Reactive Hypoglycemia

Reactive hypoglycemia is commonly diagnosed after Roux-en-Y gastric bypass surgery. It is far more common than many deficiencies are post op so it is very important that you read about, learn about it and watch for signs of it as you progress through your journey. For most symptoms will develop after the first year, going into the second year post op. Some people do not get diagnosed though until later. Recognizing symptoms is key.

Serious/severe cases of reactive hypoglycemia can requires removal of parts of our pancreas. For most of us however, the symptoms are not that severe and we can just monitor our diet, make simple changes and monitor times when we may be high. It took me some time before I pieced together my own symptoms.

The first symptoms I noticed were at work, after I had a carb heavy lunch. I would feel "all floopy" (a quote from FRIENDS. LOL!), get a little lightheaded and VERY chatty. I really didn't think much of it to be honest.

At these times as well, I'd get a little shakiness of my hands and I felt a 'little out of it'. It wasn't until watching television one night that I really clued into what was happening. I was watching Friends and was getting a little annoyed because the people on the show seem to have lost their chins. I kid you not. It seemed as though all the charactes had these long and pointy chins. I was crabby too. I realized at that point that something weird was going on asked hubby to get his blood sugar monitor (he's diabetic). He took my reading and said "Wait! That cannot be right. It says 1.1". (In Canada we have our own system for blood sugar - that would be around 18 I believe in the American system).

He scratched his head. He did the test again. Yes, I was THAT low. This is low enough that I could have had a seizure or passed out. He immediately called his Mother who was a nurse and asked what to do. He gave me 1/4 cup of juice. Within 15 minutes, my sugar came up.

This is the scary part of hypoglycemia. If you get too low you could pass out (doing almost any task or have a seizure).

Reactive hypoglycemia - also known as Postprandial hypoglycemia (low blood glucose after meals), is a medical term describing recurrent episodes of symptomatic hypoglycemia occurring 2–4 hours after a high carb meal. Symptoms may include:

Mild Hypoglycemia:

* Increased or sudden hunger ( I don't get this one)
* Feeling shaky, dizzy or nervous (YES)
* Pounding heartbeat (NO)
* Drowsiness, feeling tired (SOMETIMES)
* Sweating (cold and clammy) (YES)
* Numbness or tingling around the mouth (YES)
* Headache or stomachache (NO)

Moderate Hypoglycemia

* Symptoms above plus:
* Headache
* Irritability
* Confusion
* Slurred or slow speech
* Coordination difficulties

Severe Hypoglycemia

* Any of the above mild or moderate symptoms, plus:
* Loss of consciousness
* Seizures and/or convulsions
* Death (not common but possible)

Most doctors will want to do a "Glucose Tolerance Test" on you to find out if you officially have reactive hypoglycemia or not. If you can avoid that, do so. My doctor really wasn't in the know and she suggested it. Dummy me agreed. Well I passed out about 5 minutes after taking the orange drink. Not so much fun. If your doctor insists that you take it, take someone with you. Prepare to dump possibly too. What you can do instead is log your foods, and your blood sugars after them. Note the carbs/sugar in each product, write down your blood sugars at the 1 hour after and 1.5 hour after and 2 hours past eating. Look for trends. You'll need to find out YOUR triggers are, and what foods work best to bring you back from a crash. You'll find what you should be carrying in your purse to bring you up from a crash whether its crackers & peanut butter, glucose tablets, juice etc. The key is to learn when you feel like you are going to crash and to deal with it then BEFORE you actually have a crash. Write down everything. My blood sugar monitor went through a huge workout until I could figure out what works for me.

Also be sure to:

*Eat according to the "rules" - protein first, moderate complex carbs and healthy fats.
*Never eat a carb without a protein or fat.
*look for lower GI breads.
*Avoid simple processed sugar products.
*If you have something high in sugar, be sure to eat something else at the 1 hour mark to avoid a crash.
*When symptoms start, take your blood sugar. Be proactive.
*Write down everything!
*Eat according to a schedule.
*Swap white bread for whole grains
*Eat before you exercise.

Dawn

My First 5K

I admit it.

I was the last one picked in gym class and I still haven't gotten over it.

It's true. I have always been the overweight child and going into high school, I was not exactly eager to take Gym class. Unfortunately for me, the government sort of mandated that year that everyone had to take ninth grade gym class. I was not amused.

I was teased incessantly, ridiculed about my weight and of course, was indeed the last one picked in gym class.

Today I had my first 5K. I still felt like the last one picked in gym class. As the runners were all gathering, waiting for the race to begin, I couldn't help but feel like I was out of my league. I didn't belong. I was the one who was sorely out of place.

And unfortunately, I really wasn't prepared. When I set my sites on this 5K, I was in the middle of doing my Couch to 5K program online that told me that I would do well on a 5K and be able to run it straight by the time I was done. Unfortunately, in the middle of a long, cold Canadian winter, I was training on the treadmill and found out later, that baby, it's a whole different thing on the treadmill.

Once done my Couch to 5K training (google it if you want to for the program), I was sure that I would make the treadmill to transition rather easily. I could now run a straight 30 minutes on the treadmill and so it would be easy? Right?

Not on your life.

My goodness! I couldn't even do a straight 2 minutes on the pavement! Eek!

Luckily, I signed up to do a Running clinic where once a week everyone begins at their level and runs together accordingly. I had the option to start at the beginning level which offered running/walking intervals (much like I'd done with the Couch to 5K program on my treadmill). Luckily, I signed up in advance because I couldn't back out. I was ready to completely throw in the towel on my running, feeling so super frustrated that I was starting right back at the very beginning yet once again!

So that's where I stood until I remembered that I'd also joined up for my first 5K this weekend. (some friends had said they'd do it - but no one ever really said that for sure they were going to do so....so it was looking like I wouldn't have to be accountable...and maybe, just maybe, I could bow out....).

On Friday, my coworker came to me and said "Hey good luck on your 5k this weekend!". Oh Yah. I forgot. How did she remember? (As I'm thinking: I can just back out, no one will remember...."). It happens that my race coincided with the weekend of the Boston Marathon (which she was doing as well) so she couldn't forget.

*ugh*. Someone would keep me accountable?

So of course, Saturday's forecast predicted rain, rain and more rain. And oh yah, some pretty heavy wind action as well.

LOVELY!!!

Even the morning of the 5K, I was not exactly sure if I was still going. The original plan also called for my hubby to go with me, but having started a new job he was working this day, so no hubby support either. No friends that I knew of doing it as most had put on their facebook that they were going shopping or some other clearly not running-related activity.

So yes, I dragged my butt to the racing site. Started chatting with a lady near me who said she was the world's slowest runner. She'd been running for 2 years. She was super nice and kept the boredom factor low.

Then all of a sudden, Joanne comes into the pavillion! It's like an angel appearing with the ray of light. Joanne is in my WLS support group and she and her boyfriend Bill have been super supportive with my running. (Bill has gone hardcore after losing his WLS weight as well - now gearing up for triathalons even!). Joanne is a soft runner. She tells me that she's still fighting an injury but she decided to come out and even if she "has to take it slow. It is still better than sitting on the couch!".

She keeps me company the whole race. She stops when I stop. She walks when I walk. The rain stays away. It's cold and windy. It's miserable but we keep plowing through. I clearly suck at running. I am not able to get my breath when I am running. I walk alot.

But I still do it.

I am the slowest runner/walker in the race. I am still trying though. Joanne stays at my side the whole time, talking to me, encouraging me, pausing when I pause. The wind is killing me.

I finish in 43:40. Embarrassing slow. I could literally WALK faster. But Joanne is still by my side and hubby is at the very last turn of the race, encouraging me as well. It's a good day and I can see the finish line and it's done.

Definitely not marathon type standards but I can say that I did it. I have a starting place. I know what I can do. I know where I can go from here. I know that I am capable and that I can better. I am trying not to be discouraged, but hopefully. Everyone starts with one small step.

This is only the beginning of my next journey.

Dawn

Children and Food

As a Kindergarten teacher, it can be disturbing for me at times to see children that are already showing signs of being overweight. It can also be somewhat upsetting to see what the children are eating. In my class, we have two eating times: one is a "snack" time and the other is a "lunch" time. It's really interesting to see the variety of foods that come through the door. It's also, at times, alarming.

Growing up, I was immersed in a processed food world. It is no wonder to me that I struggled with my weight and became an obese adult. Meal times were irregular at my house and we never sat down to eat a family meal. My Father ate his meal regularly and it often consisted of the same thing: meat, potato (often fries) and corn. He was a shift worker so he ate at all hours of the day. My Mother (who also battled a weight problem) rarely ever sat down to eat a whole meal and mostly, grazed throughout the day. If she were to sit down with me, it would be for a meal of takeout, Chinese and pizza. My Mother *hated* to cook.

Dinner for me was often junkfood: toasted bacon sandwiches (I kid you not), hotdogs, Kraft dinner, hamburgers, takeout etc. We never really ate vegetables other than potatoes (fries mostly) or corn. The only time that we really even kind of sat down for a meal was on Sundays when Mom actually cooked a roast. But often that involved her and I eating in front of the television.

Is it no wonder that I struggled with my weight growing up?

I see a variety of trends with my students. I've been pushing "brain food" the last month like fruits and vegetables. It's starting to help a bit. My one boy student who struggles with attention issues (hmmmmm....diet changes might help) is forgoing the junk food and brought a banana today. I had a child today who brought in kiwi (the other children gathered, flabbergasted by this strange green fruit).

I see too many lunchables. With children it is a sad status symbol. I see a TON of processed carbs (granola bars, nutrigain bars, 100 calorie packs, cookies). I see lunches that consist of these all thrown together with no protein at all! Scary! I see a ton of juices laden with sugar (have also been promoting water as the best drink ever), and koolaid jammers (ick!). I've seen parents coming in and bringing KFC, MCDonalds etc. Thankfully they seem to know it is a treat and don't do it that frequently.

But on the positive side, I've seen children eating some nice garden salads!! Real yogurt, fruit salad, strawberries, etc. I am seeing more and more fruit coming in! I can see already that for some children, it really does make a difference.

I have a real problem with these companies that dumb down their products. Think of KD, who introduced Kraft dinner made out of cauliflower. Sounds healthy right? Not til you read the package. I hate that the local Macs store is carrying those stupid milkshakes that have no nutritional value whatsoever. I wish our society would be more critical of these products.

Oh well, rant over :)

Dawn

Probiotics and RNY

To be a successful RNY patient, there are different things that you can do to "up" your losses. One of them is exercise that will tone your body and of course, help you lose a wee bit more in the long run - especially the last 20 lbs. One often underlooked other advantage can be probiotics.

So what are probiotics? They actually sound rather disgusting when you think of the actual concept. They are basically healthy microorganisms. These microorganisms may help with digestion and offer protection from harmful bacteria, just as the existing "good" bacteria in your body already do.

Probiotics can be added to your diet through nutritional supplements or foods such as yogurt, fermented and unfermented milk, miso, and some juices and soy drinks. When reading a label you would be looking for a statement that the product contains "live and active cultures," such as lactobacillus.

Although more research is needed, there's encouraging evidence that probiotics may help:

* Treat diarrhea, especially following treatment with certain antibiotics
* Prevent and treat vaginal yeast infections and urinary tract infections
* Treat irritable bowel syndrome (IBS)
* Reduce bladder cancer recurrence
* Speed treatment of certain intestinal infections
* Prevent and treat eczema in children
* Prevent or reduce the severity of colds and flu

In a study published in the July issue of the Journal of Gastrointestinal Surgery, the Stanford University School of Medicine and Stanford Hospital & Clinics, showed that patients who take probiotics after the gastric-bypass procedure tend to shed more pounds than those who do not take the supplements. Probiotics are the so-called “good” bacteria found in yogurt as well as in over-the-counter dietary supplements that help in the digestion of food.

The researchers followed 44 patients that had RNY from 2006 to 2007. Patients were randomized into either a probiotic or a control group. Both groups received the same bariatric medical care and nutritional counselling, as well as the support of weight-loss study groups. Both groups also were allowed to consume yogurt, a natural source of probiotics. In addition, the probiotic group consumed one probiotic pill as well.

The study showed that at three months, the probiotics group registered a 47.6 percent weight loss, compared with a 38.5 percent for the control group.

The study also found that levels of vitamin B-12 were higher in the patients taking probiotics — an important bonus since patients often are deficient in B-12 after gastric-bypass surgery. So an added benefit that they didn't expect as well!

Morton (the surgeon that lead the study) said the study was prompted by the fact that some patients have problems eating after gastric-bypass surgery. “For some reason, the food doesn’t go down right,” he said. When no anatomical reasons could be found for blockages, he hypothesized that a build-up of bacteria in the intestine — bacterial overgrowth — might be the culprit.

“Bacterial overgrowth can be bad in that it changes your motility, how you empty,” Morton said. “A lot of people aren’t aware that we all carry about a lot of bacteria in our intestines and that they’re extremely helpful in aiding digestion. And I thought, ‘Well, if we give these patients probiotics, then maybe we can improve these symptoms.’

“Part of the obesity puzzle may be due to the kind of bacteria you have in your intestine,” he said.

So how can you get in probiotics - yes you can look for yogurts or foods with added cultures but as well, many supplement companies offer probiotics in a little sleeve (much like the packages of Crystal Lite Singles) that you just add to your drink or to regular yogurt. I've purchased them at Walmart, made by Jamieson Labs.