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Well the week before last I went to my PNP and got lab work done and my TSH was 96.5 (Normal 1-5ish)! She said she is not sure how I am even moving around right now. What really sucks is my level was actually right on about 6-7 months ago on 274mcg of levothyroxine but my old PNP made a mistake and told me that I was Hypo again, but really my TSH number was low. So I decided to switch from levothyroxine to Armor Thyroid (60mg twice a day) and kept forgetting to take it regularly. Anyway True Results re-drew my thyroid levels yesterday and were supposed to call me back today to let me know what they were. They didn't and now they are closed until Monday morning and I am left worrying if I will even have surgery on Thursday. The real kicker is I started my preop diet today...as if this isn't hard enough! Anyone else had experience with True Results and high TSH levels? My patient advocate said she would still try to get it approved because the Dr. normally doesn't care as long as it's not something that will affect your actual surgery.

Oh, thank you, for mentioning the Facebook thing. I'll be careful not to do that since I have decided, for now, not to tell anyone, except my husband. I am pretty sure I will share with friends and family, eventually. I just don't want to have to deal with any commentary/opinions for now. My side of the family is a little too honest at times. I remember, I hadn't seen my brother for about a year. I had had a baby, and when I saw him next his first statement to me was not even hello but a straight up "Boy, you have put on a lot of weight." Rude! When my children say something reactive like that, I always reming them; 1) You can have a whole thought process in your head but the world doesn't need to know about it and 2) If you have nothing good to say, say nothing at all. Hope your hip recovers soon. How did you get hurt?

Here is a list of some of the abbreviations used on this website. ACL = Anterior cruciate ligament AGB = Adjustable gastric banding AMRAP = As Many Rounds As Possible (crossfit) BB = belly button bc = because BCBS = Blue Cross/Blue Shield BED = Binge Eating Disorder bf = best friend BM = bowel movement BMI = Body Mass Index bp = blood pressure BPD = Borderline Personality Disorder or Biliary Pancreatic Diversion bs = blood sugar btw = by the way CBT = cognitive-behavioral therapy CC = common channel c diff = clostridium difficile cos or cuz = because CPAP = continuous positive airway pressure CRNP = certified registered nurse practitioners cw = current weight CXR = Chest X-Ray DDD = degenerative disc disease Dr. = doctor DS = Dumping Syndrome or Duodenal Switch EGD = Esophagogastroduodenoscopy EKG = Electrocardiography ff = fat free GERD = gastroesophageal reflux disease GI = gastrointestinal GNC = General Nutrition Corporation store GP = general practitioner or family doctor HBP = high blood pressure hr = heart rate hw = highest weight ICU = Intensive Care Unit Idk = I don’t know IMHO = in my humble (honest) opinion IMO = in my opinion IUI = Intrauterine insemination LAP Band = Laparoscopic Adjustable Gastric Band lol = laughing out loud LSG = Laparoscopic Sleeve Gastrectomy med = medicine MFP = my fitness pal msg = message NASH = Nonalcoholic steatohepatitis nf = non fat NG = Nasogastric NP = nurse practitioner NSAIDS = Non-steroidal anti-inflammatory drug NSV = non-Scale victory (“scale” means “weight scale”) NUT = nutritionist OA = Overeaters Anonymous omw = on my way Onederland = a magical place or destination for those trying to lose weight. It might correspond to attaining a weight in the hundreds or losing a hundred pounds. op = operation OSA = Obstructive Sleep Apnea Oz = Australia PB = Productive Burps PCOS = Polycystic Ovary Syndrome PCP = Primary Care Physician PICC= Peripherally Inserted Central Catheter PM = private message (email) PMS = premenstrual syndrome POSE = Primary Obesity Surgery Endolumenal postop or post–op = post-operation or post-surgery PPI = Proton Pump Inhibitors ppl = people preop or pre-op = pre-operation or pre-surgery PTSD = Post-Traumatic Stress Disorder PVC = Premature ventricular contractions RA = Rheumatoid arthritis RH = reactive hypoglycemia RN = registered nurse RNY = Roux-en-Y RTD = ready to drink RYGB = Roux-en-Y gastric bypass SADI-S = single anastomosis duodeno–ileal bypass with sleeve gastrectomy s/f or sf = sugar free SG = Sleeve gastrectomy SIPS = stomach intestinal pylorus-sparing surgery smh = shaking my head, scratching my head SO = significant other SOB = shortness of breath sw = weight at surgery tmi = too much information TPN = total parenteral nutrition TT = tummy tuck TTC = trying to conceive Ty = Thank you. [but according to the urban dictionary “Ty” is also an abbreviation for “a total stud with a massive carrot”.] u = You UGI = Upper Gastrointestinal VSG = Vertical Sleeve Gastrectomy Vit = vitamin wks = weeks WLS = Weight Loss Surgery WOD = Workout of the Day w/o = without wt = weight or :-) = = smiley face or :-( = = sad face

This is going to be long, so I apologize. I'm just frustrated. I'm almost 2 years post VSG and have developed a significant case of GERD. It's so severe, and not controlled by medication, that my surgeon feels we can't just let it go. He has recommended that I undergo a procedure called stretta, which seems promising. We submitted for approval to my insurance company which promptly rejected the request (took them all of 3 business days) on the grounds that the procedure is experimental and there are well accepted alternatives, including pharmaceutical therapy and Nissen Fundoplication. Well, I'm not controlled by medication and the only combination that provides any relief Protonix/Dexilant was already rejected by the Company (they won't pay for the Dexilant and at almost $400 a month, the cost is almost prohibitive). Also, given that I no longer have a fundus, a fundoplication isn't available to me (nice going insurance co . . . way to review my medical records). My final option is conversion to bypass, which I really don't want to do. Other than my GERD, I LOVE my sleeve. It's allowed me to lose 130lbs and live an active lifestyle I've only dreamed about. I like having my pyloric valve and not having to worry about dumping, reactive hypoglycemia, etc. Also, the thought of another major surgery is not thrilling me. Anyway, my surgeon gave me the cost for both Stretta ($5,000) and conversion ($100,000). We decided to seek approval for conversion just to have it in our back pocket while we appeal the denial to my state Department of Insurance. Wouldn't you know it, they approved the $100,000 surgery. This is a prime example of what's wrong with the insurance industry. Why would you approve a $100,000 solution to a $5,000 problem???? Just frustrated beyond belief and knew this was a good place to get out my aggression . . . here and in my kickboxing class where I visualize the Ins. co's medical director's face as my target!

Im hypo. Too, and wasn't familiar with EPO. I'm 8 weeks out and expect to lose hair due to surgery and stent in ICU, and difficulties with protein -- the surgery is worth the hair loss but I dread it -- I already can fill a hairbrush in a couple of days.

I would test before Breakfast and 1 hour after dinner. You want to take advantage of what little info you are able to gain. What is your typical fasting blood glucose level? Those are exactly the times that I test. Post surgery my BS is about 12 for fasting. I purposely do not take a lot of insulin at night because I live alone and if I go hypo there is no one here to help me get glucose or shake out of it if I am sleeping. I am happy with 8-10 for fasting levels right now I was a completely out of control diabetic. I only started to reign it in about 4 months ago when I had my ah ha moment. In my out of control days I was regularly at 26-31 at night and fasting levels of 18-23. Crazy numbers

I'm not in agreement with your doc's logic about doing nothing now then repeat the tests. If you're hypo new it won't magically change to normal. And since getting the dosage right to get your level back to normal can be tricky, waiting makes no sense. I'm hypo thyroid due to a total thyroidectomy. It took a year to get my dosage correct to bring me back to normal.

The general advice for a hypo ( non wls ) is to have something that is high in sugar and easy to absorb, liquid is better than solid. So orange juice, high sugar cordials etc ( avaoid carbonation). Alternatively foods such as honey or jam also wok quickly. Then once the person appears to be returning to normal it should be followed up with a good quality, low gi carb e.g a banana or whole meal bread sandwich. Obviously for wls patients i imagine the recommendations would be a little different . However it is still important to raise and stabilise the blood sugar.

I've had late stage dumping a few times which is reactive hypoglycemia. Usually two to three hours following eating something I shouldn't have. I can eat almost anything with sugar and symptoms disappear within 20 to 30 minutes. But in my case, I have always been able to identify the food that caused the dumping. From your description, it sounds like your sugar is low and pretty much stays low. I'd discuss that with your doctor. It's not common but hypoglycemia can be serious and result in loss of consciousness if it gets low enough. I'd check with the big kahuna.

I was surprised to find this thread is so current while I was searching Reactive hypoglycemia post–gastric bypass. I was having a few sugar drops recently so my GP had me do a two hour glucose test. My two hour blood draw was 36. To me the scariest thing was that the week before I had two incidents in one day where the room started to spin and I was sweating profusely. After driving myself home from my blood work I entered my kitchen and then the symptoms kicked in. So how low could I be getting before symptoms? I would have never driven if I had known I was that low. Tomorrow I go to an Endocrinologist. I have never been a diabetic so I am not very happy with this new issue.

Here is some more info on Reactive Hypoglycemia. http://www.mckinley.illinois.edu/Handouts/hypoglycemia_nutrition_reactive.html

I am 27 I had mine done Jan 26 and I have no regrets at all I have hypo thyroidism I went from 125 pounds to 225 in like 2 months BC it was so out of whack then I had two kids and was married my highest weight was 261 I am now at 240 in only three weeks!! I've never been so happy w it my parents were very supportive and I even got into a gym because the excess skin I do not want that at all my surgery went great he said it was textbook I had a little reaction to the sturry strips but no infection nothing I missed for for about a week and then I got OK w it ! Im so glad y'all divided to do it it is so life changing ! I feel 100% better already @lesleslosinit ur surgery was two days after mine

check with your PCP - could be a lot of things. Some patients have trouble with orthostatic hypotension when standing up suddenly - but it could be a number of things. I had some issues about two years out. Everything was normal the day of my workup (they pretty much checked EVERYTHING), but they think it might have been, for me at least, reactive hypoglycemia - and if so, my glucose level just happened to be normal at the time they checked it. They also checked me for inner ear issues (which controls balance), urinary-related issues, God knows what else in my blood, etc. Just telling you this because there could be a lot of causes for that.

I have reactive hypoglycemia now(I'm in no way a dr, not giving you medical advice at all). I have it now that I've had surgery, but also had it when I was younger. The things you describe are what I feel when I have an episode. Go search reactive hypoglycemia in and there is a great post from RJ's beginning on the subject. Mayne you can relate to some of it. I would start to carry around a baggie of nuts with you everywhere you go. Or a Quest Protein bar. Something with fat and Fiber both. The nuts and a cheese stick pick me uo fast when I have an episode.

I don't have hypo I have hyper. I just find the timing strange. But it is what it is and i must deal with it. Having a scan on tuesday

Congrats to you! I have Hypo Thyroid disease too. You will do fine. Just take your meds and vitamins everyday.

Hi Laurie, sounds like your insurance is almost exactly like mine, with their requirements. They wanted me to have had meetings with nutrtionists, and physician approved exercise programs. The fact he had councelled me concerning my weight and the morbidities it was causing...high blood pressure, diabetes, etc. was all wonderful....but not enough. Nothing I had was enough, after my 2nd denial, we went to Mexico and went self pay. I wish you much luck and if there is any help I had to offer it would be all yours, but you have learned the documentation importance. So along that line, every time I now go to my Dr. I don't care if it is for a stuffy nose, I intend to complain about heat rash or some skin issue under my belly fat, and beneath my breasts, and if he does not seem to be writing it down in my chart, I will go so far as to ASK it to be documented that I requested help for it. I just got my band this week, and am only down 10 pounds with the pre-op diet and all, but I am prepping for the day the PS is necessary, and hoping this talking it up now helps! I lived....and learned....gonna try it this way now!!! Proactive vs. reactive to the insurance nonsense!!! Kat

Reactive Hypoglycemia. Some of these fake sweeteners can cause it. When I gave up meat and was existing on protein bars and other protein supplements it happened to me. It was pretty terrible, I thought I was dying 1/2 the time until I figured out what was going on. Never had that issue with Premier Protein though.

So after a couple of unpleasant incidents, I've done some digging, and as far as I can tell I have been suffering from reactive hypoglycemia (RHG). All of the symptoms I get are hypoglycemic (flushed/chills, nervousness, trembling, slight mental confusion, feeling like I'm going to collapse, etc., all coupled with a sort of panicky hunger -- "I have to eat NOW or I'm going to fall over!"), and it's relieved by eating (but only if I'm careful and eat high-Protein foods, carbs just make the swings worse). I'm curious if anyone else has gone through this with the sleeve. Incidentally, some call this or confuse this with "dumping syndrome" -- they're not the same, but they may be related. Eating in a way that leads to dumping apparently can dump a lot of blood-sugar spiking food into your small intestine at once, faster than your body can properly deal with. So part of the "eat every two hours" thing is to eat smaller meals and avoid dumping. The Wikipedia article (http://en.wikipedia.org/wiki/Reactive_hypoglycemia) mentions this. I am not diabetic, according to NUMEROUS tests by my PCP (given my weight and a family history, it seemed like a good precaution). Apparently, RHG is very common for WLS patients about 15-20 months out (I'm ~19 months out). It's made worse by not eating lots of small, high-protein meals, by not getting enough cardio, and by consuming too much caffeine. I'm guilty on all counts, but it seems like caffeine is really the worst offender for me. I don't do well with moderation, and I've discovered that when I really go overboard on caffeine, I get bad RHG, often at night. Also, it seems to be the combination of caffeine and carbs for me -- I don't drink caffeine at night, but my nighttime meals lately have been carb-heavy (spaghetti, for instance), mostly for convenience. And it seems like my RHG is happening mostly in the evening. So, I'm curious who else has struggled with this, and how you dealt with it. Unfortunately, since I changed jobs in mid-June, I'm not yet eligible for health benefits so I can't go see a doctor about this. That will be changing soon (next week, I think), but I really don't think this is an emergency condition, especially since I seem to be able to manage it by eating healthier, avoiding caffeine, and so on. Mostly I'm looking for support and advice

Reactivate, do you go to Kaiser? There are groups in Sacramento I think. Send me a PM if you'd like more info.

For me, sugar is sugar, my body doesn't care if it's from fruit or a packet. (I had VSG). Protein and fiber help slow down digestive emptying, so yes they might help. But higher protein/fiber shouldnt be justification to eat higher sugar. I have found the low glycemic foods to be "better". Once it starts, you just have to let it pass. For me, it's not consistent. It seems to happen with more liquid type foods and isnt always tied to grams of sugar. High carbs in general can do it, but high sugar always does. It sometimes seems random and I havent figured it all out yet. I can eat kit kats, but not drink a premier protein shake. I can't eat mashed potatoes or soup. Oatmeal is fine. I can eat dry cereal fine, but I cant eat it with milk. I also get late dumping/reactive hypoglycemia. Between 2 and 3 hours, my glucose crashes. It sucks. Sent from my SM-G965U using BariatricPal mobile app

Here are a couple sites so you can look at it yourself..K http://www.healthlinkbc.ca/healthyeating/reactive-hypoglycemia.html http://chealth.canoe.ca/condition_info_details.asp?disease_id=73

I too am having trouble controlling my depression. I went to my family doc who changed my Celexa to Cymbalta. I also have Reactive arthritis which causes pain daily, so the Cymbalta helps with that too. I have been working (full time) with pain and dealing with the relatively new Lap Band. So I don't know if it's the combo of it all or the Lap Band. Although, the books do mention depression after bariatric surgery. Sue

I was banded April 23, 2008. I haven't lost or gained anything since. I lost 24 lbs the weeks prior to surgery during prep time but nothing since. My doc said I may not lose during the healing period, and I might even gain after starting to eat again. I haven't been exercising very much. I have reactive arthritis and am having alot of foot and ankle pain. But I also don't eat very much at all. Ive thought that maybe Im not eating enough? What do you think? Is it common not to lose before your first fill. My first fill is tomorrow.

The thing I've found with hypos as a diabetic is they happen if I have a long gap between eating. So I would recommend splitting your calories into 3 meals with 3 snacks spaced evenly. Try eating some cheese and/or nuts for your snack (something with a bit of protein), and a smaller meal to balance the calorie load. Eg Breakfast 7.30am, snack 10.30am, lunch 1pm, snack 3.30pm, dinner 6pm, snack 8.30pm. You should still carry some fast absorbing sugar (eg glucose tablets) just in case. And do healthy carbs for your meal eg veggies and beans, mixed with your protein of course. Sent from my SM-G930F using BariatricPal mobile app