My Story of Hyperemesis: 15 weeks and 5 days

Monday, March 26, 2012

15 weeks and 5 days

thank goodness the week end is over. i still am on the lower dose on my zofran pump, i am more nauseous then usual but trying to stay strong. the nurse reminded me i need to eat more like chips and cookies for calories! but i am happy with my graham crackers! but my calorie intake is still to low, trying my best, looking forward to 20 weeks, though i am not sure what that will mean?

5 comments:

Anonymous said...: Hello, my name is Jennifer love your blog, I have 3 children and have suffered from HG with all of them. I had my first before Zofran 1993 and almost died... My second made it through with the dissolve tablets (Zofran). My third it got worse could not keep tablets down and went to the pump..

My husband and I would love 1 more but I am scared to death to go through it again knowing it could be even worse you have given me hope would love your insight. I'm so happy you are feeling a little better...; March 26, 2012 at 2:51 PM
SARAH said...: I had my first in 2004 and was not offered zofran! How crazy is that! I lived in the hospital!

They may not get easier but at least you know what to expect :) Did you ever have a picc line, I have to tell you it is way better then the pump and I love it.

I would recommend having a good doctor before you get pregnant and make sure they know what you want, so you are not pregnant and sick fighting over a picc line or a pump.

If I can do #4, I am sure anyone can, trust me! You can do it if you want!; March 27, 2012 at 9:51 AM
Jen said...: Thanks Sarah for your reply, it's so nice to talk to someone who is actualy going through it. My family has always had a hard time understanding!

No I have not had the Picc line only the pump which got me through it but I was still so miserable. Did you get worse with each pregnancy?
My husband is a soldier we are stationed at fort Carson Colorado Springs on post and I've been trying to find a doctor who is familiar with HG but no luck so far, I know that is so important because my other doctors really were not aggressive with my treatment it took my last doctor 2 months before he got me on the pump.
So tell me how do you feel different with the picc??

Hang in there girl I'm so praying and thinking of you...; March 27, 2012 at 12:08 PM
SARAH said...: Hi Jen!

I would first recommend reading the book, Beyond Morning Sickness, it is an awesome book and details medical options.

I would not say it has gotten harder with each pregnancy. This baby #4 has been the hardest! But this is my first boy, so I wonder if a boy is harder then a girl. Do you have boys or girls? Could you tell the difference between them? This one is the hardest then baby #1, then #2, then #3. So they typically it gets easier, but not this time for me :)

It is so hard to find a doctor that knows what they are doing. I have had a different doctor with each baby. Most doctors have no clue. I use a home healthcare called allere. I would check your insurance to see if they cover it but they specialize in hyperemesis. They really take care of me and tell the doctor what to do. They call every single day to check in and get vitals and come out every week. They keep me alive!

The key is to be pro-active. This baby I started meds at 4 weeks, and my picc was put in 4 days after the first time feeling sick. It really saved my life. You can not wait with this disease. And it hits fast. I was fine all day one friday and it hit me at 6pm friday night and 12 weeks later I still am sick :)

The picc is really wonderful when it comes to hydration. The pump you do in your stomach and if that means you can drink then you really only need the pump. But if you can not eat, or drink and need IV fluids, with a picc you can get those at home all the time and any time you want to. So, if I have a hard day then I just hook up to my fluids. The pump is in my picc so I do not have to put it in my tummy every other day. No needles no pain. The picc keeps me out of the hospital, which I love. If I am going to feel miserable let me feel miserable at home!

I hope that all made sense, how old are you r kids?; March 27, 2012 at 12:39 PM
Jen said...: Hello Sarah, sorry about your rough night...
Thanks for the great advice. Interesting how your pregnancy's didn't necessarily get worse with each one, mine did for sure so I was just expecting this one to be worse. You give me hope on thinking maybe it won't be worse. I was so poorly taken care of last time, I just suffered and didn't know what to do. I think I was so out of it I couldn't make any decisions.
My kids are girl 18, boy 6, boy 3 so I didn,t feel that the sex made a difference for me because with my boys it got worse. I wonder if age has to do with it I am 39??

I will for sure get that book and yes the Allere was who handled my pump and they were so wonderful....

Take it easy I'm praying for you....; March 29, 2012 at 3:24 PM

Causes

The cause of HG is unknown. The leading theories state that it is an adverse reaction to the hormonal changes of pregnancy. In particular, Hyperemesis may be due to raised levels of beta HCG as it is more common in multiple pregnancies (though I never had multiples). It is thought that estrogen produces nausea and regurgitation of stomach acids in some women. A recent study gives "preliminary evidence" that there may be a genetic component (the only other person in my family who has hyperemsis is my cousin). More on causes and theories go to: http://www.helpher.org/hyperemesis-gravidarum/theories-research/index.php

Symptoms

When HG is severe and/or inadequately treated, it may result in:

Loss of 5% or more of pre-pregnancy body weight
Dehydration, causing ketosis, and constipation
Nutritional deficiencies
Metabolic imbalances
Altered sense of taste
Sensitivity of the brain to motion
Food leaving the stomach more slowly
Rapidly changing hormone levels during pregnancy
Stomach contents moving back up from the stomach
Physical and emotional stress of pregnancy on the body
Subconjunctival hemorrhage (broken blood vessels in the eyes)
Difficulty with daily activities
Hallucinations

Some women with HG lose as much as 30% of their body weight. Many sufferers of HG are extremely sensitive to odors in their environment; certain smells may exacerbate symptoms.

As compared to morning sickness, HG tends to begin somewhat earlier in the pregnancy and last significantly longer (my last until 20 weeks or half way). While most women will experience near-complete relief of morning sickness symptoms near the beginning of their second trimester, some sufferers of HG will experience severe symptoms until they give birth to their baby, and sometimes even after giving birth.

Treatment

Because of the potential for severe dehydration and other complications, HG is in general treated as a medical emergency. Treatment of HG may include antiemetic medications and intravenous rehydration. If medication and IV hydration are insufficient, nutritional support may be required.

Management of HG can be complicated because not all women respond to treatment. In some instances, women with HG may be able to avoid hospitalization by eating a special diet of clear liquids and bland food rich in carbohydrates,and eating before rising in the morning; while these may be of some assistance, they are unlikely to resolve the disorder on their own. Hypnosis has relieved symptoms in some cases, though the majority of women do not respond to this measure.Wristbands used for motion sickness and seasickness have been shown by one study to be effective in treating some cases of HG, but not others; these are worn around the wrist at a traditional acupuncture point, 3 finger-widths from the joint, and are available at many pharmacies.There is evidence that ginger may be effective in treating pregnancy-related nausea; however, in general this is ineffective in cases of HG. Nothing but medication and hydration have ever helped me personally.

IV hydration - this is what i do

IV hydration often includes supplementation of electrolytes as persistent vomiting frequently leads to a deficiency. A and B vitamins are depleted within two weeks, so extended malnutrition indicates a need for evaluation and supplementation. In addition, mineral levels should be monitored and supplemented; of particular concern are sodium and potassium.

After IV rehydration is completed, patients in general progress to frequent small liquid or bland meals. After rehydration, treatment focuses on managing symptoms to allow normal intake of food. However, cycles of hydration and dehydration can occur, making continuing care necessary. Home care is available in the form of a PICC line for hydration and nutrition (called total parenteral nutrition). Home treatment is often less expensive than long-term and/or repeated hospital stays.

Medications

While no medication is considered completely risk-free for use during pregnancy, there are several that are commonly used to treat HG and are believed to be safe.

The standard treatment in most of the world is Bendectin (also sold under the trademark name Diclectin), a combination of doxylamine succinate and vitamin B6. However, due to a series of birth-defect lawsuits in the United States against its maker, Merrill Dow, Bendectin is not currently on the market in the U.S. (None of the lawsuits were successful, and numerous independent studies and the Food and Drug Administration (FDA) have concluded that Bendectin does not cause birth defects.) Its component ingredients are available over-the-counter (doxylamine succinate is the active ingredient in many sleep medications), and some doctors will recommend this treatment to their patients.

Antiemetic drugs, especially ondansetron (Zofran), are effective in many women. The major drawback of ondansetron has been its cost. In severe cases of HG, the Zofran pump may be more effective than tablets. Zofran is also available in ODT (oral disintegrating tablet), which can be easier for women who have trouble swallowing due to the nausea. Promethazine (Phenergan) has been shown to be safe, at least in rats and may be used during pregnancy with minimal/no side-effects. Metoclopramide is sometimes used in conjunction with antiemetic drugs; however, it has a somewhat higher incidence of side-effects. Other medications less commonly used to treat HG include Marinol, corticosteroids, and antihistamines.

Other medications that are frequently prescribed for HG are Compazine, Tigan, Phenergan, and Reglan. These can be given orally or intraveneously, or administered as a rectal suppository. They are considered safe for use during pregnancy.^[15]

Nutritional support

Women not responding to IV rehydration and medication may require nutritional support. Patients might receive parenteral nutrition (intravenous feeding via a PICC line) or enteral nutrition (via a nasogastric tube or a nasojejunum tube).

Beyond Morning Sickness

BEYOND MORNING SICKNESS......I have read the best book on Hyperemesis and wanted all of the people who read my blog to go out and get this book and read it. You can find the book on amazon.com or go to the author's web page at www.beyondmorningsickness.com it is a wonderful book on hyperemesis. The author has also written a children's book about hyperemesis titled, Mama Has Hyperemesis, and my children loved it! The web-site also offers a great support system and other woman who have gone through hyperemesis!

Spiritual Connection!

I Thank my Heavenly Father every day for the beautiful children and family I have. I know that it is through God the Father, Jesus Christ, and the Holy Ghost that I made it through my 3 pregnancies. I know they have a plan for me, I know they love me and watch over me. Through Prayer, scripture study, and church they make it possible for me to survive hyperemesis. You need to be spiritual strong to survive hyperemesis, and the Lord will provide your way. I am happy to be a member of The Church Of Jesus Christ Of Latter Day Saints.

Hyperemesis does NOT equal abortion!

I have come across many web-sites for women with Hyperemesis that are pro-choice. Some even promote and support women who have hyperemesis to terminate the baby. This upsets me. There are positive treatment options for hyperemesis and women, children and families deserve better than abortion. I do not believe women, and families should choose abortion when there are other options to help with hyperemesis. I hope this blog helps women to choose to keep their baby because if I can do it, anyone can do it! Let us support one another!