Search the Community

Here is a short article on reactive hypoglycemia (RH) after gastric bypass surgery. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ The individual that I know who had this problem did not have diabetes prior to surgery. I believe the first time he encountered the condition he fainted. But ever since then he learned to detect the signs and took immediate steps to preclude the onset. So after the first incident, he never repeated it. It seems that RH occurs between 1 1/2 to 3 hours after a meal. Since you woke up at 3 A.M. this might not be RH. Since your blood sugar when you had it check the next day was 60, that is on the low side. So the condition might be related to low blood sugar (hypoglycemia) or something else. Another possibility is orthostatic or postural hypotension. Here is a link to that condition. http://www.merckmanuals.com/home/heart-and-blood-vessel-disorders/symptoms-of-heart-and-blood-vessel-disorders/dizziness-or-light-headedness-when-standing-up This is one of those problems that you will need to discuss with your medical professionals.

I consider myself an expert when it comes to autoimmune rheumatic diseases. First- let's talk your prednisone: See an endocrinologist. Pronto. I was taking 60 mg of pred a day for years. There was no weaning off, because any time I got down to 20-25mg, I literally could not function. In any capacity. Enter the endocrinologist. Because the prednisone does just as much (if not more!) damage than good, my adrenal function was gone, I had prednisone induced glaucoma as well as prednisone induced diabetes. I needed off the meds ASAP. She prescribed me ORAL hydrocortisone. It mimics- and tricks- your body into believing it is prednisone, and is MUCH easier to wean off of than the prednisone. It took a total of 2.5 months vs over a year or longer if it were the prednisone. Do this. Again, ASAP. Ask for it. Second- methotrexate, either by pill or injection: pills made me sick, puking, typical chemo side effects. The shots did not, and they actually work much more effectively than the pills, so if given a choice, it is a once a week teeny tiny needle. Side effects- don't bother paying attention to them. The benefits far outweigh any possible adverse effects. You will need regular blood work to monitor your liver enzymes. Again, I have been on a very high dosage, so mine were often screwy. Third: I can't imagine any surgeon doing WLS or ANY elective surgery while you are on either of these meds. I had to "wash out" before I could have my surgery, meaning get all traces of the meds out of my blood system and stored reserves. Both drugs make you more susceptible to infection and the prednisone especially makes healing hard. And keeps weight on. Again- seeing an endocrinologist will get you off the pred by using oral hydrocortisone pills. Usually PMR goes away after a year or so. I wonder if you don't have true rheumatoid arthritis? The tests- a sed rate and C-reactive Protein screen are used for PMR as well as other autoimmune arthritis diagnosis. Just a thought. So- don't worry about side effects of the methotrexate and get off the pred!!! Sent from my iPhone using the BariatricPal App

Controversies in Coverage for Obesity Treatment and prevention have seldom been emphasized by insurance providers, despite spiraling health care costs attributed to obesity. With more Americans overweight, obesity has become a leading cause of preventable death (65) . Direct costs associated with obesity represent 6% to 7% of the National Health Expenditure (66) (67) ; 99.2 billion dollars were attributed to obesity in 1995, of which 51.6 billion dollars were direct medical costs (67) . A study examining the 25-year health care costs for overweight women over age 40 years using an incidence-based analysis, predicted that 16 billion dollars will be spent in the next 25 years treating overweight middle-aged women alone (68) . Other investigations have suggested a relationship between BMI and health care expenditures. In one study, medical and health care use records of obese women (N = 83) belonging to a health maintenance organization were compared with records of non-obese women (69) . As BMI increased, so did the number of medical diagnoses and the use of health care resources. In another analysis of employees of 298 companies (N = 8822), obesity was directly and significantly related to higher health care costs (an 8% higher cost), even when adjusting for age, sex, and a number of chronic conditions (70) . A longitudinal observational of obese individuals (N = 383) covered by the same insurance plan reported that the probability of health care expenditures increased at BMI extremes (71) . A study of over 17,000 respondents to a 1993 health survey reported a strong association between BMI and total inpatient and outpatient costs (66) . Compared with individuals with a BMI of 20 to 24.9 kg/m2, there was a 25% to 44% increase in annual costs in moderately and severely overweight people, adjusted for age and sex. Wolf and Colditz (67) reported an 88% increase in the number of physician appointments attributed to obesity from 1988 to 1994, and a total of 62.6 million obesity-related physician visits in 1994. A recent review of the scant literature on access to and usage of health care services suggests that obese persons use medical care services more frequently than do non-obese people and that they tend to pay higher prices for these services (72) . Beliefs that obesity treatment is unsuccessful and too costly have been challenged (73) . Weight losses as small as 10% are associated with substantially reduced health care costs, reduced incidence of obesity-related comorbid conditions, and increased lifetime expectancy (73) (74) . Recent research has addressed the cost-effectiveness of drug treatments and surgery for obesity. In 1999 Greenway et al. (75) found that weight losses produced by medications (fenfluramine with mazindol or phentermine) reduced costs more than standard treatment of comorbid conditions. Gastric bypass surgery has demonstrated even more impressive effects, with lower costs and greater long-term weight loss maintenance in comparison to low-calorie diets and behavior modification (76) , as well as significant reductions in BMI, incidence of hypertension, hyperinsulinemia, hypertriglyceridemia, and hypo-high density lipoprotein cholesterolemia, and sick days from work compared with matched controls (77) (78) . Current Coverage Practices Even with some evidence of cost-savings for some weight-loss methods, medical coverage is inconsistent. Surgical treatment is often not reimbursed even though diseases with less supported treatments are compensated (79) . Some have explicitly pointed to prejudice against obesity surgery by insurance providers who are preventing its broader acceptance and use in practices (80) . As Frank (81) concludes, "... no claim to justify the denial of benefits for the treatment of obesity has any validity when held to the standards of health insurance otherwise available in the United States. It should be obvious that such a judgment is ethically unconscionable." It is typical for health insurance plans to explicitly exclude obesity treatment for coverage (82) . Physicians often have difficulties receiving reimbursement for their services (79) . Many reimbursement systems do not categorize obesity as a disease, leading physicians to report comorbid disorders as the reason for their services (79) . In 1998, the Internal Revenue Service excluded weight-loss programs as a medical deduction, even when prescribed by a doctor. In response, several organizations such as the American Obesity Association (83) filed petitions for a ruling to allow the costs of obesity treatment to be included as a medical deduction. As of 2000, the Internal Revenue Service policy changed its criteria, allowing costs for weight-loss treatments to be deducted by taxpayers for certain treatment programs under a physician’s direction to treat a specific disease (84) . The Social Security Administration has eliminated obesity from its list of impairments, which is used to determine eligibility for disability payments (65) . Because individuals who receive social security disability benefits are also eligible for Medicare after 2 years, those who are denied disability also forgo opportunities for medical coverage (65) . Although few studies have addressed this issue, a recent cross-sectional analysis of third-party payer reimbursement for weight management for obese children reported low reimbursement rates (85) . Despite the medical necessity of weight management for obese children in the study, no reimbursement was given to 35% of the children enrolled in weight-management programs, and no association existed between the severity of obesity and the reimbursement rate (85) . Although this article does not intend to examine all of the potential factors that may underlie these coverage policies, one likely contributor are perceptions that obesity is a problem of willful behavior and that treatment is unsuccessful and expensive (81) . Although health insurance typically covers treatment for substance abuse and sexually transmitted diseases, which are also considered to be problems of willful behavior, obese persons may not receive the services they need (81) . Denying obese people access to treatment may have medical consequences, but also denies people an opportunity to lose weight, which itself may reduce exposure to bias and discrimination. For example, Rand and MacGregor (58) assessed perceptions of discrimination among morbidly obese patients (N = 57) before and after weight-loss surgery. Before their operations, 87% of patients reported that their weight prevented them from being hired for a job, 90% reported anti-fat attitudes from co-workers, 84% avoided being in public because of their weight, and 77% felt depressed on a daily basis. Fourteen months after surgery, every patient reported reduced discrimination, 87% to 100% of patients reported that they rarely or never perceived prejudice or discrimination, and 90% reported feeling cheerful and confident almost daily. A further study indicated that 59% of patients requested surgery for social reasons such as embarrassment, and only 10% for medical reasons (86) . After the operation, patients reported improved interpersonal functioning (51%), improved occupational functioning (36%), and more positive changes in leisure activities (64%). Although these studies are based on self-reports from selected samples and, therefore, have limitations, it is interesting to note the dramatic reduction in postsurgical perceptions of prejudice and discrimination, and the power of social perceptions in motivating surgery decisions. Summary and Methodological Limitations A "fat is bad" stereotype exists in the medical field (87) . Further study is needed to test the degree to which this affects practice. It seems that obese persons as a group avoid seeking medical care because of their weight. One barrier to drawing further conclusions, however, is that much of the research relies on self-report measures of variable reliability and validity. There is a need to move beyond reports of attitudes to actual health care practices.

I'm 3 mos post op and lost 33 lbs including preop diet! So yeah jump for joy. I'm a slow loser & have hypo thyroid but I'm have way to goal. Woohoo!

developing reactive hypoglycemia (RH) isn't that uncommon, but I haven't heard of people developing diabetes after surgery. In any case, I'm not sure it would be result of the surgery or not, since these surgeries tend to improve diabetes (or put it in remission). in the case of RH, the things you mentioned happen to people after ingesting a lot of sugar, but the symptoms usually kick in an hour or two later. RH can be controlled by limiting (or avoiding) sugar and eating something every three or four hours. And if you eat a carb, you're supposed to eat a protein with it. I'd check with my PCP - not sure what's going on. But I'd sure want to get that under control...

It sounds like (non expert, non doctor here) that it may be reactive hypoglycemia, which is fairly common in the bypass world, as it is a result of rapid stomach emptying due to the lack of pyloric valve in that procedure, causes an insulin spike followed by low blood sugar triggering hunger. With the sleeve, we can also experience somewhat rapid emptying due to our small stomach size. DIfferent foods affect this, too - the so-called "slider" foods that slide on through because they don't trigger the pyloric valve to close, typically highly processed carbohydrates. If this is what is going on, try sticking to meats and high fiber vegetables that tend to stay in the stomach longer and see if that helps. If it is not RH, then an endrocinologist may be in order to see what is going on with this imbalance. Whether or not your sleeve was botched, you should check with a bariatric surgeon to evaluate this - if you go to your original surgeon, a second opinion from another may be in order to verify whether or not it was "botched" (would the original doc really admit that he goofed?) good luck in working this out,

Yes, stupid Graves ..... I saw my Endo 3-4 weeks post op, then blood tests every 6 weeks, next Endo appointment was 3 months later. Still have 6 weekly blood tests, and still see her every 3 months. She also communicates with me via phone and email. I finally sleep better, my blood pressure and heart rate has come down. Prior to that, I had to go back on beta blockers and sleeping tablets, as the hyper state kept me awake at nights for months! As Thyroxine is so very weight sensitive, each significant drop in weight was bringing hyper thyroid back for me. Now, even though I sleep much longer and much better, I am still tired, still have awful headaches and really bad allergies. All hypo symptoms. So, this next med adjustment may finally do the trick ...... I hope so! Got to keep an eye on the thyroid post op, that's for sure.

Betsy its really interesting that you pointed that out I actually copied and pasted that from the hospital web site, lahey clinic but I am sure it was just mis-wording on the part of whoever typed it, I know lahey is very well respected world-wide and they were willing to do brain surgery on me that had never been done before and they have given be a second chance at living a normal life, so I would put my life, stomach, or whatever it may be in their hands any day. You are correct about that statement though, I do beleive it is worded wrong, but I also don't beleive the surgeon himself is sitting at the computer typing that lol. Cocoabean, ditto on that, same goes with rare side effects. But my pounding headaches/migranes have been almost absent after 2 weeks on it. Good to hear about the diabetes thing, since I am not diabetic either. I think I might be in that small population too, although I dont know what the heck is going on with my thryoid, my TSH and T4 levels have been wacko all over the place the past 2 years even though I am on synthroid. I seem to have hyper-hypo phases......I swear to god I have hashimotos but I have had my antibodies tested twice and they were neg....I also likely have a pituitary tumor that is causing some hormone dysfunction....but I just cant wait for them to come up with a diagnosis and just watch myself BLOW up to over 400lbs....that is why I really want the band....b/c I do believe they will eventually find something....and if they do...all of us will be happy that I chose the band....its a really tough descision...and I guess I hadnt mentioned it on here before b/c you guys might think it is a weird reason for seeking a band....but if they are willing to band me (which costs a lot more than running tests to dx me) I have to go along with it...... I dont know, what would you do...just sit and wait for an abnormal test while you battle with hungry every day and watch the scale continue to go up....or do something if you were offered it...???

I read a book (or finished reading it) on Nov 1st. It's 'How to stop eating bad sugar' by Allen Carr. Since I stopped I've kicked my sugar habit which was wreaking havoc in my life. Not huge weight gain, but there was a slide upwards. It was just the mental nastiness - the feeling of constantly losing a battle and it made me sick and I'd started getting really bad reactive hypoglycaemia. So since then: no sugar, potatoes, sweeteners, honey, syrups and no processed food made with sugar. I still eat a lot of fruit but mainly apples (loads of fibre) and tangerines. Bananas are a slight problem - I note they increase sweet cravings and give me muscle cramps, but I'm recently bereaved and so allowing myself to skate that one for now. Dried fruit is also a big no. I eat meat, fish, veggies (often oven roasted), small amounts of organic proper wholewheat bread - have only found one brand - Cranks- which doesn't have a load of other nonsense in. I snack on nuts and fruit as above. I've lost 6lbs of my slide up from my lowest, but I think I might be at what is a healthy weight for me. (Need to get back to the gym really). I don't log or do macros but I aim to eat whole food, lots of veg and fibrous fruit. It's working in that I've only had the reactive hypoglycaemia a couple of times since Nov 1st (I think it was banana that did it!) and the cravings are generally gone. The evening hunger is fixed by eating a big apple very slowly and I sometimes have a bed time snack of a little fruit and cheese, or nuts, but the urge to do that is passing slowly. I do occasionally use Stevia in my posh hot milk and pure cacao/ashwaganda type drinks, but I try also to not make it a regular thing. I suppose my point will be, that having taken these steps, the obsession, and the compulsion have faded and now I'm free to deal with all my other problems!!! Good luck to you - your exercise regime is awesome. I so want exercise to be my next addiction!!

Dang girl!! ((hugs)) And saying prayers! It sounds like 1 of 2 things: Orthostatic hypotension (low bp) and dehydration can make this worse. OR Reactive hypoglycemia (but usually when I'm low enough to black out, I'm in a hot sweat, burning up inside, trembling uncontrollably, shaking hands, and needing to pee like a racehorse and very very confused, like I almost can't form a coherent sentence to let Mr. F. know I need help.) Do you have a bp cuff along with your finger stick? It's easy to tell OH because your bp will change very dramatically from one taken when laying flat and then quickly sitting up and taking it. It's a big sudden change in your numbers, it will drop lower with sitting than when laying flat. And RH is very easy to spot. Basically if you are less than 60, you need something to eat. If you are less than 40, you need to act very quickly with fruit juice or glucose tablets and take your bg every 15 minutes until you see it start to move up. Then 30 minutes to an hour later follow it with protein (I use nut butter I keep in single servings by the bed and a 6oz can of OJ by the bed -- also have glucose tablets and my bg monitor). Hope that helps! And you need to call your PCP and get seen!!! ((hugs))

Hello Mdawncooper, I am sorry for my delayed response! So, I almost didn't go through with the surgery because I was afraid the PMR flare pain would be too much on top of the sleeve recovery pain... The surgeon convinced me to go through with it and said that a week post op I could resume prednisone if needed. Well here's the miracle: severe bi-lateral leg pain is gone! It could have just been the prednisone withdrawal symptoms rather than a flare; but I am so happy to be on the other side of this surgery and OFF prednisone! The Doc told me they give all patients a dose of steroids in the O.R., so that could have helped as well. The tell-tale symptoms are bi-lateral pain (rather than one side only). The only way diagnosis can be confirmed is to try Prednisone. If the pain resolves within three days or less after beginning prednisone, then you know you have PMR. My pain was in my legs and lower back ; rather than in the shoulders and neck where it is more common. The prednisone worked and I felt great (but also gained weight). I am am hopeful that my symptoms will not return and when I have my C-reactive Protein levels tested that they are lower. It is so nice to be certain that I will lose weight and feel better as a result! Down 34 lbs. since I began this process in late November!

I have BCBS of Minnesota. So u did use the on-line tools or not? If u reactivate your account then you can Access your past weights, but it costs to do that. I just called the 1-800 number and asked. I had gained about 50pounds since the last time I used weight watchers, but it still proved my fatness. lol Good luck!!!

I experienced something very similar the first couple of weeks. I felt a lot of pressure and often had to stop until I burped or it passed before taking another bite. I think that's pretty normal - your stomach is still very swollen and healing from the surgery, so its going to feel a little reactive.

@ - Not good. When you are waking up exhausted and taking two anti-depressants, well "Huston we have a problem." (Check out crazymeds.org - best site for really monitoring the effect of these drugs). There is an art and a science of medicine. The science is "appendix burst, take it out"). The art is how to do it without creating more problems. The meds you are on are really on the art side. You have to work with the docs and tell them how it is working. You have to know how long does it take before this stuff should have an effect. For instance...I take Welbutrin. It takes a month before I should expect any changes. I marked on my calendar. You need to write this down so you have real info to give to your doc. This is a partnership. Please take it that seriously. If I seem to be over reactive, well I am with this stuff. It's not like eating a piece of pizza, it can be really bad.

I love all of the advice from people that have no clue! LOL! PCOS cravings are kicking, not sure what has reactivated the pcos, but it defiantly needs to go away! Unless you have the PCOS cravings you have absolutely no clue what I am going through. It is a stronger intensity than what a pregnant women has. It is not an excuse it is a fact, so unless you have a clue don't give your snobbish opinions. I am still waiting to hear back about my port revision. My foot is healed and I can walk again and work out again. Since I don't seem to have restriction I am going back to protein shake diet. I need to loose the weight that I have gained this summer while I was not able to work out. If you want to read more here is my blog! http://tinkrisegrind.blogspot.com/2013/07/still-waitingcarb-cravings-are-huge.html

For me, my family was part of the reason I was obese. So I found it quite empowering to make the decision by myself to go for bariatric surgery. That being said, I wouldn't be where I am today without the support I have from people around me. However ultimately it's me that has to deal with the pains from overeating. Me that has to deal with the dumping and hypos. But it's also me who can say how incredibly proud I am to have achieved what I have to date (-150lbs). You are never alone, even with yourself Sent from my GT-I9505 using BariatricPal mobile app

I am a horse of a different color. I now have Reactive Hypoglycemia..So now I eat 6 times a day...I am eating more complex carbs now to keep my sugars settled....I think that my caloric intake has gone up..But I am still losing weight and am getting where it is no longer a good idea..... Everyone is different! But at some point our bodies are supposed to level off and we need to maintain within 5-10 lbs.

You know guys, this is turning into a bit of a bash session and I don't think that helps anyone in the long run. Just as the band itself is adjustable, there are many different ways to approach living with it and many paths to success in losing weight with it. Jachut's approach has been to keep restriction light, eat well and throw herself into exercise to compensate for the higher calorie intake. Wasa's approach has been to keep restriction tight, eat 600 cal a day and exercise too. Both have done well and have lost weight successfully, but that's not the only possible approach. There's no doubt that fewer calories + more exercise = fast weight loss, but some of us prefer to take our time and get to our goals in a little more leisurely fashion. While Jachut is my personal band-hero and I admire Wasa's success, I'm not following either of them faithfully on every point. Personally, I can't see myself ever running a marathon, whether it was for pleasure or hating every minute of it but doing it for the benefits. I couldn't bear to live on 600 cal a day and I chose the band BECAUSE I didn't want to spend the rest of my life dieting or on an extremely restricted calorie regime. I try not to "diet" but focus on healthy eating, exercise sporadically but am finding I can increase it as I get more fit. I'm not going to win any speed races in losing the most weight in the shortest space of time. I plan to take at least 18 months to get to goal and at my current pace, I'm right on target for that. That doesn't mean that Jachut's or Wasa's or my approach is the right one for everyone. Each of us needs to work out for ourselves how this band works best for us. Now Brandy had an unfortunate start to her bandlife. For whatever reason, she was unaware that the band wouldn't help her limit her intake of slider foods and and struggled to find the right balance for her between restriction, food choices and exercise. She knows better now and is trying to find a pace that suits her. She knows her own mind and has stated that focussing directly upon diet and exercise causes her to become obssessed and then rebellious and she defeats her own efforts with that approach. Fine, I can relate - say the word "diet" to me and my immediate reaction is "Oh my god, where's the chocolate!!" If she feels that she will get better results by NOT triggering those reactive emotions in herself, then good luck to her. My advice to you, Brandy (and remember it is only advice, take it or leave it as you will), is to chill out a little and stop stressing about calories, diet or "focussing" on anything. Keep restriction light, aim to eat good healthy food, and let the band do it's job in helping you to not feel hungry all the time. Don't forbid yourself anything, because you know that will only make you crave it all the more, but keep in mind that it was the junk that got you to where you are now. A little treat now and then is good for the soul; icecream, chips and chocolate every day is not going to get you to goal. When you are not hungry, because you've been filling up on good quality food, it's easier to make good choices and limit the treats to the occasional small one instead of binging. Exercise when you can - look for easy ways to start this, rather than throw yourself into a strenuous routine that you can't sustain. Use little tricks like taking the furtherest carpark space at the shopping centre, instead of the closest, using the stairs instead of the elevator when it's only 1 or 2 flights up. As you get fitter, increase this at a pace that suits you. You won't see the pounds melt away with this approach. Accept that and embrace it. They WILL drift away slowly, a pound here and there, and that will add up over time. As you see it start to go, you might find that you become more motivated and want to put more effort into dropping the weight faster - you can do that too! It's all up to you and your choice. Take the examples of everyone in here and find the bits that fit with your own personality. Work out what works for you and change it to suit your needs, when it feels right for you. Good luck with your journey!

Yes mere. I have high thyroid .. Whatever that is. I just haven't been scheduled for surgery yet. This is my last month for the journey and I meet w the surgeon June 4.. Super excited If you have high thyroid then you have HYPERthyroid. Do you think I'll be approved ? Yes, I don't see why not... SOme docs say that after your surgery maybe your thyroid can resolve itself. It's not a guarantee and I am no doctor but I do read like a mad woman and research everything. If you have hyperthyroid that means you have a super fast metabolism and maybe you will lose weight. Do research it, it's called graves disease, my husband was diagnosed with it (hyperthyroid) and I have the hypothyroid (slow thyroid) maybe opposites do attract. Ask your doc all the questions and then go home and look it up. Take good care of yourself as hyper or hypo affects all of your cells, your entire body and brain. Good luck. I am here for you if you need. Thank you so much. I've done all the appointments I just have the psych Eval, and the pcp follow up all this week coming. Then my second visit with my surgeon June4th. I have a bmi of 47. Weigh 253lbs ...

It's so good to find someone with a similar problem (though I am really sorry you are experiencing this). A friend gave me a glucometer but I drove myself crazy with it and finally gave it back. I can tell by my symptoms that I am about to have an "attack." I have discovered that the correct term is "reactive hypoglycemia" and it first started showing up around 2005. Then it started being reported at scientific conferences and being written up in peer-reviewed scientific journals starting about 2012 (all this discovered from a search on the web under "reactive hypoglycemia post gastric bypass surgery"). It's can also be called "late dumping" although diarrhea and stomach cramps don't seem to be associated with it. It is most prevalent in gastric bypass patients. I think I mentioned earlier in a post that I only had these episodes once or twice a year until this year. Then, after shopping with a girlfriend all day, we stopped at McDonald's and got a large mocha frappucinno. At her house my lips started going numb and then I didn't really know who I was and could not talk straight. Her husband was a diabetic and for some reason she decided to check my blood sugar which came in at a whopping 34. Off to the ER where the physician on call told me it was "fluctuating hypoglycemia." I am searching for an endocrinologist or gastroenterologist now to see if I can get some help for this. In the meantime I am reading everything I can about what foods to eat. "Protein first," all the articles say coupled with a food that has a low glycemic index (I still don't know what that means). Searching for the sweet spot in the management of this condition!! We can journey together. Thanks for sharing.

Off to an interesting start for 2005 Please forgive the length of this post, but I really need to vent. Since the first of the year, I’ve been admitted to the hospital twice. Not so good when you notice we are just now on day 7 into the New Year. The official diagnosis is “reactive airway disease with restrictive ventilatory defect due to obesity.” The treatment: loose weight while taking massive doses of steroids. I’m so tired of them not knowing what is wrong, so they use my weight as the scapegoat. “Because you are fat, we will say that is what is wrong. While we’ve never actually been able to prove that your extra weight is the cause of you not being able to breathe, we heard about another doctor that saw someone who couldn’t breathe because they were fat. And since you are fat, that must be why you can’t breathe. That, or you are just faking it. … If only you had the strength of will-power, you should loose weight. Oh, and those steroids, well, yes, you will probably gain another 20 pounds, but don’t worry, you just need to be stronger…. What? You say you are currently on 1500 calories? Well, that doesn’t make sense, you should be losing weight. Why don’t you try running and see if that helps you lose weight? I got the flu for Thanksgiving, and have been sick since. I didn’t qualify for the flu shot in ID, since it was really scarce there. Not sure why they didn’t give me a flu shot while I was in the hospital. I’m tired of being tired. I’m tired of not being able to breathe. I’m tired of doctors scapegoating instead of finding the true cause.

I have a wonderful recipe for crab cakes. I don't know how it stacks up nutritionally but it doesn't use a lot of breadcrumbs for filler so it is better than most. I 'fry' them on a pancake griddle with just a little oil so it's not a diet-buster. I'm happy to share it. I made these when my husband and I had a food truck. Big seller! Cajun-Style Crab Cakes 6 Slices white bread 1 tsp garlic, minced 2 eggs 1lb crab meat ¼ c heavy cream 4 green onions 1 tbsp fresh lemon juice 5 slices bacon, cooked & crumbled ½ tsp dry mustard 1 tsp Cajun spice mix Salt, to taste Tear up bread slices and grind in a blender or food processor. Add eggs, cream and lemon juice to form a heavy batter, then remove to a bowl and add all the remaining ingredients. Fry in oil or on oiled grill. Serve with Creole Honey-Mustard Sauce. Creole Honey-Mustard Sauce 1 tbsp vegetable oil 6 tbsp mayonnaise 1 tbsp green peppercorns, crushed 6 tbsp sour cream 1 tsp freshly ground black pepper 1 tbsp honey 1 shallot, minced ½ c dry white wine 2 tbsp Dijon mustard In a small, non-reactive saucepan over medium heat, heat the oil and sauté the peppercorns, pepper, and shallots for about 3 minutes or until the shallots are translucent. Add the white wine and simmer until the wine has almost completely evaporated. Let cool. Add the remaining ingredients and check the seasoning. Oh, the sauce is DIVINE!! Enjoy.

Our surgeon doesn't perform the DS, but maybe I will have my wife talk to him about it nonetheless. I am so sorry to hear about your RA, my grandmother-in-law has it, and I know first hand how much it affects her quality of life. For a while, she found relief with remicade, if that helps at all. It is extremely expensive and I think is delivered with an IV. Hopefully, the weight loss might help relieve the stress on some of the joints. I've also been reading up on C-Reactive Protein (Mine is quite high) and it's effects (Inflammation). I remember reading elsewhere that white adipose tissue markedly increases inflammation, so hopefully that will help as well. I have Eczema which is also an inflammation/immune system issue, and I am really hoping the weight loss will reduce or eliminate it.

you have to ask your doctor to write a script for a monitor so you can start checking your BGL. usually the pharmacy has coupons that make the monitor free and insurance covers the strips. if you start checking your BGL several times a day (first thing in the morning, 1 hour, 2 hours, 3 hours after a meal and before bed) you will get an idea of how food affects you and if eating before bed helps how you feel in the morning. i had this issue when pregnant, my GBL was really low in the morning and i would fall over while doing yoga... i learned i needed to eat more carbs than i thought in order to get my level up to normal. this is not reactive hypoglycemia, its different. the only way for you to know what is actually happening with you is to check with a monitor for a few weeks. good luck!

I have never had Hypoglycemia before nor have I ever been Diabetic. I have previously been diagnosed as insulin resistant but since my sleeve surgery a year ago I have recently developed the symptoms and have had a number of scary 'hypo' episodes when commencing exercise especially in the morning. This is causing me great concern, I didn't sign up for this surgery to become sicker than I was before it. I hope I can get some help on how to manage the symptoms as from what I've read up about, many bariatric patients end up developing reactive hypoglycaemia which I had no idea about until I started getting the symptoms. Does anyone know how best to deal with this? I want to be able to exercise but for the last few weeks I've been unable to manage much before the sweats, the shakes, and feeling like I'm going to pass out, and worse I want to eat!! My weightloss is at a stall, nearly 2 months and no change. Would appreciate any guidance. Please also be aware that this problem occurs to many many Bariatric patients quite often some time after their surgery and from what I've read there is no cure, just guidelines to manage it. Essentially though our Pancreas are delivering too much insulin into our bodies which is what causes the hypo. I'm seeing my surgeon next week for my 1 year review and my GP next week for bloods to see if there is any help I can get for this condition.