While on a business trip to NYC, I suffered a very serious low blood sugar incident.

Many of us who have had bariatric surgery have these episodes and either think we are the only ones and generally have no idea what is causing them. I knew this happened to others, but after so many years post op was confused as to why I was suddenly getting whacked like this.

I had my RNY surgery in 2001 and had found balance between food choices and a healthy life, meaning that I really didn't have to think about what worked and no longer got upset over things I didn't allow myself to have. I know that I must eat three meals a day that contain a source of protein, as protein provides the body with a slow burning long sustaining fuel source. If I am not in a place where I can have a meal - I try to make sure I have something, a protein bar, a packet of protein powder, a Believe drink, packet of nuts, some cheese, ANYTHING with protein and preferably a few carbs - otherwise my blood sugar can dip into the 50 zone which is very dangerous. It doesn't happen all the time, only once in a while. These episodes can even hit in the early morning if I have gone to bed without having a balanced supper, or it can come out of nowhere if I skip lunch.

If I do not pay attention or plan ahead to make sure I am able to have something to eat every 5 hours or so, I may begin to fade out and get a headache, feel faint, get very fuzzy and sick to my stomach - if I don't catch these symptoms quickly, I slide into a zone where I cannot think clearly or even speak up for myself in order to get myself out of the episode. In short, if I don't act quickly and eat, I must rely on those around me who may or may not realize what is going on. This is dangerous and nothing to be glib about.

I had a very important meeting that was scheduled for 10am - at about a 20 minute taxi ride from my midtown hotel. I woke up early and the night before I had ordered a room service pot of coffee and a fruit plate. It is standard for me to order a fruit plate on a business trip as they are served with a dish of plain yogurt and I can have coffee and then yogurt and fruit while getting ready. This particular fruit plate didn't have yogurt so I did not have any protein. For some inexplicable reason I didn't ship Believe or Inspire protein supplements to the hotel as my plans were last minute as to when I would arrive. (Bad excuse as I could easily have overnighted a small package!) I left for my meeting without having eaten anything but carbs since dinner the night before.

When I got to the meeting I was already a bit wonky, as all I had eaten were a few pieces of melon and blackberries after my usual quart of coffee with milk and Splenda. I was already pushing my luck and headed for an episode right out of the chute! I didnt realize it then, only NOW in retrospect.

After TWO HOURS in the meeting, the headache hit me like a sledgehammer and things got very fuzzy. I poked my associate and quietly told her that I needed to eat. She is not a bariatric patient and thought I was merely complaining, as she had the same morning that I did, and wanted to eat as well. She sort of nodded and ignored me as the meeting was intense.

After another 45 minutes, I could not even hear what they were saying, I grew silent and was looking down into my lap. The woman next to me noticed and asked me if I was okay. I said 'NO' I was not okay and then everyone became aware that I had a problem - which I normally avoid at all costs. Suddenly there were apologies that they were going to have food but didn't know what to get.... bla bla bla. Everyone gathered around and was staring at me, asking me what they could do, was I okay... I hate when this happens. I don't like ANYONE to think I am different because I chose to have surgery! It also gives bariatric surgery a bad name - and in business I present a strong image.

I assured everyone that I would be fine, but that we needed to wrap it up so I could get something to eat. My associate asked our hosts if there was a restaurant close by, and the well meaning folks told us about the vegan places and salad places nearby where they eat. Nope, I needed food not a salad - but we were in NYC so there would be restaurants all around us once on the street.

I honestly don't remember saying goodbye, shaking hands or leaving the building - I barely remember walking into a restaurant and finding that it was not open for lunch. There was a bistro on the corner named MARKT and we grabbed a table. Liz told the waiter I was sick and needed to eat quickly. I got very angry with her and snapped to NEVER tell anyone I have a medical problem as it focuses attention on me. It is easier to quietly maneuver, when I am not center of attention. People try to help when they know you are sick and they pepper you with questions that are not helpful. The server brought menus and upon opening it saw the first item was a House Pate - I asked the water to please bring it very quickly. I knew it didnt have to be cooked and would be served quickly.

I also believe I yelled at Liz to STOP talking to me. Her talking to me was making me feel as if I were going to throw up. People do that when you are sick - they talk to you, A LOT. The room was spinning. I drank TWO glasses of water very quickly. They put bread on the table and I pulled off a crust, smeared some butter from the dish and ate it. As soon as it hit my stomach I felt better.

Pate arrived and I ate it with the dark bread on the plate. I drank two more glasses of water even though I just ate food as I wanted to push the food into my intestines to begin to raise my blood sugar. Within minutes I could think again.

The room started to come back and the voices in the room were almost clear again. I noticed the bistro was beautiful and the food was delicious - I could see in color again instead of black and white. The waiter came back to see if I was okay, and Liz told him to give us a few minutes.

I looked at her and she told me that my color had come back as I had turned very pale and was scary sick looking. She said that my eyes were sort of rolling around in my head when I told her to STOP TALKING. I asked her to please NEVER let me go more than five minutes past any time when I tell her that I need to eat... as THAT is the sign that I am getting sick. She saw me get like this once before but not this serious a case. She nodded, then asked me WHY I didn't have a protein bar or nuts in my purse. I DID NOT HAVE A GOOD ANSWER FOR THAT.

I looked at the menu and it was a Belgian restaurant. Leave it to the foodie in me to run into a tiny corner bistro to avoid dying of hypoglycemia and have it turn out to be a well known little spot with 200 year old European decor. Markt is known for Moules Frites - mussels and fries! Mussels are pure protein and easy for me to eat. I ordered mussels in garlic and broth and continued to eat the pate and bread while waiting.

As I ate the meal I felt the clouds lifting and the fog leaving my brain. By the end of the meal, I was fine with just a bit of the headache left.

I made such a fast recovery I was able to keep my 3pm hair appointment at the Fekkai salon in SoHo - I had gone there in April when I attended the Johnson & Johnson Ethicon Endo-Surgery, OAC syposium and hoped that while in town this time, I could go there again. I was happy that I felt good enough, given how sick I was just an hour earlier, to be able to hop into a taxi for the trip to the salon. I looked forward to the head massage during my shampoo to get rid of the last vestiges of the headache!

This is a typical episode of what happens to some of us when we don't eat, OR when we eat only carbs instead of a balance including protein. I do my very best to eat five small protein meals a day and do not deviate much. I usually carry a protein bar in my computer bag and will pay more careful attention to having them when I travel, as these episodes happen when my schedule is off, as during travel. I must also SPEAK UP when I feel myself sliding. I am not shy or quiet but I often don't want to inconvenience anyone. If I feel this way, I know many of you do too. We must speak up if we need to take care of ourselves, as we have a serious medical reason to eat. We are not being pain in the butts or special... we are managing a condition.

June 21, 2019
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