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, phone them on:
024 7638 2020
Lastly, the NICE guidelines on treatment are useful:
cks.nice.org.uk/topics/nausea-vomiting-in-pregnancy
I would like to thank everyone who has given such invaluable support and advice on this and on previous threads.
It has been suggested that I add some practical tooth cleaning advice: a lot of sufferers find using a child's small toothbrush and strawberry toothpaste far less nauseating.
On my image of a pink castle: that is an image I use because when I was little, my family had a Snakes and Ladders board with an image on the last square of a pink castle in the clouds. As Hyperemesis is so like a grotesque version of Snakes and Ladders - eat a meal, go up a ladder, first thing in the morning bile run, down a snake - I have used the image of that pink castle on the last square of that Snakes and Ladders board as a metaphor for the happy end of Hyperemesis.
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.

@Hello47

Hi, and sorry you’re suffering. I agree with others about stronger meds. Cyclizine did nothing for me. Ondansetron combined with metaclopramide seems to keep it under control a bit, or even metaclopramide alone helps.

6 weeks is when mine felt out of control too. I’m 10 weeks now and I think it’s getting a bit more manageable, hang in there!

Had the booking in appointment by phone! The midwife was lovely and very sympathetic about HG. Apparently my only ‘risk factor’ is my age (I’m 36!) That made me feel very old 😂 She was a bit surprised I wanted to give birth in a hospital until I said I wanted an epidural available in case the baby was back to back and hands first like my son! She actually said ouch when I described my first labour! Because I gave birth at 37 weeks (naturally) she assured me this one ‘will fly out, have your bags packed by 35 weeks!’
TBH I suspect they got my dates a bit wrong last time as my 37-week baby was well over 7lbs!

On Sunday I’ve got the appointment at the antenatal clinic for the screening bloods etc, full blood count, BP. And my 12-week scan has been brought forward to next week which is nice as husband can accompany me.

@FateHasRedesignedMost totally opposite experience here -- in France everyone has an epidural so they think it's v funny that I've had two babies with only gas and air and even funnier that I want to do it again. The docs and midwives are quite pleased though: I think a 'natural birth' is the new fashionable thing here but they are having a hard time persuading any French women to actually do it haha.

Some bad news here -- my risk of a chromosome prob has come back as 1/43, apparently almost purely because of my age (and fairly HCG, which has been high in all my pregnancies), so they want to do a CVS (bit like an amniocentesis) tomorrow morning. I am really nervous as there is a small chance of miscarriage which would be so devastating just as the sickness is getting more manageable. But at least they are doing it quickly so I don't have to wait for ages.

Don't know why some of my post is crossed through! Sorry about that.

Hi ladies, thank you for creating this lifesaving thread!

Looking for some advice. I’m 6+1 today and for the last 5 days have been completely bed bound. The only time I’m out of bed is when I make it to the toilet to be sick and at that it’s through crawling/my partner carrying me back to bed. I spoke to my GP who suggested it sounds like HG and is prescribing me cyclizine.

The thing is, I have suffered 2 MC this year and I’m so paranoid about taking anything at all so I think I’d rather hold off a little while until I take medication.

But I’m so dehydrated, I’m barely passing Urine at all now and have been sipping the same glass of water since yesterday evening and not even 1/4 of the way through....is there a way to just get fluids and not medication?

Is this dehydration going to lead to another MC? ☹️

Xxxx

@pregnancydiaries if you are passing no or almost no urine at all you probably need to go straight to hospital anyway. Unfortunately, yes, in a few cases the prolonged dehydration and starvation from HG can lead to a miscarriage, though that is usually after weeks of poor or minimal treatment. I'm so sorry about your miscarriages. Were you as sick with the pregnancies that didn't work out? Though HG is miserable for you it is often a sign of a strong pregnancy (high hormone levels). If it's any reassurance, cyclizine has been taken by women in pregnancy for decades now with no evidence of ill effects, I think it's the drug that's been used for longest. (Doxylamine has also been used for a very long time and many clinical studies have found no evidence of problems.) But once you are very dehydrated the dehydration itself can actually make you sicker and it can be hard to get back on top of it with oral medicine at home (because you may tend to vomit back the medicine before it can really work). In your situation I would recommend that you go straight to an EPU and explain that you unable to drink and are barely passing any urine, or you could call them and explain the same thing. But if you want to try the medicine first, try to take it straight after you have vomited to give you the best chance of absorbing it before you are sick again. I was admitted to hospital for the first time at 5/6 weeks with both my previous pregnancies so I do know exactly how awful you feel, and the first time it happens it is a tremendous shock as well.

Oh and @pregnancydiaries yes it definitely is possible just to have fluids and no medication -- if you don't want any medication then you can explain that and of course they will still rehydrate you with a drip. But with this level of sickness so early on they will probably strongly recommend some medication (and may give it initially via an injection or through the drip so that you can't vomit it).

My Dad has sadly died now but he was a retired doctor and he checked out all the drugs for me in my first and second pregnancies (because I ended up on all of them at one time or another!) and was very reassuring about the safety record.

@kalidasa I just burst out crying at your response thank you so so much ♥️♥️ This is exactly what I needed to hear and I am going to phone Early Pregnancy just now. I’m actually due in for my first early reassurance scan tomorrow because of previous complications so I think that’s making me more nervous to take anything before I know all is OK but I just don’t think I can wait until then and my one key worry is dehydration causing MC but I’m hoping that like you say it would have to be for a longer period of time before that happened🤞🏼

My second MC was an MMC so unfortunately still had nausea etc but was nowhere near as bad as it is now, it definitely can’t be normal to be completely bed bound surely? If EP will see me I now need to figure out how I get my OH to get me there, the thought of walking and getting into the car is so hard!

I will let you know what they say thank you so much again for being so helpful and reassuring around the medication etc xxx

So sorry to hear about your dad but that is so reassuring to hear, thank you xxx

@pregnancydiaries sorry that you are suffering so badly. I tried to avoid medication because I was worried about risks. The GP was so patient with me, and explained that I could try IV fluids only, but she really felt it was delaying the inevitable and I would end up on medication. She was correct, and I hate to think how it would have worsened, and how sick I would have been if I hadn’t started my medication. You have to do what you feel comfortable with, but I found that the more ill and dehydrated I became, the harder I found making the decisions about my care. You sound like you certainly need a hand getting on top of things for now, so I hope the EPU is helpful when you contact them.

I saw no way out of it all, but am currently 18w4d and within the last 48 hours, I feel like a fog has lifted, and I am able to picture what “normal” feels like, even if I’m not quite there yet.

@Derbee thank you so much it’s so reassuring to hear of other people who have gone through the same worries and come out the other side. Fingers crossed the fog keeps lifted for you and you can maybe try to enjoy some of the pregnancy! that’s really great news. EP were amazing and have no referred me in so just waiting for my OH to finish a meeting and then we will be heading over, how I will survive the car journey god only knows!!! @kalidasa. Thanks so much both for your help

*now referred me in

Let us know how you get on @pregnancydiaries once you’re settled and with some fluids in you. x

@pregnancydiaries I'm so pleased the EPU were sensible and told you to go straight in. I remember speaking to a (very experienced) midwife on the telephone when I was 5+5 with DS1 and she said "ooh darling, you've got it bad, you need to go to A&E"! I thought for sure she was overreacting so I went to the GP instead who took one look at me and was straight on the phone to the hospital, he sent me in a cab with a letter, I don't think he'd ever seen HG that bad. I hope they get you started on some fluids and some medications, if you feel OK about that, and that you will feel a bit better. Great that you've got a scan coming up too, that will be good for reassurance.

@Derbee also makes a good point. If your ketones are high, I found that when I was in a state of serious ketoacidosis I became very confused. I remember once being given some pills during admission to hospital and being sure I had taken them but in fact I hadn't, I was totally muddled about what was going on. When they realised they gave me an anti-emetic injection instead. It's worth warning your husband that this is a possibility and if he notices it it's a sign that you are very unwell and need to go in asap.

*@LucindaE

Sorry about the CVS, hope it all goes smoothly tomorrow. That must be a worry! Do they offer the Harmony Test as an alternative in France? It’s starting to replace CVS and amino here (less invasive as it’s blood tests) but expensive and not available on the NHS yet. Apparently very accurate in testing for genetic abnormalities… though not sure how it compares to CVS.

Interesting having an epidural is the norm in France! It’s the same in parts of the US. My cousin’s a paediatrician (neonatal unit specialist) and had an epidural with her 3rd. She said meds like diamorphine and pethidine are hardly ever used over there as they can affect the baby’s breathing and alertness, so epidural is all that’s offered. Not sure about gas&air. I had gas&air and diamorphine in my first labour, the first made me dizzy and the other made me sick with every contraction and completely out of it, neither did much for the pain. I guess everyone’s different though, my friend had 2 babies with no pain relief at all except a TENS unit and said it wasn’t too bad!

That was meant for @kalidasa sorry!

@FateHasRedesignedMost the harmony or nipt test is technically a screening test while cvs or amnio is diagnostic. One gives you odds and the other a definitive yes/no. The nipt test is 99% correct though.
Glad to hear the fog is lifting. I’m so excited to get to that stage. Keep looking after yourself though. Your body has been through hell.

@pregnancydiaries so glad you’re getting fluids. I hope you figure out a way to get more liquids into you. I use, ice cold water, ice blocks and McDonald’s frozen coke. I’m mildly dehydrated from vomitting but not enough to need to be rehydrated.

@kalidasa you’re welcome to contact me privately if you need to. I had an amnio with the son we lost, because the deadline to have cvs was too soon to when we got our test results, and it was during Christmas break so hard to get appts. I had a 1/10 chance after my scan and which decreased to 1/5 after combined with my bloods, and I was only 32. I know it’s impossible not to worry.

@FateHasRedesignedMost they do offer non-invasive DNA test thing (I think that's called the NIPT in the UK) but only if your risk factor is less than 1/50, I'm just above that threshold so the recommendation is straight to CVS. I would be much happier about the NIPT, especially as I'm sure it's mainly my HCG level (+ age) which has caused the high risk factor and the HCG has been high in all my pregnancies so is actually normal for me. But I agreed with DH before we started trying for this baby that we would do whatever was recommended, including these diagnostic tests if that was the recommendation despite the very small risk of miscarriage. I am really nervous about it though and will be very glad when it's over and I've got through the first 72 hours (apparently almost all miscarriages/problems are within the first 72 hours).

I only had gas and air with both DS1 and DS2. With DS1 I did find the gas and air quite helpful as I started it fairly early on; with DS2 they wouldn't let me have it until quite far on (they didn't believe I was going as quickly as I was, though didn't bother to check either!) and it didn't help as much. I think it works best when it has time to build up. In France it doesn't even count as an analgesic apparently! But I would still like to have it if possible, if only because I think it helps you concentrate on your breathing which is useful in itself. I saw a male midwife today to talk through the test results but just like the female one I've been seeing he was quite excited that I was keen to try a "natural birth", I think it is still a bit of a novelty here! He was very surprised I'd had no epidural even with DS1.

Thanks @Melleebacca I just saw your message. I will send you a private message.

@kalidasa That’s so interesting! Most births in NZ are natural, usually done at birthing centers where the only pain relief is gas and air. I was always told by my mother 🤦🏻‍♀️, that I couldn’t handle pain well, so planned to have my first at hospital and have all the pain meds. I only had pethidine with her, and managed ok. She was however born with the cord around her neck twice and was blue. So I was very relieved to be in a hospital setting for that. I had DD2 at the hospital too with only gas and air, despite her being back to back. But after my first birth I feel more comfortable being at the hospital just in case. We’ve moved since and I will actually have to drive past the birthing center to get to the hospital, but still would prefer a hospital birth. Even if the food was so bad I discharged myself 24hrs after DD2 was born 😅

Hi, this thread is so helpful and I wanted to ask for some advice/your experiences.

I was admitted to hospital on Monday because I had really low blood pressure/+++ ketones in my urine/was vomiting 40+ times a day and couldn’t even keep down sips of water or antiemetic medication (I got worse really quickly having started to feel better at the end of last week).
I’ve been given constant IVs of medication, thiamine, glucose and fluids but my ketones are still +++. My blood pressure is now ok, I feel a lot better and I’m able to eat and drink a small amount but they won’t discharge me until the ketones are much lower. Does anyone have any experience of how roughly long it takes to start getting normal urinalysis results?

Yes epidurals are so standard here that everyone has to have an appt with the anaesthetist at about 36 weeks, it's compulsory! Most women think it's barbaric to give birth any other way, but as I say it seems to be quite a new/fashionable thing to try for a "natural birth" so the midwives are really keen on it. They do have pools and things I think. Would love to try a pool -- was never able to as always classed as high risk so couldn't be in MLU but here it's all one thing, there don't seem to be MLUs separate from ordinary hospital. Breastfeeding is also still quite unusual (though again, theoretically promoted) so they are v pleased with me too when I told them I breastfed them both even though it wasn't for that long by UK standards (8-9 months ish) and I always did a bit of mix feeding too. Have never felt at all like an earth mother before after having such medicalised pregnancies but here I do!

@HerbivorousRex there's a bit of a lag before it feeds through to your urine. I had v severe HG in my first two pregnancies and spent weeks and weeks in ketosis. It's primarily a marker of starvation (not dehydration) so if you're hydrated but unable to eat all (or vomiting everything you eat) you won't get rid of them. In my experience though you need v little food to get out of ketosis and the glucose will help too. If you're beginning to be able to eat, even tiny amounts (a few sweets, or cereal eaten one flake at a time) and keep it down then the ketones should come down fairly fast, over the next 24 hours or so. Good luck! They are right to keep you in until they've gone because they are bad for you and the baby and if you go into ketoacidosis it makes you vomit much more even aside from the HG.

@kalidasa thank you so much! That’s really helpful to know. I’m actually eating quite a lot (comparatively- normally 3 pieces of pineapple and a small bite of toast isn’t actually that impressive!) so I’m hoping they’ll go down pretty quickly. It feels strange being in hospital when I feel better than I have in the last 5 weeks!