Hyperemesis Support

[LucindaE]

We need a new thread.

This thread is for anyone suffering from the Horrors of Hyperemesis and if anyone's got bad m/s too they're welcome to join in. Hopefully sufferers will continue to get support through talking with present and past sufferers on here.

There's no such thing as TMI here - by definition with this awful illness there can't be - and feel free to moan all you like. You have reason to!

I want to thank Everyone MOH Mother of Pearl Ovaltine (once theOnly Melange (once NitNat) FluffyWhiteKittens* and so many more
for all their stirling work, and so many more that I can't name them all.

My apologies to anyone I've rudely overlooked, I daren't keep gabbling too long, or I might put off current sufferers.

Remember, when you are at your worst, the words from the Eastern story: - 'This Too Shall Pass.' It will...

Below is some brilliant information from sites.google.com/site/pregnancysicknesssos/

However, if you don't feel up to reading it now, feel free to skip it for now and have a good moan.

Hyperemesis gravidarum (HG) is a severe form of pregnancy sickness which affects between 1 and 3% of pregnant women. Historically, it was mistakenly thought to be a psychosomatic illness and women were treated as though they had a psychotic disorder. This view has been comprehensively disproven by numerous research papers in recent decades, and it is now known to be an illness of organic origin, although its causes have yet to be fully understood. There is a persistent common belief that no drugs should be given to women in the first trimester of pregnancy. This is not true. There are a number of effective anti-emetic (anti sickness) drugs which can safely be taken in early pregnancy. Unfortunately, the erroneous views that HG is a psychosomatic conditions and that no drugs are safe in the first trimester still persists in many places, shockingly, even amongst GPs and midwives. Sadly, many women still come across unsympathetic health professionals who are ignorant of current treatment methods.

How do I know if I have HG?
If you are suffering from persistent nausea and/or vomiting which is preventing you from eating and/or drinking then you may be suffering from HG. With ordinary nausea and vomiting of pregnancy (NVP), the sickness does not interfere with your ability to eat and drink enough, you should not be losing weight and you should be able to continue to care for yourself and your family although you may not be feeling too great. With HG, sufferers often need help caring for themselves, never mind look after their family. The illness can be completely debilitating for weeks or even months. If you're not sure, the HER foundation website who have a fact sheet to help you determine whether or not you are suffering from HG
www.helpher.org/mothers/hyperemesis-or-morning-sickness/index.php

Diagnosis is important as you will inevitably become dehydrated and you will need to be admitted to hospital for IV rehydration. Starvation is another risk. When your body burns fat for energy, it produces chemicals called ketones which can be detected in your urine. You can monitor your levels of starvation using ketosticks, available from pharmacies. You pee on the stick and it monitors your levels of ketones. If levels are high, you should tell your doctor or midwife. If you are worried about dehydration and ketone levels and you can't see your doctor or midwife, you can go to A&E.

Facts and Figures and FAQs

HG is worse in the first trimester for the majority of sufferers, though a significant proportion (10 ? 20%) suffer for the entire duration of the pregnancy. If you have close relatives (mothers, sisters) who have had HG, you are also at significantly higher risk of being a sufferer yourself. HG is the most common cause of hospitalisation of pregnant women in the first trimester.

Is it worse carrying a boy or a girl?
There is conflicting evidence as to whether having a boy or a girl makes HG worse, some studies say boys, some say girls.

Is it worse with twins?
Yes there is evidence that carrying more than one baby makes HG worse.

Will my baby be ok?
Babies born to HG mothers are usually absolutely fine. If you lose some weight during the first trimester the risks for the baby are low as it does not need much nutrition at this time and your body should have enough stores from before your pregnancy. However, if you continue to to lose weight due to lack of treatment or failed treatment, then there is an increased risk of low birth weight or pre-term birth. Studies show that this is a risk for women who are severely ill, are dehydrated for long periods and lose more than 10% of their body weight.

There is also growing evidence of long term health effects in some children born to mothers who suffer malnutrition in pregnancy. In some cases this is not evident until adulthood with increased risk of chronic conditions such as diabetes and hypertension.
For more information see forums.helpher.org/viewtopic.php?t=18 and www.helpher.org/hyperemesis-gravidarum/complications/fetal-programming.php

I've heard that being sick is a sign of a healthy pregnancy, is this the case with HG?
You will often be told that morning sickness is a good sign and you should be happy that you're feeling sick. This is generally the case with normal NVP, however, it is not the case with untreated HG. There is actually a higher risk of pre-term birth and low birth weight. However, continuing to feel sick may be a sign that the pregnancy is still progressing. Some women with HG who miscarried reported that the first sign was that they suddenly stopped feeling sick.

What are the treatments?
Initially you will be advised to use non-pharmacoligical strategies which are similar to the general advice given to any pregnant women suffering from nausea. These include eating little and often, eating protein-rich, low-fat meals, avoiding triggers of nausea such as strong smells and getting enough rest. You can try ginger, seabands (accupressure wristbands used for travel sickness) and extra doses of vitamin B6. Avoid getting out of bed in the morning without something in your stomach such as a tea biscuit or cracker. Some women find that these give relief in the initial stages of HG but they become ineffective once the illness is in full swing.

The next line of treatment is prescribed antiemetics such as phenergan, cyclizine, stemetil and ondansetron. For many women these work well and control the nausea and vomiting enough for them to eat and drink normally and regain some of their lost weight. Many can even return to normal life. You may find that one antiemetic on its own is not effective and you may need to try different combinations but you can discuss this with your doctor. Even with antiemetics, you will probably still need to use coping strategies such as getting extra rest, eating small frequent meals and avoiding triggers when the HG is at its peak. If you are dehydrated, you may be admitted to hospital for IV fluids. Minerals and vitamins can be added to the drip to replace any you may have lost, as well as antiemetics.

Unfortunately, antiemetics don't work for everyone. If they are ineffective, you should be referred to an obstetrician (if you haven't been already) for the next line of treatment, which will probably be steroids. These carry a small risk of cleft palate, but this will be discussed with your doctor. In a small number of cases even this is not effective and drastic treatments such as feeding with a tube directly into the stomach may have to be considered.

My GP is unsympathetic and refuses to prescribe me drugs - what should I do?
Unfortunately this experience is all too common. In this case you should see another GP if possible. You should also ask for a referral to an obstetrician. If you remain untreated and become dehydrated, you can have yourself admitted to A&E for IV fluids and ask to be seen by an obstetrician.

Do alternative remedies work?

Some women are greatly helped by alternative medicine, particularly Homepathy and Acupunture. Some women can claim to have had the illness 'stopped in its tracks' by Acupunture, but success varies between individual patients and it tends to be expensive. These remedies are worth a try if you can afford it but have a back up plan incase it doesn't work.

How long will this last for?
For most women, HG peaks in the first trimester and tails off or disappears completely later in the pregnancy. The usual advice for morning sickness is that it will improve after 12 weeks. The majority of HG sufferers find that it takes longer than this. Unfortunately, some women suffer severely for the entire pregnancy. Others find that it improves, but they suffer from nausea and occasional vomiting until birth. Relapse is quite common especially if you have tried to return to your normal busy life. There is a great temptation to make up for lost time and become very active once you start to feel better, but this very often leads to the nausea returning. You should be very careful about resuming work and normal household activities even if you feel as though you're up to it. Be careful too about stopping your medication, do it very gradually and resume at the first sign of the condition returning. You may have to continue to take it for the entire pregnancy to prevent a relapse.
All I can drink is coke, I'm worried that I'm not eating a healthy diet.

Through pregnancy, we are bombarded with advice about what to eat and what not to eat. Women with HG often find that the list of food and drinks that they can keep down is very small and not at all from the healthy options. For some reason, women with Hyperemesis ofen find sweet and salty foods ie, sweet drinks like coke, and crisps, are more likely to stay down than healthy foods. Their peculiar diet can lead to disapproving comments and the incorrect assumption that this is how they normally eat.
Various women find different drinks acceptable. Coke (often left to go flat) Lucozade, lemonade, milkshakes and IronBru, Dr Pepper, orange squash, apple juice, lime juice, ice cubes made of flat coke or just tapwater, ice lollies and sips of tepid water can help in keeping rehydrated. 

When the illness is at its worst during the early hormonal surges - typically between eight and ten weeks- then it is difficult to retain any liquids and you may need to be hospitalised for rehydration at about this time. 

When solids do become bearable,jelly, tinned fruit, ice lollies, ice cream, crisps, fish fingers, potato cakes, crumpets, soda bread and similar potato based or salty foods have often been found to be acceptable.

The important thing to remember at this time is that it doesn't matter what you eat or drink, the crucial thing is that you eat or drink something. Don't forego something because you are worried that it's bad for you. In a normal diet, too much salt and sugar is bad for you, but when you consume nothing else, this may be your only source of calories, fluid and salt for the day. Instead of berating yourself for your unhealthy diet, congratulate yourself that you have kept something down because your body needs it. If you are able to take vitamin tablets or syrups, then do so but most women find that large multivitamin tablets make the nausea worse. You may be able to get vitamins that dissolve under your tongue which you may be able to tolerate. If and when you begin to feel better, you can start to re-introduce more healthy food.

Will it go away when I give birth?
The good news is that for the vast majority of sufferers the physical symptoms of HG disappear completely as soon as the baby is born. You should be aware though that it is not unknown for the nausea to persist after birth especially if you have been severely ill. If this occurs, speak to your doctor. For women who suffered persistent, long term nausea and vomiting, it may take some time to restore energy levels and nutritional reserves. Moreover, while the physical symptoms may leave, the trauma of HG can leave an emotional legacy for many women, especially when combined with the rigours of caring for a baby. If you have any concerns, speak to your doctor or midwife. Don't feel that you should just be able to pick yourself up and get on with things, if you're having problems you are entitled to seek support.

Will I get it in my next pregnancy and will it be the same?
Unfortunately, having HG in one pregnancy puts you at a high risk of suffering in subsequent pregnancies although it is possible to escape it. Some women find that the HG gets better in subsequent pregnancies, whereas others find it stays the same or gets worse. There is really no way of knowing how your pregnancies will relate to each other.

Can I do anything to prepare for HG incase I get it again in my next pregnancy?
The HER website has a page of advice on preparing for your next pregnancy. forums.helpher.org/viewtopic.php?t=17. If you had medication which worked for you in your previous pregnancy, make sure that you have it ready to take as soon as you feel ill. Studies show that the quicker you get on top of the sickness, the better the medication works. Because HG can start within days of missing your period, see your GP as soon as you know you're pregnant.

Useful sources of information
The Royal College of Obstetricians and Gynaecologists in the UK have no guidelines on the treatment and management of HG. However, the American College of Obs/Gynae (ACOG) and the Society of Obs/Gynae of Canada (SOGC) have published guidelines which can be found at the following sites

www.sogc.org/guidelines/public/120E-CPG-October2002.pdf 

www.guideline.gov/content.aspx?id=10939

Pregnancy Sickness Support is a UK based organisation run by GPs and midwives with direct experience of HG. They have a helpline which you can call for advice ? if nobody answers you leave a message and a midwife will call you back. They will be able to answer your questions about treatments and they keep a note of doctors around the country who are known to be sympathetic to HG sufferers and are willing to treat it with medication. Their website is at www.pregnancy sicknesssupport.org.uk

The Hyperemesis Education and Research Foundation (HER) is a US based foundation which was formed by HG survivors and has a mission to research the causes of HG and provide information and support for other sufferers. They have links to the latest scientific research and are actively involved in funding research, although you usually have to live in the USA to take part. There are loads of threads on every topic related to HG from women who have been through it, including very useful information about which treatment regimes worked. Their website is at www.hyperemesis.org.
Dealing with well meaning but unhelpful advice

Women with HG are often told by friends and family that it's just morning sickness, a normal part of pregnancy and you just have to put up with it. Many HG sufferers report extreme frustration at being advised to try ginger, dry crackers or eat little and often. Most of them have tried every remedy they can think of to no avail. Because most women are familiar with NVP, there is often an attitude of, well I had morning sickness and I just got on with it. HG sufferers are often left with the feeling that they are whingers and malingerers and that if only they could adopt a positive attitude then they would be fine. This can lead to further depression in what is already a depressive condition. In order to deal with this, it is important that the HG sufferer has some supportive friends or family who can firmly but politely fend off these comments. The sufferer will often have no energy to deal with it herself. If possible explain to the person giving the advice that you are not suffering from morning sickness, you are suffering from a condition called hyperemesis gravidarum.

I have never known anyone with HG. Where can I talk to women who understand how I feel?
There is a support thread on the talk boards here (ask MT to add link) which is run by sufferers and ex-sufferers. There are discussions of practical issues such as tips for coping and medication but the real value of this forum is that you get sympathy and understanding from people who know exactly what you're going through. If you just want to moan or let off steam, you are free to do so and nobody will hold it against you. Comments are also welcome from relatives, partners, friends and carers of HG sufferers. The HER website also has talk boards at forums.helpher.org/. There is also a UK based yahoo group called Bloomingawful at health.groups.yahoo.com/group/bloomingawful/

Thanks very much to MOH especially for such detailed advice. My own GP is on holiday at the moment, I think she's back next week so I'll try to book an advance appointment for when she's back to discuss all the points you raise.

I don't know if my mother was given anything at all, other than to be rehydrated. She was pregnant in the late 60s (my two older sisters) and the early 80s (myself and my younger sisters) and I don't really know what the protocol was then. My older sister who had HG had her pregnancies (3 births and two MCs) between 1999 and 2009. I know that she was treated with drugs but I don't know the details or what helped most. My other older sister has had one pregnancy (twins) and didn't have HG - it was twins after IVF with donor eggs after cancer treatment and she was on HRT as well so that may have made a difference. She was having a lot of artificial hormones. Neither of my younger sisters have yet had children.

Re: work, I am quite lucky because my university does almost no teaching next term - just a few revision classes before the exams. So my teaching is almost completely over until October which is a big help. A lot of what I do have to do - research, writing, admin, marking and so on can be done from bed if necessary.

I managed today OK and even made it into the office for a couple of hours to sort out a few things. Having a very early night though and I won't go in tomorrow, I'm just going to rest again.

Hello Ladies.

Sadly, I was far too over optimistic. I do have hyperemesis this time too. ARGHHHHHH :(

I've had a very very very frustrating few days, but now I am on on the other side. If you don't mind, I'd like to have a whinge/rant/moan and share my story!

Thursday the nausea was getting stronger, and the vomiting started up again. By friday night I hadn't kept anything down that day, and decided sod this for a laugh, and took myself off down to the gynae ward. I had moderate ketones, so was given IV Hartmanns and IV cyclizine. Off back home, ate a small amount of tea, and went straight to bed. The next morning the vomiting returned. I managed to control it with the oral medication, to the point where I managed an evening meal again. I am using cyclizine, stemetil, and had managed to persuade the GP to prescribe ondansetron a few days earlier (an uphill struggle, but made him ring the on call Obs Registrar who told him to definitely prescribe ).

Sunday came, and the vomiting became quiet extreme. At 6.30pm, and again, not having kept anything at all down for 24 hours, I went to the gynae ward. While I was sat for 3 1/2 hours waiting to be seen I vomited a further 9 times. I was nearly hysterical by the time I was seen. Imagine my surprise to be told there was no ketones in my urine, so they were sending me home. I point blank refused, ketones or no ketones, vomiting over 20 times just isn't acceptable, and I wasn't leaving. Eventually they agreed to fluids and IM cyclizine. This didn't work, and I vomited 30 mins after the cyclizine (which the nurse decided to give IV in the end). I had IM ondansetron then, which seemed to help. They still wanted me to go home - this was 1am by the time the vomiting was under control.

I still refused, based on the knowledge that as soon as I woke up the next morning, I'd be back in the same position, and I wasn't coming back to wait for hours on end again. I wanted regular IM/IV for a few doses to get me back under control, and for a break from the vomiting. I ruptured a blood vessel in my throat and vomited the blood up, and coffee granule type substance on my last vomit. I just couldn't bear to be sick again for a good few hours. The SHO was insistent that I should go home, and that if I stayed I would be sent home immediately the next morning, as no one would keep me in without ketones present!!!! ARGHHHH!

After refusing to go, I was admitted to the maternity ward as there were no beds on gynae. I found some urinealysis sticks in the toilet in the bay I was in, and peed on one myself - there was 3+ of ketones!! I made sure I pointed this out to the midwife looking after me. She then carried on with the IV cyclizine overnight.

I was seen by a much more understanding consultant the next morning. She made a plan to have further IV fluids, as still 2+ ketones that morning. And to continue with IM for 2 more doses, then home in the evening. I was to then attend a much further away hospital for daily rehydration and anti emetics.

That was this morning. I rang the ward I was to attend, only to find it would be completely useless to me. As my pattern of vomiting is that it starts off as nausea, with only being able to eat very small amounts for 2-3 hours, then vomiting, sometimes the vomiting will cease in the evening, sometimes it escalates and becomes uncontrollable. I never know which way it will go from one day to the next. Some evenings I do manage food, and then go to bed so it stays in. Some times I don't, and that is the point when I feel I need the IM anti emetics. The ward just expect you to go in at 8.30am, and stay til 5pm for fluids and anti emetics. I won't know until the late afternoon/early evening if I need this. Its not the fluids I feel I need though, all I need is to stop the god damn vomiting!!

So I went to my GP, and asked for IM for self medication as required, and he agreed! I was very very shocked!! He was the older male unsympathetic GP I saw when I first went 3 weeks ago. So I now have a management plan! I have the oral for the morning, and then if I vomit more than 4 times, and don't keep the oral down, to use IM cyclizine to get on top of the sickness! I know when I need rehydration, so I can just go in to the gynae ward at those times.

I am so overjoyed at this! This is exactly what I need. I know what I am doing with this, so glad he has trusted my judgement on this!

Just have to get the bottle to give it now! Its not the needle, its the damn stinginess of the stuff!!

Sorry for the long self indulgent post, but I am sure you ladies will understand where I am coming from!

Looks like I'm here for a while then... I am hoping it won't be a full pregnancy worth of vomiting though. It did stop at 22 weeks with DS. For those who have had more than one full term hyperemesis pregnancy, did it stop at a similar time in pregnancies?? Fingers crossed!

Hi Everyone,
I am about 4 weeks pregnant. At the very start of this awful ride again. I have 2 children already. One is 7yrs old and the other 2yrs old. This one was a bit of a surprise to say the least. The HG sets in at about 6 weeks for me. Had it with my other two girls. There is a history of it in my family. My two brave sisters had it. My half sister got it and my cousin had it and she had 5 girls. Personally she is my hero! She deserves a medal. I love her to pieces and it was nice to be supportive of each other through this horrendous condition called HG. I hope that you all know how precious you are and how amazing you are to be just sane going through this. Depression can raise it's ugly head with this condition. Not surprising when you feel like you have food poisoning 24/7. Thank you for all your comments. Just joined the network.

PND is just awful. I know how you feel. I think you are amazing. Keep going.

There is a really good news video on you tube about HG. If you put in -helpher - it will link you to a website that was specifically set up for this condition. It was set up by a nurse who suffered from HG. Get your doctor to weigh you too. There are certain criteria and procedures that they have to follow. Consultants in the hospital have a guideline and procedure they have to adhere to. Ask for a copy. They will start taking you seriously when they know that you know your stuff. I didn't know any of this when I had my first girl. By the second I was a bit more prepared and didn't take any excuses from the doctor. You can also get protein drinks on the nhs when you cant keep anything down. It's so hard. Nothing is set in stone for this HG. Everyone is slightly different and suffering is all relative. I think you are all doing great. My sickness doesn't kick in til 6 weeks usually so I am dreading it. It's one thing to talk about it, it's another thing to live through it. Keep going everyone, don't give up. Just remember to tackle this HG minute by minute, that is all you can do at times.
Add message | Report | Message poster heavensent123 Wed 04-Apr-12 00:28:35
Helpher - on the google site I mean. Sorry. I have no memory and get very dizzy. Signs that this HG are on the way. Hope this information has helped someone.
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Hi TheDetective,
You sound like you are really having to battle. I am so sorry. It is awful that you have to put your full body armour on to go into battle when you feel so very ill and all you want to do is to lay down and rest. I have had 2 girls and had HG all the way to delivery unfortunately. Yours may go. I hope so. If you are not getting any joy at the hospital, you can complain to the patient line. Once you tell the hospital, especially the consultant they will take you very seriously, very quickly. They don't like having bad reports and they have to resolve any complaint I think within 48hours or it goes on a report for that particular hospital. I complained in my last pregnancy as I saw a rather rude registrar. Needless to say that I got the most senior consultant after that.

Another word about keytones too. Sometimes when you are in keytosis the keytones take up to 24 hours to show. I went to see the consultant one day and I was just in keytosis. I went on a drip for the day as an in-patient and when they took the test again I was in maximum (dark purple) keytosis. I had to stay in overnight.

Let me know if you need any advise. Don't feel like a burden. I have sisters too, I was one of five. My sisters have had 6 children between them and had help. You feel bad enough having HG. Don't put anymore guilt or pressure on yourself. People want to help. It's an awful process for 9 months but you will have a bundle of joy for the rest of your life. Keep going and believe in yourself. You are doing really well in this battle called HG. Night, night.

I'm sorry if I have put some information on here that you all knew. I just wanted to chat before I read anything. Duh, feeling a bit silly now. Night, night.

Hi all. I'm still here at 41+2 but mostly feeling ok except haven't been able to shift a cold for about 8 wks now - my body is knackered from this pregnancy!
Saw on another thread that Feekerry had a little girl yesterday by EMCS after a long labour.
Hoping this one will be a short one as 2nd child - also desperately trying to avoid any drugs that might cause nausea during and after labour this time as I didn't stop vomiting for about 4 hrs after last time. So trying to practice relaxed birth breathing but so hard when nostrils blocked up so much of the time!
big hugs to everyone esp to those just starting out on this exhausting journey x

Hi all, feeling quite low and frightened this morning. Today was the first day I've woken up feeling really sick already, I haven't moved yet at all (apart from sitting up in bed to sip the tea DP made me before leaving for work). I feel sicker as the day goes on - worst in the evening - and so far I've felt reasonably OK first thing. I'm going to rest all day today.

DP has to travel for work for a fortnight, leaving a week today, and I'm worried how I will cope if I feel very unwell. Although it's so early I think maybe I should send some emails explaining the situation to my friends in London to say that I may need to ask them for help during the time DP is away.

DP is really excited now. He was trying not to be because of the early losses in Jan and Feb but I'm now past the point when I lost them so I think he feels more optimistic. I feel bad that I worrying more about how I am going to get through it all if the sickness keeps getting worse.

In more cheerful news, we have agreed that before he goes we're going to get a printer and a digital piano for the flat. Once we have a printer I'll be able to do a lot of work from home if necessary/possible; and I've wanted to have a piano for years and years. I used to play a lot. So I thought if we get that now at least it's something I'm excited about, that feels like a treat but which I can also do if I'm stuck here.

One last question for the pros - should I be monitoring my weight? I feel I've already lost a pound or so as my appetite has really dived the last few days. I'm not too worried about it at the moment because interestingly I have put a bit of weight on over the last few months (I'm sure my body did this on purpose!) taking me to just over 9 st which is heavy for me. But all the same I am fairly slim so presumably should try to avoid losing much?

Khalidasa - hugs, first of all. I know how you feel! Don't worry too much about a bit of weight loss (within reason) - the baby will be getting all the nutrients it needs and it is you that will be suffering. Not that that is much comfort. I hate that feeling when you open your eyes and already want to throw up. Just take every hour, every minute if need be, as it comes today and you will get through it - eventually you will look at the clock and it will be bed time and you'll surprise yourself xx

Thanks Barmee! I feel a bit silly now as after a gentle shower I feel better and even hungry which is good. I've also rearranged my appointments later in the week so that we are going to meet at my flat rather than in town which makes me feel a bit calmer. (It's just meetings with friends and grad students, so I think it's OK to ask them to come here!)

heavensent welcome and thanks for your input, don't feel silly, it's good to hear everyone's story and you can be assured that others will benefit from reading your post. I didn't know that about it taking time for the ketones to show up, I think it's a good idea for women to keep an eye on their own ketones and not rely on the hospital to get it right. Also, I'm really glad to hear that you got somewhere after making a complaint. It's so difficult to get up the energy to complain when you're feeling so low, but I think that things wont' improve until lots of women do it. Commiserations on joining the HG club again, we all know that sense of impending doom. I'm really interested in your family history too, especially the fact that your half sister and cousin had it. My sisters and mum had it, but my mum's sisters didn't and my cousins had fairly bad 'normal' pregnancy sickness but not HG. Did your mum have it? And is your cousin who had it related through your mum or your dad?

kalidasa oh dear, this sounds so typical. Is there another doctor you can see today or tomorrow, I have a strong suspicion that by next week when your GP come back off holiday you may well be in a bad way, and with no DP to look after you, you may be in a difficult position. I don't want to be the voice of doom but HG can progress very rapidly and in a week you might not be able to get yourself to the doctor without a struggle. I know what you mean about not wanting to dampen your DPs enthusiasm, but does he really know what you may be in for? Actually, can I just correct myself, he doesn't know what he's in for. I told my DH what it would be like (from my sister's experiences) and he said afterwards that it hadn't really prepared him, he just couldn't believe that anyone could be that ill. If your DP can't shorten or reschedule his trip, then I would strongly advise you to go ahead and send your emails and put lots of other help in place from friends or family. I unashamedly asked friends and neighbours - my family are far away - and even with my DH around, it was invaluable while he was at work. Sometimes I needed my next door neighbour to pop round and make me something to try and eat, if I went into the kitchen either the smell would make me puke, or after the effort of making a bit of toast I'd feel too sick to eat it. Please don't feel bad about worrying, the worrying and doing something in advance about it is what will get you through, there's plenty of time to get excited about the baby once you've got your medications sorted and can feel better. Normal women get to feel excited and hopeful straight away, HG women don't, we have a battle to fight before we can get to that stage. Given that DP is going away in a week, I think that this is the time for him to help you get the help you need beforehand. Can he look at the documents on www.pregnancysicknesssos.co.uk and www.pregnancysicknesssupport.org.uk for you to get up to speed on treatments? Then both of you take hard copies of the documents to a doctor today or tomorrow, show them the treatment protocols which are shown in the documents and tell them that you're not leaving without a prescription or an urgent referral to a consultant. On your last question, absolutely monitor your weight, weight loss is obviously to be avoided. Also, get DP to get you ketostix from the pharmacy and monitor your ketones, this will give an indication of ketosis which is a measure of starvation and an indirect measure of dehydration. If your ketones are high, you will need to be admitted to hospital for fluids. Hopefully you won't get to that stage, but you will realistically only avoid this by getting medication as soon as possible. I hope this has reassured you that you can get treatment rather than frightened you further. good luck and I enjoy your rest today.

Kalidasa, I so sympathise with your situation, but I really do urge you to take MOH's advise. It's exactly a year to the day that I spent 2 nights in hospital, at 7 weeks pregnant, on a drip and getting my first doses of cyclizine. It was my 2nd pregnancy, but first time with HG. I was totally ignorant about it all, and if I look back on it all now, I think I would have done things very differently indeed. I would not have waited until I had not kept any food down for days, and had not even kept fluids down for more than 24 hours, before asking DP to take me to A&E (I had started to feel as if I was hallucinating I was so dehydrated). Please don't let yourself get to that stage. I ended up taking cyclizine throughout the pregnancy but that still didn't totally stop the nausea, and I was still sick once a day - in retrospect I wish I had pushed for ondansetron. By the way, I am also a lecturer :) It does make it easier being able to work from home a lot, although to be honest, my productivity took a real nosedive. I would try to work in bed but a lot of the time I felt so bad I fell asleep! I told my head of school about the pregnancy very early on so she could understand what was happening, but asked her to keep it to herself until my 12 week scan. Please do keep us posted about how you're doing.

Cosmo, sorry to hear that you're feeling awful, but good to know that you'll be getting a break soon with family support.

Magnum, argh, the waiting at the end is dreadful, poor you (I went to 40+9). But at least you know the end is very much in sight now - good luck!

Detective, so sorry to hear about your ordeal - it makes me really angry to hear how you've had to fight for treatment. But good for you for pushing until a proper plan had been put in place. Hope you're feeling a bit better now.

Welcome too to Marmee and Heavensent. Hope you're doing as well as can be expected under the miserable circs. xx

Congratulations to Feekerry Baby at last! [grin[[grin
Magnum Best wishes, I hope it's soon.
Heavens It was nice of you to post info, and you never know when you cover someting someone here doesn't know. Welcome, I do so admire women who go for it several times...Have you already arranged about meds? It must be awful on subsequent pregnancies, waiting for it to kick in, hoping it doesn't.
Detective I am horrified by your account and can only send you cyber hugs and congratulate you on being so strong. It is so hard to fight your corner when speaking seems to bring on vomiting. Nine sessions of vomiting in three and a bit hours, bringing up coffee grounds, and they wanted to pack you off home? I am really . It seems outrageous to me, I thought understanding of treatment was improving. I'm so glad you found those kestosticks and have now got a treatment plan, but what would have happened had you not stood firm?
Kittens Hugs, how is baby now? He must be a toddler!
Cosmo Poor you, a cold as well as the rest...
Kali Sorry things are getting worse. Can only echo MOH's advice about doctors and treatment and going for it as early as you can and send sympathy. I am glad you can work from bed if necessary, but how dismal it is and I do hope you get some effective treatment. It's so awful waking up to puke, the dreaded 'bile run'...
Lucinda
xx

Thanks both. I'm really not sure what to do. I come from a medical family and I suppose there's a strong culture of not 'making a fuss' until you are really ill and I'm not sure a GP will take me very seriously at this stage since I am still eating (if not normally) and haven't yet thrown up. It is bad luck that my v. good GP is away. It's a small practice and I think there are just the two of them. We don't celebrate Easter and I've only just realised that it's Easter weekend this weekend too which isn't going to help!

DP definitely has no idea what it could be like. He was really shocked how ill I felt the first time, in January, after just a few days and was adamant that there must be "something they can do" even at that stage. He is French so used to quite a different health system. I kept explaining that I although I felt unwell I hadn't even been sick but I don't think he really understands about the endless vomiting at all. Although the early losses were v. sad, and it was frustrating feeling unwell for a few weeks each time for nothing, in a way it gave us a trial run. Both he and I feel a bit calmer about it this time and have worked out some ways of coping better at least with this early stage. I am also a lot less stressed now that teaching is over.

He will definitely cancel or curtail the trip if necessary but I really would like him to be able to go at least for the first part as he's giving a talk at Princeton and they're paying for him to go all the way over there to give it! So it's quite prestigious and a big deal for him career-wise. But if I was really unwell he could come back immediately afterwards and skip the research trip and socialising he was planning on.

I think I might also try and get hold of my sister (whom I haven't told yet) and ask her advice. I am definitely going to ask for help from everyone I can think of.

Anyway, I am really grateful for all the support and advice. I will have a proper discussion about all this with my DP this evening and see if we can decide upon a plan of action.

kalidas there are times when a stiff upper lip is the best course of action, but this isn't one of them. You are going to be ill whether you get meds or not (sorry, but this is the reality) what you have to decide now is how ill do you want to be? Research has repeatedly shown that pre-emptive medication is the most effective way of treating HG. Vomiting and nausea are almost learned responses by the body, (sorry if you know this already) once you start a cycle of vomiting, then your body gets into the swing of it and it's very difficult to break. it's a bit like chronic pain management, the best way to deal with it is to prevent a breakthrough in the first place. A rubbish GP may not be inclined to take you seriously at this stage, but that doesn't mean it's right - you have to take yourself seriously and many women on this thread will tell you, you often have to shout to get the optimum treatment. Your DPs trip sounds awesome, it would be a real shame if he had to cut it short, but I suppose he doesn't want to be over there having a ball while you're at home suffering. It's tough, HG is just tough on everyone.

I suppose my only real hesitation is that maybe I won't get too ill and just feel like this for the next few months (miserable but basically functional). MOH are there statistics on this? I mean, does the fact that I am feeling very nauseous all day on limited activity at 4w6d pretty much guarantee bad vomiting imminently?

I know just what you mean about learned cycles. I have had rheumatoid arthritis since childhood. Thankfully it got a lot better just a few years ago so now I only have one grumbling wrist and some residual damage in other joints but from 9-27ish I was in pain all the time and often quite badly disabled so I do understand about chronic pain/illness and how much it feeds into itself. (Also because once you are out of action you lose muscle tone and so on which itself increases pain.)

My mother also said that she always felt that the first time she threw up was the day she 'lost the battle' which I suppose is her way of saying the same thing.

I am going to ring the surgery this afternoon and see if there's any chance of even a telephone consultation before the Easter break. I was thinking about it and even if they won't give me anything now I would feel better if there was an agreed plan in place.

I just had my first IM injection. Was so scared, but I did it! And it was far better than when someone else has given it to me. I did it in my thigh, and the stinging was negligible!

Not managed to control the vomiting today, so hopefully I can have a better evening and manage some fluids and food.

I only did it 20 mins ago, and already the excessive saliva and nausea have gone.

detective I'm feeling sick just thinking of self IM injections and I'm not even pregnant. Well done to you and how fantastic to have no nausea. What a bloody trial you've been through to get help, I hope it carries on working.

kalidasa do you know I've no idea about that, whether it's possible to just stay at low level nausea for the duration. I suppose if you did you wouldn't be on an HG forum and we wouldn't know. I suppose it's possible, but with your history I wouldn't chance it. If you get medication early, there's no harm done (the meds are quite safe) but if you wait and it does develop into HG then you'll really suffer for it. I think your mums advice is good. How awful to have rheumatoid arthritis at the same time. Does pregnancy help with that by suppressing the immune system?

Message to all, I've updated the survey results since having more respondents and I've also added some more answers. There's some interesting data on medications, who has taken what and what has been effective. It just reinforces what we always say about trying different ones and what works for one person may not for another.

Sorry meant to post link to survey results sites.google.com/site/pregnancysicknesssos/surveys/survey-results

Thanks MOH. detective I hope you are still feeling better. V. brave of you to inject yourself.

The survey is really interesting. I actually have a medicine cabinet full of stemetil and metaclopramide left over from the last time I had labyrinthitis (which was quite a similar experience actually - has anyone else had it?). The first (and worst) time I had it I kept having to take the pills over and over again as I would throw them up immediately. I was in the States and on an incredibly expensive hotel phone line to my father (retired doctor) who kept saying: 'if you throw up within 10 minutes, take another one, and keep on doing it until it stays down'. So grim! Obviously won't use any of it without medical advice but I had no idea these were prescribed in pregnancy.

The arthritis is a lot better these days, I only have active inflammation in one wrist (the other joints are just a bit battered by past disease) but yes, all three times it has gone almost completely 'quiet' as soon as I conceived (about 2 dpo). So at least that's one benefit!

Another thing I've noticed is that a lot of people on here seem to come from large families. Is there any evidence at all for a link between HG (or perhaps bad sickness in general) and fertility? My mother and sister both got pregnant very easily, even at the very end of their 30s, and I have conceived every month we've tried.

I am feeling OK at the moment because I just worked in bed all day. I feel very lucky that this is an option at the moment.

There is no family history of hyperemesis anywhere in my family. I am an only child. My mum said she had slight nausea that settled with eating with me.

Her mum had 5 children, and no sickness.

My Dad's side, my nan said she felt awful til 12 weeks but no actual excessive vomiting. My only aunt on my dads side didn't have hyperemesis either.

No one else in the family have had children yet. I am the only girl of all my cousins on both sides to of had them.

I feel so sorry for this child if it is a girl, as not only will she have my history, but DP's sister is having her second child, and this time she too has hyperemesis. She is 33 weeks now, and it is still on going. So will have a FHx of hyperemesis on both sides :( Poor kid. Hope its a boy now!

I don't know about fertility. I think everyone on both sides of my family have gotten pregnant easily, but I can't be sure because I guess people don't talk about these things. I know my mum conceived first month, as have I each time except this time when it took 3, but that was more due to bad timing of events stopping the actual conception I think!

I tended to notice that those who get hyperemesis have very little 'common' factors about them. The women I have cared for have come from every sector of society.

I wish there could be much more understanding about this horrendous condition. It truly is a debilitating condition.

This article is interesting. A tiny sample but suggests a link between increased fertility and HG, and a possible evolutionary advantage for bad pregnancy sickness in general:

www.sciencedirect.com/science/article/pii/S0015028209037017

Hi all and welcome to newbies. Sorry to hear you all having a rough time and big nugz. All I can say is follow MOH advice and moan away.

I had a shit night last night. Barely any sleep and was sick 3 times during the course of the night. Don't feel to bad today. I was quite thristy yesterday I caouldnt stop drinking it was unbelievable. I can't think what set the sickness off again as still been taking my 'safe' foods. Excuse not to do anything round the house today.

hope everyone else is ok

bloody hell detective, jabbing yr own thigh is impressive! those injections fucking sting, i wouldn't be able to do myself. amazing you have the plan you wanted, proves to us all there are Dr's out there that will listen and you just have to demand and refuse to leave! Bloody difficult when feeling so shit.

wooo hoo feekerry! looking forward to some details, grab some cake and make your way to the pink castle

waves to fluffy