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.

GetTheRedOut if you turn in a below par performance because you still feel dreadful your colleagues won't thank you and you'll end up feeling worse about yourself. Only return if you really feel you can do it justice. Otherwise do yourself and your baby a favour and relax! You'll feel better for it. I mean this in a 'tough love' way. Don't force yourself to do something that doesn't feel right for you.

Newshoesplease my doctor compared the baby to a leech (bear with me!) He said the baby is getting all your nutrients which is why you feel like crap. That reassured me in a weird way! That and the baby measuring well at the first scan. Can't wait for my scan this time for similar reassurance. Still no date but booking in appointment is on Sunday.

freewee sounds about right! It's probably swanning around in there feeling positively nourished!
How many weeks are you?
Hugs to all x

Freewee and NewShoesPlease I have often heard that about babies in utero being like leeches, which is reassuring. One of the reasons you feel s foul is partly all the nourishment going to the baby.
Meerka Waves.
I hope everyone is coping. FreeWee Good luck with scan, it should cheer you up.
GettheRedOut I hope the turnaround comes soon .

xx

Can I get some quick advice? Had 2 ketones (not sure correct terminology!) yest and doc admitted me for rehydration. Am feeling so much better this morning but still have 2 ketones. The nurses seem v keen to send me home today and have take me off drip - when I was admitted with 2nd pregnancy, they were v strict on no ketones before sending home and I was consistently on drip for 3 days. What are your experiences? I want to go home but v scared of feeling how I felt on Friday night - was beside myself!

Dotty that is crazy that they have taken you off the drip and are considering discharge when you still have 2+ ketones! Have you seen the doctor yet? You will end up readmitted in a few days if they send you home in that state.

With my hospital you have to have nil ketones, be eating and drinking and tolerating oral meds before they will discharge, and it has been the same every admission. I hope they see sense, the pot luck of treatment for this condition is really worrying.

Thanks basgetti - that's v useful to know! My dh heard the nurse saying to the doctor (when he admitted me) "don't admit them, just rehydrate them and then they can go home". The nurse talked to me about sending me home last night (I'd been in since lunch) but when we were getting ready the doc said 'there had been a miscommunication' and he wanted me in another day. The nurse had told me there was a trace of ketones last night which I now know means they hadn't changed. It makes me feel guilty as I am not feeling nauseous at all (it's wonderful!!) and able to keep down mouthfuls of food - I don't want to take up a bed if I don't need it? I just don't know whether I should make a fuss about this - am scared of going home and just going back to how I've been for the past 3 weeks now I've had a taste of normality.

It's hard because you don't want to be in hospital any longer than you have to be, but at the same time sending you home when you still have ketones is just a recipe for you to remain in the cycle of being sick. My hospital does seem to have strict protocols for everything (see my previous post about the steroids!) but in some ways this is better as it at least gives standardised treatment and you know what you need to 'achieve' to go home. Having to argue your case when you are so poorly is terrible.

Regarding the drip, I'm assuming you have no more written up, in which case the nurses should be contacting the doctors for more as you still have ketones. I know the nurses and MW have done this several times for me either because I still have ketones, I'm not drinking much or my urine output is low. It sounds like pretty shoddy care tbh, to consider that whipping a bag of fluids through you has given you rehydration when you are still showing clinical signs of being dehydrated! Hoping you get some better care today x

Thanks basgetti , that's really helpful xx

Dottydadoo Sorry to hear you've been admitted- though it's the best place for you when you feel as ill as that. That despair is often a sign of dehydration, horrible. Remind me what meds they had you on, I think they'd tried something after cyclazine hadn't done any good? Excellent advice from basgetti.
xx

Dotty I had a similar experience with some of the doctors on one of my early admissions. I was sent home even though I wasn't tolerating oral meds and within 4 days I was readmitted. After that whenever I saw the doctor on the ward round I made sure I explained my concerns regarding ketones and oral meds and told them readmission would be likely if I was sent home early. In the end the nurses fought my corner for me too (have a chat to them too if possible).

What was also interesting is one of the registrar's told me that if you are readmitted within 7 days the hospital is fined a lot of money as it is considered the hospitals fault for not providing the correct care in the first place. After I was admitted the 3rd time (after 4 days from 2nd admission) they were really careful to make sure I was tolerating oral meds and no ketones, even if it took 5 days!

dotty it is very short-sighted of them to send you home if you are still shedding ketones. You may no longer be clinically dehydrated - ketones are principally a sign of starvation, not actually dehydration - but if you still have ketones you are not getting enough nutrition in for you or the baby. I know from long experience that it only takes a really very small amount of retained food and fluid to get you out of ketosis. There is a bit of a lag effect and the nurse may be assuming that you would be ketone free at the next test, but they should wait until you actually are. In my experience, a lot of nurses don't really understand ketones at all. (And actually, quite a lot of more junior doctors don't either - several times I've had doctors pump more and more fluid through me for days and days and it is only after five or six days on a drip and STILL 4+ ketones that a sensible consultant points out - as I had been trying to repeatedly - that I am plainly no longer dehydrated but equally plainly in a state of advanced starvation!)

Also the ketones themselves make the nausea worse so if they take you off the drip and send you home with oral meds before they have completely gone you are very very likely to lose control again quickly. In my opinion it is short-sighted to send women home in this position until they have spent a full 24 hours (at least) off the drip, tolerating oral meds and eating at least fairly normally. Especially as realistically almost all women are going to try and do a bit more at home than in hospital - e.g. get up to get their own cup of tea, make toast - and even more so if you have children at home. They should also be factoring in the realities of a journey home - always hard if you are nauseous - and even just the tiring effects of getting up, getting dressed, packing your things. Fatigue is a huge factor in worsening the nausea.

My sickness is awful today, I have had to take some ondansetron which I try to avoid completely, despite being totally in bed all day. Only managing to eat small amounts of olives and biscuits. Really worried that after fighting not to be admitted yesterday I am going to end up readmitted next week anyway for vomiting. At 31 weeks! Hyperactive baby is still 100% hyperactive though, so that's something. I really seriously don't think he ever sleeps, though surely this can't be true?!

they're supposed to sleep quite a bit but maybe he's kicking in his sleep? YOu might have to swaddle him when he's born =)

Kali You poor thing, at thirty-one weeks, as you say You are, among other things, our ketones expert after so many horrible episodes. The relationship between ketones and dehydration and starvation is so complicated. as you say. I know I've tested my non pregnant self a couple of times when I have a severe migraine and am puking ten times a day or more, I'll have 3+ketones within twenty-four hours. As I'm not pregnant it's nothing to worry about, but I'm always amazed at how quickly it happens. But I suppose that's why it's a rule of thumb its a medical emergency if a pregnant women has been unable to keep fluids down for twenty-four hours (though the way some GP's act, you wouldn't think so)?
Dotty I hope feeling a bit better, being treated sensibly?
I'm concerned at the number of women on this thread strugglingi into work with this horror.
Waves to Meerka and Everyone.
xx

Thank you so much for your advice everyone. It's fantastic to be able to speak to people who've been/ are in the same situation.

I am now at home - my ketones actually started declining very quickly yesterday morning ending in nil ketones which was such a relief. More relief not to have to fight to keep my bed as I wanted to be completely clear before going home. It's so lovely to be at home with my own bed, bathroom and no bed pans!! I'm going to docs tomorrow to sign me off for a couple of weeks. At this rate it looks likely I won't be back before xmas which I feel pretty bad about :(

lucinda I tried Prochlorperazine Maleate for a bit but it did nothing like the cyclizine. I'm now on promethazine hydrochloride (brand name - phenergan) which appears (touch wood) to be having an effect. Does anyone know, is this stronger than cyclizine? I was on phenergan with my 2nd pregnancy and it seemed to work then too.

durham very interesting to hear about the fines! In my case, it was the nurses who were trying to get me home - the Doctor was "overruling" them?!! I did find that they would start listening to me when I started getting "assertive" over what I wanted though - it makes me wonder what others do when they can't find the energy to stick up for themselves, it doesn't feel right that it comes to that.

kali all hats off to you. What an amazing achievement to get to 31 weeks with this condition. Thanks for your advice - I really hope that your last stretch goes as quickly as possible

I forgot to mention I think that my 7w scan was very good, relief! heart beating clearly! After 2 mc in last 12 months, it was fantastic to be reminded of what a healthy early scan looks like!

The other part of my relief was that there was only 1 in there....any more than that might just have finished us off I think

Glad you are out dotty!

That's such a good point meerka - we did swaddle DS who was similar inside (though this baby is even livelier) and very restless once out, but I don't think we did it consistently enough. But it makes sense that a baby who is used to thrashing around constantly in an enclosed space is going to be particularly unsettled by the feeling of being no longer enclosed. I'm going to get one of those pod things for the crib this time too which apparently help them feel more held. DS is two and he still needs to have his feet held very firmly so he can push against you if he is upset/ill - I'm sure this is because he was head down from early on, like this baby, and was constantly shoving with his feet inside! Have to say I'm a bit scared by the level of hyperactivity we may be facing though! DS only started sleeping through three weeks ago.

I am staying in bed today, but hoping for a slightly better today, yesterday was really depressing.

KalidasaOH and I used to swaddle The Sleepless Terror and it did make her take some sleep. I hope you're not feeling too bad today?
Dotty So glad you've been relelsed 'On Good Behaviour' (of ketones).

Hugs about miscarriages. Only one - well, probably several very early ones when I wasn't ttc and didn't mind - really upset me; I'm glad about the scan; of course, the chances are all in your favour, but what do statistics mean when it's your baby?
Durham That is fascinating about fines. There was an ex sufferer who used to post on here FluffyWhiteKittens who was sent home with 3+ ketones after twenty four hours, on the grounds that 'She can't stay in here forever, can she?' I don't know if at that point the ketones were from dehydration or starvation, as she said she'd been in bed unable to keep water down for a week before she reported to A and E .
Hope nobody is feeling too desperate and that helloladies1 did get some advice on the telephone advice line.
xx

dotty good to hear the scan went well, you're out and Ketones are behaving =)

short summary of the usual meds:

cyclizine (old fashioned anti-histamine; can make you sleepy)
Metoclopramide (empties the stomach faster, less to upchuck)
Domperidone (similar)
Prochlorperazine (stemetil) (works on your sense of balance; also a travel remedy; can be good for some people).
Promethazine (called Phenergan)(stronger old fashioned anti-histamine, also sleepy-making)
Ondansetron (the strongest and best, but causes constipation).

So promethazine is in the same family as cyclizine but stronger.

good lord lucinda you vomit ten times a day with a migrane? did I understand that right?!?

Mereka Ten times a day with a bad one, yes; thank goodness they're often not as bad as that. I feel very sorry for myself about it, you may be sure. Thanks for sympathy, and explanation for Dotty about the diference between cyclazine and the new pro-what's-it drug; wasn't sure of it myself. xx.

Dotty I agree that it must be awful for those who do not have the energy to be assertive with doctors. When you have no-one to speak for you (my family live so far away and my OH was at work every day when the doctors came to see me, so was generally on my own until OH visited in the evening) it is a very very lonely experience.

I am pleased to hear that you were discharged clear of ketones, I would have been worried if they had discharged you too early. I'm sad to hear the nurses were less than sympathetic to your needs. There were a few nursaes when I was admitted who were not sympathetic at all to those suffering hg, however there were some very friendly nurses who sat and listened to me and it was these nurses that fought my corner and I am forever grateful to them.

Lucinda I too found interesting about the fines, the doctor was very open about it. In fact by the time I was admitted the 4th & 5th time i noticed a complete change in my care...both nurses and doctors were concerned with how many time I had been admitted and were in less of a rush to discharge me until they were sure I was going to cope at home.

Yes very interesting about fines. Maybe explains why in my last admission this time they just kept me in for nearly a month. When I finally got out at 14 weeks I guess they thought there was a decent chance I would manage to stay out and not muck up their readmission stats!

Today has been slightly better than yesterday. MIL has had DS for most of the day and I managed to get up for an hour so that DH and I could have brunch together. Struggling now though, and daunted by having to go back to the hospital yet again tomorrow, and then I think probably every day this week. So difficult with the wheelchair and everything. But only 59 days to go now, we are below the two-month mark, and that's if I actually make it to the end . . .

Glad you're doing better Dotty.

Good luck with your appt tomorrow Kali, hope you get good results re the fluids.

I'm having a bit of a rubbish day, keep veering between feeling starving hungry and shaky, to retching and nausea as soon as I eat or move. On top of that DS is unwell again, so many bugs going round his school atm, and DP left for work at 7am and won't get home til after 10. The baby is also moving ALOT today and my bump keeps changing shape. Would be just my luck that now I've got my head round section and made plans she'll suddenly turn and I'll still be sitting around on xmas day throwing up and waiting to go into labour!

Hope everyone else is feeling okay xx

hi everyone- sorry have not kept up with the thread lately. just wanted to wave to everyone and send reassuring pats to those particularly suffering at the moment.

kali you have certainly been through it. at least on a count down now I guess.

hi to all newbies- you will not find a lovelier bunch to give you all the reassurance and advice -not to mention tons of support and encouragement - that you need and is unfortunately sometimes totally lacking in RL.

lucinda poor you with the migraines. I have been starting to get a lot more sicky type headaches lately where all I can do is retire to a darkened room to sleep it off. not sure if migraines?? think I may need eyes testing tbh! had to leave a meal out the other night before we had even ordered due to one- only just made it home. paracetamol made it much worse. have a theory that I am a 'sicky' person anyway so I guess no surprise suffered with hg!!

ps off topic but I have been blogging lately- feel free to take a look if you are running out of reading material!
http://myjobismum.wordpress.com/