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OK this is a new symptom that has started over the last couple of weeks. For those that have had reactive hypoglycaemia you know that slightly jittery feeling you start to get that tells you it's on its way? Well I've been getting that on and off lately but it doesn't become hypoglycaemia and my blood glucose levels are fine (eg. 4.8 mmol / 86.4 mg). It's not affecting me dramatically, it's just more annoying than anything. I haven't changed what I eat. I am exercising more but it doesn't seem linked to exercise that I do. Like, I could wake up feeling this way. I'm not drinking lots of caffeine. So what gives? Anyone else have this happen?

Dumping is different and involves your blood sugar going very low which causes nausea, sweating, throwups, shakes, fast heart rate. (It's usually a result for some people who have too many carbs/sugar at one time or who might have too much fat.) It can also result in big D. You're talking about foamies/throwups from not chewing your food, eating too fast, or eating the wrong thing that your tum doesn't like. It actually gets stuck in your pouch. It may also cause a RH (reactive hypoglycemia) attack which would lead to the dumping phenomenon...but only cuz it's stuck in your tool and your body released insulin on what it "thought" you were about to send down the pipes that didn't end up showing up.

Definitely regular icecream and not much of it on an empty stomach. I stole about 3 or 4 spoons of my hubby's Ben & Jerry's at the movies once and about 20 mains later I got the shakes, feeling faint, nauseous etc. Haven't tried more than one teeny spoon of ice cream since. I once had a petrol station machine mocha and a small can of Pringles and oh my that made me dump AND throw up with 20 or 30 mins. That was about 4 mths after surgery, haven't done that again. Those experiences were enough to make me very cautious about sugar. Nowadays 10 mths out from surgery I have had a few reactive hypoglycaemia attacks when I ate stuff I shouldn't have. A scone with a teeny bit of jam and some nice cream gave me a hypo two hours later. As did a whole packet of cheezles I stupidly ate in one sitting. Also if I eat sweet (white or milk) chocolate I have to be very careful or I'm hypoing two hours later. Basically if I break the rules, I suffer, which is what I (well, technically the Health Service) paid €7450 for!

Are you lactose intolerant? It honestly sounds like dumping to me. I had it just last night cuz I chose to have a crappy dinner instead of my planned dinner. Sucked. It sounds exactly like reactive hypoglycemia and some of the sugar alcohols cause this same reaction in bari-patients.

@freetobeallofme, I would love to stay in touch of your progress with your revision to RnY. I don't know why I'm so nervous now. Maybe, the closer I get to the 9/19 revision date then the more I find more frighten possible complications that goes hand to hand with the gastric bypass. My gerd is mild, per my latest upper GI. The pantoprazole 40 mg is suppressing my acid reflux for now. I'm still experiencing some mucus buildup in my throat and lump like feeling if I eat more than 4 oz of food or eating too fast. 4oz seems to be my sweet spot for comfort level and no gerd like symptoms. I use to be under the believe if I reach the 24 bmi; then my gerd goes away. However, I see some fit people posted on YouTube or othe wls boards still experiencing gerd. I have to lose 25 more pounds to be at a 24 bmi. I'm blame myself for worrying about possible side effects of the gastric bypass. The dumping and reactive hypoglycemia. I worry too much about things that have not happened yet. Up until June of this year, my gerd was not as pronounced. Not until an asthma/allergy attack put my acid reflux to being extremely bad while taking omeprazole. My doctor switched me pantoprazole and that medicine has controlled the daily acid reflux for now. On top of all of this, I will be making a major relocation to Europe, moving to the county Netherlands. So I'm worrying about would the Dutch doctors know how to handle my new medical case if I should still proceed with the bypass. My aunt had a revision from VSG to gastric bypass last year. She has no problems. She's happy. My aunt is super positive and do not let life worry her. I not at that level yet. I still have time to decide if I need to continue with the revision. I pray that I have a sense of peace about this decision. Thank you all for sharing your experiences with me and offering your kindness.

I wasn't given a permanent 'no' list but anything with quickly absorbing sugar is a big no-no. Icrecream makes me dump so fast my head spins. Same with commercial hot-chocolate/mochas. Jams and refined carbs give me reactive hypos and I HATE them with a passion so I just avoid those permanently now. But I'm lucky I can do a bit of dark chocolate without too many problems, so that's my bit of naughtiness.

I have to be pretty careful what I do eat before not-eating for a while/fasting. Anything that spikes my insulin response (that can include too much protein or something with hidden sugar like carby bread) and I'm guaranteed reactive hypoglycaemia three hours later. I hate it! But if I'm good, I'm fine. I'm doing 18:6 fasting no probs if I make sensible choices and I'm so attune to hypos I can sense when they are coming pretty early on and then I pop a glucose tablet or take a teaspoon of maple syrup. I've got it down to a fine art because I HATE hypos (T2 diabetic in remission here).

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))

Most any surgery that you can contemplate, in addition to the basic risks associated with surgery, hospitals and anesthesia, will have some risk of side effects that may be less than desirable, however we take those risks in order to correct a problem that we have created by injury, disease or genetics, with the intent that the result will be much better than what we started with. The various bariatric procedures have different predispositions to consider - conditions that happen more commonly than in the general population. The VSG is predisposed to GERD as the stomach volume is reduced much more than its' acid producing potential, and while usually the body adjusts and corrects the problem, sometimes it doesn't completely. Similarly, the RNY is predisposed to marginal ulcers (typically around the anastomosis) because the part of intestine to which the stomach pouch is attached is not resistant to the stomach acid like the duodenum is (the part of intestine immediately below the stomach outlet, which is bypassed along with the remnant stomach.) Likewise, it is also predisposed to dumping and reactive hypoglycemia owing to more rapid stomach emptying due to the lack of pyloric valve. Usually, these problems don't hit most patients, or don't persist if they do, but sometimes they are long term problems. These are things to consider ahead of time, particularly if one has any relevant pre-existing condition. Another consideration is that the VSG is fairly easy to revise if it does run into a problem that can't be resolved otherwise, while the RNY is difficult to revise or reverse. Another point to consider is that while the sleeve leaves behind a relatively "normal" anatomy, the bypass leaves a blind stomach and upper intestine which is more difficult to examine endoscopically, so some problems may not be diagnosed until they are more advanced and symptomatic. For instance, if one is subject to stomach polyps, that is a pre-cancerous condition that should be monitored, but is difficult to do after a bypass. An pre-op endoscopy is a good idea to understand what is happening inside you, even if your program doesn't require one. On the diabetes front, they both do well, typically seeing 75-85% remission rates (remission is what it is, rather than a "cure" - it can come back, particularly with some weight regain) though the bypass is generally considered to be marginally better. The best results come from the Duodenal Switch which typically shows remission rates in the 98-99% range, but that is a more complex procedure that few surgeons offer. However, if the diabetes fails to go into remission, or comes back, after a VSG, a revision to the DS is straightforward (as the DS uses the VSG as its basis) while revising an RNY to a DS is very complicated, which only a handful of surgeons are able to perform. So, while the VSG may not be quite as good as the RNY in that respect, it has a much more viable "plan B".

There are two types of dumping, early and late. I had plenty of experience with early dumping. Anytime I ate a little bit too much, it would lead to early dumping. Because of this I learned to detect the signals my body gave me to tell me that I was at the edge, such as hiccups, sneezes etc. and then I would just abruptly stop eating not one more bite. But I never experienced high blood pressure or fainting symptoms. There is another type of dumping syndrome called late dumping or reactive hypoglycemia. The following link explains the two types. I met someone with this late dumping condition at a bariatric surgery support group meeting. He was not diabetic prior to surgery but after surgery, he experienced severe reactive hypoglycemia. He even fainted a couple times before he figured out this was a problem. Once he knew the problem, he knew what he had to do whenever he felt dizzy afterwards and found he could easily manage and live with that condition. Dumping Syndrome After Gastric Bypass Surgery But when I looked at your meal, I did not see anything to trigger this reaction. If you had a blood sugar monitor, it might be interesting to know what your blood sugar levels were during your dizzy episodes.

I too am experiencing severe episodes of reactive hypoglycemia. I’ve been hospitalized 3 times in the last 2 months. My sugar drops rapidly. It’ll go from 60 to 37 in minutes. Assigned to an endocrinologist team my last hospitalization and have now been prescribed Acarbose & a told to eat 6 small meals, high protein some fat & no more than 30 grams of carbs each meal. Just started med yesterday and concentrating very hard on following diet. It’s basically the keto & I could stand to loose about 10-15 lbs so I’m eager to try this. I’m wearing a freestyle glucosemeter (no pricking) to help track sugar & bump it up before I start feeling the symptoms. I’m also carrying glucose tablets to bump it up quickly. I have an appointment next week with endo to discuss progress & decide if anything additional or different needs to be done. I pray that something can be done because living with this has turned my life upside down. I’m afraid to drive long distances; lots of confusion; no interest in usual activities and also depression has set in. I feel awful that I’ve put my family through this worry simply because I chose to have the surgery. But I would have it all over again if given the choice of being very unhealthy & obese and my life as it is now. I just have to remember that and I’ll get through this! Sorry for being long winded. I just felt if anyone would understand my feelings it would be my fellow bypass friends. Take care, I’ll keep all posted as I go thru this. 😊

We are all different. My doctors’ instructions for my reactive hypoglycemia may not work for other people. It may help to contact your Dr. that has your medical history or an endocrinologist who works with diabetes/hypoglycemia. I’m fortunate that hypoglycemia was a lesser complication after surgery. Just like a diabetic manages blood sugars you also learn to manage reactive hypoglycemia.

Thanks! I already eat full fat but with the surgery I think I absorb only 20-50% of it. Same with protein. The only thing I absorb at 100% is sugar but that's what gives me the reactive hypoglycemia!

So, I know it sounds like this is a great problem to have, but... I had my SIPS (modified Duodenal Switch) surgery just about 2 years ago. Since then, I have gone from 268 to 98 lbs. (I'm 5'1.") I haven't had my period in almost a year. I don't fit into adult sizes anymore (even J Crew petite 00 is too big!) and have to shop in the kids section. I get reactive hypoglycemic reactions 1-2 times a week (even from just half a glass of orange juice.) I'm permanently on iron supplements due to chronically low iron, hemoglobin, etc and these make my stool really fun lol. I had skin removal surgery (abdominoplasty + brachioplasty) in late October 2018 when I thought I was done losing weight (at 125) but then the weight loss randomly started again and I've lost an additional 25 lbs since the skin removal, which makes it less effective (still very happy I got it though!) I'm a bit torn, because on the one side, this surgery has been HUGELY successful. I'm still not technically underweight for my height since I'm so short. But I'm hating all the comments I'm getting that I'm too skinny, why am I still losing weight, the weird looks if I have the reactive hypoglycemic thing where I'll be super nauseated, lightheaded, and shaky for 20-30 minutes. Has anyone else experienced this? If so - what did you do?

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,

I just go back to basics when I need to lose weight. Protein first, then non-starchy vegetables. If I have room after that, maybe a small serving of fruit or whole grains. I don't think I could go all the way back to shakes only at this point. I also have reactive hypoglycemia. Eating something every 3-4 hours helps with that. Either a protein or, if I do a carb, then I pair it with a protein - for example, some apple slices with peanut butter.

I dont have a sleeve. Does that matter? I had gastric bypass. Plus I have reactive hypoglycemia, what do I do about that? Sent from my SM-G970U using BariatricPal mobile app

It might be, but probably not. Presumably, the doc has prescribed omeprazole, or similar PPI medication for it. The sleeve is predisposed toward reflux problems as the stomach volume is reduced much more than the acid producing capacity, and it takes a while for the body to adjust (doesn't mean that one will have that problem, just that the odds are higher than the general population, in comparison, the bypass is predisposed toward marginal ulcers, dumping and reactive hypoglycemia, so there are potential problems with whatever procedure one chooses. ) Usually, the problem goes away as the body adjusts, but sometimes it doesn't completely and one needs to stay on some type of medication for it, or in extreme cases, revise the surgery.

Some stretch, or growth or adaptation is to be expected - we don't stay at eating only 3 tablespoons forever. This doc gives a good idea of the progression of meal volume that can be expected, and is consistent with my experience - You may or may not get along with his prescription for countering this effect, but it is a viable one. In short, we need to learn to accommodate some increase in eating volume without allowing the calories to get out of hand - taking up that added volume with high bulk, low calorie veg is a good way to do it. As to which procedure to go for a revision, the first thing I would want to know is whether the stretch that your doc sees is unusual - sleeves done by docs early in the learning curve of doing sleeves (and 2012 is consistent with that for many surgeons) may have undue stretch if it wasn't formed well to begin with. Sometimes excess fundus (the stretchy part of the stomach that is largely removed with the VSG) is left behind at the top or bottom of the stomach, or other shaping issues may lead to the problem. If the sleeve is nominally well done, there is probably little to gain be resleeving it - you will lose some at the outset from low capacity due to surgical inflammation and the very restricted diet that we have early on, but overall you shouldn't expect great things from it. Likewise, a bypass is similar in its overall power to the sleeve, but does have some temporary caloric malabsorption that can help get a little extra weight off, but doesn't do any better when it comes to resisting regain; in some patients it is worse in that regard due to reactive hypoglycemia inducing more inter meal hunger. Overall, when I think in terms of revisions, I see a procedure that is more complicated than the original virgin WLS, and usually less effective overall (think in terms of your stomach originally having a capacity of 32-64 oz, and now a few years post op it may have a capacity around 6 oz, so there is less difference to play with. Being more complicated both in implementation and in the reason for doing it in the first place, I like to get a second, or even third, opinion on the matter - different surgeons have different experiences and perspectives on these things. There is also the aspect that while doing a virgin sleeve is a fairly straightforward procedure, and most surgeons are now fairly well up the learning curve in doing them, repairing or revising a faulty sleeve is another matter, so I would look to a surgeon who has done lots of them. In NJ, I would suggest Dr. David Greenbaum as a good guy to consult with. A final thought - what is the capacity of your sleeve now? How much chicken or steak (and nothing else) can you comfortably eat? We usually remain fairly restricted on firm meats for a long time, but can eat an almost unlimited amount of "sliders" - things that just slide on through with limited restriction, which are frequently also pretty junky.

Early on I had 'meat sweats' a few times right after eating, and the dizziness and would need to lie down. It's sounds like reactive hypoglycemia https://www.google.com/url?sa=t&source=web&rct=j&url=http://www.eigerbio.com/resources/Goldfine-2016.pdf&ved=2ahUKEwj12ZTU94niAhUNvKwKHU2qAx8QFjASegQICBAB&usg=AOvVaw3_1GW7msGkeuZlxOShhfXR

Thanks ladeedee - like you I wish there was more for vets. I have a horror of being where I was and am so aware that it's psychology as much as physiology. I get reactive hypoglycemia if I overeat sugar. It's happened more than once. That statement tells me all I need to know about sugar but I struggle to act on it. Well done you for your own stats. And maybe the key is gradually changing behaviour rather than back to the see saw. I can do 7lbs in a week intermittent fasting. But I can't sustain it. I need something for everyday that I can comfortably do! Anyway. We get to give ourselves back pat's. We're doing okay !

I had gastric bypass surgery around 6 years ago and I am very pleased with the results. It is sort of like the gold standard for bariatric surgery. They have most of the bugs worked out. Mini-gastric bypass is somewhat new so I can not really assess it. In general, many people try various kinds of diets prior to eventually getting gastric bypass surgery. Most of the time these are referred to as yo-yo diets. Because the individuals will lose some weight but then over time give up the diet and then gain the weight back and then some. So it is like a yo-yo. In your case it went to the extreme and you slid into anorexia. So the only advise here is that the psychological treatment component is very important for you for the surgery to work. (the package with the 12 phycologist sessions). Also if things go south sometimes after surgery then reactivate the physiological component. The three most important elements after gastric bypass surgery are to meet your daily protein, fluid and vitamin requirements. Food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight.

Never give up, chatted with a lady who was worried because she was 3 years out, wondered if it benefited her? Reminded her You're still alive, there's a bonus right THERE, when you start out at 300 or 400 pounds all you hear is Doom, Gloom and You're Gonna Die Soon! Are you still hearing this from doctors? No? Good Step! I even had my pastor get on my case, wondered how soon he would have to preach my funeral? Told him put the prayer books and Bible away, I am not plotting my demise in the near future, if anything happens , I'll have my son call YOU!❤ Yeah I too have Thunder Thighs and a Hubba Hubba Heinie, joked I could feed an entire cannibal family off one butt cheek for Easter dinner! As I lose weight, I hardly recognize myself, I used to have pudgy chipmunk cheeks, round-square shaped face, now my face has narrowed out and I am starting to resemble several dead relatives, never saw a likeness before. I think my color is off, live in Ohio so winter pallor, sunshine has yet to kiss my face, of course when it does I will either freckle or it will reactivate my rosacea, the curse of a Celtic ancestry. Its hard to be accused of being a lush ( just because I'm Irish) for my blotchy cheeks and 👃. Few attempts I made at alcohol made me only sleepy, if I'm gonna get taken advantage of, might as well stay awake to enjoy it! Yeah, I once might have been as big as the Blarney Stone but inside me resides a leprechaun spirit, don't take a lot serious anymore, I'm more fun at 73 and losing down weight than I was at 30, or even 50-60, I now have hope and that enlivens all the facets of my life. The world had discounted me as fat, worthless, might as well die, well I am proving them wrong, they were looking at a. fat shell, they didn't try to know me, the real me inside. For a while I couldn't visualize any changes in my exterior, thought it was useless. Then I started being able to sit in chairs I used to have my son help pry me out of. I could stand up off of furniture without him holding and yanking me up. I was having better luck having strength to go places, pay my bills, do all those little errands. And clothing that used to split me where I was trying to sit, suddenly I had wiggle room. And those little things kept mounting up. One of my latest, bought an outfit for an upcoming doctor appointment, hung it in the closet, morning of the appointment I started dressing, pulled on the pants and they fell down! Good thing I had saved all the tags. Back they went to get a size smaller. Still didn't believe it totally so I tried the next lower size on! OMG I really was that much smaller, fit better than any others had recently. I had a lot of " well it's close to right, I'll just have to settle for that." All of the sudden I can try clothes on, choose what I really want, not to panic and buy something just because you're afraid they won't get that size again. And it is so blasted cool to have such an option. Now I Am not the Largest size they carry!💦Tears of Joy!

I get a variation of dumping with my sleeve where I get reactive hypoglycemia if I eat too much sugar (for example, I ate a pack of Skittles earlier this week, and within an hour or 2 my blood sugar was crashing and I was shaky and sweaty). It feels awful. It's a result of the massive changes to my metabolism causing hypersensitivity to insulin, and my body being used to dumping insulin into my system whenever I eat sugar. Hopefully it will balance out. If not, I'll just have to cut out all refined sugars (which I know I should do anyway!)

13. One skill or hobby you want to take up. I have three and I can't choose between them. When I get down a bit more, Imma reactivate my scuba license; take up horseriding with my daughter and start doing zumba/aerobics Sent from my SM-G930F using BariatricPal mobile app