Karen K.

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 DUMPING SYNDROME DEFINED, EXPLAINED, AND AVOIDABLE!



                       The weight loss that is achieved through the RNY appears to be primarily dependent upon the removal of the pyloric val...ve, leaving the individual without a regulator of food movement into the small intestine. This results in the well-known phenomena called "dumping syndrome" which can cause an individual to feel sick or even faint. It can also cause you to sweat, shake, feel tired, and sleepy. Rapid gastric emptying, or dumping syndrome, happens when the lower end of the small intestine (jejunum) fills too quickly with undigested food from the stomach. "Early" dumping begins during or right after a meal. Symptoms of early dumping include nausea, vomiting, bloating, diarrhea, and shortness of breath. "Late" dumping happens 1 to 3 hours after eating. Symptoms of late dumping include weakness, sweating, and dizziness. Many people have both types. Stomach surgery is the main cause of dumping syndrome because surgery may damage the system that controls digestion. Treatment includes changes in eating habits and medication. People who have dumping syndrome need to eat several small meals a day that are low in carbohydrates and should drink liquids between meals, not with them. It is imperative to the Roux En Y or other procedural gastric bypass patient that they follow their diet plan to reduce the risk factor of Dumping Syndrome. Many people equate the term solely to be spasmodic fits of diarrhea, when that is merely one of the symptoms of a more intensified unpleasant experience. Dumping syndrome is usually divided into "early" and "late" phases - the two phases have separate physiologic causes and shall be described separately. In practical fact, a patient usually experiences a combination of these events and there is no clear-cut division between them. Early dumping is caused by the high osmolarity of simple carbohydrates in the bowel. The various types of sugar all have small molecules, so that a gram of (for example) sucrose has MANY more molecules than a gram of protein, creating a higher concentration (number of molecules per cc) from simple sugars than from other foods. This matters because, inside the body, fluid shifts will generally go toward the higher concentration of molecules. So, if a patient consumes a bite of milk chocolate (lots of sugar), when it gets to the Roux limb it will quickly "suck" a significant amount of fluid into the bowel. This rapid filling of the small bowel causes it to be stretched (which causes cramping pain). This also causes the activation of hormonal and nerve responses that cause the heart to race (palpitations) and cause the individual to become clammy and sweaty. Vomiting or diarrhea may follow as the intestine tries to quickly rid itself of this "irritant." Late dumping has to do with the blood sugar level. The small bowel is very effective in absorbing sugar, so that the rapid absorption of a relatively small amount of sugar can cause the glucose level in the blood to "spike" upward. The pancreas responds to this glucose challenge by "cranking up" its output of insulin. Unfortunately, the sugar that started the whole cycle was such a small amount that it does not sustain the increase in blood glucose, which tends to fall back down at about the time the insulin surge really gets going. These factors combine to produce hypoglycemia (low blood sugar), which causes the individual to feel weak, sleepy, and profoundly fatigued.Late dumping is the mechanism by which sugar intake can create low blood sugar, and it is also a way for gastric bypass patients to get into a vicious cycle of eating. If the patient takes in sugar or a food that is closely related to sugar (simple carbohydrates like rice, pasta, potatoes) they will experience some degree of hypoglycemia in the hour or two after eating. The hypoglycemia stimulates appetite, and it's easy to see where that is going....The reason that sugar does not cause dumping in non-operated people is that the stomach, pancreas, and liver work together to prepare nutrients (or sugar) before they reach the small intestine for absorption. The stomach serves as a reservoir that releases food downstream only at a controlled rate, avoiding sudden large influxes of sugar that can occur after a Roux En Y. The released food is also mixed with stomach acid, bile, and pancreatic juice to control the chemical makeup of the stuff that goes downstream and avoid all the effects outlined above. Obviously, surgeons consider dumping syndrome to be a beneficial effect of gastric bypass -it seems to be important to provide quick and reliable negative feedback for intake of the "wrong" foods. In practice, most patients do NOT experience full-blown dumping more than once or twice. Most simply say that they have "lost their taste" for sweets. Of course, this is always a great topic to ask patients about directly, so you may want to ask about it at our support group in person, or in a support group online. It is an unpleasant side effect of this surgical procedure, experiencing it means one simple thing; you are not following your prescribed diet, and unless you do, dumping syndrome is going to become a major part of your life. Do yourself, and your body a favor and follow doctors orders, to the letter.


Thank you to Leslie for the Information... Great Resource

So
 

     As  most people are aware Im struggling with keeping food down.. I either Yak or Dump.. I record every bite that enters my mouth.. So After my stress level reached breaking point. I emailed my RD and asked for a meeting. Thus began my May 6th day.. I went in for 1 pm and didn't get out till almost 4..

       RD says Im eating all the right things. the right amounts. ( well maybe less than I should) and Im the high Average of weight loss.. So with that 1) Im suppose to stop taking the pernatal vit... Im suppose to continue with Welless,, and Vit D.. ..
 
Then after that appointment I was asked to see Dr Davey.. He said that it takes up to 8 wks to heal and that maybe I have a block ? But due the fact that Liquids stay down.. he isnt sure.. So he looked at my journal.. and agreed .. I am doing ok.. Im doing every thing that they ask.. Not drinking with eating, taking time when I eat. dont watch TV and eat ect..
 
But he is concerned with my protien.. so Im on 2 Ensures 1/2 with milk 2 times a day.. Mostly liquids and he booked me for a flora scope today. Which I went.. they were too get back but I guess they got busy. I will call Monday.. Cus This is crazy. I puked on the Radiologizt.. Im sure he wasnt impressed. but I did warn him..  :-(
 
Im also 304 which is down again from Monday.. So Thats good some what.. Im wanting to be down atleast 275 ny my birthday and thats a mth and a bit away...

 So I will just plug along and see what next week holds.. Im sure Im where Im suppose to be.. Just frustating.. And personally.  Its been tough on my hubby cus he cant help..

He has been amazing.. Very supportive. Very understanding and really putting up with my cranky behavior. Im normally a very easy going person but this somedays sends me over the edge.. And he gets it for the little things.. I have to stop and remember..   Its Not His Fault..

its amazing how time flies.. Its almost 1 mth since surgery. I did my 3 wks check and was weighed in at 311. OMG. Almost to 300.. I havent been that since before having kids. :-(   The pain is somewhat gone. still some uncomfortableness but all in all No Pain meds.. Which is a blessing cus it caused Major BM Issues. Im still trying to get straight..

 Im trying to get a better food regiment as I was told to go to 3 meals and 2 snacks.. the issue is, I can't eat more than 2 tbs at one time. So . Im struggling in that department. I did try water melon. Not a good choice. And then cus Im stubborn had to do it again just to make sure.. Nope.. Cant eat that . Yet.. I did find Peaches in water, havent tried Salmon yet thats tomorrow.. and I am going to do the Cottage cheese with Spa, Sauce..Im sure that will be ok.. I really have made some great friends who have helped me with this journey.. Its great to have the support so I dont feel like my hubby is the only person I can talk to about this..

My next goals are too..1 )  Walk more / Im going to try 45 min per day. I will drive to the mall if it's raining. 2)  Also to eat the 3 meals 2 snacks... 3)  Continue journalling.. that's my life saver somedays..


 Next appointment is at the clinic on the 17th with the RD  and then I have booked my self the modules  2-7  again most of all to get some more information that maybe helpful..

 My greatest Note To Date Is ::::

My son .. He was blessed with the food issues I have.. .. He has agreed to see the Dr and Im going with him and he will requesting a referal.. I think this is something special..Im very proud he has agreed.

thanks for listening

Ok so since getting having surgery  on the 6th, I was taken to hospital on 2 occasions for major pain and drainage in my left side.. I think that I have come through that some what ok.. We still have pain but not as bad. I was given Toradol but the RN told me NO DONT TAKE IT as it causes issues with the liniing.. OMG Are Dr's Crazy.,.

   .. So They then perscribed Codein.. I take only 3 mm and that seems to be ok.. I saw the Clinic Dr and he said it will take time. Im down 330 which is 8 lbs since surgery.. Im happy..  I see Dr Birch Monday and Boy do i have quesitons........

  I have had 2 non waking sleeps which was remarkable.. Im less emotional. I have  started on Solids and have done the tuna, vegs * frozen  and Cheese with a little FF mayo... and Ground Turkey and Vegs.. So far its been ok.. Im up to drinking 5 glasses of water and one V B drink..  Im in the process of making Turkey stew. it has   21 g of protien.. The only thing Im finding hard is the lack of energy. It seems I go for a walk Im exausted. I try and do dishes . Im exausted.. Shower .. Again Exausted.. I will be so glad to get past this.. 

Karen 

 Wanted To Keep This As A Guide For Me..


High Protein Fruits and Vegetables

• Avocado
• Asparagus
• Papaya
• Watermelon
• Broccoli
• Carrots
• Cauliflower
• Cabbage
• Lettuce
• Potatoes
• Spinach
• Tomatoes
• Beets
• Brazil nut
• Coconut
• Corn
• Celery
• Cucumber
• Dried apricots and prunes
• Dandelion greens
• Date
• Endive
• Mushrooms
• Onions
• Pumpkin
• Sweet potato
• Squash
• Peach

High Protein Fish

• Salmon, sock-eye, cooked, dry heat
• Shrimp, mixed species, cooked, moist heat
• Anchovies, in water
• Cod fillets (baked)
• Salmon
• Swordfish
• Rock-fish, Pacific, mixed species, cooked, dry heat
• Haddock
• Halibut, Atlantic and Pacific, cooked, dry heat
• Mackerel
• Pollock, Atlantic, cooked, dry heat
• Tuna, tongol

High Protein Poultry Foods and Beef Products

• Chicken thigh
• Chicken breast
• Chicken Wing
• Chicken, broilers, fryers, breast, meat and skin
• Chicken, canned, meat only, with broth
• Drumstick
• Roast chicken
• Turkey, dark meat, no skin
• Turkey, light meat, no skin
• Beef, chuck, blade roast, separable lean only
• Beef Product High In Protein
• Roast beef
• Round steak
• Steak
• Hamburger patty

High Protein Beans

• Soybeans, green, cooked, boiled, drained, without salt
• Black beans
• Beans, baked, canned, with pork and sweet sauce
• Beans, baked, canned, with pork and tomato sauce
• Beans, navy, mature seeds, cooked, boiled, without salt
• Beans, Cowpeas (Blackeyes), immature seeds, boiled, without salt
• Beans, Kidney beans, red, mature seeds, cooked, boiled, without salt
• Beans, Cowpeas, common (blackeyes, crowder, southern), mature seeds
• Beans, white, mature seeds, canned
• Beans, baked, canned, with franks
• Garbanzo (chickpeas)
• Lentil beans
• Lima beans
• Navy beans
• Soybeans (edamame)
• Tofu

High Protein Grains

 

• Buckwheat groats, roasted, cooked
• Buckwheat flour, whole-groat
• Cornmeal, whole-grain, yellow
• Cornmeal, degermed, enriched, yellow
• Oat bran, raw
• Oatmeal, rough cut
• Pancake, whole wheat
• Popcorn, dry
• Rice, white, long-grain, regular, raw, enriched
• Rice, brown, cooked
• Wheat flour, white, all-purpose, enriched, bleached
• Wheat flour, whole-grain
• Whole wheat bread Rye bread
• Wheat flour, white, bread, enriched
• Wheat flour, whole-grain
• Wheat flour, white, bread, enriched

High Protein Dairy Foods

• Cheese, ricotta, part skim milk
• Egg
• Cheddar cheese
• Cream cheese
• Cottage cheese, non fat or low fat
• Cheese sauce, prepared from recipe
• Egg whites
• Milk, lowfat
• Muenster cheese
• Mozzarella cheese
• Parmesan cheese
• Ricotta cheese

I want to appologize for not being on lately seems I didn't have much time.. or energy.. No excuses but the truth. the last few days took all i had for energy.. And my job well thats another topic.. but Here I am got sprung yesterday from hospital around noon.. Took the most crappy cab ride home. but got here safe... Now I know why I drive.. LOL

I didn't do much of anything yesterrday except rest,, sleep and eat very little.. Today I went for a walk but it was dang cold... I did the eating and drinking thing. Found that when I at about 30 ml. of Creme of chicken soup. strained with milk.. Was ok but gave me a sore tummy. so I will take it easy tomorrow.. The going is going better than i have ever in 25 plus yrs.. which is remarkable.. For me. .. The only sore part of me is one inceision point.. that was packed, unpacked.. repacked. then upacked.. so I think i will have to go to the Medi centre to get it checked.. They didnt close the strips very well.. ?? or maybe its the area.. ( dr said it was were they put the stapler through).. Im very excited.. and will post pics.. asap... Off to bed.. Really Tired...

 Hugs to all .

I also want to give my hubby a big thank you for all your support, care over the past little while.. I know sometimes. I can be a pain.. But I know We are both in this together. Love you muches..

Well
 
      I guess My Tummy has other plans cus today wasnt such a good day. I went to the the Dr.. And they think it maybe that Im needing to change. It maybe to much.. So Tomorrow I will Start Glucerna.. I was going to go get weighted but only made it to the drs and back.. Im not giving up.. Cus No Pain No Gain..  Well ...This time next week I will be in the Hospital . And hopefully Had or in the process of having my RNY.. Im excited.. This is just a minor blimp..

Well Day 10  of My LD....And I have killed anyone. ( yet)   LOL...

Im not hungry. I  am allowed to have  5 Cans of  Ensure's A Day.. I can have Skim Milk, or Yogurt.( 100 calories)  a day.. And 2 ltrs of  calorie free beverage.. that limits me to WATER 

 So the way I have been breaking it down is.
 
1 can in Am. and a Yogurt ( which is 40 ).. 2 Can's at Lunch time.. 1 can at dinner and a Yogurt .. (40 ) and then around 1130 pm  or so I have 1 more can of Ensure.. In between I have Water..

.  Today I woke up with a  sore tummy " Not  Sure" what from..  I will get myself weighted on Tues and see what the numbers say.. Im getting excited... I know that the last few days will drag. So Im getting  a list of things to do ..  I have my class that I missed last thursday this thurs.. Maintaining the  change with the RD.. I cant beleive i missed it.. I was so mad.. but they were like.. OK you have never miss ...  I was more mad at myself.. cus I thought it was going to be after. thats the date I had.

 So only thing really left to do. is get a scale. ( that can wait also)..  some food in the house that I will be able to eat.( for first stage ) . I bought my blender, cups, vitamins, calcium from Costco..  spoons, ect.. some new Pj's, summer socks...  and Runners'.. Yes I bought things for me.. thats not always easy.. and I bought not cheap runners this time..

When I got weighted last Wed < I was 334.9 that was so amazing.. So lets see what this week holds..

So... Its day 3 of my liquid diet. so far so good. Not cranky yet. I had my admin clinic last thurs. and it went well.. minus the wait.. LOL

It was nice to get it over with.. Stil have some stuff to get. Scale, measuring tools, and small plates ect.. Hope to do that next week..I have a dr's appointment at the clinic on Wed so I will weigh myself again and see how this LD is going.. Im sure Im doing fine.. 

 

 Ok.. So Now with Pre Admin Booked.. New Wed. @ 0800 .  Liquid Diet to Start Next Thrus.

Now comes the time to start getting the house in order.. I have one more appointment with the OT Spec. To Be Fitted for a girdle. ( to help with excess body mass).. :-)  I think the best for me will be.. Stop Researching. I have done lots.. Get plenty of rest and when I cant. WALK.. Thats My goal.. Less Computer.. More Walking.. 

I told work yesterday and they werent happy.. Because the same time they will be loosing 2 other full time workers going away.. 

 but..... Hey.. Its for me.. So My last day of work will be April 3...  And Maybe Someone will call about a new job..;-)..  If not I will go back and keep looking.. But Im going to take the time I need to make sure that everything is ok with me first.. ( thats a big step) cus Im always. Worried about others..