The highs and lows of blood sugar

Melting Mama posted an article to her blog this week about the relationship between gastric bypass and low blood sugar. The article was of particular interest to me, because I was diagnosed with hypoglycemia a few weeks ago. Since then, life has been a constant balancing act as I figure out the best way to keep my blood sugar level throughout the day.

Before the diagnosis, I thought I was losing my mind. I was lethargic, spacey, dizzy, easily confused and could not focus on the simplest tasks. It would take every bit of willpower I had to stay awake at work and on the drive home. As soon as I'd walk in the door, I head straight to bed and crash. Often, I'd sleep for the entire night only to spend an hour the next morning willing myself out of bed.

After a month of dealing with this, just about any diagnosis would have been welcome. But once I heard the news, then reality set in. Not only is this most likely a permanent condition that will require constant diligence, I had trouble wrapping my brain around my body's new dietary needs.

Here I had spent two years following the gospel of three meals a day (no snacks), few to no carbs, protein drinks vs. protein bars (drinks are lower in calories), and absolutely no sugar. I had finally gotten the rules down pat and didn't have to think about them anymore.

But hypoglycemia carrries its own set of rules: Eating every three to four hours keeps blood sugar most level; protein elevates blood sugar but fiber helps level and maintain it so complex cars are a good thing; protein bars are better than protein drinks because they don't cause a rapid change in blood sugar; and in low moments, sugar can be the difference between maintaining consciousness and passing out.

I had a brief moment of bitterness upon hearing my surgeon's bariatric coordinator rattle off this advice to me. I felt like the rug had been pulled from beneath me. Eating four to five times a day worried me. What if I gained all my weight back? Carbs a good thing? What if eating them led me to feel hungrier or caused me to binge? Eat sugar? Seriously? What planet was this and what did the pod people do to my doctor?

After getting off the phone, I did a little Web research and talked to other post-ops who also had hypoglycemia. I made myself a shopping list and other notes based on their advice. Though my doctor wanted me to eat three full meals a day and two protein-rich snacks, most post-ops I talked to said their blood sugar levels were best maintained by eating four or five equal-sized mini-meals each day. All the post-ops I spoke to said cheese and peanut butter were their best friends. Some kept glucose pills handy; others didn't. All recommended I keep a stash of yucky-tasting crackers that I could grab when at a low point but that wouldn't be tempting to me otherwise.

Next, experimentation came into play. Cheese was definitely my best friend, but peanut butter wasn't as helpful. I keep a jar of it at the office just in case I get desperate, but I'm more apt to select a protein bar instead. My body feels best if I eat at least three whole-food meals each day.

For me, bars are definitely better than drinks. My favorite bars are Think Thin cruncy peanut butter (available at Trader Joe's) and Oh Yeah! chocolate-mint wafers (available online and at the Vitamin Shoppe). A half-serving is all I need to keep my blood sugar level. Both Think Thin and Oh Yeah! chew down very well so as not to overfill my pouch, but the Oh Yeah! bars are more convenient because they come with two wafers in each pack -- instant portion control.

Liquid protein is a toss-up for me. AchievOne sends my blood sugar soaring through the roof and then crashing down, but I can mitigate that if I eat an ounce of cheese after finishing my drink. Nectar-brand drinks don't cause any wackiness at all.

Carbs are a necessity for me, but I'm still learning how to effectively use them. My typical breakfast is high-fiber cereal mixed with flax seeds and Fage 0% Greek-style yogurt. Cheese and crackers is not as helpful and ends up being more of a trigger food. Salads are a good way to incorporate complex carbohydrates with my protein. I eat salad almost every day now.

As I said before, it's a balancing act. It's a challenge but it's not impossible. and if anything, at least it prevents me from getting bored.