Thanks punk that is so helpful. I think my HG last time was at the severe end, I went into hospital for the first time at only five weeks and I threw up all the way through. I too powered through a host of drugs and drug combinations between weeks 5 and 9. I think I should probably have had a trial of steroids although I am a bit cautious about steroids in general as I was on them recently (for rheumatoid arthritis) and they messed with my mood.
So drugs-wise, yes I have cyclizine, ranitidine, pryidoxine and (a small amount of) ondansetron newly prescribed, as well as stashes of these and other things from the last time. I am already taking cyclizine at night and the ranitidine and pyridoxine each day, I know the ranitidine helps a lot with acid which last time wasn't really a prob until the second half, but this time I noticed heartburn alongside the nausea within a few days of conception (but my digestion has never gone absolutely 100% back to normal after HG). Last time I took metoclopramide for a long time as well but I have been told to avoid it as I had a lot of neurological symptoms and was probably on it much too long. I don't think it did much anyway.
I have really mixed feelings about ondansetron. I think it did, eventually, help keep me out of hospital, but it really wasn't a magic bullet, I continued to throw up a lot, and actually food replacement drinks made the biggest difference to me at that absolute worst stage (9-11 weeks ish), when I had been starving for weeks. I was on a massive dose of the ondansetron for ages and the constipation was absolutely unbearable, absolutely nothing worked apart from enemas. So even though I know I will need it I am not very keen.
As you say my plan is to start taking the ondansetron the first time I throw up and hope this avoids rapid escalation. Last time I completely lost control of the vomiting almost immediately.
We have thrown money at the domestic side of things: we have recently switched to a nanny, and we also have a cleaner once a week.
I'm seeing the GP tomorrow and I am going to ask if we can put in place a system of telephone consultations. Last time every time I got bad I had to go to the GP who would then send me to A&E and every single time it took hours and hours to be admitted even though they knew I was coming - there was no option to skip any stage. It was crazy as I would be very ill to start with and extremely ill after five hours or so on a chair in A&E unable to eat or drink. My last admission I was delirious by the time they finally admitted me, so confused that I couldn't manually take a tablet and in the end they injected me instead. It is very difficult to work round this though as it is a huge central London hospital (Royal Free). I have ketostix at home so can test myself for ketosis.
If I do end up in hospital I will try to arrange some sort of work around the first time for any subsequent admissions.
Unfortunately there is no HG clinic at the Royal Free as far as I know. It does have a big team and they seemed pretty good - I guess it's a big enough hospital that they do see even v. severe HG fairly regularly - but not absolute specialists. I found it quite demoralising in the second half of pregnancy that though they scanned the baby v. v. regularly as I was still being sick they didn't really seem to care how miserable I was! Even though I was on crutches/wheelchair with severe SPD for the last months as well. Actually consultants I saw in other hospital departments - e.g. rheumatology and haematology/thrombophilia - were MUCH nicer to me at that stage and seemed genuinely shocked.
Finally, do you know what you are having? Just wondering if the worse HG is sex-related (as some doctors say) or whether it's just a reaction to doing it again?