Tuesday, April 12, 2011

New HG Protocol - Draft Version

I couldn't stand it! Everyone around here had such awesome protocols (Knocked Up, Knocked Over and Island of Grief, Mountain of Joy come to mind)... I just had to have my own!

There is something about being an HG mama that induces protocols. They're everywhere! I wrote my own before I knew that others were doing it, and since then I've seen tens of them - HG forums are loaded with protocols.

Why is that? I think it's for the security that it gives. I know that I can't control my pregnancy, but I can control my plans and my research. Last time when I put all of my research into my first protocol, the items on the protocol itself didn't help very much - but feeling prepared and ready was worth all of the effort.

When I look at my current protocol, my main feeling is.... feeling tired. I've already done so much of this, and it has to be done all over again. Ah, well. 

Anyhow. The protocol I have here is very different than my first.... I don't know if it would be of any help at all, but it's always worth it. Here it is!

You will notice that I have censored a few items... this is because they are either personal, or just things that I don't think would be good to share on the internet due to privacy. 

(Ladies, I would love any input here. If I have missed something, or if something is incomplete or incorrect, or you have any ideas - please chime in!!)

Things to do before TTC – Medical:

- Set up with an OB (or CNM?) who is (1) okay with working with a midwife’s client, and (2) knowledgeable about and aggressive with HG treatment
    • Comment: I already have an excellent OB, who worked with me during my last pregnancy, and whom I know would be willing to do so again. And it worked out okay, since my insurance approved Zofran and Zofran was kinda-sorta good enough to get me through. But I never felt confident that she would have been willing to be appropriately aggressive if my HG had turned super-ugly - there were just too many mentions of lemons and ginger. It made me nervous. So while it worked out, I don't have the security of knowing that my current OB would really step up in case things got nasty. Too bad, because I'm really not comfortable in OB-land (I love my midwives!) and I don't enjoy stepping into that realm.... but it's necessary. 
    • Comment (August 2012): My OB supported me through another pregnancy, and was great, so I will stick with her unless there are problems - and this time there were no mention of lemons and ginger! 
    • Blood work: Vitamin deficiencies (Bs, K, D, magnesium, zinc), thyroid, Addison’s, H. Pylori
      • Comment (August 2012): Let's face it, I never got around to this - I'm lazy. What can I say?
    • Get Rx for Primabella wristbands 
      • Comment:  "Knocked Up Knocked Over" said that these don't work worth beans, but.... it might be worth it to try it. However, they're rather pricy, so I'm not sure.Thoughts?
      • Comment: Never got around to this... considering how useless seabands are, not going to bother. 
    • Talk about vitamin shots during pregnancy (Vitamin B6, Vitamin K, magnesium)
      • Comment: This is based on this article.
      • Comment (August 2012) - I did this through the local naturopathic medical college, and would do it again - cost was not high and I think they helped. 
    • Talk about his/her treatment drug protocol (i.e. how does he/she prescribe for HG)
    • Talk about Zofran availability from my insurance

    - Think about [** Issue A **]
     - Comment (August 2012) - Have thought about it, and decision has been made! Now, aren't you all dying of curiosity?

    - Talk to insurance about Zofran coverage (different insurance, boo!)
    - Comment (August 2012) - Thankfully our insurance covered Zofran without too much hassle. Unfortunately, one can't count on that from pregnancy to pregnancy, even with the same insurance, because policies change constantly. But for this time, we didn't have any real snags.
    - Find acupuncturist, meet or email with her - preferably someone who has experience with women's issues, NVP. Maybe start meeting with her now?
     - Comment (August 2012) - I found an acupuncturist during my last pregnancy, who was just awful (refused to see me because of insurance issues) - but I now have a recommendation to a new person. Hurray! 

    - Do I want a naturopath? If so, find and interview.
    • Comment: I actually interviewed and worked with a naturopath a year before our last baby was conceived. However, I never got the feeling that she truly knew what she was talking about - not that she was incompetent, simply that she didn't really work with pregnancy or women's issues. Eventually, I just stopped going to her. Is this worth the time and money? Thoughts, anyone?  
    • Comment (August 2012) - I have several recommendations to naturopaths, and I still can't make up my mind - I really want one, it's just a matter of money.
    - Do liver cleanse/detox
    - Comment: Completed a ten-day cleanse on 5/25/11. Our very scientific method: Went to Sprouts, found what was on sale, bought it, and took the supplements! Have no idea if it did any good or not, but it was fun - never done that before.
    - Comment (August 2012) - Did another cleanse, April 2012. Planning to do yearly.
    - Do [**Issue B**]
    - Comment (August 2012) - Have completely forgotten what that was. Hope it wasn't important!
    - Work on diet – (1) clean, (2) alkaline, (3) grain/wheat/dairy free, (4) paleo, (5) try the Florida doctor’s anti-NVP diet
    •  Comment:I was going to start #5 today, but getting over stomach flu doesn't go well with a carb-free diet! Going to try again tomorrow. Unfortunately there are various aspects that clash between alkaline/paleo/Florida, but they agree on the whole. 
    • Comment: As of 5/26/11, I have been on the diet (the Florida very-low-carb diet) for 40 days and counting! Very pumped about that! It is relatively clean, somewhat alkaline, entirely grain and wheat free, low-dairy and mostly paleo, so it also covers those bases. 
    • Comment (August 2012) - It is my guess that the Florida very-low-carb diet was what made this past pregnancy much more manageable. Only another go-around will tell! 
    - Supplements: Probiotics, milk thistle, prenatal, vitamin B, vitamin D, magnesium, zinc. Maybe dandelion? Adrenal extract? Any suggestions, anyone?
    - Comment (August 2012) - I need to start taking milk thistle. I always take vitamin B, but I need to get a better type. I am taking magnesium in about twenty different forms (liquid, tablet, epsom salt baths, mineral drops, etc.), and I need to take zinc as well.
    - Call Motherisk to confirm treatment plan with Unisom
    • Comment:  I spoke with them before our last came along, but I'd like to do that again (that was over 2 1/2 years ago). 
    • Comment (August 2012) - I did talk with them at the start of our last pregnancy (June 2011), and they were, as always, very helpful. Call them up! See link on sidebar. 
    - Lose 15 pounds – Do this as soon as possible, so that I can do a liver cleanse afterward to deal with toxins released during weight loss (which can contribute to NVP).
    • Comment:Have already lost about eight with paleo!!! Hurray!!  
    • Comment: 5/26/11 - have lost about 18 pounds on the VLC diet - hurray!
    • Comment (August 2012) - I lost 20 pounds. And gained it back during the last pregnancy, so now I need to lose it again!!!!
    - Deal with [**Issue C**]!!!
    - Comment (August 2012) - Mmm.... yeah. Whatever Issue C was.
    - Start making kefir a part of my diet
    • See this comment
    • Comment (August 2012) - Errr... forgot this part. 
    - Start doing baths with Epsom salts for magnesium
    • In process! :)
    • Comment (August 2012) - I am going to make my first order with Azure Standard this week, and epsom salts (a LOT of them!) are part of that order! So excited!! 
    - Start drinking magnesium water if I can find it (recommended by Busca at Birth Faith)
    - Lemon water, half weight in ounces every day (no, I am not posting that) :)
    - Comment (August 2012) - Working on this! I have also heard that this helps with magnesium absorption, as well as liver cleansing. 

    Things to do before TTC – Practical:

    - Get housecleaning help

    - More telecommuting for DH – good!
    • Comment: DH's work has started letting his department telecommute one day per week... the end goal is four days per week, but we have no idea how long that will take. More telecommuting days would be a big help for me. 
    • Comment (August 2012) - DH's work went to two days a week telecommuting.... then back to none.... then back to one. So we're where we were three years ago! 
    - Get baby sleeping through the night
    •  Comment:This is a hard one... No, he is not sleeping through the night yet (we co-sleep after he wakes up mid-night). With his health issues and his "adjusted age" - he is much younger mentally than his 19 months - I am not comfortable doing much sleep training. When our first was eleven months old, we ended night feedings and co-sleeping very easily in two nights using the "Nanny 911" method (or was it "Super Nanny"?). But that would not be cool with this one. Ideas, anyone?  
    • Comment (August 2012) - Baby did not start sleeping through the night pre-pregnancy, but he did start sleeping through the night before our newest arrived - good enough for me! 

    - Get baby on solids
    • Comment:  Again, with our little chap's health issues, he is still 100% on pureed food. He has a gag reflex that can sense texture from here to Milwaukee... and when he does, he vomits not just everything he's had for the current meal, but the last one as well! However, dealing with baby food (making it or serving it) - not fun while pregnant. No ideas on that one. 
    • Comment (August 2012) - I felt well enough to make baby food during the pregnancy (which shows you how good it was, by comparison!), and our little guy is now on soft table food (oatmeal, etc.). 
    - Work on keeping cleaning and organizing jobs done as much as possible so as not to be caught off-guard
    • Comment:  I'm currently on a wonderful spring organizing/decluttering spree! So much fun! I go through this about every 3 months, and it's so handy. I love throwing things out - it is such a stress reliever!! 
    • Comment (August 2012) - This is getting harder and harder with more children around! 
    - Make list of freeze-ahead meals that I can make
    • Comment:  This is a hard one! I've tried to make food before for DH and DS before, and the same inevitable fate awaits it every time. #1 - It usually isn't heated up anyway, and #2 - whenever it is made, only a tiny bit is eaten and they end up going out for fast food. Honestly, I think one of the hardest (and most expensive) family issues with HG is watching one's family subsist on fast food. I'll have to work on a list of foods that will be more popular to avoid that.
    - Make a list of things that DH can do with the kids while I’m sick (park, etc.)
    - Comment (August 2012) - I didn't get around to this, but I did do it for the postpartum period. Guess what? DH didn't look at it once (his usual reaction to lists). So next time I will save myself the bother and let him figure it out on his own (always the best way).
    - Read through my old HG notebook to get caught up on the research I did last time

    - Finish putting together my new HG research notebook

    - Learn how to make kefir! 


    Upon BFP - Medical:

    - Get an appointment with Jenny (our wonderful chiropractor!) for the adjustment of a lifetime

    - Get an appointment with acupuncturist, set up regular visits

    - Get appointment with OB

           o Start vitamin shots - B complex, K, magnesium

    - Start anti-emetics - Bendectin

    - Order Primabella wristbands; start wearing as soon as they arrive

    - Buy and start taking Morning Sickness Magic (recommended by a friend)
    - Comment (August 2012) - I did this, and I don't know if it helped, but since it's just a ginger and Vitamin B supplement, I would definitely take it again.
    - Eliminate sugars/grains, pump proteins!!

    - Make final decision on [**Issue A**]
    • Comment: I'm not writing on this one, because it is rather private, but.... this is one of those super-hard decisions that I'd rather not have to make!! Aarghh!!! 
    - Ginger
    • Comment: I guess. Maybe. Really, why bother? It doesn't help. Sometime I'm going to make a series of T-shirts that say "Ginger" with a big X through them. 
    • Comment (August 2012) - I think I took ginger. Or maybe I didn't. One way or the other, it doesn't really matter since the stuff doesn't work!!!!!
    - Sea bands
    • Comment:Again... maybe, but why bother? This is if I don't get the Primabellas. With my first I wore them religiously... with my second I got them out for a day then tossed them back in the box. Again, they don't really work, and one has to spend all of one's time dealing with questions or funny looks. I probably won't bother. 
    • Comment (August 2012) - I no longer bother with those blasted things. 
    - Enzymes, before meals
    • From this comment on helpher.org
    • Comment (August 2012) - Errrrr... forgot about this.
    - A-F Betafood by Standard Process
    - Kefir - lots of it!
    • Source - see same comment
    • Comment (August 2012)  - Need I say? I forgot about it. 
    - Start mega-doses of probiotics - minimum 4 capsules, 4x per day - every time I eat, 1 minimum - use a good brand, maybe Beeyoutiful or Gr8dopholis
    Upon BFP - Practical:

    - PRAY!
    - Comment (August 2012) - No need to remind me about this; I think I spent the first trimester on my knees.
    - Buy lots of paper plates/bowls/plates
    - Comment (August 2012) - Yes, this really helped. Definitely do this!
    - Buy lots of easy kid snacks – goldfish, juice boxes, etc.
    - Comment (August 2012) - Yes, for sure!
    - Arrange all of baby’s therapists to be home-based
    •  Comment: Oddly enough, this happened without my even having to bother much about it. Done!

    - Go to the dollar store and buy a bunch of disposable aluminum baking pans in order to…..

    - Freeze one heck of a lot of meals in advance!!!
    - Comment (August 2012) - This one does not work for me, because nausea hits early and hard - by the time I get a positive test, cooking is out - not to mention that DH doesn't eat the stuff I make anyway when he's on his own (hello, fast food!). But this might work for you if you have a breathing space before the NVP hits.
    - Make and Freeze a TON of baby food!!!
    - Comment (August 2012) - See above, so this didn't work for us. If I needed it, I would just buy prepared baby food. I don't usually buy baby food, but desperate times call for desperate measures.
    - See if anyone has an extra freezer we can borrow to store extra food in

    - Is it possible to get baby sleeping through the night?

    - Contact friends to form prayer group for my pregnancy

    - Kick it up a notch with house cleaning and organizing to be prepared

    - Contact my mom and see if she is available to come out should we need her
    • Comment:  Unfortunately, both sides of the family have made it pretty clear that they don't support us having any more children, so I can't count on this one. Not to mention that my parents are considering moving twenty hours away from us (instead of six). *Sigh.* I didn't realize how hard it was not to have family in town to help once one had children!!


    Upon First Nausea - Medical:

    - Start Zofran, with colace (*sigh*)

    - Pepcid, Zantac, Prilosec
    •  Comment: These are just OTC drugs I've seen bandied about in different places. Input as to usage, combinations, dosages, anyone?
    - Coconut water (not coconut milk) for hydration
    • Comment:  Read this one somewhere!!
    • Comment (August 2012) - Forgot about this one. 

    Upon First Nausea - Practical:

    - Move coffee pot to garage
    • Comment:   Thankfully, the microwave and toaster oven are still out there from our last pregnancy - we never moved them back, LOL!! :)
    - If we don’t have housekeeping help yet, arrange for that

    - Talk to my mom about coming out


    Two closing points:

    #1 - Thinking hopefully, maybe maybe maybe I wouldn't be sick with another child. Maybe. Hopefully. I can dream, can't I?? But it's always best to be prepared.

    #2 - We have no idea if God will ever bless us with another child. I might go through all the pre-TTC work and then never get pregnant again. But really, as above, it's best to be prepared. Receiving a positive pregnancy test is the time to sit back and let one's plans work for one - not the time to be scrambling about madly trying to find all of the resources and healthcare providers that one needs. So, regardless of the future, I do need to work through the pre-TTC tasks in order to be prepared.

    I welcome your input, ladies!!


    1. This comment has been removed by the author.

    2. This comment has been removed by the author.

    3. I removed my comments following chat with GP because they said they hadn't heard of Diclectin and wouldn't get it for me anyway, they'd want me to work through the other things they do prescribe.

      I wasn't sure I wanted to do that over the other option anyway so it looks as though the decision has been made.

      I'm so fed up with my useless docs etc. She didn't even listen and was really patronising, assuming I was just being taken in by the patter of a drug company. I TOLD HER I'd been researching HG and treatments since I had my baby 15 months ago. I'm going to get deeper into the cannabis research and talk with the Sickness in Pregnancy folk researchers so I can get my hands on some more scientific papers. I think I'd rather have cannabis than diclectin anyway as all the research suggests it is the most effective and safest from what I've read. Still illegal though. I'm going to find myself a medical cannabis compassion group as part of my preparation.

    4. Looks like a great game plan. That article about the B12 and magnesium injections was really fascinating. You know I love magnesium! :-) Speaking of... I was drinking a lot of this bottled water during the beginning of my last pregnancy and, though I didn't have HG to begin with, I do believe it really helped. You might want to check it out: http://www.noahs7up.com/ourstory.php

      Good luck!!

    5. It looks a lot more organised than my plans were - mine was all just in my head and I was hoping that the things I did differently would mean I wouldn't have it.

    6. Busca - I will look that up! Thank you! Also, I don't know if I told you this, but I started doing the green smoothies you recommended - they are awesome, and had the side effects of unexpectedly really helping with menstrual cramps! I've been meaning to blog about that - but thank you! I've stopped the green smoothies for the anti-NVP diet (no fruit allowed for the first part), so I'm trying to replace them with kale salads. Hoping it still works!

      Saved Sinner - I'm pretty good at organizing, but not so good at carry-through! Last time I only got about 40% of my to-do list... I need to do a better job this time!

      Sleepwalker - Sounds like your doc is definitely a dud! If you want to do Bendectin/Diclectin, though, you can just do what we do here in the states - make it ourselves with B6 and Unisom. There's a link to the directions on my sidebar, and you can also call up Motherisk to get directions. Do let me know what you find out with your cannabis research. Guess what's going on here in Phoenix? A medical marijuana convention! Hurray! :)

      Okay, you all! Off to Sprouts! Have a great Sabbath!

    7. Busca - where did you buy the water? It looks awesome! :)

    8. I've decided that since cannabis is 98% effective and my research suggests it is safe that's what I'll do, I'll use a vaporiser if I can't keep liquid down and if I can I'll figure out how to make it as a tea. I'll get it from a medical cannabis supplier if possible and if not, grow it or find a decent source. I don't really want to work my way through lots of drugs that haven't been developed for use in pregnancy when there is a medicine that has been used for as far back as we can look.

    9. Wow, what a great resource! I am SO going to have to spend some serious time studying all the links and tips you gave.

      And cannabis - I knew it must be useful for something if God made it and our government forbids it... :) Sleepwalker, would you mind sharing what research you have found on this? There's a guy I keep seeing on Southern Ave. in Tempe with a sandwich board that says you can get a medical marijuana license for $150.

    10. Re-reading for obvious reasons. Tried sea bands and didn't help at all. Can't take Zantak during pregnancy which is a pest as they are only thingwhich helps when Ihave heartburn.

    11. Sorry, meant Zantac. They stop acid being made so are actually influencing cell signalling. Maybe that is why they are not recommended during pregnancy, maybe they could influence other parts of body. There's a generic name too, Rantac. In the UK you can get gaviscon on nhs free but it tends to be aniseed flavour rather than peppermint. I was swigging it from the bottle by the end and it really did very little. Does come in little sachets for travell too. The gloopy texture tended to make me gag though, sometimes decided I'd rather have the heatburn!

    12. Hi – It’s good to read such interesting stuff on the Internet as I have been able to discover here. I agree with much of what is written here and I’ll be coming back to this website again. Thanks again for posting such great reading material!!
      Chiropractor Phoenix AZ

    13. Zantac is the best in the market. I have been using many other anti acid and none of them worked the way it worked for me.

      Chiropractic Mesa AZ


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