Preparing for Repeat HG

Discuss ways to prepare yourself, your family, and your protocol for HG.

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Preparing for Repeat HG

Postby PamelaRose » May 30, 2004 11:28 am

Repeating HG is one of the most difficult challenges you'll face. Very few things can match the feeling of dread that accompanies the decision to try for another child. But many of us have come through many times, so it's absolutely possible!

For me, the most important thing was admitting that I would be sick again. You can waste a lot of precious time and energy trying to convince yourself it's not going to happen again! Preparation falls into a couple categories: medical and personal. Find a good doctor who understands HG and is willing to try new treatments. Actually meet with the doctor and ask some questions, share your history, get to feel comfortable. Draw up a protocol list--a rated progression of what you'll try first, second, so forth. Also have in mind WHEN you'll take the next step in your protocol. Most women start with Unisom/B6, then up to Zofran as nausea increases, then to the next step with vomiting. Just knowing you have more possibilities, more steps to take makes coping easier--you know you're not really at the end of the rope! The second component of preparation is personal. I'd list everything I did all day, every day, and then figure out how those things would get done (or if they needed to) while I was too sick. Working through this before, while I still had energy to think straight, helped tremendously and cut the stress level. Don't be afraid to ask for help--people always said, "If you need anything...", but I was too proud (or sick) to bother asking. Instead, I found it easier when I called right away with a specific task: "Would you be able to help by coming once a week to clean up the kitchen?" Those kinds of pre-prep go a long way when you're in the midst of it.

Other people will have much better ideas--I never got too far on planning before I got surprised with another pregnancy! Good luck to you.
Pamela

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Postby Milli » May 30, 2004 4:19 pm

OK as Andy said I got extremely lucky in that I prepared for the worst and then managed to escape without HG. I'm not saying this will happen for anyone else, though I pray that it will.

Medical preparation: I met with my new midwife (we've moved since I had my son) and gave her my history and asked about her treatment of HG. I was glad to find that she was very aggressive and believed in stronger drugs earlier than my last OB. She also firmly believed that since I'd been there before then I would be the one who said what I needed when. I really liked that about her.
Protocol was: begin taking B6 supplements (50mg a day) 3 months before TTC
When pg, up B6 supplement to 100 mg a day and add unisom at the first hint of nausea. Don't be a hero and try to tough it out!
When B6 and unisom don't do it, add reliefband (shock bracelet).
After that, add Zofran tablets.
If Zofran tablets come back up, add dissolvables.
IV hydration as needed.
NG tube for hydration, food, and med delivery if it comes to that.
Picc line if it gets that far, change all meds to IV.
Steroid treatment after 11 weeks in addition to zofran and unisom.
Home health nursing must be available.
Don't pester me with the wimpy drugs.

Personal: Planned to ttc so my first trimester would be during the late spring/summer months when DH is not in school. This would have been a bust though because we ended up coming to the coast for DH's research. It was the idea though.
Set up bed in playroom so I could lie down and be in the same area as my 2 year old. DH would fix all meals in advance so all I would have to do is hand them to him.
If needed send him to daycare, hire a nanny, or have my sister or MIL come live in our house to help care for me and son.
Dh would take on the bulk of chores. I might manage to get clothes into the washer, but don't even expect that.
I would sleep in the front room since it was farthest from the kitchen.
Yuk buckets placed in strategic locations throughout house.
If this pg was HG, no more children unless we adopt.

Prep for myself:
A lot of soul searching to see if I was really ready to handle the mind job.
1st trimester MUST be in a sunny time of year as I have SAD and depression just adds to the mess.
Saturated Fat intake has been linked to HG in research, so I cut out all fried foods and most fast food.
I lost 15 lbs, (I am overweight and estrogen is stored in fat cells.)
With my first pg I worked full time at night at a high stress job. I decided after having my son to become a stay at home mom.
I warned my friends what was coming and they assured me that I would not be forgotten, they would come to me and help me through.

That's all that I can think of for now. I hope this helps someone else prepare!
Milli
Rowan 5/12/02 - HG pregnancy
"Charlie" edd 12/15 - normal pregnancy
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Zofran dissolvables?

Postby Rachael » May 30, 2004 5:05 pm

I've noticed a lot of mention of zofran dissolvables. Are these obtained from the same pharmacy that I'd get my zofran pills? How do they taste? I threw up a lot of expensive pills last time, so if I could stomach the taste, they just might be a life saver next pg!

Also, does anyone know how I can get dissolvable B6? Do I have to order it online?

Thanks, just trying to prepare for next time!!
Rachael
sahm to Gabriel Ryan 4/14/03
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Postby Milli » May 30, 2004 6:18 pm

I don't know about the b6, but I really don't like the taste of the zofran dissolvables. They taste kind of like sour baby aspirin to me. It's really hard to keep them down, but since you put them under your tongue the medicine gets in your bloodstream right away so you get some even if you vomit. Not much comfort there huh.
When I had to take one I would be by myself, grit my teeth, not move and hold on trying to keep it down. The good thing is it kicks in relatively quickly and if I could hold on for 15 minutes I was good to go.
hth,
Milli
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"Charlie" edd 12/15 - normal pregnancy
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Postby Rachael » May 31, 2004 12:08 pm

Thank you. I'll keep that in mind. I just hope it doesn't get bad enough to where I can't keep a regular pill down. Yeah right, wishful thinking, huh?!
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Postby yellowm3 » Jun 01, 2004 2:09 pm

I didn't really care for the taste of the dissolving Zofran. Everytime I'd take one I'd think they would've been better off just leaving them as they were than to add this fruity flavor trying to make it taste "good."

After weeks of the regular Zofran and then the dissolving tablet my doctor finally decided neither was really working well because of my metabolism. I'd take a tablet and be ok for a couple of hours but then I'd throw up until I could take another one. My insurance would only pay for 4 tablets a day so my doctor decided the Zofran pump was the better option for me considering they'll pay for ANY amount of medication aministered that way. Weird but ok they're insurance companies, right?

Anyway, I'm 33wks now and have been on the pump since mid-February. We've tried weaning a few times but haven't been able to get me there. I'm just preparing myself mentally that the HG will last until I deliver.
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Postby RebeccaM » Jun 01, 2004 2:52 pm

The Zofran ODT was a godsend for me. Since I couldn't even keep water down, the other pills weren't doing me much good. I would just puke them up after a few minutes. With the ODT, even if I puked a few minutes after taking them, they still worked (it usually took about 15 minutes for them to kick in).

The taste didn't bother me much. I just put them under my tongue and I could barley taste it, and there's always the option of plugging your nose :)

The one downside: you can't really break them in half, so if your getting 8 mg tablets and breaking them to take 4 mg at a time, you can't do that anymore. You would have to just get the 4 mg tablets.

I think it's definitely a wise idea to check into what your insurance will allow or pay for. We just had to change insurance and we had three options. I called all of them to find out how much Zofran would cost me. One plan didn't even offer the ODT tablets so that was out of the question.

Hope some of that helps.
Rebecca
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Mom to:
Tierra Ashlee 9/15/03
Eli Spencer 7/16/05
Haylee Belle 3/4/09
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Postby babykismet » Jun 01, 2004 2:58 pm

yellowm3~ I would love to hear what you think about the zofran pump. What are the pros and cons of it as you see it?
Thanks for your help with this. I just posted my protocol and the pump is something my doc wants to try as soon as the nausea gets overwhelming due to how bad the HG was with my first pregnancy.
33weeks, huh! The end is so close now!! I'm sure it doesn't feel like it though.
Hugs,
~Diana
1 HG pregnancy, 1 m/c at 13 weeks with mild HG
Mommy to Katie ~ 7-01
Preparing to try to conceive again
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Postby PamelaRose » Jun 01, 2004 7:07 pm

Just check with your insurance to make sure they won't have a problem with the Zofran pump. My insurance co. would have demanded a Reglan pump be tried before Zofran due to cost. The insurance co. nurse cheerfully explained to me that a day's worth of Zofran pump costs more than a day in the hospital--surprise, surprise. I'm sure the doctor can override that, but still--big headache when you're sick and needing treatment.
Pamela

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*Brody (8-11-98 )
*Avery (1-24-01)
*Reilly (12-16-02)
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Re: Zofran dissolvables?

Postby theannex » Jun 02, 2004 12:02 am

Rachael wrote:I've noticed a lot of mention of zofran dissolvables. Are these obtained from the same pharmacy that I'd get my zofran pills? How do they taste? I threw up a lot of expensive pills last time, so if I could stomach the taste, they just might be a life saver next pg!


Another, lesser known, option is Zofran elixir/liquid. My OB decided to prescribe that for me (to be honest, I don't think she knew the dissolvables existed) since I was unable to keep any pills down. It has a very mild flavor, strawberry-like. It didn't work that great for me during the worst of my HG (not because the taste made me throw up, I just don't think my stomach really did a good job of absorbing even liquid at that point.) Once I was past 18 weeks or so, though, I was able to switch from IV Zofran to the elixir with no problem. We had to call around to many pharmacies before finding any that stocked it initially.

Just throwing this out there for anyone who might want to include it in a possible protocol...

Patricia
HG Survivor, mom to 14 month-old Lily
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Postby Ivydragon » Jun 13, 2004 1:13 am

Sublingual B6 is bitter - mind you it kicks in nearly immediately, and it is really helpful for that pick me up, and I've heard the peppermint is much better than the orange. Ok, so "normal" non pg, non HG people couldn't taste the bitterness of the sublingual B6, but I could, and it was certainly a "sleep through it, waking only to move the stupid pill to a new spot under my tongue clenching my teeth and clamping down my tongue to try in vain to avoid that bitter taste few moments".

Injected B6 is great - stings like hell, but very effective - I'd rather suck on sublingual B6, but didn't know about them until I'd done the shots for 1 month in my 1st pg, and nearly 2 in my 2nd. Depends on how effective you need things to be, really.

Start oral w/ time for it to kick in - before ttc.

Andy
Mom to Aaron 14 (HG), Anna 11 (HG), Adam 8 (adopted), Andrew 8 (adopted), fostering a newborn . . .
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zofran is my best friend

Postby joannajoachim » Jul 02, 2004 12:23 am

i had hg until the day after my daughter was delivered. i used the 8mg odt for the first 12 weeks or so until a mix up at the pharmacy (they don't keep zofran in stock and had to order it) and they gave me the 10mg pills. they seemed to work better and of course didn't have the terrible taste of the dissolvables that made my nausea worse.
wondering...anyone have a second pregnancy? did hg exisit with it? considering second now, but worried.
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Postby Ivydragon » Jul 02, 2004 12:53 am

joannajoachim, Yes, most HGers have had two pgs. Some even go on to three, or four, or five, or six, or seven! Ok, the average is probably 2.something, and the ones that keep going should live on pedastals or something around here, because they are amazing women. :)

HG is known to recure. Most subsequent HG pgs progressively are a bit more severe - who knows if it's the tiredness or stress or guilt because you already have one child (or are mourning loss), but HG tends to take more drugs to control, more hydration, more attention in subsequent pgs.

But, all is NOT LOST! Through research, HGer support, knowledge, good Drs., progressive treatment, preparation and family and friend support ~ HG pgs are something that become endurable, more-tolerable, repeatable for most ~ I'm not saying that every woman should repeat HG, because there are some whom would scare me to death if they were pg again. HG tends to follow the same path as last time, and you know drugs that will or will not work again for you. It's an intensely personal decision, and no one else can make it but you, we have all had to decide here, and there are examples of every ending to the decision possible.

My HG was worse my 2nd time. I, too, was told that it wouldn't be as bad, I couldn't possibly be that sick again (and my 1st HG was mild). Most HGers are, but time and again, that's not actually what happens. Mine was bad enough that I'm not willing to do it again ~ but I am the biggest needle weenie I know, and there's just no way I could ever mentally survive what many women have here to endure their pgs, so I did the right thing for me and said, "no more babies outta me!" (And no PICC line for me ever - Yeah!)

We'll do what we can to help you learn what your options could be, find you a good Dr., and allow you to make an educated choice on whether or not you have it in you to fight HG again.

Huge hugs, Andy - I, too, loved Zofran. :)
Mom to Aaron 14 (HG), Anna 11 (HG), Adam 8 (adopted), Andrew 8 (adopted), fostering a newborn . . .
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Postby J&Jmom » Sep 21, 2004 10:15 am

Hi,

I'm new to this, and feel so lucky that I found this site.

I just got pregnant for the 3rd time. I'm lucky to have 2 beautiful girls, ages 3 1/2 and 6. I didn't want to wait so long to have another child, but after having HG the full 9 months w/my first 2 pregnancies, I've been procrastinating.

Now that I'm 5 wks pregnant, I'm starting to panic b/c I'm sure my HG will start again. As a military spouse, I'm lucky to have great insurance. I've already talked to my doctor about getting a prescription for Zophran, which I hadn't heard about before. In the past I was given phenergen, but all it did was make me sleep. The only thing that stopped my vomiting, at least temporarily, was getting an IV. Wouldn't Unisom just make me sleep too?

Other than "suffering through it" as I've done in the past, please let me know any other pieces of advice you have for preparing for HG.

Thank you,

Danielle
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Postby MamaLily » Sep 21, 2004 3:00 pm

Danielle -

Hi! I'm so glad that you have found this wonderful place for HG sufferers/survivors. You are brave to do this again...it's not an easy decision!

I wanted to write and encourage you to visit the "1st Trimester" area of this forum. There are women there who are in your same position, or who have recently been there, and I know you will find lots of great advice and support from them.

There is a very informative 'Sticky' post in the 1st Trimester area that discusses your medication options - Zofran, Unisom/B6, etc. I recommend reading it for some ideas on how to get a handle on HG. It's probably best to start something NOW - before you feel sick. Unisom/B6 could help delay HG or help lesson your symptoms. And I think you ought to start Zofran right when you feel nauseated - even before you vomit.

Anyway, welcome to the boards here. Please post about yourself in the "1st Trimester" folder - and in the "New to the Forums" area as well. There are so many women here with great experiences, ideas, and knowledge. You have all of our support...

- Anna
"The little reed, bending to the force of the wind, soon stood upright again when the storm had passed over." - Aesop
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