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.

@MrsNovember

Good luck with Occ health. Stress and movement makes HG worse for me, in my first pregnancy I threw up multiple times a day until 37 weeks (when I gave birth, though vomited throughout labour too!) But then I wasn’t taking the stronger meds, and kept trying to return to work as I’d just started a new job. This time I‘ve been signed off since the start of pregnancy and GP put me on metaclopramide, ondansetron and omeprazole straight away, as well as cyclizine for night time. I’m 14 weeks now and not vomiting every day, it comes and goes and some days I feel quite lively (although SPD in my pelvis and lower back is now kicking in!)

Can you get signed off sick so you can rest properly? Occ health agreed with my GP’s decision to sign me off for the pregnancy, and it doesn’t go on your record if pregnancy-related illness.

@Permanentlymildlymiffed

I was on prochlorperazine (stemetil) last time though it didn’t help my sickness much sadly. It’s very widely used for nausea and vomiting, and was the anti emetic med we used to carry in our kits when I was a wilderness medic, as it’s widely regarded as safe (and you don’t need extra papers for customs). It makes some people drowsy.

I’ve never heard of it actually being prescribed as an anti-psychotic in real life although it is listed as one. I work on a psychiatric unit and in the 5 years or so I’ve been there I haven’t seen it on a meds chart, or heard it mentioned in MDT or pharmacy clinics, so I don’t think it’s commonly used in psychiatry nowadays.

It’s often given as an injection after surgery to prevent nausea and vomiting.

@Permanentlymildlymiffed that's what I'm on and, although it hasn't gotten rid of my nausea, it does allow me to eat and drink. I've been on it a week and at first it made me very drowsy! But that side effect has lessened considerably over the last week, so hopefully it'll be the same for you 🤞

Thank you @FateHasRedesignedMost and @Holskey that’s reassuring. Also pleased to hear the drowsiness might lessen. It’s not having the impact this morning it had last night but it’s working enough that I can get on with my jobs so I’m happy with that.

@Permanentlymildlymiffed

Ondansetron helped me through the worst weeks this time. I had to get a private prescription initially as my NHS GP was reluctant to prescribe, but the private GP was lovely, so caring and understanding (it was a phone appointment) and he prescribed 4mg ondansetron every 6 hours, increased to 8mg in the worst weeks. The appointment cost about £60 plus £10 prescription charge, but it was worth it as he also wrote to my NHS GP recommending ondansetron (it was the only thing that helped in my first HG pregnancy). It doesn’t suit everyone (and be sure to take a gentle laxative with it) but without it I don’t know how I’d have stayed out of hospital this time. It actually relieved the nausea a bit as well as the vomiting.

I’m also on metaclopramide, and at 14 weeks I feel stable enough to keep the ondansetron for emergencies/bad days only. I take the metaclopramide 3x day. The one time I forgot my evening dose about a week ago I woke in the night and spent an hour vomiting bile and acid, so I guess the metaclopramide works for me.

I also take omeprazole (anti acid that reduces acid production and lines the stomach with a protective coating) which is a game changer. In my first pregnancy I was only prescribed the omeprazole AFTER birth, when I still had issues with reflux and occasional vomiting. I think if I’d had it whilst pregnant it would have helped a lot!

Hope you feel better soon. Do push for meds and try a private GP if you’re not getting anywhere 💐

@Melleebacca

Congrats on your scan! Sorry about the vomiting afterwards.

That’s fascinating about how the anti sickness meds work, thanks. I always carry some ondansetron in my handbag in case I think I might throw up on the school run, as it seems to work quickly.

@alpinia

Welcome! Feel free to lurk. I know what you mean about trimesters. Last time the first was a total nightmare, the second a fraction better and the third I couldn’t drink more than a few sips of water, I think the pressure of the baby under my ribs made the last trimester hard, along with SPD.

This time I seem to be getting a bit of relief at 14 weeks (still medicated but not vomiting daily) so I’m trying to get as much done as I can in case the 3rd trimester is bad again!

@Permanentlymildlymiffed as others have said prochlorperazine (stemetil) is a really standard first-line drug. It's actually the only one I've never had as my mother had a very rare side-effect to it -- it paralyzed her chest or something really weird so she couldn't breathe properly! So I have avoided it for that reason just in case. Like cyclizine it can knock you out though most people find that the sedative effect of these drugs wears off after a while. If it allows you to eat then that is brilliant. The effect might also build up over a day or two so keep taking it consistently. I have actually had a manic episode (years and years ago, it was triggered by medication and luckily has never happened again but I did quite a lot of reading afterwards just in case it did) and I don't remember ever seeing stemetil mentioned for mania. But lots of random drugs have psychiatric uses listed even though they're not mainly used for that, so I wouldn't worry about it.

I had some acupuncture this morning mainly for my pelvis but I did mention the ongoing sickness and she said she'd try to treat that too. Weirdly the sickness is really bad this afternoon, the worst it's been for a few weeks. But last time I had acupuncture it got worse first as well, and then it got a lot better, so fingers crossed it's doing something. I have to say I had repressed the memory that it made it worse first until I started to feel really sick again! Have gone to bed for the afternoon to try to take the edge off it.

@FateHasRedesignedMost have you got the dissolving ondansetron or the tablet form? This time around I’m on the tablet form since while the dissolving one kicks in fast, it tastes like berries and my taste buds are so sensitive this time around. I find the tablet one still kicks in fast.

I’m planning on starting to reduce my meds in 3wks when I’m on summer holidays. I’m wanting to drop the cyclizine during the day first and just have it to help me sleep at night. But also nervous to drop any meds as I know my current routine is working. Has anyone dropped cyclizine before and noticed a change? I’m going to stay on ondansetron longer, usually I drop the lunchtime dose of that first.

@kalidasa I remember acupuncture used to make me feel like I was badly jetlagged immediately after but helped with what I was having it for the next day so maybe it will be the same for you. I spoke to my cousin who is a pharmacist and she said it’s in much higher doses that stemetil used for psychiatric purposes, starting from 100mg doses so that’s put my mind at rest. It’s still working but when it wears off I’ve found it quite dramatic how the sickness just switches back on, need to learn how to space the doses to allow me to do the school run, cook dinner etc.

Permanantlymildlymiffed I take Prochlorperazine as Stemitil to reduce vomiting with a bad migraine; it makes me sleepy. I so agree with FateHasRedesignedMost about getting signed off for a bit.
FateHasRedesignedMost kalidasa and everyone - great advice.
kalidasa I do hope the Acupunture has that effect with you again.
Melleebacca Silly me- I saw you mention 'summer holidays' and I thought, 'What? It's coming up to Christmas,' forgetting you're down under! It's so good you're feeling well enough to think about reducing the meds.
Apologies to anyone rudely overlooked.

Holsley That's really good about the sophorific effect with Stemitil wearing off and you're being able to eat and drink again.

Holskey Sorry not Holsey- I'm not doing well with names, recently.

Sick as a dog this morning. Threw up my morning Xonvea twice in a row the first time so violently and unexpectedly that I also totally lost control of my bladder, how glamorous so in the end took an old cyclizine to knock myself out for a couple of hours. Am tentatively sipping water and nibbling biscuits. Haven't been this ill for a few weeks now. I think it must be the acupuncture effect -- I was incredibly sick the day afterwards the first time, too, but then I was really better so fingers crossed the same thing happens . . . Bit horrible to be so sick again so will only really be worth it if I feel pretty amazing from tomorrow! Will report back.

@kalidasa I’m thinking positive thoughts for you. I do find that as I’m recovering, the vomiting sessions are more unexpected, and also more violent.

Managed to eat my dinner with the kids at the dining table last night, although it felt like it took a huge amount out of me. I only sat with them for 5mins, but they had so much joy to see me.

Has been a terrible day. Have thrown up violently six times so far, kept nothing down at all, including the Xonvea which I've chucked three times now. Have resorted to cyclizine twice just to knock myself out for a couple of hours. For the last week or so I've not been throwing up at all, or only once in the morning. But I had a day just like this right after acupuncture last time so I really hope it's the same effect and I'll feel better tomorrow. I really hope so as DS1 has his birthday and party on Sunday and there's loads to do. Haven't been able to do a single thing today, have just been lying motionless waiting to vomit again! Have wet myself three times!! Think baby must be sitting right on my bladder. We were all supposed to be going out this evening -- first family social thing I've done for months but they're going to have to go without me. Bit fed up and also quite surprised at such a violent reaction. I was very ill like this after acupuncture last time too but I was much iller in general then so it was less of a shock.

@kalidasa does taking the xonvea at the same time as the cyclizine help with keeping them both in?
Birthdays are the hardest as they’re such a family orientated time, that the guilt of being sick is really high. Christmas is another, but fortunately covid here is NZ is the worst it’s ever been, so everyone is going to have to have a small Christmas.

@Melleebacca I'm not taking them together, I'm just using the cyclizine as a back up if I haven't managed to retain the Xonvea. I don't want to take too many "extra" Xonvea from vomiting them in case they refuse to renew my prescription early. But I have loads of cyclizine -- my dad was prescribed it when he was dying and after he died I took it just in case I got pregnant again!

I know from previous pregnancies that even thought the cyclizine isn't very effective it doesn't cause me any probs and often knocks me out which on a day like today I was grateful for. Up to 7 vomits now, have retained absolutely nothing today. Bit grumpy about it as I am 17 weeks!

@kalidasa I’ve been taking my cyclizine at the same time as taking ondansetron. The cyclizine makes me sleepy for about an hour after I take it, and by then hopefully the ondansetron has kicked in. I need to stagger them a bit now, as I’m getting fed up at waking at 4am every morning, so I’ve skipped my morning cyclizine today so I can have one in the middle of the night if I need it.

For a long time in both previous pregnancies I was on three or four meds and used to stagger them all. I think cyclizine actually works in essentially the same way as the doxylamine in Xonvea though so I'm guessing they shouldn't really be doubled up. That's why I'm just using it when I have repeatedly tried and failed to keep the Xonvea down and don't want to keep wasting the Xonvea tablets. I also found Xonvea quite sedating to start off with but the effect faded after a week or two taking it consistently.

kalidasa Oh dear, poor you. I do hope you feel as much better tomorrow as you do today, and are fine for your DS's birthday on Sunday.
Meleebacca It was nice you had that together. I hope you can have that a lot.

Thanks @LucindaE yes I feel much better today. Not sure though if I'm really better than before the acupuncture so won't have it again unless I keep improving as yesterday was really horrible. It definitely does do something though!

Hope everyone else is hanging on ok.

kalidasa I hope tomorrow brings a further improvement. Wishing you all luck with DS's birthday tomorrow.

Hello! Hope everyone is ok?

Just popping in for emotional support.. reading all your posts helps me and has made me realise how many mums to be are going through this! I am currently 19 weeks coming on 20.. on two types of anti sickness meds.. second pregnancy.. (was admitted in my first pregnancy to hospital at 8 weeks.. and at 16 weeks with this current pregnancy.. starting to struggle again.. honestly don't know how we do it. My sickness didn't even wear off till around 30 weeks with my first please tell me it's not going to be the same this time round 😭😭😭😭 feel like I can't talk to anyone about it in person as know one understands what I'm going through.. so much easier to talk to other mums on here who know what I'm talking about..

Hope everyone is okay! Hang in there we all know the end result it worth it just the journey getting there 🤞🏼💖💙