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Monday, July 06, 2009

Dumping Syndrome Revisited

Recently Ky, author of Turtle + Butterfly = Turtlefly Adventures left this comment on the LivingAfterWLS General Store post:

"Hello. I found your blog tonight after reading your article, "Dumping Syndrome: The Dirty Secret Gastric Bypass Patients Keep". I found your article doing a google search on dumping syndrome. I am 2 years 1 month post op (Gastric Bypass) and lost 205 lbs which I have also kept off. I haven't however been able to avoid dumping and your description of how you dump almost mirrors mine. I have become very frustrated, and just wanted to say that when I read your article I didn't feel so isolated or alone. Thank you for sharing your journey and helping me to know that there isn't something wrong with me - but rather that I need to focus on the basics in order to avoid this very uncomfortable and distressing consequence of WLS. Anyway - thank you again."
It has been a long time since we talked about Dumping Syndrome on this Blog so it seems appropriate to drag out this old article from my syndication library. This is the article to which Ky refers. I still dump occasionally, still don't know why all the time. But the more I follow the Four Rules the less it happens. Take a look at this article and let me know about your experience with dumping syndrome.

Dumping Syndrome: The Dirty Secret Gastric Bypass Patients Keep
By Kaye Bailey

Dumping syndrome is an effective result of the gastric bypass system which alerts the body of inappropriate eating. Dumping syndrome is described as a shock-like state when small, easily absorbed food particles rapidly dump into the digestive system. This results in a very unpleasant feeling with symptoms such as a cold clammy sweat, pallor, butterflies in the stomach and a pounding pulse. These symptoms may be followed by cramps and diarrhea. This state can last for 30-60 minutes and is quite uncomfortable.

That was the clinical description of dumping.

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. In most cases eating the inappropriate food for my gastric bypass 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 weight loss 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 triggered a dumping episode.

More articles on the First Year Post-Weight Loss Surgery

2 comments:

Moonlight Sonata said...

Kaye,

Thank you for this article. I am five months out from surgery and was in denial for the first four about whether I was experiencing dumping syndrome. Once I had a "Come to Jesus" meeting with myself, I have come to terms with the fact that I just can't eat everything I could before. This article reinforces that I need to continue to monitor what I eat and to make the best choices possible to maintain the 66 pounds I have lost to date and continue to lose the other 80 that I hope to lose over the next year.

Best Regards,

JoAnn

Raquel V. said...

This article was very interesting and enlightening. I am pre-op with my surgery scheduled in exactly on week (July 22), and this article brings home all the points about sticking to your diet and being very strict about it. I am scared about experiencing dumping syndrome because it sounds awful, but because I chose to have gastric bypass I know that unfortunately this is a likely event in my future. I will try everything in my power to eat right and prevent this from happening to me. Thank you again for the insight.

I am a newbie so please feel free to read my blog and leave any encouraging comments :)

Raquel
http://raqs-blog.blogspot.com/