The medications are the things that will actually stop/prevent/ and/or help the nausea and vomiting. It doesn't really matter how many home IV's you have, or a PICC or NG tube. Those things CAN be a delivery vehicle for the medications and food and fluids, but they are treatments for the SYMPTOMS and side effects OF the HG and do not really treat the root cause itself.
I had infusion clinic orders (i.e. the same thing as a home health nurse coming out to administer IVs three days a week, except I went to the clinic Mon/Wed/Fri and did 2 liters for hydration and IV meds) and did that for a month. I then had a PICC line in for 6 months, the rest of my entire pregnancy (the PICC line came out post partum). I still had HG the entire time.
For sure, being dehydrated makes vomiting and nausea worse and it can help keep the cycle from spiraling downward, but you can still be quite sick and just as nauseated and still vomit a lot even if you are hydrated.
NG tubes aren't really very useful, if the food goes to your stomach, it can still be vomited back up, so in HG women it's mostly NJ tubes that are used that go further past the stomach to the jejunum where the contents can't come back up. NJ tubes, I think, in the women who have used them on the boards are only tolerated about probably 50% of the time. The insertion can be a quite an ordeal and sometimes needs to be done under sedation. The tube itself it relatively safe, but there can be complications but many women can't tolerate it because it hurts/irritates the throat and can trigger the gag reflex incessantly.
PICC lines are not an easy answer. Back when I had mine, I thought it was great. It still was a good option since I was never able to maintain my own hydration for more than a week and needed the veinous access. However, having been around the boards for the past 7 years, I now don't recommend them at a first course of action. They DO get infected. And that means sepsis- and that can mean a very very very sick mom and baby. It can mean a dead mom or baby is the symptoms are missed for a long enough time.
I have found my circumstance was an exception far more than the rule- to have a single PICC line in for so long. And I did have complications. The line clogged twice, and I also ended up with an air embolism due to user error (also potentially life threatening).
My point in all this- is that those invasive treatments come with risks that always have to be weighed with the benefits. And none of those things actually cure or treat the underlying HG. If those things can be avoided, you want to avoid them (well except for home or in clinic IV's- those are pretty safe and you DO want fluids of course when they are needed).
Medications and finding the best combo that works for you is key. Preemptive treatment is also key- it may not stop the HG, but I just spent a month doing preemptive treatment (Zofran) and it was amazing to me how well the Zofran DID work for mild nausea (compared to how little it did once the HG was in full force in my previous pregnancies).
You need to find an OB ahead of time, and you need to know and find out ahead of time what you hope and expect and what a Dr is willing to try. Some OBs *will not* do PICC lines. Some OBs (probably not many) may also not be willing to do preemptive meds w/out reviewing your medical records too, so you want to make sure you and the Dr are on the same page.
And ER will not order a or place a PICC line. Or Home health or an NJ tube. That would be ordered only if you are under the care of a regular and ongoing physician or for the short term if you were hospitalized. Those types of things need ongoing orders- for instance a PICC line has to have a dressing change weekly and it has to be inspected by a nurse or Dr for signs of infection/etc- there are medical supplies that go along with those that can only be ordered by a Dr.
You didn't mention all the medications you used before, but many women do combinations of various medications. Sometimes mixing anti-emetics works much better than taking one by itself. You also probably did not try steroid therapy, which is definitely worth trying (and works great for some women too).
With my twins pregnancy, I unfortunately wasn't given access to Zofran before I was dealing with full blown HG, BUT I did take a couple other meds and even that helped delay the onset/downward spiral into HG by about 10 days. So it's really always worth to go the preventative route first.
Bert , 3/2000 HG#1, wk 6 - birth, GB removed @ 16wks
Chloe & Kaylie, 12/2004 HG #2, wk 7 - birth, pre-E/pancreatitis
~Angel babe~ March 2012