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.

@kalidasa thank you so much !! I'm going to try what you suggested and just keep an eye on it. Sorry you're so sick too. It sucks. How do you look after your other children ? Are you off work ?

I have been off. Tried to go back, but I think I need to go back on sick leave.

Hi @nubbie yes I've been off work for a couple of months nearly and honestly I am not looking after my children at all! My husband, our au pair and my MiL are. I try to do a bedtime story if not too ill but our priority was to keep me out of hospital if possible as with DS2 I was in hosp for 2 months!! And we know my only chance of staying out is basically just to lie completely still the entire time. It's v tough on everyone though and DH is at the end of his tether so I really hope the vomiting eases off (and stays better!) soon so I can do a bit more.

@nubbie sorry you’re here. Ketones appear in urine when your body is burning stored fat instead of calories. Desirable in weight loss, but not when trying to grow a baby. Unfortunately your body does get accustomed to starvation and ketones will decrease naturally over time, hence why it’s not the best thing to measure. Your body can support a baby while in starvation mode for quite some time, but the worry is dehydration. If you’re not peeing and drinking is s struggle, you may need IV fluids. I had 3 lots with my first, but have avoided them in subsequent pregnancies due to working hard at taking in fluids. Babies really are the most effective parasites. You may need to work hard on nutrition after the pregnancy, to build up stores, especially if you plan to go through this torture again.

@kalidasa oh you poor thing. I always feel rough around 12wks, as it is a mental struggle that I should be improving, but I’m not. I’m sorry the stress has made you feel worse, I also had an awful weekend last week due to the stress and anxiety of my daughters birthday. This week I have managed better fortunately.

@FateHasRedesignedMost hubby bought me yoghurt as I have used that in the past to soothe my throat after vomiting. But I can’t even stand the thought of it at the moment. Although I am planning on being able to eat ice cream in January.

I spent 20hrs in bed yesterday, managed a walk around the garden, which bought me great joy and didn’t vomit at all. I had some pretty horrendous dry heaving sessions but managed to keep everything in. I’m 9wks today and after 3 pretty rough weeks, it’s nice to have a relatively good day.

@Melleebacca thank for explaining. How long do you think you can support a baby whilst being in ketosis ?

I've had IV twice now. But could probably have had it more. I was told to go in today by the GP but just forced water down and ate and now my ketones seem to have subsided... I didn't know that can happen so quickly.

@nubbie if you have ketones of 1.5-2+ or more you need IV fluids. I had to have them on a daily basis in my last pregnancy for months. Each day I went in and was told I couldn't leave the hospital until they were 0-1.5+ at the most. Being dehydrated and in ketosis is extremely dangerous for you and your baby and should be taken very seriously by GPs Midwives and the hospital. If in doubt please get to a and e this weekend to be checked and get some IV fluids if needed.

@nubbie I think it depends on your fat stores and how much you are managing to eat, as that is what causes ketosis. Most HG sufferers do get some relief around week 20. If ketones are resolving pretty quickly, you’re probably not in ketosis all the time. My rule is if I’m vomiting more than 4-5 times a day for at least 2 days, and not managing to keep in fluids, that when I feel I need IV rehydration. Mental state is also something to consider. On my darkest days, I have gone in for fluids without ketones as I needed the safety of being around medical staff.
I also feel best in the mornings when I haven’t eaten and then as the day goes on, I get more nauseous, especially after I eat. Currently trying not to move after eating breakfast and feeling green.

nubbie Welcome. Sorry you are suffeirng. Are you on meds? I'm assuming so, if you've been admitted for fluids twice. Here's my normal spiel, though you have already had great advice from kalidasa and Melleebacca. Most sufferers find that they improve a lot at some point between weeks 14 and 20, or sometimes later. Even those who are unlucky enough to suffer throughout generally are not as ill later on as they are in the first part. A good anti acid can make a surprising difference to the sickness. Kesostix are worth buying online or from a chemists, as while they aren't they best test of dehydration, hospitals take them seriously. When reporting on the vomiting to doctors, remember to emphasize the number of heaves in each vomiting session, as doctors tend to count these as 'vomits' and this can lead to their underestimating the severity of your symptoms. Besides drinking through a straw, here are some drinks that have helped others: full sugar flat coke (if you don't find it too acid), ice lollies, the juice of tinned fruit, Lucozade, apple juice, Ribina, Dr Pepper, soda water, Elderflower water, tonic water, ice cubes, Iron Bru, lemonade, lemon squash, orange squash, orange juice (if not too acid), fizzy orange, 7Up, isotonic drinks, sips of chocolate milkshake (maybe soya), fizzy water, apple juice, Robinson's fruit drinks, Rubicon sparkling mango drink , raspberry Lucozade sport and frozen ice cubes of flat Lucozade sport. Also, pink lemonade , cloudy lemonade and Sprite. Foods of a sort include tinned fruit, cuppa soup, nibbles of crisps and chips, cheap ice cream, Scotch pancakes, bagels and biscuits, potato smileys, slices of melon and mango. Protein drinks have also been mentioned.
FateHasRedisignedMost I shall enjoy welcoming you to the fabled Pink Castle after the awful Snakes and Ladders Hyperemesis.
That's so reassuring for those who have suffered previous miscarriages about that drop to 2 per cent after a heartbeat has been detected: I wish I'd known it myself, and I wouldn't have worried throughout after that first miscarriage.
Derbee That's good news!
kalidasa Great advice as ever. Sorry about disappointing sickness. Would you be safe to travel to an Acupunture appointment now? They might fit you in as an emergency, if you're rapidly going downhill.
Apologies to anyone rudely overlooked.

@LucindaE thank you for all that useful advice.

I've tried quite a few drugs, but they haven't helped. Cyclozine, does nothing. Then there's another travel sickness one, they just make me sleep. Metroclooamide ( sorry I'm spelling these all wrong ), also does nothing.

It really depends on the day how much I eat. I basically feel best if I eat very little, as any food makes me feel sick. Right now I'm feeling very sick because I had some soup. Anything I put in my mouth, will make me feel sick after 5 minutes. I enjoy it sometimes, but even during the meal I start to already feel ill. It's relentless. I vomit not long after. But not always always. I don't think a and e take me seriously because I can keep some stuff down sometimes. I have ketones a lot when testing at home. It sucks.

I tend to eat around lunch time and that's it. So at least I get some evenings sometimes where I don't feel constantly sick. If I have dinner, I'll feel sick and or vomit the entire evening and through the night. If I avoid dinner, I still don't feel great, but sometimes a little better.

@nubbie

I had the same experience as you, I felt that the medication just made me sleep throughout the day but as soon as I was awake the sickness would start again!

I honestly can't think of anything to advice you as I'm still the same rn (18+4) but I tried haribo tangfastics (the salty ones) and sometimes I can get through the day eating them! (Not sure about the nutritional content I'm getting but I guess you just have to manage!)

[quote abbs1]@nubbie if you have ketones of 1.5-2+ or more you need IV fluids. I had to have them on a daily basis in my last pregnancy for months. Each day I went in and was told I couldn't leave the hospital until they were 0-1.5+ at the most. Being dehydrated and in ketosis is extremely dangerous for you and your baby and should be taken very seriously by GPs Midwives and the hospital. If in doubt please get to a and e this weekend to be checked and get some IV fluids if needed. [/quote]
DID NOT KNOW THIS!!!

I got turned away at 2!

@theconfused I have also had to fight for fluids at 2+ Ketones. I visited a private OB with DD2, and she said she would provide fluids whenever her patients requested it. Unfortunately by the time I got to visit her, I was already 16wks and the vomiting was easing. Different doctors have different requirements.

@nubbie there are stronger meds. The strongest I am on is ondansetron which works to close the valve at the top of the stomach. It also does cause constipation, which I am managing by having 2 glasses of pulpy orange juice a day. I’m also on cyclizine which works by turning off the vomit signal is the brain. I find the side effect of drowsiness amazing as the more I sleep, the less sick I feel.

@theconfused my hospital and EPU midwives took it extremely seriously. The first time I went my ketones were 4++ and the midwife said youre not leaving until your hydrated properly through IV and youve got medication. Took 3 bags of fluids to get my ketones down to 1+ She couldn't believe the GP had done nothing with how severe my sickness was. I went back in the next day for more and it carried on for months until i got put on home visits with a backpack i carried round with fluids in it and even had to have fluids pumping next to me while i slept at night for a few nights.
She said that baby is ok without food from me vomiting and baby will get nutrients from my body but being dehydrated affects the neurological system and can cause all kinds of issues. They honestly saved me and my little boys life.

There's also a distinction between ketosis and ketoacidosis, which it can lead to. This is essentially a kind of poisoning of your system from excessive ketones. It's this stage which can make the vomiting much worse, make you confused and can cause organ failure. It can be caused by prolonged starvation even if you are not dehydrated (eg on a drip). I have had that experience in both my previous pregnancies where I was stuck in hosp on a drip but the drugs weren't working to reduce the nausea and vomiting. I think this is quite unusual, however, and it is true that for most women with HG dehydration is the main problem and you feel at least a bit better once rehydrated.

After an awful day yesterday thank goodness I am better today so won't have to go to hosp. DH has just left for a short holiday with the boys. He was in a truly awful mood though, saying he can't cope anymore. I really hope I am better by the time he gets back so I can do more and give him a real break.

Hope everyone is surviving. @nubbie I agree that it might make sense to try ondansetron. It didn't work that well for me but that is unusual, most women find it very helpful. (In my first pg one doctor tried to tell me that it wasn't possible that I was still vomiting given all the drugs I was on!) Do treat the constipation aggressively though if they put you on it.

@kalidasa your situation sounds horrific I really hope you feel better soon. Do you know if any of the meds can help with the nausea ? I mean just take that away. Or do they stop the vomiting only?

Thanks @nubbie this pg has actually been way better than my previous ones so I am pretty grateful overall, just worried that DH is really at the end of his tether.

Unfortunately in my experience none of the drugs help the nausea as much as the actual vomiting. The antihistamines (like cyclizine etc) can help if only by knocking you out -- you don't feel so nauseous when asleep! Some women find ondansetron does help with the nausea as well as the vomiting. I didn't find it made a huge difference and for me it caused such severe and untreatable constipation that in the end that actually made the nausea worse. Many people find the constipation manageable though so def worth trying. The only drugs that really helped in my second (truly horrendous) pregnancy were steroids, which I was on from 8 weeks or so. They do seem to help the nausea, or at least make it easier to feel like eating despite the nausea, but they will only give steroids if you are in hosp and severely ill despite all the other drugs, it's end-of-the-line stuff. They did help though.

How’s everyone coping today?

I slept for 9.5 hours last night but have been sick all morning. Think I threw up the ondansetron but I’m trying to use them sparingly as it’s around £80 to speak to a private GP and get the prescription renewed. My NHS GP will only prescribe metaclopramide unless the private GP sends him a letter directly recommending ondansetron (?!?) and the private practice only do referrals to consultants, not to GPs. So frustrating!

I’m relying on my trusty ice lollies (Roundtrees fruit pastel ones) to get fluids and sugar down.

Sorry some of you are suffering badly too! I wonder if the worsening around the transition from first to second trimester is caused by the placenta taking over from the yolk sac? According to my NHS app the transition can cause mood swings, increased sickness and other hormonal symptoms, but once the placenta takes over fully these stabilise? I’m currently 11weeks+5 days so around the time the transition happens. I don’t know if it suddenly takes over or if the process takes days/weeks though… anyone else know?

@nubbie Hi and sorry you’re feeling so ill.
Have you tried ondansetron? It’s the only med I find helps the nausea a bit (not always but sometimes). If I’m feeling really sick I take an ondansetron 8mg and lie down, it seems to alleviate the nausea at times.

@FateHasRedesignedMost I think it's a gradual process which starts from around 8 weeks but isn't always completed until 14 or so, but I'm not sure if they really know in detail. I just threw up a scrambled egg which I over-ambitiously made for myself, but that's the first vomit of the day which is excellent compared to yesterday! It's just so annoying I was so ill yesterday, DH really needed my help with packing etc and I couldn't do anything at all.

Sorry everyone. I'm really not able to concentrate, but will drinking enough water and having a couple of slices of toast and maybe a plate of noodle soup keep me out of ketosis ? I'm confused, it's starvation or dehydration that puts you in ketosis or both? From some posts I see, it's from starvation. How can you work out how many calories you need to keep you out of starvation ?

@nubbie yes that sounds like a good plan and should be enough to bring your ketones down. Ketosis is caused by lack of calories (starvation) but hospitals often use it as a proxy for dehydration because most women who are vomiting enough that they're not absorbing any food are dehydrated too. There are other signs of dehydration like a bad headache, dry skin and lips and passing little urine which is very dark. If you can manage something like noodle soup I think that's really good because it will give you fluid and some calories. Good luck! Let us know how you get on.

@kalidasa thank you ! I'm just a bit stunned because I have been managing that amount of food some days and still somehow have dark Keto sticks. Maybe I get it very quickly or something. The other day I had two bowls of noodle soup and managed some potatoes too. I felt really sick but I managed to hold it. Then the next day I didn't have any breakfast and did the urine test at lunch time and it was really dark.

Ladies you are all so incredibly kind thank you for all your kind words recently. @kalidasa I really hope that you go easy on yourself, you are doing more than enough by carrying this little tot so just remember that ♥️

The stemetil seems to have helped slightly with the physical vomiting but the nausea is now through the roof, I can’t leave bed at all, does that count as HG or is this just an awful pg side effect. Does anyone know if any of the other sickness meds work better for nausea?xx

Hey all,
Very bad day for me today. I’m at the end of my tether, I feel so low and weak 😞.
I’m also suffering with Dysgeusia - has anyone else suffered with this alongside hyperemisis?

Currently lay wondering whether I need a trip to hospital for IV, I haven’t been able to keep a single thing down today even fluid and feel really weak . This is honestly torture 😞

Hi sorry Im rubbish at replying to people on here. Thank you for all the support.
Just need a little reassurance, I’m in week 8 with terrible sickness but my back is hurting a bit and abit of tummy pain like when you’ve had food poisoning kinda tender. It doesn’t seem to be coming from the baby’s area if that makes sense. Xx

@HopefulJ2018 the back and tummy pain might be pulled muscles if you've been vomiting a lot? I have often wrenched muscles being very violently sick. I think unless it feels like strong period cramps or you have other symptoms like bleeding it's unlikely to be anything to worry about re: the baby.

@nubbie yes I think some women do kick out the ketones faster than others, it's good you are keeping an eye on them.

@pregnancydiaries yes very acute nausea such that you can't function at all definitely counts as HG even if the drugs are preventing the vomiting. I think you often feel worse initially when not vomiting at all, because at least when you are sick you generally have a few minutes of feeling better (and maybe being able to eat / drink OK) immediately afterwards. In this pregnancy, which has been much less extreme than my previous HG pregnancies, I have mostly been able to limit the vomiting to 2-5 times a day and as a result still been able to keep eating and drinking at least small amounts (after each vomit). But in my previous pregnancies I couldn't control it at all, as soon as I started vomiting it was completely relentless, I couldn't retain anything at all and very quickly ended up in hospital again.

Some women find ondansetron helps a bit with the nausea as well as the vomiting. Some also find that the anti-histamines like cyclizine don't help directly but do knock you out which can make the nausea easier to bear (if you're asleep most of the time!).