dumping

[chasmur]

hi. I am coming up for seven years post op ivor lewis full oesophagectomy aged 59, I have managed to steady my weight, and keep reasonably well, and still in employment. I am allways tired these days lack of sleep the dreaded acid, I sleep upright bed propped and plenty pillows. The worst thing though is dumping I eat small meals, spreading them out during day, nothing after seven or eightish, it seems to be getting worse, no blackouts but they don't seem very far away, any ideas? before I give hospital a phone to see consultant

[Magpuss]

Gaviscon should stop the reflux, if taking just one dose at bedtime doesn't work for you you could try taking it after each meal that may help but if I were you I'd discuss with your doc first. Have you tried taking a probiotic? That might help to reduce the dumping episodes, not guaranteed to work but may be worth trying - the tablet form though, not the actimel type.

[brucemillar]

Hi

It may be worth you checking your blood glucose levels and doing so several times a day. I ended up getting my own meter and the test cassettes from the NHS. What I found was that I have fairly severe "reactive hypoglycemia". Sounds very scary but the reality is that simply means that I do not tolerate sugar in almost any form. The symptoms are now very defined (for me) if I eat too much sugar, at the 90 minute after eating point, I will start to shake, followed by my vision strobing and heavy sweating. If at this point I do nothing? I will pass out. If I have eaten a smaller amount of sugar then I get the sort of 'out of body' feeling as if I am doped up, but it is not really pleasant.

By checking my glucose levels myself I was able to plot the timescales and link them very clearly to eating and drinking. I also discovered that coffee causes a similar reaction but de-caff does not.

One cake will send me over the edge, or two chocolate digestives will do the same. I now (sadly) find it easier to just try and avoid sugar. I was also advised that adrenaline can cause the symptoms and have noticed that if I get really stressed I can get a bit giddy and light headed.

I do hope that this helps. Feel free to ask more if it will help.

Bruce

[HerIndoors in reply to brucemillar]

That is some very interesting information you have just given. I'm type 2 diabetic so I had the meter etc. At first it never occurred to me that hubby could be having a hypo, but when he passed out in the garden, giving himself the most enormous black eye and resulting in a trip to A&E, I looked into things further. The next time he felt 'funny' I checked his blood sugar and sure enough it was 3.3. The hospital explained to me, in layman's terms, that the pancreas gets confused by the non-digested food in the small intestine and so floods it with too much insulin which by process causes a lack of glucose in the blood.

What I found very interesting was you said you got the same hypo feelings when you were stressed. Hubby has/does get very stressed by the whole food issue, so it makes perfect sense to me that this could also be a case for hypos. Conversely, a diabetic's blood glucose will rise when stressed. So it is a good point that other enzymes produced in the body can have an adverse effect.

[brucemillar in reply to HerIndoors]

Maybe this will help you here?

MY blood sugar now, typically sits between 4.2 > 4.8. If I eat or srink anything with simple sugars in it (lets say I eat a Kit Kat) It will very quickly rise to 10+. Then at the 90 minute mark it will plummet as low as 2.3 and in some instances lower!!!

My meter bottoms out at 2.0 then just reads "LO" As I understand it anyting under "3" should be considered "dangerous" and most certainly will have brought on, some if not all of these symptoms:

Shaking

Sweating

Nausea

Light Headed

Strobing/Flashing Vision

Staggering/Drunk appearance

Collapse

As the levels drop we also develop what is referred to as "denial" symptoms. As it says we deny ourselves that anything is wrong and try to plod on. Being is denial is strange. We do not recognise that we are in denial, but others will. This can also be shown as being angry in our responses to being asked "are you okay?"

It is important to note, that all of the above does NOT stop when we go to bed. So if you start to get the symptoms? simply going for lie down will not stop your blood from dropping or the symptoms from from occurring. YOu are now asleep so may not notice it, but it is still going on and you can pass out in your sleep!!! Scary stuff, as others will assume that you are simply sleeping when indeed you are unconscious.

Waking up in the night with soaking bed sheets is a god indicator that you are having hypo's when asleep. You sweat so much that the bed is soaked.

I bought a Freestyle Libre testing kit that continues to operate while we are asleep. That showed that (as suspected) I was having hypos's in my sleep) IT also alerts you when they are happening during the day, allowing you time react and take glucose.

If you are going hypo? The solution is to take glucose very quickly> I now carry a packet of Dextrose everywhere. Take about six of these ad my symptoms recede withing around 5 minutes.

Now the bad bit:

People die from hypo's and recognising what they are, or that they are having them.

I broke my spine badly, in two places during one collapse. I have also damaged my wrists etc. Some have been known simply, to not wake up from sleep!!

I now treat my hypo's with prescription drugs that slow the sugar intake into the lower gut (Acarbose). Since starting this, and measuring my blood sugar levels, I have managed to avoid any collapse.

It is recognised that people with upper GI surgery (us) will very likely start to be affected by hypo's (Reactive Hypoglycemia) in one form or another.

Some say it is Dumping!! It is not. It is separate part of the Dumping cycle "if" we ingest simple sugars? If we do not then it is very unlikely we will ever suffer.

I do hope that this helps somebody?

[HerIndoors in reply to brucemillar]

Everything you have said is very true and I do wonder how many people who have had upper GI ops realise that they can have hypos, which as you say are thoughtto be part of dumping But are in fact another factor resulting from the body's reaction to the altered digestive tract.

If I hadn't been diabetic myself I may not have been so switched on to my husband's symptoms. I do worry other people may not realise or even know these hypos can happen to them without being diabetic, but rather directly due to the surgery.

I have to admit once I had read up on dumping and hypos I was really surprised that the dieticians had advocated eating sugary and simply carbs to put weight on. I honestly feel that most dieticians are not really up to speed with the complex needs and potential reactions to foods of upper GI operated patients.

I personally carry jelly babies around with me (only because I don't particularly like the dextrose). I also carry a few wholemeal biscuits to keep the glucose at a decent level after the jelly baby (which is only a quick fix and needs to be followed up by a slow release glucose - i.e. a complex carb).

I totally agree with you about not going to bed when you have these feelings. My mother in law, who was unaware that she was type 2 diabetic at the time, didn't feel well and so went to bed. It was only when her husband tried to wake her and couldn't that he realised something was wrong. She ended up being blue lighted to hospital where she spent over a week recovering from a coma caused by a hypoglycaemic attack.

[Mentalmicky6]

I'm nearly five years post Ivor Lewis and still have Dumping which in all honesty I probably bring on myself, with my very sweet tooth and love of carbs, to avoid this I believe you need to have a very low sugar intake and your carb intakes spread over a long period