Hypoglycemia (with whining attached)

[Guest guest]

I will just start off with: I am scared.

I have spent the last hour reading every post in the archives on hypoglycemia

and, while some of the issues fit, many don't, so I am still pretty much at a

loss of where to go for help. Perhaps sharing some of the things that are going

on... and what I have tried... might help someone see a piece of the puzzle I

just don't see. My surgeon, her nursing team (most of whom are long-term

posties) including the nutritionist, my PCP, and my midwife friends are all

(what it seems to me) clueless. So, I turn to the REAL experts... you all here.

I had Type II diabetes badly pre-op. It disappeared with the surgery (17 months

ago today), but I stayed on the Glucophage for another 6 months because of the

insulin resistance issues. All co-morbs gone within a few months (most the day

of surgery) and I began a very active lifestyle almost immediately... something

I had never had before. I lost 180 pounds in my first 12 months... have dropped

another 10 in the last 5 months (see .sig file for details). As you can see by

the information below, I have also dropped an incredible amount of fat... from

75% to 25%. I was gymming it, walking like crazy, biking... and then, began

working (couldn't work because of my fat) towards my midwifery license (taking

that exam in early March)... going to dozens of births, working on-call, working

prenatal clinics, working in the office... travelling back and forth to El Paso

to work in a birth center there (also regular 12 hour days plus waking up and

assisting at births).

And now, I am getting sicker and sicker... and more and more frightened. (I can

feel the tears right *there*.)

About 8 weeks ago, perhaps a tad longer than that, I started having hypoglycemia

stuff happening. My BGs were going down into the 40s and sometimes as low as

the mid-30s. I have been so sick that I have not been able to figure out how to

take my BG with the glucometer I have used thousands of times in every manner of

stressful situation (on newborn babies who were sick). At a birth once, I began

shaking so badly, I had to go sit in the bathroom and chew on candy to get my

BGs up enough to finish the job (I was charting, nothing terribly crucial, thank

GOD!).

I CANNOT BE A MIDWIFE WITH THIS ISSUE GOING ON! I cannot be responsible for two

other people's lives while my own health is so sucky. I cannot/should not drive

in the middle of the night, at 90 mph, when I could have my BGs crash right

before I do.

There is NO warning of when it is going to happen. It is *not* dependent on

what I eat or when I eat; I have tried every variation on a theme. I am a

CAREGIVER, for crying out loud... I counsel women on how not to have

hypoglycemia! I have stopped riding my bike (the first [bG] crash occurred on

my bike), stopped walking alone, stopped gymming it (yet, my muscle mass remains

at 25% even after not doing formal exercise for over 3 months). Gads, now that

I think about it, I was having BG crashing in the gym way back at about 7 months

post-op! I just remembered that! The consensus was I needed to eat more. That

is pretty much what everyone has said... eat more often (the proverbial " small

meals " crap) and focus on protein, limiting carbs. Well, damn it, I DO THAT and

I still get sick.

I have eaten ALL protein, 75% protein, 50% protein... really eat simple carbs

incredibly rarely (high glycemic index carbs is a more accurate description)...

was " using " almond M&Ms to avoid crashing right before a birth, plus hard

candies (I do not dump from sugar, but do some from butter and cream), but, on

the advice of others, stopped that and began eating almonds, peanuts, and dried

fruit on the way to a birth; they have protein and glucose, but also fill me up

WAY faster than M&Ms and last longer in the pouch/intestines. I quit all candy.

(Was only using candy as a medication for the BGs in the first place... good

excuse, eh?)

Today, for example, I ate a LOT... way more than I feel comfortable eating...

cheese with turkey ham and crackers (I can eat two slices of each with about 3

crackers total), some strawberries, an Ensure at breakfast (before my 1 hour

drive to work), an Ensure before my afternoon of clients (this on the

recommendation of my surgeon and others)... and then, within 2 hours, my BGs

were 50! I was nearly fainting, sweaty as a 400 pound marathon man, and so

sleepy, I thought I was going to die. There was no way for me to see clients

this afternoon, so, after eating more cheese, meat, and a cracker, I came home,

where I ate more before finally feeling somewhat human again.

I have done protein drinks (Isopure, Proteinex, and others) and they are so

disgusting the thought of them in my mouth makes me gag [and I drank the clear

Isopure for 8 months as my *only* source of protein])... the Ensure isn't much

better, that's for sure, but at least it goes down.

My labs are pretty normal, but my last glucose, not even fasting, was 80.

I am going, one more time, to my PCP next Friday (the 13th) and asking to see an

endocrinologist. Do you all think this is warranted? Is there any test s/he

can do to determine if this is hypoglycemia and not some other organic wasting

disease? I am so scared that I will be asked to leave the midwifery practice I

so want to be a part of because of my health issues. It is damned (and that is

NOT the word I wanted to use, either) ironic that I couldn't practice midwifery

because I was fat and now I am not utilizing my potential because I am not fat

(enough?).

So, my question is, do you all see anything I don't? I mean, I read what I ate

today and it isn't the happiest of what a postie would be eating, but I swear!!

I have eaten from 70-120 grams of protein daily (varying to test the results),

eaten from none to 25% carbs with my protein, and tried everything inbetween...

I am compliant to a fault (ask those in my support group!).

I *so* want to exercise again... want to have the mental stability to focus on

the exam I need to take in March... want to be able to do everything my body

physically allows me to now... and yet, instead of great globs of fat, I am tied

down by a glucometer and constant eating. How can I ever even think of going on

the & Trail or running the Disney Marathon if I can't even go

through a normal day without crashing?

And, another question: Is smashing fatigue a part of this? I sleep 4 hours, am

up for 3, sleep another couple... and then am awake... until I, all-of-a-sudden,

NEED to sleep. Why can't I sleep 7-8 hours in a row? It isn't waking to pee...

it is waking so that my body says GET UP NOW (sometimes it is screaming to be

fed, but not always).

I am feeling like such a lost soul... after helping so many people through their

first year... speaking about WLS with my surgeon, knowing SO much about my own

health and the health of others... I am lost. And, as I have mentioned a

hundred times already... scared.

Thanks for listening.

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%

07/27/02: 160#/ BMI: 29.3/ Body Fat%: 25%

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