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.

Thanks Meerka I'm on Cycilzine and metaclopramide and omeprazole already, because of my past history the doctors let me have it with out to much hassle. Unfortunately it does not really seem to do anything.

Thanks I found the other meds made me constipated last time. I will be aware. Thanks. I really hope it helps.

Evening all, well I went to the doctors today to ask for Ondansetron, and she refused to prescribe it. She looked on the internet and said that she couldn't see anything about it being used to treat hyperemisis, and that it wasn't licensed for use during pregnancy.
She also scared me rigid about the antacid medication the doctor last week gave me - said it absolutely should not be used in pregnancy, and when I started to get panicked she wouldn't give me an answer as to whether I'd caused any harm by taking it.
I started a thread (isn't MN fab ) and some people who know more than me came on to reassure me that I wouldn't have done any harm.
I feel really cross actually. If this pregnancy is going to progress well I'm fully expecting to be feeling shockingly awful within the next few days. I have two children to look after, one of whom is still breastfeeding and very clingy and she wouldn't take it into consideration. How on earth am I going to manage?! Her advice was not to take any medication at all because it's not worth the risk, and she said she'd sign me off work for as long as I needed. Fat lot of use that is.
I have an early scan booked for the 15th at the hospital, and I am hoping that they will be more sympathetic than the doctor today. Roll on the next two weeks!
Sorry this is all me me me, am just really cross

chintaria I dont blame you for being cross, that doctor sounds terrible. My doctor said to me that the benefits to me outweigh the risk to the baby and was happy to prescribe ondansetron because nothing else was working for me and i was nearly admitted to hospital. Is there somewhere else you could try, i know some of the ladies on her have recommended a doctor that has helped them get prescriptions (think this is through pregnancy sickness support). I took meds all the way through my last pregnancy and have a very healthy girl!

On a separate note i had my 16 week check and heard babys heartbeat today, i mentioned iron levels to midwife following my fainting episode on friday - she couldnt have been less concerned if she tried. She said my iron levels were good at 9 weeks so didnt see the point testing. My blood pressue was 100/60. Actually feel ok this evening and managed bedtime routine with dd which is a first for weeks!

Another day nearly over ladies, keep going!!

chintara there are a LOT of ignorant doctors. Consultants use and prescribe it very regularly and she really should know this :(

I can't pull it up, it's blocked outside the uk, but look on the NICE guidelines link here

cks.nice.org.uk/nauseavomiting-in-pregnancy#!prescribinginfosub It says clearly there that ondansetron can be used.

The NICE is the Government's own body on best practice in medicine and all doctors are supposed to follow this (if the guidelines have changed, please someone let me know before I keep on spouting them!)

look also here New England Journal of Medicine. The NEJM is a highly respected journal in the medical world. In fairness, there has been a later analysis of the data which is more ambivalent but the point is that severe sickness and vomitting can become dangerous to both baby and mother and that at times people have lost their livelihoods due to HG. it shouldn't happen but it does.

There is a LOT of stuff on ondansetron being used in preg on line. Try also the www.helpher.org/forum3/ and even this thread and its predecessors!

Also it is stressful for older children to see their parent so very ill.

As ems says, there is a wonderful elderly doctor you can get hold of through the Pregnancy Sickness Support helpline. He was willing to prescribe me ondan as I too had culpably stupid doctors. (strong words I know, but they are. cyclizine in particularly is pretty well proven safe; its sister drug is officially considered so safe in the states and also Canada that it is FDA Category, which uis a Big Deal).

The doctor also has a list of HG-aware doctors in various areas that you could go to if necessary. Leave a message and he'll get back to you.

kayme one thing with metoclopramide. If you start getting twitchy legs, stop it until you've spoken to your doctor or at least a pharmacist. In a small minority of women, there can be bad effects (but it's still perfectly safe for the baby)

Kayme - I got restless legs and high anxiety with metachlopramide, stopped it immediately and have been on only ondansetron since.

Had an awful 48hours, hoping it's just due to having such a busy week last week. Hubby is quite concerned and not wanting me to go back to work in 4 weeks if I relapse so badly from a couple of days visiting mum.

Hope everyone else is doing well!

Hi ladies, sorry I lost you for a while!

I have been having a really good week (as far as HG allows) still vomiting on a morning and close to vomiting on an evening, but for some reason I am now OK(ish) during day as long as I am eating something small every 30-60 minutes! I am only taking cyclizine once a day but think this could be helping me eat and keep it down. Still not doing great with liquids... not only can I not drink water but lucozade, which I was surviving on, now turns my stomach! So all I can really have when I feel up to it are ice cold smoothies. But still, I'm getting what I need and feeling better so I really can't complain.

Sorry to those feeling ill :( I'm trying to see it as each day I get through is a day closer to the end! 17 weeks tomorrow so it does feel like its started going quicker now.

Chintaria I was really struggling with my doctors (I'm in the UK). I wish they were more aware of HG... or at the least maybe an experienced regional doctor/consultant for the poor HG ladies to be able to go to for help.

Chintaria I'm shocked at that GP's attitude - what decade is this?! With your medical history, it's absurd to think it's better you get dehydrated and end up in hospital. I so agree with Meerka's great advice, do ring that doctor on Pregnancy Sickness Support on Britain I think, 44, then
024 7638 20 20 and he will get back to you with great advice. He's helped so many woman on here who've been stymied by unhelpful GP's. On dehydration, particularly as your breastfeeding, it seems presumptuous of me to ask when you are the veteran,but have you got those famous kesostix in to check?
Daffodil Sorry to hear about some bad days, and I'm glad at least you had your sick note extended and this thread has helped.
Kayme Almost everyone has felt amazingly better after birth; I've only known three or four exceptions out of all the women who have been on this thread over the years; very, very occasionanally people seem to react badly to breast feeding and it sets off the symptoms on and off again, and of course, being awkward, I was one of them - but it generally clears up after a couple of weeks. I don't want to horrify anyone and don't like to emphasize this as it's very rare.
Hello I've written a message for you,and my handwriting is so bad even I can't read it...But that's great advice about constipation, and best to stock up on those magic suppositories, though I believe they won't sell them to pregnant women though they use them in hospitals if you can't get that lactulose.
Ems Congratulations on sixteen week check up being fine. Well, it's good she's not concerned about irons.
Mellee So sorry about relapse after a nice break. But as others say, those good days will be more and more frequent after you've had a couple, as a good day is usually a sign of the turnaround.
Any Lovely to hear from you, we were becoming anxious. Glad things have improved, that's great. It's a shame when your standby drink becomes disgusting to you. Is that true too of flat coke and soda water?
Meerka Do tell about the ten children - I know not your own, and nobody who gets Hyperemesis is quite that brave as to go for it ten times .
Apologies to anyone rudely overlooked. Lilac and everyone, how are things?

ten children? uhhh im sorry, I am having a very dozy moment, I can't find the reference and I can't remember it ... really am tired atm!

chintara ofc if you're not in the UK you cant access the NICE guidelines either, nor the list of HG-aware doctors. Sorry. As said, v tired! But honestly a lot of consultants in many countries in the West use ondansetron.

(Mother hen could you be kind enough to check the NICE 'lines for me and just doublecheck that ondan. is still on?)

amyy it really is worth keeping on with cyclizine for a few weeks longer. It's absolutely harmless and it does have an effect for lots of people. Sometimes they think it isn't, then they stop and suddenly discover it really was, after all!

mellee 4 weeks can make quite a difference in HG, depending what stage you are at. How far along are you again? sorry, I've lost track.

Is there any chance of a staged return to work?

Lucinda Flat coke was a no no but haven't tried soda water. I was going to buy a bottle of sparking water at lunch time but was a bit wary of trying while at work, so will give that a go when I'm back home.

Meerka I thought it would be best to keep on them too. I'm 17 weeks tomorrow, when do you think would be a good time to stop if say I continue how I am? I don't want to be on them too long as they make me really drowsy and its affecting my work a little!

hmm. YOu're having a good week but still struggling to drink which is not great ... I'd say that if you have a good weekend, try next Monday without any cyclizine at all. If you're okay, try the tuesday as well (1 a day is a low dose, but cyclizine builds up in the system so it'll probably take time to go out of the system as well. So, one day without will give you a lower level, 2 days without a notably lower level). Then try taking it again for 3 days and see if it makes a difference.

If you find no difference you can pretty well stop it, unless you have a bad day. There's absolutely no harm at all in starting it again if you have a bad day. It's pretty likely you will at some point, becuase the hormones fluctuate so. Don't feel that it's a failure; it's way better to take cyclizine and stress your body less than to stress your body by not taking it. Preg is so heavy on the system, the more you have in reserve physically the better.

If you find you are drinking less without the cyclizine or vomitting more then keep on it for another 2-3 weeks, then try again. It really is harmless, so don't feel stressed about it.

That's great thanks Meerka x

Hi everyone, apologies for posting here as I'm not suffering from HG, but am just increasingly frustrated with ongoing morning sickness which I know is pretty trivial in comparison with HG, but I was hoping you may be able to share some advice on how best to cope.

I'm currently 24 weeks and have had sickness since week 7. To begin with it was pretty awful, vomiting 5 times a day, constant nausea, smell aversions etc. but I was assured by my midwife that this was nothing to be concerned about.....and it would probably get better at 14 weeks. It didn't, but I have seen a gradual improvement, to the point of just vomiting once or twice in the morning before eating, and going without nausea for much of the day, occasionally I was even getting a day off sickness altogether.

Still, the relentlessness of it was really getting to me and last month the doctor prescribed me some metacloperamide to try. Unfortunately this didn't seem to make things any better, and in fact since then evening nausea and vomiting has returned. However, I've not suffered with dehydration, and though I lost weight initially, I have now returned to pre pregnancy weight (though presumably the baby accounts for that weight gain!). I've now stopped taking the meds and am due to see the Dr again next week. Throughout this time I've managed to keep working (helped by the fact that I work part time and from home, which makes things much easier). But I'm worried that things might get worse and was keen to get your thoughts as I'm nervous to try new meds in case the side effects are worse than my current nausea, but am also concerned that stress at work could be behind feeling worse over the past couple of weeks.

I'd be really grateful if anyone's able to advise about if it's worth trying a different medication, or if I'm best off just to keep going.

Thanks everyone and sorry for the long post!

Sunshine Welcome. This sounds like a very severe form of ms, vomiting five times a day and losing weight seems more like Hyperemesis, particularly as it's never lifted. I think it's well worth while asking for different meds, there are several combinations you can choose from. Sorry you have had to soldier on alone for so long, and feel free to join us on this jolly thread if you like, everyone is very nice.
Meerka Silly me messing up that link. Ondansetron is on still, and a study is quoted that says no additional risk of abnormalities.
cks.nice.org.uk/nauseavomiting-in-pregnancy#!prescribinginfosub:10

I hope that link comes out, I'm such a fool about links.

Hi Sunshine welcome to the thread, sorry you're still suffering at 24weeks. have you seen a consultant or just GP? IME many GPs don't know much about pregnancy sickness or HG, so it's possible you might have HG that's been missed. Either way it sounds like you're suffering and not getting much help from current doctor! If you're in UK midwives can refer you directly to an obstetrician via antenatal clinic, you can ask your midwife to phone antenatal clinic and make you an appointment to see a specialist.
I'm 26 weeks and still vomiting several times every day, though having a run of good days at mo, less nausea . An excellent piece of advice someone gave me on here is to stop waiting for the sickness to disappear and accept it might be present during your whole pregnancy; for some it does disappear but for many it comes and goes. I was really upset when I passed 20weeks and was still vomiting and feeling awful, as my GP kept saying the vomiting would stop at 20weeks! I find RESTING helps a lot. I've had some bad relapses as well as periods of feeling much better, when having a bad day I try to stay in bed. Can you take time off work? I was struggling in on reduced hours for ages but felt so much better once i took longterm sick-leave.

Amy glad you're feeling better. I agree with Meerka about cyclizine, be cautious coming off it and watch out for symptoms flaring up again. I didn't think it was helping me until I tried to come off it and re-lapsed! When i first started it I noticed drowsiness but only the first month I was on it. Re drinks, have you tried yogurt-drinks? I find them easiest to keep down, the thickness must trick my body it's not a liquid!! Also finding I can tolerate lukewarm hot chocolate if made with milk instead of water.

Mellee sorry you're having a bad relapse! Can you extend your sick-leave if necessary?

chintaria that sounds really alful that they just fobbedyou off. I was told no om my last pregnancy. I spoke to my friend a G.P who also took ondansetron in her pregnancy. She said Make sure you look rough and dehydrated when you see the doctor say how bad things are and you can't cope with normal life. I was going to try and get some. What anti acids was it you were given?
I don't think people realise how bad it is. I have had it twice before and even I thought maybe I can tough it out this time, that I will have to keep going. When it's bad you just can do or think of anything else. I had really forgotten how debilitating it is.
It's so nice being able to chat my first pregnancy I felt like I was going to die I seriously thought about a termination. I desperately tried to find help lines or anything but there was nothing I felt so depressed and isolated. It really helps to talk to other people. X

Hi all - my doctor friend says when you're visiting the GP, you MUST exaggerate your symptoms. They expect all patients to, so when you're honest, they downgrade your symptoms in their minds.

Meerka - I'm 19w and off work until 23w at this stage. GP says if I'm still suffering at my next appointment, she will write me off for the rest of my pregnancy. Hoping that doesn't happen as need to do some changeover at work, and it would be nice to earn a little more money prior to maternity leave. At this stage I plan to work 10weeks at 4 days a week until taking maternity.

Was just shocked to spend last 2 days almost completely in bed after such a good week last week. Hoping to feel better soon.

Melleebacca really feel for you. Hopefully the good days will overtake the bad. If you have had a good few days then hopefully more to come. Just don't over do things.

Thanks Kayme - feeling a bit better today, hopefully I keep recovering. Normally I can predict my bad days by knowing when I've overdone it, and it doesn't normally last a full 2 days.

Hi everyone, thanks for your kind thoughts Kayme, Lilac and Mellee.

I was being seen by a midwife, but am now being seen by an obstetrician. I've only seen her the once so far, and when I mentioned the sickness was still there she was very good and immediately offered medication to try, and said we will review at my next appointment, so I'm really reassured by her approach. I tend to get a bit nervous around doctors (made worse by the fact that we're overseas for the next year or two, so dealing with an unfamiliar system), it means I end up playing everything down and saying things aren't 'too bad'. I probably should have sought proper help a lot sooner, I just kept hoping it would get better at 14 weeks, then 16 weeks, then 20 weeks......As you say Lilac, I think accepting it probably won't go completely will probably help! Also, I should really be grateful that it's not all day every day any more, and I only get the odd really bad day if I've overdone it. Most days I can look on the bright side, but sometimes it gets a bit frustrating.

I'm sure it would help to take some time off sick but im working in a tiny organisation with a big project due in soon and it would mean leaving them completely in the lurch. I'm worried that might stress me out even more than just working through. Plus, working from home you somehow feel more obliged to tough it out if that makes sense, as at least I have the comfort of home. I think if I had to commute to an office I'd have been forced to take proper time off sick. On the plus side am taking mat leave fairly early so only 5 or so weeks to go!

Will see how things go at the dr next week (have the GTT test which should be fun with the sickness!) and what she recommends. Thanks again for all the thoughts, and sending best wishes to all of you!

Ah bugger, had a really bad morning :( vomiting at home, in the car outside of work, and then toilets in work for all to hear! For a very long time... I thought for sure my boss would send me home but instead he laughed and said "That's what you get for being pregnant!" A*hole!!

Will definitely not be coming off the cyclizine any time soon then!!

Hi everyone,

I'm having a really bad day, I feel like I could cry tbh. I've been in and out of hospital for reduced movements as the last 2/3 weeks she has really slowed down. Over the last few days though her movements have really, really picked up again. This has coincided with me trying to reduce my metoclopromide. It may be a coincidence though.

Today I am feeling awful. Had a bit of a stressful day yesterday as dh had a job interview he really wanted to get etc, and think it's just all got on top of me. I'm trying not to 'give in' and take a metoclopromide as I'm worried this will reduce the movements again, or maybe I'm being irrational? I don't know. It's hard to think straight when I feel this rubbish :(

I can't believe your boss said that Amy!!

Penguin and Amy sorry you're both having a bad day.
Penguin that must be so worrying about reduced movements! Did doctors at hospital think metoclopamide might be causing it? Did they offer you any alternative meds? My consultant is against metoclopamide although a different doctor prescribed it for me earlier in pregnancy. I'm just on cyclizine now, seeing obstetrician every fortnight to review sickness. He's keen for me to try Ondansetron again though had awful migraines last time.

Amy your boss sounds horrible! What a rude, thoughtless thing for him to say. Hope you're ok and manage to get through rest of day. If I were you I'd take rest of the day off sick regardless of what boss thinks.

Had a few nausea-free hours this morning and a lovely hot chocolate in Costa... then got over-confident when home and tried to drink a full glass of water, which triggered reflex-like vomiting... just made it to bathroom but not as far as loo... very glad we don't have carpet!! Been feeling really queasy since then so might go lie down.

Obstetrician doubled my dose of ranitidine as heartburn still a problem, he said heartburn might explain why I'm still vomiting a lot. He also confirmed I have mild SPD and referred me for physio. Nearly got stuck on examination couch, my hips sort of locked and it was too painful to to roll onto side, he had to help me sit up so I could get down... very dignified!