Wednesday, October 13, 2010

Input Needed

Hello, HG mamas out there! I would love any input you all might have on behalf of a friend who is dealing with some severe NVP/HG right now. She has had bad NVP/HG for her whole pregnancy, but now, at 24-ish weeks, after several weeks of "it's finally getting better," her NVP is back - stronger than ever and getting worse. She has tried Unisom and Phenergan, both to no or little use, and the Zofran that got her this far is not helping that much anymore. She is still losing weight, though baby seems to be doing well. Does anyone have any advice for this mama? Medications to try, good advice to give, how to know when to get help, etc. This is beyond my knowledge, so I'd love to hear from experienced HG mothers out there.

Warning: Absolutely no "brisk walks in fresh air" or "sucking lemons" or "listening to soothing music" etc. etc. etc. Heavy duty advice only!

7 comments:

  1. LOL D, I love you! And I love your "PS." Thanks for "getting" me. And I still think you were far sicker than I ever was, especially with C.

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  2. Mine does this very same thing. It's horrible in the first tri, somewhat "stabilizes" in the second and then about 24-26 weeks it ramps up again. I attribute it to the baby getting bigger and moving all of my insides around and squishing them.

    My recommendation is to try medications that work on moving food through her system quicker and reducing the acid in her stomach.

    Reglan is commonly used to help speed up the digestive system.

    75mg of zantac, twice a day to help reduce the amount of acid in her stomach already (much more effective than tums). Can go up to 150mg, twice a day if needed.

    Prilosec OTC, once a day. It's a proton pump inhibitor so it will slow the acid production. The zantac will then help reduce what does get produced.

    Is she maxed out on her zofran dosage? What about switching to the orally disentegrating tablets if she's not on them?

    If she doesn't have ketone testing strips at home, she needs to get some and make sure she's not throwing ketones in her urine. If she is, she's dehydrated/malnurished and needs IV fluids. That's when it gets dangerous to baby and her as well. If she wants she could either talk to her OB/CNM about going in periodically for IV fluids or just go to an urgent care facility periodically.

    Sometimes just getting a few liters of fluids and some IV meds will help to "reset" your system a little. When you get dehyrated, one of the symptoms is vomiting (which I'm sure you know so much of this already) so it turns into a vicious cycle.

    Good luck to her! And if she wants to talk send her my way akn82878 at hotmail dot com. ;)

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  3. I don't know the reglan dosage -- I tried it 4 years ago when pregnant with KT but it didn't work so we haven't tried it this time around.

    Also, with the other meds, she can still take TUMS for some more instant relief.

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  4. Thank you for your suggestions! I've been on Reglan too, which made me more sick, but I will ask my doctor about the others! I'll look for keytone strips, too. I thought about going and asking for an IV to reset, but I wasn't sure if I was that extreme.

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  5. My lifesaver was Diclectin, but if she's in the US it's not available there :( If I understand it properly, it's a combination of antihistamine and vitamin B? Maybe with a little research with a Dr. they could come up with something safe and similar?

    Also, looking back, I should have pushed my Dr. more and been a little more assertive about how sick I was, and there were times that I really should have just gone to the hospital to get some I.V. fluids and give my tummy a rest, but I was determined to "tough it out" for some reason.

    My heart goes out to your friend! (and I had to LOL at the bottom of your note. I once told my mother and grandmother, who also had HG, that if anyone suggested crackers in bed again I couldn't be held responsible for my actions!!)

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  6. Thanks so much, ladies! Anyone else who has input, bring it on!!!

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  7. I've used Reglan/Metaclopromide too - it worked great for me but has a high incidence of side effects. If she's been using meds orally, she should see about getting a subcutaneous pump. They are expensive, so sometimes it's hard to get insurance to pay for it, but cheaper than a hospital admission or repeated ER visits.

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