My Story of Hyperemesis: finally home from the hospital

Thursday, March 15, 2012

finally home from the hospital

well after a morning of nervousness and pretty sure i was going to die it is all over with. i did not want to go to the hospital and my poor hubby could not figure out why i was so nervous. he says i have gone throw much harder things in this pregnancy then a clot removal. i was still nervous beyond words. my mom took me and dropped me off in the infusion at 8:45am and she had the kids.

i sat down and was sure I was going to pass out due to nerves, what was my deal? Come on I can do this! I gave my self a pep talk. The nurse came over and told me what was going to happen. She said they would insert a medication into my picc line and let it sit in my picc line kinda like drain-o and let it de-solve the clot and then in 2 hours when would pull the medicine out and the clot. She said it should work and no worries. I was almost 100% blocked. She did the medicine and then I had 2 hours, 2 hours to sit and stare at the wall and freak out!

I called my mom and hubby and I think they thought I was going to have a nervous break down. I think I hit my breaking point, I have constant nausea, I throw up all the time, I can not eat or drink, I have constipation, diarrhea, cramps, chest pains, room spinning, been to the ER, and now this.............how much more can I handle? What if I can not do this, what if I am not strong enough. Mental breakdown! Its only been 14 weeks, how many more can I go before I am suicidal?

Then I find the personal TV everyone has by their bed and watched Will and Grace. I usually do not watch this show and the last time I watched it I was in an infusion unit in California with baby #2. It brought some sort of comfort to me so I watched 3 episodes. Then the guy next to me who was getting 2 bags of blood (I hate blood) turned his TV on as loud as it goes and I had to watch what he was watching because his TV was so loud. He decided on Mud Cats, has anyone seen that show? Painful! It is about hillbilly's fishing with their hands in wife beaters! The guy next to me would yell things to his wife like,"Hey Wanda, you ever seen a fish dat big! I ain't never caught a fish dat size!" It was ridiculous yet humorous at the same time and it made me laugh, almost out loud.

Then the nurse came over because it had been 2 hours and bad news, she was so confident 2 hours ago. She tried to remove the clot and nothing would move. I was still all blocked. She said to give it 10 more minutes and she would come back. 30 minutes later after a tearful call to the hubby that it was not working, the nurse came back. And she got a teeny tiny bit out. Not a lot.

What they do is try to pull the medicine back out of your line and as they pull the medicine out it should pull blood out which means the line is clear and open. But that did not work. She got some blood but not what she wanted to prove the clot was removed. The whole thing grossed me out I do not like any blood and she kept telling me to go to my happy place. I did not want to go anywhere I just wanted to close my eyes and have it end. So then she did what nice people do to help you keep your mind off things, they talk to you and ask you dumb questions. I know she meant well but I could not handle talking I just wanted to close my eyes and be done. When this happens to me I just answer whatever. The last time this happened was when I was in labor with baby #3 I had been pushing for 3 hours and she was stuck and sunny side up, the drugs had warn off and I was in pain. The nurse kept asking me questions and I wanted her to be quiet. She said,"so, mom what are you having, a boy or a girl?" I yelled,"I do not know and I do not care!" The truth was I knew I was having a girl. When the baby was born the nurse turned to my hubby and said,"Announce to the room what it is, mom really wants to know what she had!" My husband looked at her and said, "We have known for 20 weeks it was a girl, what are you talking about?" It was so funny.

So the nurse said we could do the treatment again and if it is still blocked they will pull the picc line out and have surgery to get it put back in today. I can not handle that info, surgery today? I just had surgery 10 weeks ago, I can not mentally handle it. I told her if she pulls it then I am done and will think about surgery next week. We decided to do a second treatment and wait and see.

So at 12:11 treatment #2 started. I was sure the world was ending, my mom called and needed the keys I had with me to get into my house because she had to go to work and Brad was coming home, but Maddie was asleep in the car. I told her I would run them out to her. I could not find a nurse so I just left, well I got stopped at the door and was sent back to my bed and some lady that worked there took the keys to my mom.

Then my dad showed up I think he was called in for reinforcements to make sure I did not completely lose it and end up in the mental institute at the hospital! We talked for it seemed like a few minutes not hours and the next thing I know the nurse was there saying it was 2:13 and time to try again to remove the clot. Well she tried and was able to get the medicine out along with a bunch of blood. Then she tried flushing the line and it flushed but not as well as it should. She said it was still about 40% clogged. That was good enough for me, I am ready to go home!

My dad brought me home and I started IV's and I think it about only 10% clogged, my fluids are running well. It really was not that bad and I was worked up over nothing, it was the un-knowing, the I have never done it before. I am glad I did it and thankful it is working better. i would do it over again if I needed too, but hope and pray I will never need to!

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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!