Hyperemesis Support

[LucindaE]

I hope everyone suffering from the Horrors of Hyperemesis will find this thread useful as a source of support and information.

There's no TMI on here - can't be by definition - and nobody should feel ashamed of moaning as much as they feel the need to.

MOH's wonderful website is full of useful information on this illness:
sites.google.com/site/pregnancysicknesssos/
Another invaluable website is:
www.pregnancysicknesssupport.org.uk/
If you need help in obtaining medication, this phone number is
brilliant:
024 7638 2020

Lastly, the NICE guidelines on treatment are useful:
cks.nice.org.uk/nauseavomiting-in-pregnancy#!prescribinginfosub

I would like to thank Everyone who has given such invaluable support and advice on this and on previous threads.

Remember when you are at your worst, 'This Too Shall Pass'. It really will.
So many women on this thread have thought they couldn't get through this, but they did.

Basgetti - actually if you've got an existing bowel prob I think you should be v cautious with the ondansetron. Are you managing ok on the dose you're on at the moment?. I've not gone into too much grisly detail here about my struggles with this but it was extremely severe and they had to take me off it completely in the end because on it I simply had no bowel function at all no matter what laxatives (and other worse methods!) they tried. I haven't gone back on it though I have some which I could use as a one off to try to interrupt a really bad spiral. I would not take more than one again though, and outside this thread I know a woman who is still having serious bowel probs more than two years after delivery, probably partly from high dose ondamsetron all the way through, partly from an extremely severe case of HG in itself. (She's the only person I've 'met' in any capacity who's had a worse time than me in this pregnancy.) It turned out that the obs/gynae people didn't really know anything about the side effects of long term ondansetron because it's typically used just for a day or so after surgery or around chemo/radiation for cancer patients, but the palliative people really did know about it and they took this side effect very seriously and recommended that I did not go near it again. Happy to PM if you want to discuss the bowel stuff in more detail, I have actually found the constant bowel dysfunction (still not at all normal) one of the hardest things to cope with this time. Really doesn't help you feel like eating either, and starvation has always been the biggest prob for me.

Mary - welcome, but sorry you are here! If you are vomiting that much you need some medication because otherwise you are likely to end up admitted for rehydration. I am a freak outlier (especially in this preg) but almost everyone finds that the right drug combo will keep them out of hospital, though sadly a lot of women have to go in once before their GP takes it seriously enough to prescribe properly. Good to avoid that if possible, but equally don't be scared of it - once you are dehydrated you'll feel a lot better on a drip even if the whole process of being admitted etc is unpleasant and alarming. At 7 weeks you are unfortunately probably still a couple for weeks from the 'peak' so it sounds like you need some help. I have a toddler too (DS is 20 months) so I really feel for you in that front.

for you emsy. Your Doc is wrong and a twat! There are stronger drugs than the ones you are on, and whilst they aren't magical they can and should be used. I'd consider using the private scan money to see a private doctor tbh. Are you under consultant or MW lead care? It was a consultant that first prescribed Meto to me (although my GP who it it on repeat prescription). Either that or another GP, some are much less likely to fob you off than others!

Welcome Mary settle in and rant away. No such thing as tmi here!

Emsy - cross posted, I would ignore the GP and try combining the metoclopramide with the cyclizine, in staggered doses. Those two drugs work very differently so are safe to combine. You could also try calling PSS for advice on safe combining, My sickness is also v v movement related so I really feel for you in that one. I haven't been out of bed for months, but on bad days even completely motionless in bed I still feel like I'm on a boat in choppy seas, it is really awful, just lifting my head from the pillow can set me off, or weirdly seeing someone else move even if I am motionless! So weird and extreme. Even my mum who had HG herself (though with somewhat less, er, total 'commitment') doesn't understand this as she didn't experience it that way. It is a lot like labyrinthitis though so surely must be messing with your inner ears somehow. Do be aware that e.g. Cyclizine can make you a bit dizzy so can slightly exacerbate that effect unfortunately.

Emsy - sorry, missed that you hadn't had metoclopramide already, definitely worth asking for that. You do have to keep an eye out for side effects with it - I became allergic to it in the end in my last pregnancy - but most people are fine on it and it seems to work well alongside the antihistamines for a lot of people.

Also, just wanted to reassure you that your feelings about the baby/embryo are v v normal. I was v clear in both pregnancies that these were planned, wanted pregnancies but that I did not want to endure a day longer than I had to and that it was important to me to be reassured that the pregnancy was viable. I never had to pay for this as if you are admitted unusually early - e.g. Five weeks - they scan anyway to rule out multiples/very unusual things that can cause extreme sickness. But I would totally have paid for it otherwise. Not wanting to endure this if you don't 'need' to is completely rational. You're also right though that these pregnancies are usually very robust.

Thanks lottie and kalidasa
I feel a bit stuck after today's appointment because I'm sure if I don't give this promethazine a try before going back they are going to get annoyed with me. At the same time another week with no progress is not good either.
I'm MW care at the moment and would really like to keep it that way as I want to stay away from consultants for the birth if poss. I had preeclampsia in my first pregnancy and my labour was pretty horrid under their care, lots of interference.
Thanks for understanding how I feel re the scan. I feel horrible for even thinking about it but just trying to be realistic.
I had 3 lots of acupuncture last week and wasn't sick for 3 days so maybe that's the way forward for now. I have an appointment in the morning and will try and book some more sessions.
I guess if these promethazine don't work by next week I'll go back, maybe to a different GP!

Thankyou for being so welcoming. Only been sick 4 times today and managed some Rice Krispies. Not been to GP yet as haven't been able to get an appointment. Yes it's my second I was signed off for my first due to sickness (luckily as a teacher I'm off at the moment but school hols ruined!) just wish I had an end in sight I was sick throughout my first pregnancy and dreading the coming months so much. Just miss feeling normal and spending proper 'fun' time with my toddler.

Thanks kali, I have had several hospital admissions for obstruction in the past, usually requiring NG tube and it's pretty grim. GP has said 4 mg once a day now for Ondansetron, twice a day at a push and I have to try to get the balance right. When I took higher dose I was blocked within a couple of days, new lower dose and it's doing little for the sickness. I'm not sure it's worth it if I can't get the benefits of it anyway. I'm going back to GP in the morning so will seek their advice.

Sorry for everyone else who is suffering.

Having a horribly rough day and decided to resign myself to nine months of misery, then hopefully I'll be pleasantly surprised at some point if it eases up. Currently signed back on at work for part-time hours only and finding it hard to do my job well in such a limited time frame, it feels even more stressful than just being off, but I'm miserable when I'm completely not there.

There's just no winning in this, is there?

Emsy I would give the promethazine a try before giving up. I cycled through all of the various drugs in my first trim including combinations and found that promethazine was actually the most beneficial. It's different for different people.

Fox that's what I try to do. Expect the worst and then on good days you are pleasantly surprised and then get your hopes up things are improving only to get a horrible reality check the next day

Kali how could anyone possibly have it any worse than you !?

Poor you Basgetti, do you have an underlying condition that causes this? Obviously no need to share if you'd rather not but I was wondering if you have access to a GI specialist/consultant or bowel nurse or something who might be able to advise? I really found that aspect of my v v long admission very demoralising, poor you dealing with it regularly.

I think one 4 mg dose of ondamsetron might be useful if/when you have reached the stage where there is a regular rough patch of a few hours each day with the rest of the day being better. Not very useful for overall control of severe vomiting though I'd imagine.

I feel like after this pregnancy I will be actively grateful for the rest of my life for being able to go to the loo regularly and normally. I really felt I would never go again at one point! The nurses were amazed by the number of things that had absolutely no effect whatsoever.

I really feel for you - can't remember how far along you are now, bit hope things begin to ease for you a bit soon.

Thanks oklahoma you've cheered me up, fingers crossed.

Just attempted and failed to eat dinner. I'm dreaming of the day I can enjoy a nice meal in a nice restaurant...! It's amazing the things we take for granted when all is well isn't it?!

Okla - I was matched with her by PSS as the only volunteer they had who had had a similar experience! And actually that was before I bounced back into hospital for by far the longest admission. I think basically we had similar first trimesters but she got no or almost no relief at all in the rest of the pregnancy, so it was basically like an horrific first trimester all the way through. This is v v rare I think. If it happens to me - please God not as I am already a bit better - I would just be in hospital all the time, but she managed to set up IV at home so at least she avoided being in hospital all the time. I think she was basically on an IV all the way through though! She has a lot of long term probs as a result.

I suppose it could always be worse! Though last time the doctors were quite upbeat about the possibility of a second pregnancy, saying it might not be so bad etc, whereas this time at least one doctor has actually come right out and said I shouldn't do it again. Not that we have any intention to! Will seriously consider being sterilised I think after this. Both my mum and sister were still fertile in their early forties and I'm not sure I can face a decade or so of The Fear.

Am really curious to find out at 20 week scan whether this one is a girl as it's felt different (worse!) very consistently from the very beginning. Apparently a few unfortunate women just get worse every time though!

Kali I have adhesions from previous surgeries that cause the obstruction, last episode was a year ago requiring hospital admission and I'm desperate not to do anything to aggravate it again. Sorry you've been suffering so much with that side of things in addition to the sickness.

I'm 20 weeks now, with DS my sickness eased off at about 28 weeks and then I was diagnosed with gestational diabetes! Hoping I will start to feel better soon, I've also felt even worse this pregnancy and found out yesterday it's a girl!

Sorry gross question... I've taken 2 pills as doc said I could double the dose at night but just been sick, about half an hour later. Is that long enough for them to get into my system? This is definitely a bad day, not kept any food down at all :(

I don't know emsy sorry, but things sound bad? Time to call NHS direct? Are you using ketostix?

No can try and get some today, do they sell them in pharmacies?

Hi!haven't dropped by in a while but I'm in need of some advice! Still having my morning bile runs every morning and at 32wks the nose bleeds have started. Every morning so far this week whilst being sick.

I woke up about 1:30 am with another massive nose bleed. If I get up at night I'm instantly sick and there was So much blood in that too it freaked me out a bit so we rang the midwives who again didn't seem too concerned. They said if there was blood in my morning puke to ring them again. Sorry if this is TMI but there was a few globules of blood and the bile had a reddy tinge to it this morning. Do you guys think think I ought to ring them again or . Do you think that it's just blood from last night's episode?

So many new people suffering :-(

I've been throwing up again because of the stress of trying to breastfeed and feeling very nauseous while doing so. I've decided to abandon breastfeeding altogether and go with formula because I just can't cope with any more sickness or nausea. I want my mind and body back. My emetaphobia is awful at the moment and I'm back on my anti anxiety meds too.

The toll hg takes on your body and mind is massive. I wonder if there are slightly more rates of post natal depression in women who have had hg... I know I am breaking down in floods of tears randomly at the moment and panicking a lot too.

How have others coped with the aftermath of hg? Does anyone have any advice?

Sounds like rough times all round. Nothing to offer except sympathy ladies.

Emsy my GP told me that if you can see the whole pill in the vom you can take more but not to otherwise. Some chemists sell ketostix but online is a more reliable source.

MrsB I would ring just to be sure. You'll only be worrying about it otherwise.

Starry that sounds rubbish. As if you've not already put up with enough!! A few of the others Meerka, Living, Lucinda, Punk had similar issues so will hopefully be able to advise.

I guess it's something I vaguely expected because it must be difficult for anyone to experience something like hg for so many months without coming out the other side entirely unscathed. I suppose it's something we probably all ought to be aware and looking out for so we can try and access the support we need to cope afterwards. I'm not entirely sure what to do and just trying to take things as slowly as I can .

Just reading a breastfeeding book called The Food of Love and a paragraph made me laugh out loud.

Apparently in order to be happy we all need:

• a good diet
• plenty of exercise
• the company of other people
• control over our lives
• meaningful activity

If any one of those isn't being met then we're likely to get depressed.

HG basically kills all of those...

Starry - bfeeding made me nauseous too; a lot of women describe a lovely relaxing mildly drunk feeling at let down but I hated it, I felt extremely dizzy and nauseous. I stuck with it because DS really enjoyed it and found it easy; if he had had probs with it too I would definitely have stopped, and as it was I think I underestimated how the nutritional and lifestyle (e.g. Interrupted sleep) demands of breast feeding slowed my recovery from HG even more. I think there should be more advice and research about this and women who are ill throughout pregnancy should be advised that it might be better for them not to breastfeed. I did not really recover physically from pregnancy, both in terms of nausea and my lingering SPD, until I stopped bfeeding at about 9 months. It does generate low levels of hormones v similar to pregnancy which women who had severe HG may be especially sensitive to. In any case, I think you have made the right decision.

I had a very bad post-natal depression (suicidal at worst) which took a long time to recover from. It is my biggest fear about doing it again really, though I am hopeful that this time we are better prepared and supported (we will e.g. keep our nanny on throughout mat leave so that I won't be so isolated and can get more rest). So far despite a significantly worse pregnancy and v stressful family circs my morale has actually held up much better than in my first pregnancy. In any case, yes, there is a marked correlation between HG (especially for women who vomit throughout) and PND but I don't think doctors/midwives make enough of this. Do speak to your HV or midwife (if you're still seeing her) or make an appt with the GP to discuss it. You are in a high risk category so much better to be proactive. Do do prioritise rest, nutrition and some time to yourself, and don't compare yourself to other women with newborns after normal pregnancies. I was so desperate to get back to normal last time that I didn't rest enough, and to be honest both DH and I totally underestimated how depleted I was.

Haven't been on for a while but feeling particularly ropey so popped on, but reading is making me feel worse. But just thought I'd say Emsy I had meto first which helped reduce actual vomiting but not nausea and then got promethazine which I found much better. It can help for some and not others like all the drugs so do at least try for a few days. FX it helps at least a little. I did find it utterly floored me with exhaustion, and I thought I was already struggling with the tiredness far more than with either of my others! In fact things have eased up a fair bit for me now (already, cant believe it, earliest improvement ever, only 11 weeks) and I have managed without any most days this week as now the sickness is preferrable to how misserable I was when so tired I couldn't move. Well, preferable for the two little ones at least!

In haste - promethazine is actually pretty good, better than cyclizine. It's used to counteract the nausea induced by opiate injections. It also has sleepy-making effect and well, being asleep is the best way to get through HG.

< waves to everyone and dives off>

Hi all
I haven't been sick today so you might be right the new tablets might help. Went for a private scan today and discovered exactly why I feel so bad, it's twins!! Eeeeeek! So glad I went. Hopefully the sickness won't last as long as some of you are suffering, fingers crossed. I'm 8w5d so 12weeks can't come soon enough! Big big shock. But good shock. Two babies, aaargh!