Cyclic vomiters (drive me up the wall)

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I don't know what in the heck causes cyclical vomiting, but my cynical side tells me they are a little nuts. My compassionate side gets shoved into a dark closet when taking care of these folks.

I try to be nice, of course, but it's ever do difficult.

Specializes in Pediatric ED;previous- adult Ortho/Neuro.

We see it regularly in our ER (Peds only). Sometimes it seems like the diagnosis for "I have no idea why your kid keeps vomiting every week/month/fill-in-the-blank, since every test under the sun has come back normal". At least 1/2 the time it seems legit, but usually seems to stem (IMHO) from some kind of stress/psychosocial place. Most often pre-teen girls. Sometime parents bring them in not even amidst a current episode, but "Our appt with GI isn't for another month, and we are sick of this and need answers, so we came here". ? similar for our frequent abd pain kids that have no other symptoms, and are asking for a cheeseburger.

Parents are always very receptive to the fact that if GI specialist hasn't pinpointed the issue yet, ER doc isn't going to probably either.

I hate chronic GI stuff that doesn't have an obvious answer. Too many possibilities, and people aren't willing to make diet changes to optimize their health and minimize their symptoms.

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Yeah diet changes are important, as is dealing with emotional/behavioral issues, which people don't like to do either

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I've noticed a trend that our CVS pts also tend to drink from the sink when they are told they can't have water. I don't know much about CVS, but I wonder if its because they feel so thirsty, because their throats are burning from the acidity, or because it feels easier to vomit something up than to just dry heave.

I personally would rather be in constant pain than to have constant nausea. I find that pain has more treatment options, but chronic nausea has far fewer treatments, and next to nothing over the counter works.

Or maybe because we're dehydrated? I'm in my 30s now but as a kid I vomited A LOT and dehydrated several times with many trips to the ER and urgent care and even multi-day hospitalizations (ages 6, 8, and 15 for admissions, lost count of the ER/UC visits). This was years ago so there was never a dx made, just told by the ped that I had a weak immune system and got sick easily. Blood was drawn, IVs started, even CXR taken but nothing was ever found. It eventually did taper off as I got older, in my mid-20s, but it was not fun as a kid. When I was in my early 20s I went to my PCP for it. I was wearing a baggy pair of jeans and he noticed they were loose on me, I explained that they were a size big because I didn't want them pressing on my stomach. He then asked if I knew I was slender and asked if I had ever forced myself to vomit to lose weight. Yes, my PCP insinuated I had bulemia. That was the last time I saw that PCP. I was watching an episode of Grey's Anatomy (don't judge me) and they had a pt with CVS and I looked up the website for it and I'm pretty sure that's what I had as a kid. I also had HG with both pregnancies (hyperemesis gravidarum) and wonder if there's a connection to that. I hate vomiting and nausea.

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Specializes in Emergency/Trauma/Critical Care Nursing.
Or maybe because we're dehydrated? I'm in my 30s now but as a kid I vomited A LOT and dehydrated several times with many trips to the ER and urgent care and even multi-day hospitalizations (ages 6, 8, and 15 for admissions, lost count of the ER/UC visits). This was years ago so there was never a dx made, just told by the ped that I had a weak immune system and got sick easily. Blood was drawn, IVs started, even CXR taken but nothing was ever found. It eventually did taper off as I got older, in my mid-20s, but it was not fun as a kid. When I was in my early 20s I went to my PCP for it. I was wearing a baggy pair of jeans and he noticed they were loose on me, I explained that they were a size big because I didn't want them pressing on my stomach. He then asked if I knew I was slender and asked if I had ever forced myself to vomit to lose weight. Yes, my PCP insinuated I had bulemia. That was the last time I saw that PCP. I was watching an episode of Grey's Anatomy (don't judge me) and they had a pt with CVS and I looked up the website for it and I'm pretty sure that's what I had as a kid. I also had HG with both pregnancies (hyperemesis gravidarum) and wonder if there's a connection to that. I hate vomiting and nausea.

I agree with the dehydration part, that's what I was referencing about them being thirsty. Sorry you had to go through that but glad to hear its gotten better.

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Drinking a lot of water during an episode is a fairly common behavior. Enough so it's documented on several articles I've read.

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Specializes in Emergency Department.

Yup Haldol. :D

5mg of Haldol. Seriously it is the absolute best I have ever seen for stopping it.
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My 10 year old autistic son has cvs. I thought I would end up being investigated for munchaussen by proxy we have spent so much time getting ivf. Haldol is the only thing that has ever helped even tho our pcp thought I was nuts when I suggested it.

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Yes when suggesting sedation the hospital staff thought I was crazy and refused to try it.

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I absolutely HATE the sensation of nausea. Even feeling extremely nauseous (with and without vomiting...mostly a lot of retching) for just a day makes me miserable...to the point where even drinking a little bit of water makes you feel that way....I couldn't imagine experiencing that for an extended amount of time.

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Specializes in Med/Surg, ICU, ER, Peds ER-CPEN.

It's a slippery slope with this one, I have taken care of a few CVS pts and one in particular is a super sweet teen who gets set off by stress, welcome to high school night brought on an episode, the excitement of first homecoming dance and game brought on another and every time her first question was to get her letter saying she can go back to school right away. Others I've seen have learned to manipulate their parents and the parents allow it grrrrr

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Specializes in Pediatric ED;previous- adult Ortho/Neuro.
. Others I've seen have learned to manipulate their parents and the parents allow it grrrrr

This is exactly it for many of the kids we see with it!

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Interesting thread! I admitted an 18 year old with CVS not too long ago. Smoked massive amounts of weed. He had come with his mom who thought it was "funny". He wanted alllll the pain meds. And all the phenergan. Night doc d/c his IV pain meds and he signed himself out AMA at 4 am....

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