getting ready to do it again - questions

[JennyK]

My HG baby was born in January 2004 after zofran, PICC lines, TPN, many hospitalizations, etc. I'm getting ready to TTC in December or January and have some questions.

1. Another HGer advised me to take Unisom/B6 for several months BEFORE TTC, but I couldn't find anything about it on the web site. What's the story?

2. This is subjective, but how sick do you think is too sick to go to work/to be place on disability? Last time I was in the hospital or bedridden for the first tri. After that I worked as much as I could but ran myself into the ground. I think that's why I was in the hospital so much. I am going to my OB on Friday to talk to him about this, but I'm wondering what the threshold is to be put on disability. I'm in the process of getting disability insurance (to pay a portion of my wages) and hospital insurance (pays a fixed amount for every day in the hospital).

3. What do you think are the signs that you need to go in for fluids? I had a hard time with this before and usually waited too long. Not peeing? Not keeping fluids down for a certain amout of time (how long?)? Ketostix turning the darkest color? Or a lighter color? Something else? My doctor wouldn't give me any objective standard last time, but I really needed one.

4. Are there any new protocols or treatments in the last couple of years? My doctor was right on top of it last time, but he said I take the cake for being the worst HGer he's treated (although I know some of you have it even worse!), so I don't want to miss an opportunity to further educate him on hyperemesis.

5. Any other planning I should do or advice you can share?

Thanks for the help. I can't believe I'm gearing up to do this again!

[bibliojo]

Hi Jenny!

Welcome! Glad you found us!

In answer to your questions:

1. I've never heard of taking unisom and B6 before you get pregnant. The standard advice around here is to take 50 - 100 mg of only B6 in the months before you start to ttc. The idea is that HG could be made worse by a B6 deficiency so if you take it beforehand it will hopefully eliminate that deficiency. Once you are pregnant, you can start the unisom and B6 combo. There are recent studies showing that taking the B6 and unisom at the first signs of nausea (and then adding other meds as needed to it) can prevent the HG from getting as bad.

2. Hmmm...how sick is too sick to work? Well, this can be very relative! Every doctor seems to have a different opinion. In my case, my doctor signed me off as soon as she saw how sick I was. Not all women are that lucky though. What I would suggest is talk to your doctor beforehand about this. Explain to him that you were worse off because of having to work and the stress that went along with it. Emphasize that you now have a child to care for this time round on top of everything else.

3. Dehydration - again this is another thing to talk to your doctor beforehand about. Some doctors say if you haven't kept anything down for 48 hours come in for fluids. Others say 24 hours. It really depends. But if you are vomitting everything up, hardly peeing, and your pee is a dark yellow I'd say it's time to get some fluids.

4. I'm afraid there isn't a whole lot new in terms of treatment of HG in the past year or two. What meds did you take with your dd? It may be worth checking out the medications experiences folder just to see if there are other options for you. There's also a list of all the medications used to treat HG under the HER site. I'll find the link for you and post it.

5. Other prep - well, this next time you are going to have a toddler to take care of as well as deal with the HG. You're going to have to have some plan in place on ways to entertain her while you are sick or line up help from family and friends in this regard. I would suggest that you go through some of the protocols posted in this folder. There are some really good ideas on what to do with your child while you are sick.

And finally, do you have a good doctor? One that is agressive and pro-active with treatment? That takes you seriously? That in my opinion is one of the most important things!!

Best wishes to you as you plan - I know how scary it can be as you start seriously planning to do this all over again! Prepare the best you can and you will get through it once again. Looking forward to gettting to know you better!

Joanna

[bibliojo]

Here's the link to the list of HG treatments: http://www.helpher.org/mothers/treatments/index.php

Hope this helps,
Joanna

[JennyK]

Joanna,

Thanks for your reply and advice! With my first pregnancy they started with the more basic remedies that work for most people (i.e. compazine and small meals) and we quickly progressed up to zofran and TPN. I tried about half the drugs on the web page. At one point I printed it out and took it to my doctor and said, "nothing has worked so far--pick something new from this list." The only thing he wasn't willing to try--and I'm not sure I was comfortable with it either--was steroids. Unisom/B6 didn't make a difference, but I may have been too far gone by the time I tried it. Off the top of my head, I also tried reglan, mirtazapine, thorazine, ambien, meclizine and phenergan.

The only things that helped were zofran, which reduced the vomiting but didn't control the nausea, and TPN/IV fluids. I improved quite a bit somewhere around 14 weeks, but stayed sick until the end. For the second and third tri's I was in the hospital about twice a month and on drugs right up until I was induced at 38 weeks.

Last time I had a PICC but I've been reading posts about PICC vs. NG tube. Even though there are a lot of advantages to the NG tube, I'm not sure I can overcome the concept of it!

My doctor was very aggressive last time and I am so thankful for the good care he gave me. He did not hesitate to put me on zofran and TPN once he saw the usual treatments weren't touching it. My main worry is that he won't sign off on disability because last time he never even suggested I cut back from work or take a leave of absence. I ran myself into the ground trying to work because I couldn't afford not to. I just can't do that again, especially with a toddler.

What is the deal with detox? What does it entail and does it make much of a difference? I drink very little caffiene and eat fairly healthy. Is there something more I could do that might help?

Thanks again for your advice, Joanna. Good luck with TTC!!

[ischa]

Hi, I am now 11 weeks pregnant and I did a bunch of stuff in prep for HG. I have had 3 HG pregnancies and I am thrilled to say this one is not an HG pregnancy at all. In fact I think it is just mild morning sickness with nauseau and unfortunately the excess saliva problem.

There is a thread in this folder under detox plans so below I copied my message from there. I feel almost like a radical about this but I also struggle with not wanting to be too pushy and offer false hope.

These steps have worked for me which is the exact opposite of what you would expect as in all the other pregnancies my HG became substantially worse each time.

When deciding to ttc I started by seeing an acupuncturist. He diagnosed me with a liver/spleen defeciency and did about 6 treatments. When I found out I was pregnant I stepped up my detox by eating fat free/ natural for the first 3 weeks and also started seeing the acupuncturist weekly. I then slowly began adding some fats but definatley I would suggest staying away from any sort of red meat. It seems to over tax the liver.

I also started taking Zofran once a day at week 7. I felt the nauseau coming on and I didn't want to give it a chance to take hold. I started adding unisom at night at week 9. Week 9 was a bummer because of all times, I got the stomach flu. I vomited 3x in the span of an hour and I totally came unglued. I thought it was HG hitting. Fortunately it was the flu and this has been the only time I have thrown up. That is a miracle as last time it was continuous!

At week 10 I added pepcid to the regime because I was experiencing heart burn. As I said it was no where near like before but I think I am so afraid of HG starting that I immediately act on the tiniest of things.

I am now at 11 weeks and doing well. I am still taking the Zofran but considering stopping at around week 13. I am still seeing the acupuncturist but believe I will also stop this at week 12.

I hope the stuff below will be of some help. Please feel free to pm me with any questions. I would love to see us be able to come up with a way to save others from this.


copied from detox thread

I have been following a liver detox plan and have been seeing and acupuncturist for about 7 months now.

Here is what I have done so far. I started taking Milk Thistle and Dandelion Root, B6, calcium with mag, and zinc, Vit K. I also have been taking and Essiac Tea, the brand name is Ojibwa Tea of life. It is supposed to be one of the best liver detox plans. I think this has been a huge help as since I have taken it (started last summer) I have been extremely healthy. No winter colds... You can find it online under Ojibwa tea of life.


When I started the tea I also did an extremely strict detox diet for one month. I planned to do it longer but one night I got out of control and drank a Coke and then fell completely off the wagon. However, for a month I ate absolutle nothing that wasn't completely natural. I also ate no white sugar and no fat. For the first 8 days I was miserable then it became much easier (until the Coke, followed by the chips, followed by the BK cheeseburger.) Since I found out I was pregnant I am again limiting my fats.

[bratty477]

Hi Jenny,

I think you should just outright ask for a note when you feel that you need to be taken out. When I was sick as a dog, I had to ask my doctor for a note because work was requiring it - - especially since I missed 5 days in a row (standard policy).

I don't see how anyone could work while having HG!! I remember sitting in my office and throwing up into the trashcan 15 times before noon! The bathroom was not close enough for me to have made it so I used my trashcan and changed out the bag each time. The night crew just about passed out!

Last time, my gasteroenterologist told me that the best defense is offense and advised me to take everything early...before it hits and that is how I was able to manage during my final trimester. I am currently ttc and am taking 100mg of B6 and prenatals. I am planning on taking Unisom and zofran as soon as find out I'm pregnant!

Thanks Joanna for the wealth of info! I feel a lot better about going through this a second time especially having discovered this forum!! I wish I had found this forum the first time around!!!

[bibliojo]

Thanks, Ischa, for summarizing your experience so far with detox! I never did look into it much as my doctor poo-poo the idea but now I'm wishing I had but really can't now since I am ttc already and don't want to put it off any longer.

Welcome, bratty477! Glad to have another "ttc"er around here to go through those monthly highs and lows with!

Joanna

[Kadinga]

Ischa, I am SO GLAD to hear about how much better you are doing!

Jenny, on the work topic.... I think there are a lot of factors to consider and it's well worth weighing it up before the HG fairy starts playing with our perspectives.

Here's a fistful of questions for you.

These are the ones where I feel a "yes" makes working a bad idea.
Is your job in any way physical? Do you need to be on your feet? Do you need to move around a lot? Does it involve times when you really can't shut down for half an hour if you have to? Are you supposed to be being responsible for anyone else while you're there? Are you required to think creatively? Are you required to "think on your toes"? Is there any pressure from co-workers to maintain their idea of standards? When you take sick days does that raise the pressure on colleagues and therefore the pressure/guilt for you?

There's a lot of grey area left in the middle, particularly with regard to how you are going to cater for your toddler's needs while you're sick, but now these are the questions where a "yes" might make working an okay idea.
Are you someone who benefits from the social contact that comes from working? Does the money outweigh the time to concentrate on your own health?

For what it's worth, I tried really hard to hang on to working thinking that I was hanging on to self-respect and the respect of my colleagues. When I heard how hard those colleagues were finding it trying to work around my erratic absences I rang in (from hospital) to tell them that I was going to use up all of my accumulated sick leave, etc. When I hung up that phone, knowing that I was no longer under any pressure to be anywhere else for anyone else's benefit, I was able to actually relax and give myself a chance to focus on just getting through the next hour. I hesitate to say that I felt "better", but there was an improvement in that moment.

I think stress and exhaustion can only make things worse.

Good luck with your prep

Amanda

[JennyK]

Ischa, Bratty, Kadinga, Joanna --

I have my annual exam with my OB on Friday, so I plan to discuss all these issues with him then.

As for my job, I spend most of my time sitting at my desk, so it's not like I have to be on my feet all day. Last time reading made me horribly nauseous, so I puked in my garbage can or darted to the bathroom frequently. I needed the income and benefits, didn't qualify for FMLA, and was too self-conscious about people thinking I was a wimp. I still need the income and benefits, still don't qualify for FMLA, but I'm going to work on not being so self-conscious this time.

During my last pregnancy my job was one where I could come and go without causing much trouble for my boss and co-workers. In my current job that would be a big problem. Lots of deadlines and people depending on me to meet them. So maybe I'm better off just checking out for a while.

As I think I mentioned, I am applying for AFLAC policies. I've talked to other HGers who've used AFLAC and they paid out just like they're supposed to. The agent just left me a message saying that as long as I'm earning less than 80% of my base pay due to disability I qualify for 100% of the benefit (which is about 2/3 of my net pay). That might be perfect...I expect to be totally out of work for the first tri, but if I feel well enough to work 1/2 or 3/4 time on a regular basis in the second and third tri's, I can afford to do that!

Another thing I'm worried about that maybe some of you can give me tips on, is taking care of Annie, who will be around 24 months when I get pg if all goes as planned. Based on her need for supervision and attention at 17 months, I don't see how I can possibily take care of her when I'm sick. Does it get easier between 17 and 24 months??? (I doubt it.) My husband works 4 pm - 1 am, so she will be my sole responsibility for those hours. I know family and friends will help, but they can only do so much. I wish my mom could move in with me during those first few months!

I'm curious what my doctor will say about disability and detox--I'll let you know after my appointment! Good luck to everyone who is TTC! How long have you been trying?

[bratty477]

I agree that stress and exhaustion only makes HG worse. I'm in a job where I don't have to be on my feet or be physical; however, I was throwing up enough to a point where I couldn't "function" in my capacity. The nausea got so bad that I couldn't even sit up.

I don't know how many times I threw up into my trashcan in my office in the middle of a conference call or had to run to the nearest trashcan in a meeting full of people simply because the frequency of vomiting reached 30 times a day (when awake!).

I almost got into an accident on my way home from work on the freeway several times when I all of a sudden started violently vomiting and couldn't pull off fast enough. At that point, I knew I needed to be home.

As hard as it was to watch the day pass at home by myself, it was still a lot better than trying to go to work. It's one thing if I'm able to still manage a schedule but HG was dictating my schedule. It was also not fair to subject people to witness my moments of hell.

Next go around, I'm not going to hesitate with going on leave if I feel that it's getting bad.

Thanks, Joanna for the welcome...I'm thrilled about this forum and feel so much more empowered knowing that I have you guys to share the upcoming highs and lows with!!!

[bratty477]

I have an 11 month old daughter and I share the same concerns with getting pregnant. What I did do was buy a big indoor play yard pen so that if my nausea and vomiting gets too bad, I know that she is contained in a safe, enclosed area until I can get over my "moment". The pen is big enough so that I can lay inside it with her (since she insists on being attached to my hip ).

The pen is HUGE! I put her little play couch (it pulls out into a sleeper) so that I can even nap her in there if necessary. That will minimize my needing to lift or take her from one room to another.

I also have friends who are referring college students (majoring in child development and needing money) for hire to help during times when my husband or family can't. I also find that church groups have plenty of wonderful older women and others who are at home/retired and willing to help out during those difficult times.

If you can even find a buddy (if one is nearby), perhaps they can be of some help too and you can return the favor once/if that buddy gets pregnant! Wouldn't that be great!!!??

We've literally started trying last week!

[acorn26]

Hi, there.
I'm Amy, and also have an 11 month old daughter. I want to have another baby, and am thinking seriously of ttc.

However, I was completely OUT of commission with HG. I could not sit up, see lights, talk to anyone, move even my arm (it would cause extreme waves of nausea), watch TV (the flashing lights made me so very dizzy), etc.

I had to be carried to the car for doc appts, and cried in the car the whole way due to extreme dizzyness.

I did acupuncture for one year before ttc, on a weekly basis. I also sought a chinese fertility specialist who concocted raw herbs that I cooked up (took two hours each night to prepare properly--what a pain!).

Anyway, on the one hand, I have no idea how I am going to do this next pregnancy, especially with a toddler.

Until month 6.5, I was totally incapacited, and only got a bit better around month 7 but was still SO nauseous until the end. At least the dizzyness let up in month 6 and I could stand up for short periods again (walk myself to the bathroom without help).


Hearing that your 3rd pregnancy was completely devoid of HG gave me a glimmer of hope, but it's also dangerous for me to rely on that too much because with severe HG you just have to plan for the worst case scenario.

Braty4, when was your due date with your daughter? My daughter was born on 7-10-04 of last year.


Amy

I still had horrible HG. Th

[bratty477]

Hi Amy, my daughter was born on August 5th.

[bibliojo]

I'm struggling with how to cope with work and HG too...I'm currently applying for a new job which I'll most likely get. We've decided not to delay ttc for it. So I know this is going to be an added stress when I do get pregnant. I'm going to feel awful for having to take time off and leave my co-workers in the lurch but at the same time I simply cannot work and have HG. It's not possible physically for me. I couldn't drive nor could I take transit so I couldn't get to work, but if I could by chance get there, I would be on my feet all day with no bathroom nearby - not even a private corner to puke! I think they would probably beg me to stay home just because I would be of no help to them and it would be so gross to listen to me being sick all the time! The thing to remember is that you have HG and we are not like normal pregnant women in that respect. We don't have normal m/s that we can work through. We are incapticitated! And our employers need to understand that. But most of all, we need to accept that ourselves and not try to be like a normal pregnant woman. Trying to be a normal pregnant woman with all the usual commitments only puts added stress on us which makes the HG even worse. So if you can't work because you are sick, you're not a wimp! You're just having to deal with a lot more than most pregnant women have to deal with.

Jenny, I hope you dr appt goes well! Let us know how it goes!

Joanna

[Kadinga]

Jenny,

I’m glad to hear you’re going to work on that self-conciousness! Especially if you think you’re going to be under pressure when you’re at work.

My DD is now 21 months, and yes, definitely easier. If she knows I’m watching she’s happy to play in the backyard, and can manage our slide without any help now. I’m thinking I’ll take a chair out to the swing, though . Also, she’s now hit a stage where her friends’ mothers love having her to play because then both kids really occupy each other and both of us get a break. The only other thing I’ve really figured out for when we’re home alone and I’m putting on a display is to take after a friend of mine who has done this 4 times and who taught her older kids that “The Chunder Bunny always feels better when she gets a hugâ€ÂÂ

[JennyK]

Bratty,

The pen sounds like a wonderful solution. Do you have a link to a picture of it or place that sells it? I wonder at what age most kids can climb out of it. Great idea!

[PamelaRose]

Hooray, Jenny! It sounds like you're really going for it. I'm so happy for you. Well, for starters, you could bring Annie to me and I'll spoil her for a few months. Love those little cheeks!

These ladies are awesome, and it looks like you'll be in good company when you go through it again. Liver detox and homeopathy are two things I would definitely do before ttc were I ever to go through it again. As I recall, didn't you pull the PICC--infection? Maybe keeping it in to the end would help. Plus, you had that setback at the beginning when they did TPN with no fluids, right? It's been awhile, but those are things that, if I'm remembering correctly, could make a difference next time. Plus, you know which meds you reacted to and which worked, so you've already weeded through some of that mess. If you were able to slug through at work with your last pregnancy, you'll probably be able to do roughly the same again. Will you want to, with Annie around to further sap what little excess energy you have? I don't know. I do know that you have awesome family support, so that will definitely help. It sounds like your employer will be good to work with this time around, so I guess the best you can do it play it by ear and see how another HG turns out.

[JennyK]

Hi Pamela! (For the benefit of other readers, Pamela helped me every step of the way through my last pregnancy, for which I am forever indebted to her!)

I really am going to do it again--after the way I talked when I first met you, can you believe it? I wish I really could send Annie to you for a few weeks! Or better yet, you and your family could come take care of her. You've been meaning to take a vacation to Montana, right?? We thinking of TTC in December--if we are successful right away I would incur all my medical bills in one calendar year, which would make it a lot cheaper.

I'm not sure how I'll go about it, but I am not going to be shy about asking my friends--in advance of getting pregnant--to help with cooking, cleaning, errands and babysitting. It takes a village. At least in the case it will. I keep telling my mom she should retire so she can help me full time (not gonna happen). Instead, she threatens to leave the country because she can't stand to see me sick again.

I can't believe how big Reilly is!!! For some reason the size of Brody and Avery matches my expectation, but Reilly is such a big girl now! Are you enjoying your summer so far?

[PamelaRose]

Yeah, Reilly thinks she is quite the big girl. Big attitude and big mouth, usually. But she is not a baby anymore, that's for sure. It really goes fast once they approach the 2-year mark. Lucky for you, you'll have another one on the way when Annie's at that magical point! I am really excited for you. And I KNOW your mom is, too. I recall her saying she'd stand on her head, naked, on a busy streetcorner if it would help you... LOL I think it's a pretty safe bet she won't skip the country. And now that you've all got time to plot and plan, I'm sure you'll come up with a solution that will get everyone safely and sanely through another HG. Let me know if there's anything you need! I'm still hoping we'll be able to make it out there later in August, but nothing's ever a guarantee around this place!

[bratty477]

Hi Jenny,

I sent you an email with the name of the playpen and the link. Hope the link works for you!