Why is there so much fixation on ketones in hyperemesis?

[gretagreengrapes]

They are a measure of starvation and not dehydration, and in any other condition (like D&V, tonsillitis, appendicitis etc) health care professionals would not test for ketones and deny treatment for dehydration based on this!

I have got hyperemesis. My BP is a bit low. I am so thirsty, peeing less. I go dizzy and my eyes blurry when I stand. And my heart is racing at times. But because I haven't got the required amount of ketones in my urine I don't qualify for any IV fluids.

Has anyone else had this experience? I just feel like I need to vent because I feel so ill and sad.

That's a good point. When I was pregnant with my first it was always the ketones they cared about and not the cracked bleeding lips etc which showed I was horrifically dehydrated. Even at that stage it was just "eat little and often" like that's going to work when I'm telling you I can't keep down a single sip of water.. ice poles were the only thing that kept me alive.

Sorry I can't help, but I feel your pain. I ended up buying urine test strips to use at home because I was way to unwell to trust their once a month evaluation of how unwell I was. I didn't get ketones until 17 weeks. By that time instead of gaining a stone I'd lost over a stone. That they didn't care about either. They admitted me to hospital and made me wait about 6 hours for a drip. Then they didn't come and see me or give me medication all night so thankfully I took in the meds I was already on. Honestly I think hyperemesis care is shocking.

Ketones being high can have a damaging effect on the IQ and mental capacity if you baby. There’s a fair bit of scientific literature on this so probably why they take that so seriously. I’m suffering too though and completely understand it must be so frustrating not to even get a drip. X

@singleandttc Sorry you had to go through that. I am fed up of the "tips" tbh I just want to be able to chug a pint of water abs pee often! I will definitely get some ice pops though. They seem like a good idea.

@BuffyFanForever I have no doubt its been well studied but dehydration comes before starvation so I just cannot see why they are so reluctant to treat before it gets to that point! If I wasn't pregnant but vomiting and dehydrated I'd "qualify" for help.

Maybe I am just ill and tired and being too precious, I will accept that!

Yes, I had this. Was fobbed off for two weeks.

Was then carried into A and E as I couldn't walk. I was dangerously dehydrated and ended up being on a drip for days.

They wanted to test my ketones in A and E but I was so dehydrated I couldn't pee. They had to take blood and it's wouldn't come out.

At my hospitals maternity care unit I've been given iv drips with and without ketones. My gp used to refer me too when I was really weak. I can say from experience that going to A&E was the worst place to go. I don't think ketones are always accurate on how you feel. Feel for you x

This just happened to me, I took a really orangey pee in to the doctor but there was no sign off keystones so I won’t need a drip. Does that mean I’ve not been sick enough?

I’m dry, lips are cracked & choking for a good chug off water.
I don’t exactly want to go up to the hospital to sit in a drip with a mask on myself but I just want a doctor to actually see the state my days get into with the sickness.

X

@alanares89 I've only just seen your comment. Sorry you're feeling so rough. I completely understand how you feel. I worry people think I'm lying or being lazy because being so sick is such a private thing.

Exactly the same happened to me. I was vomiting profusely and continuously, couldnt keep fluids down, was bedbound for weeks due to dizziness and feeling faint as soon as I so much as sat up - but they only ever gave me fluids on the occasions that I had 3+ ketones in my urine. The fact that I couldnt stand, couldnt look after my older children and had lost almost 10kgs escaped them....

I sympathise hugely OP. Have you been on the excellent Hyperemesis support thread here? I also recommend the Pregnancy Sickness Support Charity (number on google) - they were a great source of advice and support at my lowest moments.

Hope you feel better soon

This happened to me at nearly 16 weeks. My barely there pee was bright orange but because I had no ketones they refused fluids or iv ondansetron. I ended up being admitted and they could not get blood from me. Nurses, doctors and the consultant anaesthatist. Yet they continued to claim I wasnt dehydrated .

I wrote a very angry letter of complaint and changed hospitals I was that outraged. The RCOG guidelines clearly state that ketones is one sign of dehydration. It should not be relied upon solely. Yet hospitals continue to deny women in need.

Having HG is utterly horrendous. This is my second and last one. Sorry it happened to you too.

My son has Ketotic hypoglycaemia (aka accelerated starvation) so I know how dangerous high ketone levels can be. But as you say, even if your body isn’t at the point where you are producing high levels of ketones due to insufficient food intake, doesn’t mean you’re not dehydrated.

Absolutely fluids need to be given if your ketones are high as this helps to clear the ketones from your system (or at least that’s how it has been explained to me) but doesn’t mean you don’t need fluids if there are no ketones.