Hypoglycemia

[Izzy44]

Hello All,

My wife is post esophogectomy 8 months. About one month ago in the evening she became totally disoriented and started sweating profusely.

I took her to the er and they said her sugar was very low. They kept her for 3 days and did complete testing fasting for 3 days and found nothing wrong.

Last evening the same thing occurred but this time I have her a glass of orange juice this is what they did at the hospital the first time. She seemed to recover.

The interesting thing is that she remembers nothing for about 3 or 4 minutes.

It appears this is the new normal , and reading the posts on this website she needs to check her sugar. thanks to all for your comments

[SteveJ]

Hi Izzy. This sounds very much like Dumping syndrome that all of us who have been through an Oesophagectomy get at times. There are lots of posts on here discussing this subject as I'm sure you have already found. One of the thing's to be aware of is that this can happen any time not just in the evening although I must say it is usually from mid afternoon onwards that it happens to me. So I always carry my home remedy with me when ever I am out just in case and what I have is a Mars Bar and a bottle of Coke, the full sugar one not diet coke. I'm sure as you get more answer's to this post others will give you good advice on this subject. All the best to you and your wife.

Kind Regards

Steve

[Magpuss in reply to SteveJ]

Yes I have this from time to time but (fortunately for me) it's not something that happens frequently. I always have some sweets in my pocket, in case it happens while I'm out but it's mainly in the evening, after my main meal when it's happened.

[Izzy44 in reply to Magpuss]

My gosh that is interesting because that is the same time it happened to my wife. Both times in the evening around 9 PM after she had eaten a meal. The first time she ended in the hospital with tests for 3 days all negative. How often has this happened to you and when did you have your surgery?

[gutlesswonder in reply to Izzy44]

Is it a surprise that the Hospital didn't recognize what was the matter the minute she came through the door?

[Magpuss in reply to Izzy44]

I had my op just over 3 1/2 years ago. I'm fortunate as I've only had four hypo episodes - the last one being just 8 days ago but I've frequently had digestive problems after my evening meal which often, tho' not always have lead to late dumping. I know that sugary or dairy products are most likely to affect me at that time of day but sometimes, I've felt so hungry that I think I probably eat a little more than 'my tum' can cope with.

Every so often I rethink my diet and portion size and things settle down, then when things have returned to 'normal' for a while, I get a bit over confident and portions get a little out of control - again! I hope this helps.

[Izzy44 in reply to SteveJ]

'Thanks much Steve, what is the difference between oesophageal and the surgery my wife had called tranhiatial esolphagectomy. No sure I am spelling it correctly.

[gutlesswonder in reply to Izzy44]

No difference - just the route in that the surgeon chose to use.

[gutlesswonder]

Welcome to our exclusive club for those who suffer from the "Wobblies"!

[Hidden]

Taking something sweet will have a dramatically good effect because it is an insulin spike that will be causing the problem. And it can cause sudden fainting, so do not ignore this.

But the best thing is to try and avoid food that creates too much of an insulin rush to counterbalance the sugar content as the food reaches the lower parts of the digestive system. It is as if your wife were diabetic, so look up Dumping Syndrome and low glycemic food on the OPA website. opa.org.uk/pages/factsheets... When in doubt eat food recommended for diabetics.

Think about an insulin:sugar meter to monitor insulin levels.

[Izzy44 in reply to Hidden]

Are you suggesting that eating something high in sugar would cause the insulin spike ?

If this is fact my wife did eat some cake before this episode.

Then what your saying again is that if the insulin spikes because of eating something sweet she need to again eat something sweet to counteract the insulin spike?

[gutlesswonder in reply to Izzy44]

Yes--it bounces up and down like a yo-yo!

In practice only the first massive peak then trough produce noticeable physiological effects.

If you can detect the hypo onset early then only 2-3 sweets will neutralise it but if not noticed until later (and with more rapid depletion caused by exercise) then the antidote dose will double or triple.

There is bound to be some overshoot since the craving for sugar when hypo is extremely strong and not readily satiated.

Nobody knows what damage this syndrome will do long term.In theory there is a risk that it could induce resistance to Insulin, which is type 2 Diabetes; but intriguingly our type of surgery has been shown to cure type 2 Diabetes --- seemingly a contradiction.

In any event I am still here having endured it for 24 years.

[Hidden in reply to Izzy44]

Yes. Exactly right! The food gets down into the lower reaches of the digestive system in a less digested state than it is designed for, and the body gets tricked into generating lots of insulin to keep the balance. Sugar content of foods will start to become vital reading for you (it is surprising how much sugar some foods contain). Sugar substitutes are just as bad, and probably anything ending in ' -ose'. And anything like carbohydrates that cause the body to generate its own glucose level may well have an effect.

So the emergency remedy is something sweet because this whole thing is to do with the sugar:insulin balance in the body.

[brucemillar]

Eating anything high in sugar will indeed cause an insulin spike and then a glucose crash.

In my youth I was happy on cigarettes and alcohol. Now it's Dextrose and Orange Juice.

Try to avoid sugary stuff (this can be torture) or as other have said carry a rescue kit. As above I take Dextrose tablets and pure orange juice at the first sign of the wobbles. That stops it very quickly. Failure to do so has led to passing out (see my other posts).

Remember. This spiking and crashing happens even if you got to bed/sleep. It can be very bad news indeed. So try and avoid the sugar before bed time.

[Mentalmicky6]

I am three years post Ivor Lewis and still doing well but sometimes I forget myself and overdo the sugar which gives me a hypo. It's never a big thing we me , I never go anywhere without a fruit drink and an apple which resolves the problem.