Here's a question from a client.  The issues that first brought her to me
were positioning and oversupply.  She phrased her current problem so well,
I'll just offer it exactly as she sent it to me.  Anyone ever hear of it, or
have thoughts on it??

Diane Wiessinger, MS, IBCLC
www.wiessinger.baka.com

If I have too many carbohydrates at once, fifteen minutes later I begin to
feel *extremely* lethargic.  Over the following fifteen minutes, I
gradually lose my ability to move parts of my body, my ability to
communicate verbally, and finally my ability to think clearly. Forty-five
minutes after I ate, the symptoms begin to dissipate in reverse order -
first my thinking improves, then my ability to talk, and finally my ability
to move.  An hour after eating, I feel almost completely normal again, as
if nothing had ever happened.  Under 30 g of carbohydrates has no effect on
me; over 45 g of carbohydrates brings on the full impact.  Between 30 and
45 g, the symptoms are increasingly noticeable; for example, on the lower
end, I feel a mild lethargy, while in the middle I am lethargic and
noticeably impaired in my ability to speak, but mentally okay. Foods
including prune juice (8 oz), whole wheat bread, and pasta have provoked
these episodes.  I am now reasonably good at avoiding episodes through
careful dietary choices and timing; occasionally I have an episode when
eating outside of my own home when the carbohydrate content of the foods
available is unknown to me. Thus, the situation is under control, but
unresolved and somewhat inconvenient.

An episode was induced in my primary care physician's office to allow
medical monitoring.  My blood pressure remained consistent throughout the
episode.  Blood was drawn before and at the peak of symptoms; my glucose
levels and my insulin levels were completely normal.

Other pertinent details: Baby is 4 months old, exclusively breast-fed.
First episode occurred almost exactly two months after baby's birth.  I am
33 years old, Caucasian, 120 lbs (current weight and pre-pregnancy weight),
5' 6".  I have a history of getting very sleepy if I have too much sugar;
the amount of sugar which causes a problem has been decreasing over the
last few years (that is, smaller and smaller amounts of sugar are causing a
problem for me). I have been tested numerous times for blood sugar problems
(including the standard gestational diabetes test), but nothing has ever
appeared abnormal.  I am currently undergoing a variety of tests (abdominal
CT scan, upper GI series, full blood work-up during an episode looking at a
wide range of hormones and components) under the direction of the local
endocrinologist.

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