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.

Hi everyone,

I'm currently 10 weeks with my third pregnancy (2nd successful), this is the 3rd time I've had HG. Last pregnancy I was in and out of hospital constantly and was really very bad. I have HG again this time though I don't seem to be as bad as before. I'm being sick about 12 - 15 times a day and I've lost almost a stone in 4 weeks. I've been keeping an eye on my ketones, I haven't had any yet so I haven't been to the hospital, yet. The medication hasn't worked so far and the new stuff knocks me out so I can't take it as I need to drive and work. Work is hard, I've had 3 weeks off as a coincidence (booked previously for childcare), being here is hard though.. I'm struggling to cope as I'm constantly being sick and really weak. I keep thinking about last time and how I was much worse to help get me through but it's really really tough.

I hope you're all doing okay.

@Tdcp
I could have written some of your post. I really take my hat off to you for trying to continue work - I have hyperemesis too, and on a few different meds now. I'm also about 10 weeks and haven't been able to work at all, ( i work in healthcare).

I hope this eases for us soon. Have you spoken to anyone at work about your pregnancy and how awful you're feeling?

Hi everyone,
I am after some support and advice.
Currently 7+5/40 and really suffering. Don't remember being this bad in the previous pregnancies.
My GP has given me cyclizine and prochlorperazine. Not even touching it
Was admitted last week for fluids.
Went again on sun and started on xonvea by EPAU. It hasn't made any difference. I noticed last night that 1 tab came out when I vomited and again this morning ( about 2 hours after taking the dose)
Contacted GP for advice but he hasn't even heard of xonvea so unsure. Advised me to try metoclopramide.
What's your experience of xonvea? Does it actually help? And can I take metoclopramide with xonvea?
Thank you for your support.

There are multiple combinations of medication you can take, it's a little bit of trial and error to find what works best for you. Metclopramide can be combined with Xonvea, as I have been offered this combo.

I also had problems vomiting the tablets. Some of the other options are either melt in the mouth tablets or suppositories which can be a good alternative.

Personally, I find Xonvea to be a lifesaver, but I take the max dose in combination with almost the max dose of Zofran, and Omeprazole. This doesn't stop the vomiting entirely but removes the worst of it all. I am still on sick leave though, and still have weekly rehydration, and at 34 weeks I don't think there will be any improvement until birth.

@Beebs1234
I’m so sorry you’re so unwell with HG this time. I also suffered more this pregnancy compared to my first and it took a while to get the right combo of medications.

are you on the max xonvea dose of 10mg morning, 10mg mid-afternoon, 20mg at bedtime? Have you considered asking for ondansetron? I personally did not find xonvea or prochlorperazine helped me and only got things under control on cyclizine, ondansetron & metoclopramide. But I know lots on here who they worked very well for, everyone is different.

FYI I find this resource very helpful as my gp wasn’t very clued up on the various combos possible! www.hyperemesis.org/tools/hg-treatment-algorithm/

Hello @alpinia and @gg9320 ,
Thank you for your advice. I have only just started on xonvea 2 days ago. I have only increased to 20mg at night and 10mg in the morning. It's helping me to keep fluids in but not food.
It's so drowsy that I didn't want to increase unless had to. I will increase the dose from tomorrow to see if it works and hopefully, addition of metoclopramide brings some relief.
Thank you

If it's any help, I found that after a month or two the drowsy effect wore off (or I've just become totally used to being half out of it all the time😂)

Good luck! Hopefully you find a good combo soon!

Yeah I really struggled with the drowsy ones like cyclizine. Odansetron is the only thing that’s worked for me. I took metoclopramide for a bit but have now stopped it.

So, it's now 7 weeks since the HG started. No meds are working, I'm not keeping anything down after 11 am so I'm trying to eat toast and drink water first thing in the morning. I don't have any keytones still so I haven't had to go to hospital thankfully. I'm still working somehow but I think I'm one step away from a breakdown at the moment. I keep thinking that I'm nowhere near as bad as last time but I just want it to stop now.

I don't know what the current advice is in the UK but elsewhere it's been updated that ketones are not the indicator of severity or need for rehydration...

I think this has been bought in in Feb this year but it doesn't seem to have filtered down to any health care provider I've spoken to in the last 8 weeks.

Sounds typical...I find I really have to advocate for myself with some of the providers. Some are excellent but some still don't believe HG exists.

The last time I had HG I was hospitalised 4 times before 12 weeks. The registrar (male..) then came round to see me with 2 trainees, 2 nurses and a cleaner in my room and then told me I was doing it to myself, all I needed to do was drink more water, then he halved the medication and said I wouldn't be admitted again. I ended up having a termination because I also had a toddler at home and a self employed partner who couldn't work. Things got very bad very quickly. I wish I had been mentally stronger as I didn't even put in a complaint. It's disgusting when any medical issue is treated as though it doesn't exist but for something that so many women suffer from is horrendous.

I printed off the RCOG guidelines published Feb this year and brought to my GP. I’ll link it below! It did help speed up getting hold of ondansetron. Previously they said they wouldn’t prescribe it until after 12 weeks 😯 despite me struggling massively on other medications. It also talks about not relying on ketones for inpatient treatment.

doi.org/10.1111/1471-0528.17739

I’m so sorry this happened to you, it’s unacceptable treatment!

I'm sorry, and it's unacceptable, but it's not the first time I've heard of this type of story, and I've had plenty of 'just eat a ginger biscuit', 'nausea in pregnancy is normal' or 'medication will harm the baby' type conversations, even with young doctors who should be up to date with the training. No wonder so many women suffer through.

Even though the HG has been just as bad this time I feel more in control because I know what I need, and the consultants have been very clear with the Junior staff and midwives that they aren't to mess with my medication and rehydration schedule. However, I do often see other women in earlier stages struggling with the differing advice and sometimes it's hard to share advice without directly contradicting the doctor.

I'm so sorry this happened to you! It's absolutely unacceptable that you were treated this way x

I'm not sure how active this thread still is but I was just wondering if anyone is on a mix of steroids and Ondansetron/zofran? Or on a second pregnancy and able to get Ondansetron/zofran straight away?

I’ve had a successful pregnancy (with hyperemesis) and then unfortunately two miscarriages (both HG), hence being on the steroids. With my DC, zofran was the only thing that worked. Currently, I’m taking prednisone in the morning and it's holding back the vomiting but it starts wearing off mid morning/lunchtime and the nausea steadily increases and I’m flat out on the sofa with a sick bowl until bedtime. I’ve thought about splitting the pred in half to have a half dose later in the day but it gives me insomnia as it is and if I take the full dose then at least I get the morning to get stuff done. I really don’t want to faff around with the first line drugs because they never worked before. I’m hoping my doctor is sympathetic on Tuesday when I see her and we can figure out something that gives me a bit more day to day function, although I suspect she’s from the “have you tried ginger” approach. Ginger flavoured vomit anyone?! I’m overseas and technically I can just buy the zofran but that doesn’t feel comfortable.

Can I ask what dose of prednisolone you are on ? I am in a similar situation but they have agreed to adding thiamine and Prochloperazine and xonevea my dose of prednisolone is at 10mg three times a day

@Saim86 thanks - I’m on 20 at the min, which seems to be standard protocol for recurrent miscarriage, once a day in the morning. How do you find the Prochloperazine? It had such a sedative effect on me and very little antiemetic benefit. Xonsvea seems to be new since my first pregnancy, I’m not sure if it’s available where I am.

I find Prochloperazine buccal tablets work better along with ondansetron and xonevea also try thiamin it’s available over the counter and defo helps ask for a increase of prednisolone for hg the dose is 10 mg 3 times a day from what I have heard women on lower doses have had similar experiences to yours where as women on higher doses have praised the effects

@Saim86 that’s helpful, thanks, I’ll discuss the options with my consultant in a couple of days. Things don’t seem to be getting worse so that’s something

Thought I'd post for some motivation for all you ladies suffering!

I had severe HG throughout my pregnancy, had to be in hospital sooo many times throughout my pregnancy, had all the meds but still vomited 24/7, in the first trimester I considered a termination. I was in a very dark place and really struggled throughout. Every day i woke up and cried because it was another day i'd have to survive. Literally bed bound most of the time.

But I had my sweet baby girl 13 days ago, she was born at 40+2 weighing 6lb3. And my god it was worth every single second of it.

I felt instantly better as soon as the placenta was out. I've found post partum easy because I don't feel sick anymore and I'm not being sick anymore. I've been living my best life eating everything in sight, everything tastes so nice again!!

So keep going ladies - this is only temporary and you will feel normal and healthy again. And it is so so worth it!

Does the prednisolone help the nausea or just the vomiting? Keep us posted on how it goes x

Thank you most definitely motivating ❤️