This is what I experience when I dump: shortly after eating a food I don’t tolerate (sugar, milk, sugary milk products or starchy carbs) I begin to feel a bit disoriented, maybe dizzy and then an overall sense of confusion or panic takes over my mind and body. This is a mild state of delirium. Then I begin sweating. Profuse sweating that can completely soak my hair, my clothes; it drips and glistens on my skin. During this state of sweaty panic I feel like I’m out of my mind! A few times during extremely dramatic dumping episodes I literally thought I was dying, the state of distress was that severe.
At this point during a dumping episode I have learned it is best to lie down on my side and let it nature take its course. The body is efficiently, albeit painfully, correcting a chemical imbalance in the cell system. It takes great presence of mind to calm myself and lay down, but even in a state of near-delirium I now know this is the only action to be taken. I know the event is passing when the sense of panic is replaced by exhaustion and cold chills instead of sweating. Occasionally I have suffered diarrhea at this point. If I have the luxury I’ll try to take a nap or go to bed after dumping. If it is in the evening I’ll sleep through the night, and wake feeling like I’ve been run over by a truck.
The mild delirium associated with dumping is the result of an interruption of nerve impulses affecting cerebral metabolism. The interruptions are caused by metabolic disturbances such as fluid or electrolyte imbalance. When the incorrect foods are consumed and dumped into the digestive system the electrolytes get out of balance. Dehydration will also cause an electrolyte imbalance. This mild delirium is characterized by a reduced ability to maintain attention to surroundings or disorganized thinking. The daily routine can become confusing. In extreme cases a person who is dumping may experience rambling, irrelevant or incoherent speech.
After the dump passes the interrogation begins: what caused that dump? I have dumped on yogurt, sugar cookies, lobster bisque and blackberry sorbet. I have dumped after one margarita. A particularly impressive dump followed a love-fest with a piece of pecan pie. Salty potato chips that should have never crossed my lips knocked me flat quicker than a prize-winning boxer could have. I have dumped a few times for which I never determined a cause. I believe stress has caused me to dump. I’m certain dumping is not exclusive to food intake, that it can be triggered by the body’s physiological reaction to stress. However, in most cases eating the inappropriate food for my short-circuited system is the culprit. Through trial and error I can predict most things that make me dump and I avoid them contemptuously.
The most efficient way to avoid dumping is to maintain the strict regimen practiced during bariatric infancy: follow the four rules. Eat protein first making sure it comprises one-half of every meal. Avoid snacking. Avoid all sources of simple sugar; and yes, this includes cookies, cakes, candy, sodas, ice cream and sorbet. Sip water throughout the day. When you practice this eating behavior your blood sugar will not fluctuate and you will not dump. Most patients, who crave a taste of something sweet, have learned they can tolerate a bite of fruit at the end of the meal. Proceed with caution and discover what works for you.
The first reaction when dumping begins is to try and make it stop. There is a feeling of helplessness – like trying to stop an earthquake. I have tried eating myself out of it. I have tried flushing it away by drinking water. I have tried physical motion – pacing – to get myself out of it. I have not successfully stopped a dumping episode. I don’t know anyone who can successfully halt a dumping episode. Sipping a sports drink like Gatorade will relieve my symptoms, although my surgical weight loss specialists do not recommended this practice. If you find something to bring relief during a dump, and it causes no further harm, then do it.
It is important to note that the dumping experience is different for every person. Some will always have extreme dumps and others more mild episodes. Individuals will notice dumping episodes will vary by incident. No two people dump the same and no two dumps are alike.
Dumping is a bittersweet fact of life after bariatric surgery. Because we must fuel our bodies by eating we will experience dumping. Adherence to the four rules will prevent dumping in most cases. However, every now and again we will be blindsided by a dump caused by a food never suspected. Keeping a list of poorly tolerated foods will help you avoid them. The acutely dramatic event of dumping is a convincing motivator to follow the rules and avoid the foods that have trigged a dumping episode.
Being people who love food, we may now and then, willfully break the rules fully aware of the consequences. We are all vulnerable to the desires of the flesh. Not long ago I was quite certain I could not go on living without a taste of ice cream – I’d been an ice cream celibate for over three years. So carefully I selected my tasty treat, settled myself in the safety of home, and I savored a totally decadent half-cup serving of vanilla ice cream. I accepted that a dumping episode would follow. As expected my body entered the shock-like delirium complete with profuse sweating then clammy chills. No matter how good that ice cream tasted, that momentary pleasure was not worth the price. It is a mistake I won’t soon repeat.