of you. But for people who don't have diabetes, as you, need to know what they need to do if this occurs to them. Something like this probably has never happened to them so they haven't been educated, nor can they wait on the physician's office to call them back, so think people need to know how to bring up those numbers up because hypoglycemia can be more dangerous then being a diabetic. At least a diabetic knows what to expect and so does a hypoglycemic person, but a person who never experienced either/or, I feel needs help. In reading the websites DL put out there for us, I'll probably just eat six times daily, which is really what a diabetic should do anyway and in my case I already know "white process carbs" are an issue with me. I have convinced myself I am allergic to them . So you may be right I won't have this issue of dumping, but definitely will be safe rather than sorry. Thanks guys.

You are certainly most welcome! Love the candor in your posts and looking forward to following your journey to a healthier, happier you. You're gonna love the new you!!

[oldoneyoungagain 200]

Okie dokey, I said I would share what we should eat when we have a hypoglycemic moment. Talked w/PCP and asked that question. Answer: Complex carbs i.e. whole wheat bread, natural Peanut Butter (no sugar added or oil) anything complex to get the blood sugars back up. For those that never had diabetes this can scare you, the drop in blood sugars, as it is one of the symptoms of dumping, for those of us who have/had diabetes we would probably know the these feelings when blood sugars take a nose dive.

[DLCoggin 1,788]

Okie dokey, I said I would share what we should eat when we have a hypoglycemic moment. Talked w/PCP and asked that question. Answer: Complex carbs i.e. whole wheat bread, natural Peanut Butter (no sugar added or oil) anything complex to get the blood sugars back up. For those that never had diabetes this can scare you, the drop in blood sugars, as it is one of the symptoms of dumping, for those of us who have/had diabetes we would probably know the these feelings when blood sugars take a nose dive.

A deal is a deal! You did your part. Now for mine. I have had reactive hypoglycemia about five times over almost two years. On two or three of those occasions I ate an orange (and a small square of year old chocolate that my wife found somewhere the first time I had it). Symptoms have always disappeared completely in 20-30 minutes. In the case of the most recent problem, we were out of fruit and the closest thing at hand was a Protein bar with 17g of carbs, 2g of sugar and 4g of sugar alcohol. It also did the trick and symptoms were gone in 20-30 minutes.

But now your PCP has me wondering. Fruit is considered a "simple" carb as opposed to a "complex" carb. I have read that including complex carbs in five to six meals a day will help to avoid hypoglycemia. The idea being that complex carbs take longer to digest and help keep blood sugars at a desirable level over a longer period of time. In other words, complex carbs will help you avoid hypoglycemia in the first place. Makes perfect sense.

But it raises the question if doctors make the same complex carb recommendation if you are already hypoglycemic? It's too late to avoid it. The question is how to resolve it? And I would add resolve it as quickly as possible (it's definitely not pleasant)! My understanding is that simple carbs are digested more quickly, which raises blood sugar levels more quickly, which in turn should resolve the hypoglycemia - more quickly.

Now to be my own devil's advocate - I have often wondered if eating too much simple carbs while hypoglycemic has the risk of creating a yo-yo effect. In other words if you ate two or three oranges, hypoglycemia would be temporarily resolved, but blood sugars could spike again, and then crash AGAIN in response to the increased insulin prompted by the spike. So you're right back to being hypoglycemic. I have never experienced this scenario but on the surface of it, the logic would seem sound.

Hopefully someone a lot smarter than me will weigh in on this!

[Rabear 15]

A deal is a deal! You did your part. Now for mine. I have had reactive hypoglycemia about five times over almost two years. On two or three of those occasions I ate an orange (and a small square of year old chocolate that my wife found somewhere the first time I had it). Symptoms have always disappeared completely in 20-30 minutes. In the case of the most recent problem' date=' we were out of fruit and the closest thing at hand was a Protein bar with 17g of carbs, 2g of sugar and 4g of sugar alcohol. It also did the trick and symptoms were gone in 20-30 minutes.

But now your PCP has me wondering. Fruit is considered a "simple" carb as opposed to a "complex" carb. I have read that including complex carbs in five to six meals a day will help to avoid hypoglycemia. The idea being that complex carbs take longer to digest and help keep blood sugars at a desirable level over a longer period of time. In other words, complex carbs will help you avoid hypoglycemia in the first place. Makes perfect sense.

But it raises the question if doctors make the same complex carb recommendation if you are already hypoglycemic? It's too late to avoid it. The question is how to resolve it? And I would add resolve it as quickly as possible (it's definitely not pleasant)! My understanding is that simple carbs are digested more quickly, which raises blood sugar levels more quickly, which in turn should resolve the hypoglycemia - more quickly.

Now to be my own devil's advocate - I have often wondered if eating too much simple carbs while hypoglycemic has the risk of creating a yo-yo effect. In other words if you ate two or three oranges, hypoglycemia would be temporarily resolved, but blood sugars could spike again, and then crash AGAIN in response to the increased insulin prompted by the spike. So you're right back to being hypoglycemic. I have never experienced this scenario but on the surface of it, the logic would seem sound.

Hopefully someone a lot smarter than me will weigh in on this![/quote']

I knw for me I can't have the sugar alcohol

[SoccerMomma73 1,867]

A deal is a deal! You did your part. Now for mine. I have had reactive hypoglycemia about five times over almost two years. On two or three of those occasions I ate an orange (and a small square of year old chocolate that my wife found somewhere the first time I had it). Symptoms have always disappeared completely in 20-30 minutes. In the case of the most recent problem' date=' we were out of fruit and the closest thing at hand was a Protein bar with 17g of carbs, 2g of sugar and 4g of sugar alcohol. It also did the trick and symptoms were gone in 20-30 minutes.

But now your PCP has me wondering. Fruit is considered a "simple" carb as opposed to a "complex" carb. I have read that including complex carbs in five to six meals a day will help to avoid hypoglycemia. The idea being that complex carbs take longer to digest and help keep blood sugars at a desirable level over a longer period of time. In other words, complex carbs will help you avoid hypoglycemia in the first place. Makes perfect sense.

But it raises the question if doctors make the same complex carb recommendation if you are already hypoglycemic? It's too late to avoid it. The question is how to resolve it? And I would add resolve it as quickly as possible (it's definitely not pleasant)! My understanding is that simple carbs are digested more quickly, which raises blood sugar levels more quickly, which in turn should resolve the hypoglycemia - more quickly.

Now to be my own devil's advocate - I have often wondered if eating too much simple carbs while hypoglycemic has the risk of creating a yo-yo effect. In other words if you ate two or three oranges, hypoglycemia would be temporarily resolved, but blood sugars could spike again, and then crash AGAIN in response to the increased insulin prompted by the spike. So you're right back to being hypoglycemic. I have never experienced this scenario but on the surface of it, the logic would seem sound.

Hopefully someone a lot smarter than me will weigh in on this![/quote']

Okay so I'm glad I'm not the only nut over analyzing this.....peanut butter and whole grain bread is awesome! Complex carbs, some protein....if I eat something and I'm afraid i'll dump, Peanut Butter toast is my antidote BEFORE I dump... (Works magically for this purpose). In an urgent state I would have expected 1/4-1/2 cup of orange or apple juice, followed by the Peanut Butter toast. Because the orange juice is going to get you up quicker and then the peanut butter toast will help stabilize your levels. FYI this is essentially what I teach my diabetic patients as well.

I actually referred to the yo yo effect in an earlier post, I'm not volunteering but I'm sure if you crashed, guzzled OJ but nothing else, you'd crash again, rinse, lather repeat.

I got myself with grapes this morning, second time I've dumped off grapes (best grapes ever!!!! So sweet and crunchy) but it'd been 3 hours since Breakfast, no Protein on board and boom, they got me, not a bad dump but enough to let ya know you screwed up. My solution was more grapes and a cheese stick

HW 312, pre-op (RNY) 255, current weight 199

[vicki s 146]

So, I have had reactive hypoglycemic since I was a teenager..absent of diabeties...so when we are talking about "late dumping", is that what we are talking about, and if so, why do they call it dumping?

[oldoneyoungagain 200]

Now to be my own devil's advocate - I have often wondered if eating too much simple carbs while hypoglycemic has the risk of creating a yo-yo effect. In other words if you ate two or three oranges, hypoglycemia would be temporarily resolved, but blood sugars could spike again, and then crash AGAIN in response to the increased insulin prompted by the spike. So you're right back to being hypoglycemic. I have never experienced this scenario but on the surface of it, the logic would seem sound.

Hopefully someone a lot smarter than me will weigh in on this!

Everything you have said is right on tract and the above is right on track. Whether you are hypoglycemic or diabetic when you crash, first course of action is glucose tablets, tube of frosting, M&M's, hershey Syrup, simple sugars and fast, even a sugar laden bottle of pop. Once we get to a safe level preferably over 80 more like 100 BS then follow with a Protein to keep it stable. My go to is always Peanut Butter as the stablizer it is easily digested.

With the above being the case, of course my concern was, if after having bypass (and forget anyone having diabetes) you have an episode of hypoglycemia we can't turn to those sugars, I didn't think because we would yo-yo push up the blood sugars and 30 minutes after we get them up down we go again. Might be able to follow with some sort of Protein if fast enough. But think you have the right idea, fresh fruit a totally different type of sugar then followed by protein. My PCP even recommended diluted orange juice. From the description of this dumping episode, those of us that have experienced low blood sugars with our diabetes should be able to feel the signs coming on. It definitely something you won't forget once it happens.

Thanks for replying. You at least gave me some ideas, might be a trial an error on my part, but I'm just not going to push the issue. Protein, protein and protein, veggies, veggies, veggies, and then complex carbs if there is room left. This is easier said than done.

[oldoneyoungagain 200]

Okay so I'm glad I'm not the only nut over analyzing this.....peanut butter and whole grain bread is awesome! Complex carbs, some Protein....if I eat something and I'm afraid i'll dump, Peanut Butter toast is my antidote BEFORE I dump... (Works magically for this purpose). In an urgent state I would have expected 1/4-1/2 cup of orange or apple juice, followed by the Peanut Butter toast. Because the orange juice is going to get you up quicker and then the peanut butter toast will help stabilize your levels. FYI this is essentially what I teach my diabetic patients as well.

I actually referred to the yo yo effect in an earlier post, I'm not volunteering but I'm sure if you crashed, guzzled OJ but nothing else, you'd crash again, rinse, lather repeat.

I got myself with grapes this morning, second time I've dumped off grapes (best grapes ever!!!! So sweet and crunchy) but it'd been 3 hours since Breakfast, no Protein on board and boom, they got me, not a bad dump but enough to let ya know you screwed up. My solution was more grapes and a cheese stick

HW 312, pre-op (RNY) 255, current weight 199

Think the moral of the story is if you eat simple carbs follow with a complex carbs, because you are right on. I usually am required to see a Nut to address my diabetes every couple of years. Down side of this you don't want to be driving when it happens.

[Pam Peltz 56]

I have diabetes and am on insulin pump. Since surgery (RNY) I've only had a couple of lows. I usually drink a few ounces of milk and after 15 minutes follow with a Protein low carb snack. Once it was really low and I took 1/2 a glucose tablet. They have 4g of carbs so way under the 12-15g that triggers dumping. My a1c has gone from 8.6 to 6.7 as of a week ago. Also (DL) my c-peptides has gone from 0 to 1.5!!! My pancreas is STARTING TO WORK!!!

[oldoneyoungagain 200]

I have diabetes and am on insulin pump. Since surgery (RNY) I've only had a couple of lows. I usually drink a few ounces of milk and after 15 minutes follow with a Protein low carb snack. Once it was really low and I took 1/2 a glucose tablet. They have 4g of carbs so way under the 12-15g that triggers dumping. My a1c has gone from 8.6 to 6.7 as of a week ago. Also (DL) my c-peptides has gone from 0 to 1.5!!! My pancreas is STARTING TO WORK!!!

I have a omnipod pump so really like what you are saying. Milk might be an issue though, probably would stick with either coconut or almond, no lactose. I have already lowered my basal dose because of the liquid diet as my mornings were getting low when they use to be high. My highest a1c was, before the band was out at 7.9, then I dropped it to 7.1. 7.9 has been my highest in years. Want to thank you for the info about the amount of carbs that tigger the dumping. This way I can really watch how much I stick in my mouth.

[DLCoggin 1,788]

Okay so I'm glad I'm not the only nut over analyzing this.....peanut butter and whole grain bread is awesome! Complex carbs, some Protein....if I eat something and I'm afraid i'll dump, Peanut Butter toast is my antidote BEFORE I dump... (Works magically for this purpose). In an urgent state I would have expected 1/4-1/2 cup of orange or apple juice, followed by the Peanut Butter toast. Because the orange juice is going to get you up quicker and then the peanut butter toast will help stabilize your levels. FYI this is essentially what I teach my diabetic patients as well.

I actually referred to the yo yo effect in an earlier post, I'm not volunteering but I'm sure if you crashed, guzzled OJ but nothing else, you'd crash again, rinse, lather repeat.

I got myself with grapes this morning, second time I've dumped off grapes (best grapes ever!!!! So sweet and crunchy) but it'd been 3 hours since breakfast, no Protein on board and boom, they got me, not a bad dump but enough to let ya know you screwed up. My solution was more grapes and a cheese stick

HW 312, pre-op (RNY) 255, current weight 199

Now that makes a lot of sense. OJ or AJ to get the sugar up, peanut butter toast to level it out. And even better yet, eat the toast before you dump. I was hoping you'd respond to my post!

I've dumped on grapes twice. "Wow those are good" and a couple of hours later bam.

Thanks so much SoccerMomma!

[DLCoggin 1,788]

So, I have had reactive hypoglycemic since I was a teenager..absent of diabeties...so when we are talking about "late dumping", is that what we are talking about, and if so, why do they call it dumping?

So called "early" or "early phase" dumping usually occurs 15-30 minutes after eating. "Late" dumping usually occurs 2-3 hours after eating (but one member on the board experienced it 12 hours after eating and her doctor said it was likely dumping). Early dumping is more often associated with vomiting, nausea, etc. Late dumping (reactive hypoglycemia) with weakness, shakiness and rapid heart rate. About two thirds of folks who experiencing dumping experience early dumping. The remaining one third late dumping.

Dumping simply refers to partially digested food moving too quickly (dumping) from the stomach or pouch into the small intestine. My understanding is that it is usually associated with some type of abdominal surgery (not only RNY).