Endocrinologist Schmendocrinologist

I had that long-awaited appointment with the Endocrinologist yesterday morning.  I explained everything that's been happening to me and basically told him what I thought it was (a hyper-active pancreas) and he agreed.  Then he told me it's also likely that my blood sugar issues mean that I'm "pre-diabetic" which shocked and appalled me.   

Part of me thought it sounded right: that the pancreas has only so much lifelong function and that I'm promptly wearing it out by allowing it to work too hard (pumping out too much insulin with every meal).  I know from watching the other diabetics in my life that the pancreas does ACTUALLY wear out, at which point type 2 diabetics go from taking medication to control their blood sugar, to the dreaded insulin needle.  But the part that struck me as odd is that I wasn't even pre-diabetic at 309 pounds!  I always thought that if I didn't get diabetes when my body was perfectly primed for it with 100+ extra pounds of crazy-hormoney, insulin-screwy body fat, then I would NEVER get diabetes.  Not to mention that there is absolutely ZERO family history for me.  No member of my family has ever had it.  The diagnosis seemed odd.

So I immediately came home and e-mailed the resident expert on all things hypoglycemic: Melting Mama.  And she sent me this link to a report about pancreatic islets, of which I understood only about every third word.  But I'm going to forward it to my Endocrinologist, a man who inspired virtually zero confidence.  He was obviously nervous (which I'm going to pretend to attribute to being alone with me and my tightest muffin-top-producing jeans and greasy ponytail) and didn't seem to have much expertise with gastric bypass patients, since he kept attempting to inform me how important it was to get my vitamin levels tested.  I finally told him that my old doctor used to just hand me the blood work sheet and tell me to fill it out myself, since I knew more about the tests I needed than he did.  My latest test was completed less than a month ago and all levels are normal.

I also plan to call the surgeon who performed my surgery.  He is still an expert, still performing 3+ gastric bypass surgeries every day, and I can't imagine I'll be the first post-op to call his office five years later saying, "what the hell is going on with my blood sugar?"  Maybe he'll have some answers.  The most important thing to note here is that this is definitely a POST-OP GASTRIC BYPASS SURGERY problem.  I wouldn't be bottoming out with a blood sugar of 35, like I did last night after dinner, if I hadn't had this surgery.  NOT THAT I WOULD TAKE IT BACK.  Because, NO, NEVER.  I'm just interested to see what this means for my long-term health. 

Comments

[PatP]

Don't dread the needle. Learn about insulin pumps instead. It's the healthiest way to manage insulin-dependent diabetes.

It's not The 'Betes. If it's post RNY hypoglycemia, and the doctor doesn't know anything about it, it's time to school him. :) Page Dr. Google. "Nesidioblastosis."

[shannon]

I am curious as to how you KNOW it has anything to do with your surgery.

[jenB]

Lovely, I will always be diabetic. Having a pregnancy irrecoverably damaged my pancreas. Even as my weight becomes closer to "healthy", my pancreas will never produce enough insulin to cover the amount I eat, however small, however low in carbohydrates. I suspect that even at 300+ pounds, your insulin resistance was deteriotating into producing less insulin at up until now and still being resistant to its uptake. IT is a pisser, but I take 4 units a meal now, instead of 30. The pump is not for people who still have some relatively decent pancreas function. Insulin resistance, or "pre diabetes, which isn't even a medical term, is progressive, for everyone. It is manageable. I am sure that your doctors will test you, give you a proper glucose tolerance test, some some full, everything blood panels and get to the bottom of this. After the WLS, my hypoglycemic and blood sugar control is easier to take care of.

blah de blah blah.

love Jen

[Gidge]

I went through a weird "blood sugar" thing once a billion years ago and have been hypoglycemic ever since. I had lost weight via the "I'm in my early 20s and will just exerszie and NEVER EVER eat diet".
I'd wake up to a coffee and a vitamin, go work out for two hours, eat some fruit for lunch, drink beer for dinner and more working out before bed.
It started out with fierce headaches. Then I'd feel really bad, dizzy, icky after I ate. So I ate less (because I was retarded).

Eventually one day in cafeteria line that I felt really bad. I'd just had a burger to eat bcse I was so hungry and had gone back up to get a diet coke, and my hands were shaking, and I told her "I have this ringing in my ears. I dont know what is going on."
Next thing I knew I woke up on the floor.

After all the USUAL tests, what the doctors decided was that my food intake had so radically altered that I'd messed UP my pancreas. It didn't know what to do.

Mine never recovered but they told me at the time that many people's do.

[Jennifer]

My sister has gastric bypass about 5 years ago also. She's experiencing the exact same problem with her blood sugar now. She can't even drive right now because her blood sugar dips so low she sometimes passes out. I will ask what her doctors have diagnosed and let you know. I know she's doing better now and having less problems than she was 6 months ago....

Jen

[Darwin]

This is called Darwinism.

[Darwin]

We feel sorry only for your kids.
Their parents didn't care enough to stop shoveling food down their throats.
It's no wonder you topped 300 lbs recently.