Guest guest Posted February 14, 2001 Report Share Posted February 14, 2001 Hi Suzanne! I believe Hussman has a Q & A about hypoglycemia and BFL, so check out his Q & A page for that. Energetically, --- FMBC: Fitness and the Mind-Body Connection an unofficial Transformation Support site and " on ramp " for Body-for-LIFE by and Cherita Axel http://fitmind.home.mindspring.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2001 Report Share Posted February 14, 2001 Thanks , I did look and didn't see anything. Maybe I didn't look hard enough? Suzanne Axel wrote: > > Hi Suzanne! > > I believe Hussman has a Q & A about hypoglycemia and BFL, so > check out his Q & A page for that. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2001 Report Share Posted February 14, 2001 Thanks Debbie! I still don't know much about it, I need to do some researching. Oh, I just loooove bread and potatoes. Waaaa! :-) Mostly I am wondering about the tweaks in the program. Like is it still beneficial for me to exercise on an empty stomach? I do okay if I make it to the gym at 6 a.m. and then eat my first meal at 8, but most days I can't get there until AFTER I have taken my son to school. (My baby wakes up at 12, 2, 4, and 6, which makes me so tired in the morning it's very difficult for me to get up earlier than I already do.) Then I can't start my workout until 9:30 a.m. and then I'm looking at practically noon for my first meal. I was doing that but worried that my muscles were being ravaged. Then I found out about the hypoglycemia and am even more concerned about it. Also, what should my last meal be? No carbs at all? I'm afraid if I do that I won't be able to shake off that hungry feeling. Suzanne Debbie Holland wrote: > > Suzanne, > I also have hypoglycemia. I was diagnosed years ago. The nutrition > plan the doctor gave me was almost exactly like BFL. You know - eat 5-6 > small meals, low sugar carbs, lots of water. A Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 14, 2001 Report Share Posted February 14, 2001 Thanks Debbie! I still don't know much about it, I need to do some researching. Oh, I just loooove bread and potatoes. Waaaa! :-) Mostly I am wondering about the tweaks in the program. Like is it still beneficial for me to exercise on an empty stomach? I do okay if I make it to the gym at 6 a.m. and then eat my first meal at 8, but most days I can't get there until AFTER I have taken my son to school. (My baby wakes up at 12, 2, 4, and 6, which makes me so tired in the morning it's very difficult for me to get up earlier than I already do.) Then I can't start my workout until 9:30 a.m. and then I'm looking at practically noon for my first meal. I was doing that but worried that my muscles were being ravaged. Then I found out about the hypoglycemia and am even more concerned about it. Also, what should my last meal be? No carbs at all? I'm afraid if I do that I won't be able to shake off that hungry feeling. Suzanne Debbie Holland wrote: > > Suzanne, > I also have hypoglycemia. I was diagnosed years ago. The nutrition > plan the doctor gave me was almost exactly like BFL. You know - eat 5-6 > small meals, low sugar carbs, lots of water. A Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 15, 2001 Report Share Posted February 15, 2001 Thank you Debbie! I too have found that the protein/carb meal right before bed really helps me sleep and even feel better in the morning. Last night I tried the cottage cheese/granny smith apple right before bed and it was great! I have no problem exercising if I do it at 6 a.m. And I never feel like eating until an hour after my workouts. It's just the later morning workouts that are hard. I have started having a shake at 7:45-8 (have to let my thyroid medicine absorb on an empty stomach and can't stand to eat any earlier than that) and getting to the gym at about 9:30 or 10. It is working out fine for me. I figure my breastfeeding will help me with my fat burning too, so if I'm not 3 hours from my last meal when I start my workout I'm okay with it. I'm glad your advise is to skip the carb elimination in the last meals. I just can't do it! I need those carbs. :-) Now, to find the Labrada for her bars... I did find some regular ones. The salesman told me the blueberry cheesecake was the best selling thing in the store. I can't wait to try it! Suzanne P.S. If you have been doing BFL for 1 1/2 years, let's see your pictures!!! Debbie Holland wrote: > > Suzanne, > I was concerned when I first started the program (I've been doing BFL > for 1-1/2 years) that I would be too weak from not eating in the morning to > get through the cardio. It is REALLY not a problem. I've never been > bothered by it. As a matter of fact, the shake I drink before going to bed > actually helps to regulate my sugar and sort of evens things out for me so I > sleep great!. I get through my cardio at 5:00 a.m. just fine, and eat > around 7:00 a.m. > > On Saturday mornings I sleep in and usually get up around 9:00 a.m. to do my > cardio, that means no food until about 10:30 a.m. and try to cram in 5 more > meals. It's tough. That's why I use the Labrada bars (lots of protein and > 300 calories). I usually only get in 5 meals on Saturday. > > Eating 5-6 times a day will really even you out and you won't get into that > roller coaster feeling of highs and lows, or the shakes - needing food. Try > to get the early start when you can, if not, have a small meal around 7:00 > a.m. if you don't get to the gym until 9:30 a.m. If you ever feel like > you're a little weak before going to the gym have a small meal and wait > about an hour or so, and then hit the weights. Rarely have I felt weak and > shakey prior to weight training. But if I do, the feeling goes away after > you get started. > > Make your last meal a meal replacement shake (Myoplex Lite) or a protein > drink and a low sugar carb, or something like cottage cheese and peaches or > pineapple. If this is your first challenge, I would not skip carbs with any > meal. Save that tweak if you need it later on when you hit a plateau. Work > at the program like it says in the book and you'll do great.` Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2001 Report Share Posted December 16, 2001 I am Hypoglycemic Anne... Have had it for almost 20 years... Sugar things are for quick fixes only... But they sure do taste good once in a while... Usually something Real Sweet, makes me nauseous ( meat, potatoes, veggies is my diet ) Fruits when I can tolerate them... Signs and symptoms of Hypoglycemia may include: Weakness Trembling Dizziness Rapid heartbeat Cold perspiration Pale or ashen appearance to skin Nervousness Hunger Blurred vision Tingling sensation in hands and feet Headache Difficulty walking, lack of coordination Confusion, irritability, impatience In extreme cases, signs and symptoms may include unconsciousness and convulsions, and, rarely, stroke. If you watch the ads, you can sometimes get a blood glucose meter free... You have to pay for it in the beginning, but you get the rebates back where it costs you nothing, or minimal... The sticks are expensive though ( About a dollar a piece... You keep watching that sugar !!! A Proper diet is the way to go, when ya can remember it, ( talking about my self here ) Keep me posted !!! {{{ Sugar Free Hugs }}} Helen When out yesterday after a delicious out of ordinary brekkie of a donut, very sugary and sweet, I felt fine and left the house, 2 hours later, I am getting into my car when dizziness and the staggers hit, I drove straight home,by then I had started a flushed feeling, weak legs, shakiness, irregular heart beats, now I have had this problem in the past like 30 years back, but it showed its ugly head again. I ate a high protein lunch, some orange juice and all was well within 20 minutes (and I blame the doughnut I honestly do, also I had felt lazy the night before and just had a light supper, bad move), it came back last night just before dinner,that time I caught it in time, a steak and potatoes caught it( high protein in the steak)and knocked it out. Today I have been damned careful and eating a balanced diet. I am wondering if anyone has got the same problem. The doctor said no sweet stuff at all except for a quick fix, a proper diet is the key to preventing these attacks, it is not diabetes, but the insulin level still drops fast or something does Anne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2001 Report Share Posted December 16, 2001 Thanks Helen, it is ugly isn't it, I only got 1/2 of the symptoms so I was lucky! Anne Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 3, 2003 Report Share Posted September 3, 2003 This is interesting. I see wt regain and hypoglycemia (both) in patients who consume mostly 'easy-to-tolerate' carbs. I feel like our patients are extremely sensitive to carbohydrates and their blood sugars become very erradic with a primarily carbohydrate diet. I would first refocus the diet around proteins - with carbs from fruit and veggies only. This usually does the trick - if the patient is compliant. But the nausea is something I am not very familiar with. Is the patient drinking a lot or too little fluid? Drinking and eating at the same time? Is the patient going through personal stress (ie divorce,etc)? Does the patient chew thoroughly, eat slowly - esp with the proteins? Sorry I am not much help - I would investigate the patients eating technique - encourage her to slow down and chew more - and then push the proteins! Hypoglycemia I have a pt who is s/p Gastric Bypass from 4/2001. This pt is new to our practice. Pt c/o documented hypoglycemia via accu check, BS in the 40's and only responsive to concentrated sweets. Pt reports traditional diet therapy for hypoglycemia ie avoid concentrated sweets, protein with frequent meals etc has not helped prevent low BS. Endo w/u negative for cause of hypoglycemia, neg. for insulinoma. GI w/u to date has been negative. Pt Also c/o persistent nausea requiring phenergan also takes reglan. Pt reports most protein foods cause nausea and esophageal spasms. Tolerates yogurt, cottage cheese, peanut butter and shredded cheese. Pt has regained about 100# which is wt she previously lost after surgery. Not taking any vit/min supplements due to secondary nausea. Primary intake is carbohydrates including refined sugars. I would like to find out if anyone has had a pt with hypoglycemia after gastric bypass, unresponsive to typical guidelines and problems with persistent nausea and esophageal spasms as long 2 yrs. post-op and if so any advice would be greatly appreciated. Pt has come to our practice seeking a revision. Thank You Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 3, 2003 Report Share Posted September 3, 2003 With her GI workup did they check for staple line breakdown? If she is having issues with reflux sounds as if staple line disruption may have occured. With hypoglycemia want to avoid simple sugars due to rebound hypoglycemia reoccuring. Is the hypoglycemia possibly a sign of dumping syndrome? Is she chewing her protein adequetly - if soft protein do ok she may not be chewing adequatly and getting a chunk of solid protein in her pouch which can be very uncomfortable and cause nausea till the body breaks it down. Is she drinking with meals? This can also cause overdistention of pouch causing nausea. Just my thoughts on the subject "The information in this electronic message may be privileged and confidential and is intended for the use of the individual(s) or entity(ies) named above. If you are not the intended recipient, you are on notice that any unauthorized disclosure, copying, distribution, or taking of any action in reliance on the contents of these electronically transmitted materials is prohibited." -----Original Message-----From: Ellen Sabatella [mailto:maryellen.sabatella@...]Sent: Wednesday, September 03, 2003 11:31 AM Subject: Hypoglycemia I have a pt who is s/p Gastric Bypass from 4/2001. This pt is new to our practice. Pt c/o documented hypoglycemia via accu check, BS in the 40's and only responsive to concentrated sweets. Pt reports traditional diet therapy for hypoglycemia ie avoid concentrated sweets, protein with frequent meals etc has not helped prevent low BS. Endo w/u negative for cause of hypoglycemia, neg. for insulinoma. GI w/u to date has been negative. Pt Also c/o persistent nausea requiring phenergan also takes reglan. Pt reports most protein foods cause nausea and esophageal spasms. Tolerates yogurt, cottage cheese, peanut butter and shredded cheese. Pt has regained about 100# which is wt she previously lost after surgery. Not taking any vit/min supplements due to secondary nausea. Primary intake is carbohydrates including refined sugars. I would like to find out if anyone has had a pt with hypoglycemia after gastric bypass, unresponsive to typical guidelines and problems with persistent nausea and esophageal spasms as long 2 yrs. post-op and if so any advice would be greatly appreciated. Pt has come to our practice seeking a revision. Thank You Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 4, 2003 Report Share Posted September 4, 2003 Most of the nauseousness I see is with patients who eat too fast, eat too large of a quantity, and drink fluids too soon prior to meals (less than 30 minutes) and/or with their meals. Is she taking her vitamins with meals rather than between? Did she try a small amount of carbohydrate with the small frequent meals? Just a few thoughts. SR , MS, RD " Buckley, Sheila " <sheila.buckley@rw " ' ' " juh.edu> < > cc: 09/03/2003 02:46 Subject: RE: Hypoglycemia PM Please respond to BariatricNutrition Dietitians This is interesting. I see wt regain and hypoglycemia (both) in patients who consume mostly 'easy-to-tolerate' carbs. I feel like our patients are extremely sensitive to carbohydrates and their blood sugars become very erradic with a primarily carbohydrate diet. I would first refocus the diet around proteins - with carbs from fruit and veggies only. This usually does the trick - if the patient is compliant. But the nausea is something I am not very familiar with. Is the patient drinking a lot or too little fluid? Drinking and eating at the same time? Is the patient going through personal stress (ie divorce,etc)? Does the patient chew thoroughly, eat slowly - esp with the proteins? Sorry I am not much help - I would investigate the patients eating technique - encourage her to slow down and chew more - and then push the proteins! Hypoglycemia I have a pt who is s/p Gastric Bypass from 4/2001. This pt is new to our practice. Pt c/o documented hypoglycemia via accu check, BS in the 40's and only responsive to concentrated sweets. Pt reports traditional diet therapy for hypoglycemia ie avoid concentrated sweets, protein with frequent meals etc has not helped prevent low BS. Endo w/u negative for cause of hypoglycemia, neg. for insulinoma. GI w/u to date has been negative. Pt Also c/o persistent nausea requiring phenergan also takes reglan. Pt reports most protein foods cause nausea and esophageal spasms. Tolerates yogurt, cottage cheese, peanut butter and shredded cheese. Pt has regained about 100# which is wt she previously lost after surgery. Not taking any vit/min supplements due to secondary nausea. Primary intake is carbohydrates including refined sugars. I would like to find out if anyone has had a pt with hypoglycemia after gastric bypass, unresponsive to typical guidelines and problems with persistent nausea and esophageal spasms as long 2 yrs. post-op and if so any advice would be greatly appreciated. Pt has come to our practice seeking a revision. Thank You Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2004 Report Share Posted August 5, 2004 Personally I would never GIVE AWAY medical nutrition therapy. We are poorly paid enough as dietitians already! One suggestion is to have the patient visit their local public library, learn how to use the internet, and do their own Google search for " hypoglycemia. " Or " gastric bypass, " I have learned a lot about what many of the bariatric centers around the country recommend for diet just by doing a simple search and reading all the sites that come up. Of course, you will get some junk mixed in with the good information, which is one reason why the patient should still be seeing a R.D. anyway. Ideally, you would want to see this type of patient in the doctor's office and have them to do the billing under whatever system the doctor is using--I am sure the endo doctor is not seeing this patient for free, right? Others who are in private practice will know how all that works these days. Hilleary, MPH, RD San Diego VA Healthcare System ________________________________________________________________________ Date: Thu, 05 Aug 2004 03:58:32 -0000 From: " Beverly " <bevlyann@...> Subject: hypoglycemia I had a call from a local endo today about a pt who came to him 2-3 yrs post GB complaining of hypoglycemia. He said she doesn't have any insurance or money and wanted to know if I had anything written that I could give him to give to her. This doc refers to me all the time so I want to help but I don't have anything like that. Does anyone here have anything they can share? Thx, Bev Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2004 Report Share Posted August 5, 2004 Bev, I did my research project for my master's degree on reactive hypoglycemia after gastric bypass surgery. I developed a 2 page basic pt education handout relating to this topic. It is attached. We have had several pts referred to us for this problem, especially if the pt is fairly close to their postop goal wt and lost a great deal of weight. The symptoms seem to occur 2-4 hours after eating. We've found pts that check their blood sugars at home to have them below 40 at times. Small frequent meals, avoidance of simple sugars, including protein with every meal, and avoiding carbohydrate by itself seem to help. There is literature supporting this in pts following gastric resection for CA and also in pts following low calorie diets, but not specifically in bariatric pts. With the rapid improvement in insulin sensitivity as well as decreased counterregulatory hormone activity after gastric bypass, it's not surprising that pts are experiencing hypoglycemia. I hope you find the handout helpful. Sylvester, RD, LDN The Reading Hospital and Medical Center sylvesterh@... hypoglycemia I had a call from a local endo today about a pt who came to him 2-3 yrs post GB complaining of hypoglycemia. He said she doesn't have any insurance or money and wanted to know if I had anything written that I could give him to give to her. This doc refers to me all the time so I want to help but I don't have anything like that. Does anyone here have anything they can share? Thx, Bev Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2004 Report Share Posted August 5, 2004 Thank you so very much. RE: hypoglycemia Bev,I did my research project for my master's degree on reactive hypoglycemia after gastric bypass surgery. I developed a 2 page basic pt education handout relating to this topic. It is attached. We have had several pts referred to us for this problem, especially if the pt is fairly close to their postop goal wt and lost a great deal of weight. The symptoms seem to occur 2-4 hours after eating. We've found pts that check their blood sugars at home to have them below 40 at times. Small frequent meals, avoidance of simple sugars, including protein with every meal, and avoiding carbohydrate by itself seem to help. There is literature supporting this in pts following gastric resection for CA and also in pts following low calorie diets, but not specifically in bariatric pts. With the rapid improvement in insulin sensitivity as well as decreased counterregulatory hormone activity after gastric bypass, it's not surprising that pts are experiencing hypoglycemia.I hope you find the handout helpful. Sylvester, RD, LDNThe Reading Hospital and Medical Centersylvesterh@...-----Original Message-----From: Beverly [mailto:bevlyann@...]Sent: Wednesday, August 04, 2004 11:59 PM Subject: hypoglycemiaI had a call from a local endo today about a pt who came to him 2-3 yrs post GB complaining of hypoglycemia. He said she doesn't have any insurance or money and wanted to know if I had anything written that I could give him to give to her. This doc refers to me all the time so I want to help but I don't have anything like that. Does anyone here have anything they can share? Thx, Bev Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2004 Report Share Posted August 6, 2004 Stupid question but.....how do you open the attachment? I'm very interested in checking out your handout. Thanks, Boyer RD, LDN > Bev, > I did my research project for my master's degree on reactive hypoglycemia after gastric bypass surgery. I developed a 2 page basic pt education handout relating to this topic. It is attached. We have had several pts referred to us for this problem, especially if the pt is fairly close to their postop goal wt and lost a great deal of weight. The symptoms seem to occur 2-4 hours after eating. We've found pts that check their blood sugars at home to have them below 40 at times. Small frequent meals, avoidance of simple sugars, including protein with every meal, and avoiding carbohydrate by itself seem to help. There is literature supporting this in pts following gastric resection for CA and also in pts following low calorie diets, but not specifically in bariatric pts. With the rapid improvement in insulin sensitivity as well as decreased counterregulatory hormone activity after gastric bypass, it's not surprising that pts are experiencing hypoglycemia. > I hope you find the handout helpful. > Sylvester, RD, LDN > The Reading Hospital and Medical Center > sylvesterh@r... > > > hypoglycemia > > > I had a call from a local endo today about a pt who came to him 2-3 > yrs post GB complaining of hypoglycemia. He said she doesn't have > any insurance or money and wanted to know if I had anything written > that I could give him to give to her. This doc refers to me all the > time so I want to help but I don't have anything like that. Does > anyone here have anything they can share? > > Thx, Bev > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2004 Report Share Posted August 6, 2004 : I didn't have any trouble opening this Word document and then I saved it on my hard drive so I will try to attach it here for you. And thanks again to ! Bev hypoglycemia> > > I had a call from a local endo today about a pt who came to him 2-3 > yrs post GB complaining of hypoglycemia. He said she doesn't have > any insurance or money and wanted to know if I had anything written > that I could give him to give to her. This doc refers to me all the > time so I want to help but I don't have anything like that. Does > anyone here have anything they can share? > > Thx, Bev> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 6, 2004 Report Share Posted August 6, 2004 , Make sure you open the email (double click on it) and scroll all the way down to the bottom...there should be an icon --- a piece of paper with a big blue "W" in the corner --- double click on that. Hope this helps. Let me know if it doesn't. M. Roy, RD, LD St. 's/Duluth Clinic Health System 400 East Third Street Duluth, MN 55805 (218) 786-3143 hypoglycemia> > > I had a call from a local endo today about a pt who came to him 2-3 > yrs post GB complaining of hypoglycemia. He said she doesn't have > any insurance or money and wanted to know if I had anything written > that I could give him to give to her. This doc refers to me all the > time so I want to help but I don't have anything like that. Does > anyone here have anything they can share? > > Thx, Bev> > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2004 Report Share Posted August 18, 2004 , Thanks for sharing this great handout! Sara Sara Halfwassen Frieberg, RD Advanced Nutrition & Wellness Consulting 2600 Garden Road, Suite 201 Monterey, CA 93940 831-643-2027 On Thu, 5 Aug 2004 " Sylvester, " <SylvesterH@...> writes: > Bev, > I did my research project for my master's degree on reactive > hypoglycemia after gastric bypass surgery. I developed a 2 page > basic pt education handout relating to this topic. It is attached. > We have had several pts referred to us for this problem, especially > if the pt is fairly close to their postop goal wt and lost a great > deal of weight. The symptoms seem to occur 2-4 hours after eating. > We've found pts that check their blood sugars at home to have them > below 40 at times. Small frequent meals, avoidance of simple > sugars, including protein with every meal, and avoiding carbohydrate > by itself seem to help. There is literature supporting this in pts > following gastric resection for CA and also in pts following low > calorie diets, but not specifically in bariatric pts. With the > rapid improvement in insulin sensitivity as well as decreased > counterregulatory hormone activity after gastric bypass, it's not > surprising that pts are experiencing hypoglycemia. > I hope you find the handout helpful. > Sylvester, RD, LDN > The Reading Hospital and Medical Center > sylvesterh@... > > > hypoglycemia > > > I had a call from a local endo today about a pt who came to him 2-3 > yrs post GB complaining of hypoglycemia. He said she doesn't have > any insurance or money and wanted to know if I had anything written > that I could give him to give to her. This doc refers to me all the > > time so I want to help but I don't have anything like that. Does > anyone here have anything they can share? > > Thx, Bev > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 18, 2004 Report Share Posted August 18, 2004 Hi! I would love a copy of the handout but can't find it to download it. Please help. Thanks! Ginny Weale Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2004 Report Share Posted August 19, 2004 I have the same message, please! Barbara Scobey, MS, RD, LDN, CDE barbara.scobey@... -----Original Message-----From: gwwgrw@... [mailto:gwwgrw@...]Sent: Wednesday, August 18, 2004 7:32 PM Subject: Re: hypoglycemia Hi! I would love a copy of the handout but can't find it to download it. Please help. Thanks! Ginny Weale Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2004 Report Share Posted August 19, 2004 Your welcome. hypoglycemia > > > I had a call from a local endo today about a pt who came to him 2-3 > yrs post GB complaining of hypoglycemia. He said she doesn't have > any insurance or money and wanted to know if I had anything written > that I could give him to give to her. This doc refers to me all the > > time so I want to help but I don't have anything like that. Does > anyone here have anything they can share? > > Thx, Bev > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 19, 2004 Report Share Posted August 19, 2004 Barbara and Ginny, I will send both of you a copy via your personal email. Sylvester, RD, LDN RE: hypoglycemia I have the same message, please! Barbara Scobey, MS, RD, LDN, CDE barbara.scobey@... -----Original Message-----From: gwwgrw@... [mailto:gwwgrw@...]Sent: Wednesday, August 18, 2004 7:32 PM Subject: Re: hypoglycemia Hi! I would love a copy of the handout but can't find it to download it. Please help. Thanks! Ginny Weale Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2004 Report Share Posted November 4, 2004 what is she doing for physical activity? - may impact BS -----Original Message-----From: emmyparkes [mailto:mparkes@...]Sent: Thursday, November 04, 2004 3:01 PM Subject: hypoglycemiaI have a patient who is about 13-14 weeks post RNY, has lost about 45# and is having symptoms of low blood sugars, even though she is not on any diabetes meds. Her documented FSG last clinic visit was 58. She prefers to eat only 3 times a day, and I believe she is following the portion guidelines to the letter. At her last visit, I suggested adding in a snack mid-morning and mid-afternoon. This was something that she had started doing already because she was feeling so bad between meals. However, she was eating only PRO and very little CHO at the snacks. I told her to make sure she was eating CHO with her PRO. I just talked to her today and she is still having problems with low bg sx, mostly in the late afternoon. She hasn't been sticking to the snacking very well, because she says she feels like she's "eating all the time" and she is afraid she will gain weight again. I tried to make her feel more comfortable with the snacking and she's going to keep a 3 day food diary and fax it to me next week. Has anyone else had this problem or have some suggestions for what I can tell her? I'm afraid she's near her plateau in weight loss - she has lost about 50% of her excess wt already. So I don't want to add any unneeded calories. Also, she seems to be getting enough PRO, but she says her hair is falling out. Our MD always runs thyroid tests q visit, and her last TSH was WNL, although it was in the low normal range. Any thoughts?Emmy Parkes, RDUniversity of MS Medical Center, MS Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2004 Report Share Posted December 16, 2004 Maybe just add switch to calcium citrate to help absorption? >>> jheusinger@... 12/16/04 12:53PM >>> Pt s/p gbp 5/03. highest weight 305, today 135(5'5 " ) Surgeon wants me to visit with her regarding hypoglycemia. I called her today. She gets hypoglycemia after eating cake, when she skips meals and had one during the night. she was not dm before surgery. she is taking Zoloft, mvi, vit b12, viactiv chews, prilosec, vit e. she uses no protein shakes. she had a panniculectomy in nov 04, Is there something not obvious to me. I see her Tuesday. #1 don't skip meals #2 no sugar #3 balance meal with protein fat and cho #4 have a snack before bed #5 ask her if she is exercising #6 have blood work done Thanks Janelle Heusinger RD/LD Grinnell Medical Center 641-236-2488 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2005 Report Share Posted November 23, 2005 -- If you review Nutrition and Diagnosis-Related Care by Sylvia Escott-Stump on page 402-403, it is recommended to include between meal snacks. In most cases, mild hypoglycemia can be handled with use of readily available CHO's including cheese, milk, fruit, and crackers. Balanced, regular mealtimes are also useful. I see nothing wrong with between snacks if they are planned as part of the total calories needs. I believe in individualizing weight management plans. Penny > > Hi All, > I have a pt who is s/p gastric bypass surgery 2 years ago. She has lost 65% of her excess body weight however it has slowed down. Pt is grazing throughout the day on various items such as crackers, pretzels ect. She is hypoglycemic and reports blood sugars in the 50's if she doesnt snack. > I placed pt on a 1200kcal meal plan that includes btw meal snacks (even though I am opposed to btw meal snacking), focusing on dairy, protein or fruit. Do any of you have any other suggestions for me? I dont want her to gain weight by snacking but then again I dont want her blood sugars to drop too low. Any thoughts would be greatly appreciated. Thank you, > O'Donnell RD, LD > Outpatient Dietitian > SMMC > Biddeford Maine, 04005 > > > --------------------------------- > FareChase - Search multiple travel sites in one click. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 23, 2005 Report Share Posted November 23, 2005 There is a great handout in the files section on reactive hypoglycemia. |---------+--------------------------------------------> | | ODonnell | | | <jlod2@...> | | | Sent by: | | | @yaho| | | ogroups.com | | | | | | | | | 11/22/2005 03:01 PM | | | Please respond to | | | | | | | |---------+--------------------------------------------> >-------------------------------------------------------------------------------\ ---------------| | | | | | cc: | | Subject: hypoglycemia | >-------------------------------------------------------------------------------\ ---------------| Hi All, I have a pt who is s/p gastric bypass surgery 2 years ago. She has lost 65% of her excess body weight however it has slowed down. Pt is grazing throughout the day on various items such as crackers, pretzels ect. She is hypoglycemic and reports blood sugars in the 50's if she doesnt snack. I placed pt on a 1200kcal meal plan that includes btw meal snacks (even though I am opposed to btw meal snacking), focusing on dairy, protein or fruit. Do any of you have any other suggestions for me? I dont want her to gain weight by snacking but then again I dont want her blood sugars to drop too low. Any thoughts would be greatly appreciated. Thank you, O'Donnell RD, LD Outpatient Dietitian SMMC Biddeford Maine, 04005 FareChase - Search multiple travel sites in one click. Quote Link to comment Share on other sites More sharing options...
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