hyperemesis

[jeepgirl]

hello!

I am about 13 weeks pregnant. About 3 weeks ago, I was diagnosed with hyperemesis gravidarum. I had been on phenergan for some weeks before, which didn't help at all. When I was diagnosed, I had ketones in my urine (high... but she wouldn't tell me how high). At that point, I hadn't peed much in a few days, I was visibly dehydrated, along with the fact I was 8+ lbs down from my last visit a few weeks before. With my first pregnancy, I had morning sickness that was very severe... I would almost say this bad, but I had a family practice doc (who was very conservative and didn't want to intervene as long as I was coping semi-well - which I guess I understand), I didn't work outside the home, and I had a mom at home who stayed with me and pushed fluids on me during the "good times" of the day).

But the morning sickness with my first pregnancy lasted past the 6th month. I am so, so afraid that this will continue on with this pregnancy as well. So that is my first question... if I had morning sickness for a long time with my first pregnancy, are my chances of having it for not very long this time slim or is there a good chance this one will be different?

My next question: How can I have this and work? I have zofran, and now I am paying for it out of pocket because my insurance won't pay for much. It is the only way I have been able to even halfway function and even go to work. It is a wonderful drug, and it worked pretty well the first two weeks. But since last week, I am having a LOT of breakthrough n/v. I work twelves on a pedi unit (sometimes pp/nursery) and it is absolutely killing me that it is not working as well as it was... I try to push fluids at work when I am not actively sick, but sometimes I just don't have the time to drink what I need to. I can tell that it takes me at least 2-3 days to recover after working and not being able to eat and drink adequately.

In addition to the meds, I have tried preggie pops to decrease the n/v. I have tried only eating bland wet / dry foods separetly and hours apart. I have tried eating crackers before I get out of bed in the AM. What things have other people (nurses!) done to get through the day with this? I just really need some practical advice because I am not coping well... when I am not forced to go to work, I literally am in the bed for most of the day (between trips to my new home, the bathroom!).

[Aneroo, LPN]

Clinicals, of course, was a whole different story. The Zofran "took the edge off," but the plethora of strange smells could send me running to the bathroom at the drop of a hat. I quickly learned that "smell prevention" was very important. For some strange reason, sniffing alcohol wipes (sometimes!) helped to break the incredible waves of nausea. I think that I equated isopropyl alcohol with "clean," which helped.

The other thing that sometimes helped was chewing on mints... all day long. I went through MANY tins of Icebreakers mints. Some days they worked, and other days they made me gag.... but the few moments of relief were worth it.

I forgot this! The smells were what got me! Mints were a God send! I couldn't eat Taco Bell or hot dogs for a good part of this pregnancy because of the smells! (And try telling a preggo not to eat Taco Bell!)

[VickyRN, MSN, DNP, RN]

I forgot this! The smells were what got me! Mints were a God send! I couldn't eat Taco Bell or hot dogs for a good part of this pregnancy because of the smells! (And try telling a preggo not to eat Taco Bell!)

Still have a hard time with hamburger, chicken, and eggs. My food preferences changed permanently. The "smell" of the artificial sweetener aspartame also made me sick (incredibly, I could smell this from a room away).

I remember throwing up being so commonplace, that I would go right back to eating, trying desperately to keep something down. I would eat all the time, trying to keep the nausea at bay. I found out that if I had SOMETHING in my stomach (usually a carbohydrate), the nausea would not be as bad. I would eat very small portions throughout the day and evening. I also remember standing outside on a bitterly cold winter's day with the cold wind blowing in my face, trying to not throw up my small meal I had just ingested. The cold wind helped diminish the nausea. Iced tea also seemed to help.

Ahhh, but it was worth it. I now have two beautiful healthy grown children. If I had to, I'd do it all over again.

[rehab nurse]

i had hyperemesis with both my pregnancies, and i had it all the way to birth. i was in the hosp all the time for iv's. i had a lot of medical problems, so i was very high risk.

anyways, i saw that you had some trouble getting zofran. my insurance company is the same way. i can only get 9 per month (i still use it for my migraines, but i did help immensly with the n/v of pregnancy). i don't know what dose you were prescribed, but i had my doc write for 8mg tabs, and i broke it in half to make 4mg. this was done with my doc's knowledge of course. maybe you could ask your doc to write the script like that, at least it would double what you're currently getting.

i had a terrible time with smells. i hope you feel better!

[jeepgirl, LPN, NP]

i had hyperemesis with both my pregnancies, and i had it all the way to birth. i was in the hosp all the time for iv's. i had a lot of medical problems, so i was very high risk.

anyways, i saw that you had some trouble getting zofran. my insurance company is the same way. i can only get 9 per month (i still use it for my migraines, but i did help immensly with the n/v of pregnancy). i don't know what dose you were prescribed, but i had my doc write for 8mg tabs, and i broke it in half to make 4mg. this was done with my doc's knowledge of course. maybe you could ask your doc to write the script like that, at least it would double what you're currently getting.

i had a terrible time with smells. i hope you feel better!

Rehab nurse... what a great idea! I will ask her!!!!

I really, really appriciate all of the feedback on this thread. I am calling my doc again today and I will ask about a lot of different things we can do to help make me feel better.

[SmilingBluEyes]

Iwish you a very happy and healthy pregnancy!

[matchstickxx]

Some of my patients have had pretty good luck with fresh lemonade. Try to use very little or no sugar. I have also used the "sniff the alcohol swab" on nauseated post-op patients....never tried it for hyperemesis but it probably wouldn't hurt unless you are constantly sniffing them.

I had hyperemesis with my pregnancy many years ago. For me, the phenergan helped to keep some foods down. Yes, I would still have some N/V, but at least I was able to keep some things down. I also did not follow a typical hyperemesis diet. On my rare "good" days, I ate what I wanted. On those days, I could keep pizza down but not the "sensible" bland food.

I also believe hyperemesis often has a psychiatric or emotional component which hampers the physical treatment. I'm not saying that all hyperemesis patients are mental cases....I just think many have something else going on that needs to be addressed in order to help facilitate the resolution of the hyperemesis.

I know how miserable hyperemesis can be and I hope you start feeling better soon.

[HillaryC, RN, CRNA]

I've never been pregnant, nor am I an OB nurse, but I used to have a friend who had hyperemesis gravidarum for all four of her pregnancies. I lived with her family and helped take care of her the summer she was pregnant with one of her kids, and the two things I remember working for her were peppermint tea and, to a lesser degree, plain baked potatoes.

I hope you feel better I'm miserable if I have nausea for a couple of hours, let alone nine months. You guys are my heroes.

[rehab nurse]

i'm glad you liked my idea....hope your doc will do it for you! that zofran is so expensive, but it works!

take care of yourself.