Sugar ??

[rachelthomas]

I keep reading about hypos and insulin rush, will my husband have to omit sugar from his diet after Ivor Lewis op, please advise.

[brucemillar]

Rachel

We are all different after surgery.  Some suffer no sugar symptoms at all others have mild issues and others (like me) can have pretty severe symptoms.  In some cases the issue simply goes away with time.  In others it appears after a time (me).  It is all rather confusing.  You really just have to wait and see what you can tolerate.  You may find that you absolutely no symptoms, so preparing for it would be fruitless (no pun intended).

To add even more confusion (sorry) it can also be referred to as "late dumping" when in my case it is not.  I can prove this (for me) by eating some chocolate, let's say one Mars Bar.  After 1.5 hours I will get the shakes, rapidly followed by flashing lights and a feeling of extreme anxiety and sweating.  If I do not take sugar (Dextrose) at this point then I will probably pass out.

If I don't eat chocolate or any obvious sugary foods - cakes, sweets, puddings etc then I never have the symptoms.  Likewise with tea and coffee I try and avoid sugar although the odd teaspoon seems to work.

I have also discovered that caffeine can ad to my symptoms.  I now opt to drink de-caffeinated coffee (but not tea).

I was referred to a Gastro-Enterologist after several big collapses.  He prescribed Acarbose, three times a day with meals.  This slows down the bodies intake of sugar but not compensate for eating too much of it.

A combination of the Acarbose and no chocolate and I have no symptoms at all now.

So it is very manageable and a small price to pay for the huge surgery.

I am eighteen months post op now and about the same age as your husband.  I am back working and generally living life to the full with no outward signs of my experiences. 

If anything life has improved somewhat.  I am slimmer (clothes fit) healthier (no sugar) and sleep well.  I also found that low sugar stopped my reflux at night.  This means I no longer take Omeprazole (which made me feel sick every morning).  So I take very few drugs now. 

Message me if you want any further info.

Good luck.

Bruce

[brucemillar in reply to brucemillar]

Apologies I should have said.  That what happens is you eat chocolate and your sugar level spikes, then it crashes as your new plumbing cannot cope with the sugar intake.  The crash requires your blood to have sugar immediately.  That is why you need to carry Dextrose (or similar).

[haward]

I agree with Bruce. I have almost no sugar symptoms. Just occasionally, if I do something silly, like eat too many chocolates, I get very tired. I never get to a hypo but I do get very tired and a mint might help. It is very much an individual thing. One thing you learn by speaking to patients is just how different we all are.

[AoifeMcC]

I had type 1 diabetes long before the chemo and surgery, it makes life 'interesting' to say the least - chocolate is fine for me but other things are not, the problem is that the list changes even over 9 years post surgery...

[Hidden]

The taste buds can often change because of the surgery and chemotherapy, but these return after a while, so be prepared in case all food tastes like cardboard for a while.   Some people do advocate trying to do with less sugar in the diet beforehand so that it is not such a shock afterwards.   I think that organising the meals can be very frustrating after the surgery because it often feels that you just cannot win.   The priority is to eat little and often, and let him simply 'graze' on snacks and liquid / soft food first of all.   Keep a food diary / note of what he can cope with (but this may not be the same from day to day).   I think it probably is a good idea to avoid sugar (and food that converts too quickly into sugar) - or, if this is too much to bear, at least be prepared for the fact that you might have to cut down if it causes a problem.   Everyone is involved in a trial and error system, and there are very few that do not find that they have had some errors!   These complications are not compulsory, and a good many people find that they have a relatively smooth ride - we'll hope that this is true for you as well, and wish you all the best!

[Suelue]

Brucemillar, I am pleased to see your explanation of dumping syndrome as my son has this but straight after meals. I've been worried about how he will cope with this and his job, although he works from home so he can always lie down after meals. Not so useful if he gets another job though. We always have dextrose tablets around as I am diabetic so I will make sure he has some with him. He also drinks a lot of cola (mainly for the calories as he is underweight) so maybe he should cut that down.

[brucemillar in reply to Suelue]

In your son's case I would strongly advise trying a blood glucose meter that he can use when he wishes. 

I did this after months of trial and error on myself and a complete failure to get any help from any GP's.

What this showed me was when my blood sugar was spiking and crashing.  Now it just confirms my own recognition of the symptoms as I have managed to correlate the two things.

Cola is very sugar rich and I know that I could not tolerate it.  It is one of the drinks that is suggested when you have a crash to bring your sugar levels up quickly!!  That would suggest to me that he wants to avoid it.

To be 100% clear here.  I am not saying that Dumping and Hypo's are one and the same thing.

What happened with me (and others on here) is their hypos were dismissed as dumping.  This meant that they went untreated for hypo's.

By reducing my sugar intake I have controlled my hypo's and also got rid of the late dumping.  That may be coincidental (for the dumping).

What I do see now, is that lots of sugar is, for most people, not a great thing anyway.  So reducing it can only do good.

What can be difficult is knowing what contains "too much" for you.  In the end I gave up trying and just cut out the lot.  This was after I was hospitalised twice and fractured my spine in two places, having collapsed after eating sugary foods.

In one instance it was a bit of millionaires shortbread and in another it was a strawberry muffin.  Both times the symptoms were identical and started exactly 1.5 hours after I had eaten the sweet stuff.  Both times, I had forgotten to take any Dextrose with me and collapsed.  Once in a country lane with no help and once in the middle of ASDA.  In ASDA I realised I was going to be ill but got into denial (a recognised symptom) and tried to carry on.  I woke up in hospital having terrified my poor wife and all the other shoppers.

I now carry Dextrose in every jacket pocket, briefcase, trousers etc.  My wife also carries several packets.

The Acarbose is great but it is not a substitute for not eating too much sugar it merely slows down your bodies consumption of sugar so can help.

[tallbear in reply to Suelue]

Hi Suelue,

Just a quickie reply after reading your comment.

I have the same problems as your son and my advice for him would be to seriously limit the size of his meals, make a normal sized meal three sittings with at least a half an hour in between each portion (this is where the microwave comes in handy) and knock the cola on the head completely. 

Avoid sugary fizzy drinks of any kind, they are causing part of the problem. Don't drink with the meal to help it go down, drink a little while after each meal and you will probably see an improvement.

Unfortunately getting your body to accept the new eating regime seems to me to be the most difficult part of all.

Best of luck to you both either way about

Best wishes

Richard

[Suelue]

Thank you for your quick reply. I will try to get through to him but it will be very difficult. 

[liz_crisp]

Hi

I Agree with Bruce we are all different and all have developed our own ways of coping with these sugar spikes,  some people I know have lucozade others use dextrose tablets (my favourite) I also have boiled sweets in my pockets or handbag as lots of patients do. My favourite chocolate limes a friend always has pockets full of polos.  It is learning to recognise the onset symptoms that is the trick as. Find it can happen with all sorts of food or drink depending on how much I eat and wether I sit still or move around a lot straight after eating.  I am 6 years post op and have found that with time things have changed and I have different triggers to those I had originally. As long as you are aware of dumping and how it affects you it becomes something you manage without really thinking, I just sit down and take some sugar and give myself 15 mins to feel better before carrying on.  

[brucemillar in reply to liz_crisp]

Liz

What a great post.  You are absolutely correct to say that Recognising the on-set is the key.  As soon as you recognise the on-set!  you must take whatever action works for you (be it sweets or drink etc).  What I now know is that denial is a recognised condition and is part of the hypo process.  In denial you will attempt to carry on as if nothing is wrong.  At this point it is likely that others will think you are drunk or drugged as you start to mumble and stumble about.  If untreated you may well collapse into unconsciousness which can be fatal.

[liz_crisp in reply to brucemillar]

Hi Buce

Yes denial is not good and it leaves you feeling as though you have been kicked by a horse, you will collapse and sleep deeply but you will wake as your insulin is working and it is not diabetes. But you can kill yourself driving, leaving the kettle on, falling down in the wrong place etc,  I had hypoglycaemia as a teenager and it is very similar, I used to be able to get drunk on pineapple juice but I did not find it as easy to balance my sugar then and if I let it go too far it was always a trip to hospital.  Dumping is a little different same symptoms but if I do pass out asleep I do wake up, my sugar can go as low as 1.2 before it hits me what's happening and a packet of dextrose will sort me out and save a trip to hospital.  If you have a monitor it helps so when you start to feel odd you can check your sugar, and you can see how you are responding to sugar intake if you check it at 20 min intervals, my doctor gave me one which I still use 5 years on when I muck up my regular eating habits and it seems my system goes haywire for a while. Ie on holiday,  or when I have been doing lots with little rest. 

Trying to explain dumping to a paramedic especially when you are trying to get your sugar back up and feel a bit fuzzy is a nightmare, it is also more frightening for people around you as they see the colour drain from you, feel the clammy skin and try to work out how you got so drunk on a banana split.  I have phoned a fellow patient before now to explain to a paramedic rather than be taken to hospital. God bless them they are fantastic people but don't come across too many of us. 

Good luck Lizzy 

[Robotgirl]

My original surgery was in 02 and I had surgery this past September t where most of my stomach was removed...  I'm tolerating less and less the longer after surgery...  I am beginning to get frustrated with it...  Any ideas I would appreciate them.  I've limited sugar intake as I had already been doing that...  No carbonation- that hurts...  Very small meals and I'm not tolerating small ones any longer...