Reactive Hypoglycemia (and me)

[Guest guest]

Well, it seems that after all that... it might just be what everyone

thought all along. Here's the story.

Starting early on, at the gym... about 7 months out... I was having low

glucose issues... so just drank more Isopure... ate before and after the

gym. Not much thought about it all. As time passed, I got more and more

active... and ate more and more. Remember when I rode my bike and couldn't

stand afterwards? That, most likely was because my glucose crashed (this

knowledge in retrospect). Around 8-10 weeks ago, I started having

hypoglycemic crashes. I don't mean just some shakiness and feeling

weak. I mean nearly calling 911 crashes. My BGs (blood glucoses) would go

from normal (90-110) to the low 40s with NO advanced warning. I would find

myself on the floor begging for help... unable to even figure out how to

work my glucometer that I have used thousands of times... even during times

of intense stress with newborns... I would lose all brain function except

asking/screaming for help. Last Thursday, my BG was 35. I went to the

doctor the next morning.

(Signs of hypoglycemia: shakiness, nausea, headache, mental confusion,

profuse sweating, and irritability. Many of those are similar to dumping

symptoms... and some people call this hypoglycemia experience " late dumping. " )

Research on the web spoke of eating every 2 hours... and so I did. Also,

since early on, I have also slept 4 hours or so and then am WIDE awake for

another 2-3, then dead tired and sleep another couple hours... 5-6 total

per 24. Well, my body, apparently, was begging me to eat during the

night... and so I did. I began eating M&Ms (almond), eating desserts,

eating almost anything I desired... trying to quit losing weight and quit

having low BGs. My weight stabilized, but I continued losing fat... I was

shrinking and it was scaring me a lot. I lost 180 pounds in 12 months...

and went from 75% body fat to 25%... not a bad thing, but, I have lost 3%

body fat in the last 12 weeks... doing NOTHING active beyond general daily

life (which is WAY more than I did pre-op, but NOTHING compared to what I

was doing before that)... no biking, no hiking... no gymming it... nothing,

but I continued losing fat anyway.

And the BGs continued crashing. I manipulated my diet as best I

could. Traded the M&Ms for dried fruit and nuts (almonds and peanuts)...

stopped eating lots of high glycemic index carbs (the [bad] white foods

like rice, pasta, potatoes, carrots, etc.)... yet continued having a very

hard time. (Here is an amazing site that discusses and details high

glycemic index foods and their

explanation: http://www.mendosa.com/gilists.htm)

Once I started working as an apprentice midwife in this practice I am in,

it got worse (stress?) and eventually, I had to take time off to go to the

doctors (PCP/endocrinologist/surgeon) so I could figure this all out. I

mean, I would be at births, eating hard candy like there was no tomorrow

because I began getting fuzzy-headed... or drinking Ensure Light so I

wouldn't have an accident on the way to a birth at 4am... or eating nearly

constantly while *at* the birth. I simply cannot be the midwife in charge

with this issue going on... and it took a LOT for me to acknowledge that I

needed to bow out for a couple weeks to figure stuff out. I have to be

1000% for my clients... I will be holding 2 lives in my hands... literally.

So, I went last week and had a lot of different blood tests (fasting and

not fasting) and saw an endocrinologist and the preliminary diagnosis was

either Reactive Hypoglycemia or that my pancreas was flipping out from my

losing so much weight so fast. I had severe PCOS and insulin resistance

pre-op, so they thought my pancreas might not have quite caught up to the

fact that I was 190 pounds lighter yet.

Labs came back and I saw the docs again on Friday. Most of the labs were

fairly normal (thyroid, liver, insulin levels [not BG levels] were WNL...

the insulin, instead of reading high, actually read *low* ( 5.8 with a

reference range of 6-27), so the diagnosis really is the Reactive

Hypoglycemia (RH).

Now, I get to go to a dietitian. Wheee!

In the meantime, I am not to consume ANY high glycemic index carbs... threw

away the cereal, the crispy bagels, the cereal snacks in a bag that I was

eating while driving... took the Ensure Light back to the store for a

refund... no more sushi (rice)... no more rice, no more pasta (even with

chicken), no more potatoes, no more BBQ sauce, no more candy, no more ice

cream, no more nothing I should have ever put in my mouth in the first

place. I can only eat half a nectarine at a time and ONLY after my

protein. I have been told to increase protein tremendously (does any of

this sound familiar?) and to increase fat (omg... Atkins?!?!) and to call

for my nutrition appointment on Wednesday. And I continue on a mission to

find a protein drink that doesn't end up in the toilet or in the sink (I

cannot believe they are all so disgusting!). Protein bars are a necessity,

too, for births, but they all taste like compressed dirt. Oh, kind of like

the protein drinks, but with the moisture removed. Yum.

The docs have ordered me to eat cheese and meat and crackers (for constant

snacks)... Triscuits... since they are made with whole wheat. A snack for

me is 2 slices of Swiss cheese, 2 slices of turkey ham, and 3 Triscuits. I

am dousing it with mustard to add some sort of flavor. I have been told to

be liberal with the Ranch (I still use Light) and add more mayo to my tuna

or egg salad. I made a turkey meatloaf tonight... had that with tabouli (a

parsley salad). I have been a salad eating fool... with tuna thrown in.

I hope this de-tox doesn't take too much longer.

It was kinda fun eating whatever I wanted and not having any

repercussions. Uh, well, weight ones, anyway. And the endocrinologist

isn't 100% sure this is the final diagnosis, either. After the nutrition

counseling and a month of changes and taking my BGs 4-6 times a day (and

continuing to eat every 2 hours... is that frightening or what?!), I am to

return and see what has happened with labs and my experiences. At least

for now it doesn't look like there are any grand disturbances with my

pancreas or liver (pancreas being responsible for the insulin and the liver

for the glycogen that regulates the insulin) and that is a good thing.

Today is the 4th full day without high glycemic index carbs and it is

TOUGH. I am near tears as I look at food with a longing I haven't felt

since 2 weeks post-op. I am still having hypoglycemic episodes, but not in

the low 40s anymore... they have been less frequent and are in the high 40s

and low 50s. I have to remember why I am not eating those foods that

tasted so delicious. I want to be well.

I know that, with dropping all of those foods, I will soon be losing weight

again, and that, in and of itself, is scary, too. Perhaps I needed this

way station of no weight loss in order to allow my brain to catch up to my

body. I am actually fairly comfortable now with what I look and feel like

in this much smaller body. I have to be open to being smaller, however...

and am working on that issue now. Those around me say that the 3% fat loss

has looked like a 20 pound weight loss (and people work a *year* to lose 3%

fat!)... it will be weird to lose 20 pounds for real on top of that! I

can't think too hard about that right now. I have to concentrate on

getting healthy, not have BG crashes, not having intense fatigue several

times a day, eating correctly, drinking liquids, taking vitamins, and

slowly re-introducing movement (exercise) into my days. I have to begin again.

And so I shall.

Barbara Herrera

San Diego, CA - 41 years old

Open RNY April 5, 2001

Dr. Ellner, Alvarado Hospital, San Diego, CA

04/05/01: 344# / BMI: 63/ Body Fat%: 75%

04/05/02: 172# / BMI: 31.6/ Body Fat%: 28%

09/06/02: 160#/ BMI: 29.3/ Body Fat%: 22%

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