New to group.....need advice

[Corrie]

Hi! My name is Corrie and I am new this group. I am about 8/9 weeks along....haven't been keeping track. I have 3 sons ages, 5,3,2. Had bad HG with all.
I have Kaiser for HMO insurance and apparently they have new protocols since my last pregnancy. I tried all types of meds before with prior pregnancies, but nothing helped except the Zofran. With this pregnancy they are refusing to give it to me, in fact I was told yesterday morning, straight out, that it is too expensive and they have to try me on cheaper meds 1st. So she told me I would have to go on Reglan. Which never worked before, infact I felt worse. I am not sure what to do. She wanted to keep me yesterday and start me on IV tx, but I had to get back to my 2 little boys.
Any advice as to how to deal with Kaiser?
Also....I have some expired Zofran.......would it be safe to take that?
I am keeping down some fluids each day.....so I could be doing worse. So I am trying to figure out if I should just hand in there on my own. It is so hard to know what to do.

[rjdecker]

Corrie,

Have you considered vistaril? it is an old drug but it is very effective and safe and much cheaper than zofran. It is an antianxiety and will make you tired for the first little while, but I was able to take care of my little family once I got over the tired part. It also made me hungry, believe it or not. Zofran never worked for me. Also, if you are taking unisom, you don't want to take it with the vistaril because they are the same class of drug and it could overdose you. Same with benadryl.

I haven't had to deal with kaiser, but a lot of the ladies have. Hopefully some can give you some advice there.

Congratulations on your pg and welcome to the boards!

Jenny

[JennyK]

I don't know about Kaiser, but I'm pretty sure there are people here who've had the displeasure of dealing with them. Let's see if we can round them up....

[Corrie]

Jenny,
Is vistaril over the counter? Is it only available in pill form? Pills are impossible for me to keep down. Along with most everything solid.
Wow.....5 babies? You had HG every time? Congratuations on the lastest one. What a cutie!
----Corrie

[teddi]

In '04 I was told by my Kaiser NP that "Zofran was no longer available".

It IS. It's restricted on their formulary and is supposed to be used when other drugs have failed.

They will probably try you on:
Phenergan, Tigan, Compazine, Reglan, Anzemet, and B6 (perhaps in combo w/unisom).

You just need to make the point to you Dr- it is not in your best medical interests to tinker around wasting time and weight trying to find some other cheaper med that will work better IF the Zofran has proven to help you in the past. It might be worth trying the Vistatril - don't know about that one on the formulary.

The most expensive option is to keep you in the hospital. If they don't treat you aggressively, you will surely end up there. Zofran is cheaper than that.

W/my first pregnancy, I suffered along doing mostly Zofran/Reglan, and had IV's in the "infusion" clinic or more often, in the ER, or L&D. That was stupid, to just go from very dehydrated, fill-er-up-send-her-home til the next fill-her-up.

In my 2nd pregnancy (in 04), I was set up quickly w/standing orders in the infusion clinic for IV fluids as needed. Was doing that about 3 x a week for the first month, then, we decided it (after I asked) about getting a PICC line. I did IV fluids (D5LR bags and added vitamins to make "banana bags") at home. They sent me my supplies to my doorstep. That is not normally done, but w/a child at home to care for- getting IN for IV's was not very easy to do. Now, *I* asked for that and I was comfortable doing that. You may not be. If you are dehydrated there are times it's too much even to do your own fluids, etc.

ASK ABOUT HOME HEALTH. I"M SURE THIS IS A SERVICE THEY CAN DO. Perhaps that would be the best option for you- either using a PICC/midline or a NG tube.

Now, there are downsides to a PICC (or a midline). Perhaps you might want to consider about an NG tube if it comes to that. (see preparation for HG folder to learn more about it).

All I can say it, Kaiser isn't going to be PROACTIVE. They will let you be the squeaky wheel, but that is hard to be when you are suffering w/HG and too sick to do much of anything.

PM if you want more info.

[snowmoon]

At least they should be trying with another drug in the same categoty like Anzemet rather than reglan. If they can't stabilize the HG within a week I would pitch a fit and, if necessary, get a new doc who will work with you and not just the insurance company.

[rjdecker]

Corrie,

Vistaril is available as an injection. In fact, that is how I first took it. With this last pg, I was able to start the pills before I got really bad. It helped a lot as I was in a little more control of the situation. Before with the injections, I had to wait for a nurse to come and give me the shot, or try and make it to the docs. But I also waited until I was vomiting so much I couldn't keep anything down. The education here taught me not to do that and so I was able to stay on top a lot easier, because I knew more. I imagine that if I had known more with the injections, I probably would have had them more often. I had them about twice a week, and looking back, I probably needed them about every other day. When I was in the hospital and dehydrated, I was getting them every four hours.

Jenny