Members Protocols

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

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Members Protocols

Postby teddi » Mar 13, 2006 9:30 pm

Basically a protocol is a "game plan" for HG. They can include pre-HG prepping activities, treatment timelines, medication options, hydration and nutrition options, food and drink ideas, home and child care solutions, and anything else you feel you want to add.

(To clarify- I just copied and pasted word for word)


In the subject line is will say WHO's protocol it is, and their USERNAME.
Hope that will help avoid confusion.
Last edited by teddi on Jan 31, 2008 11:17 am, edited 2 times in total.
Teddi
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
~ Baby Chuckles~ July 2013
teddi
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Robin's protocol- USERNAME: rdevine10

Postby teddi » Mar 13, 2006 9:31 pm

Well, here it is, my new and improved protocol!!! Please add any imput you feel is helpful, as Im always looking for suggestions. Also, I didnt add stuff about preparing my house, food for fmaily when pregnant, but have a game plan here, just not actually typed!!! We met with my Peri earlier in the week and he is on board with our plan so far!

Here it is:

Protocol for HG Treatment:


Prior to TTC:

• B6- 100 mgs daily
• Folic Acid- 800mgs
• Rainbow Light Just Once Daily prenatal vitamins
• Exercise 3 to 5 times weekly
• Stay hydrated.- brink a minimum of 40 oz of non-caffeinated liquid daily
• Acupuncture Treatments to promote good health
• NAET allergy elimination treatments
• Chinese Herbs as directed by DR for Body Detox and overall improved health
• Ensure you are mentally and physically healthy
• Aciphex 20mgs daily (40 mgs if needed)

Upon Positive Pregnancy Test:

• Increase B6 intake. Take in 25 or 50 mgs doses. Increase up to 150 mgs. At worst nausea may take up to 200 mgs- not to exceed this dose for more than 1 month, as it may cause nerve damage over a prolonged period of time. If oral pills are not tolerated, use sublingual.
• Add Unisom, up 75 mgs a day. Comes in 25 mg tabs. May break into ¼ to ½ tabs to reduce drowsiness affect. Pair with B6 for best effectiveness.
• Ginger Root:- capsules up to 1000 mgs daily.
• Stop taking Chinese herbs.
• Start taking (500 to 1000 mgs) Dandelion Root and/or Milk Thistle (1000 mgs) for increased liver function.
• Call Mom and make flight arrangements for her trip.

As Nausea increases:

• Zofran (start will pill, then try ODT if pills wont stay down)- up to 32 mgs daily. Try: 8 mgs every 6 hours. Do NOT delay taking this if the previous meds are not addressing the nausea and vomiting.
• Increase Acupuncture treatments to help reduce nausea.

Consider the following:
• Phenergan- suppositories (25 mgs). Cut in half lengthwise to use as necessary, OR oral
• Consider Vistaril- up to 25 mgs every 6 to 8 hours (this may additionally help with anxiety). – not sure if this can be taken with other antihistamines (Unisom, Dramamine, meclizine).
• Switch from Unisom to one of the following: Meclizine- up to 75 mgs daily. Pills may be split as well. Benedryl- 200 mgs daily in 25 mgs increments. Ambien- 5 mg tabs, may be split into smaller doses to reduce drowsiness. Dramamine- 50 mgs every 4 hours.
• Add Sea Bands for motion sickness to see if they offer any relief.
-Address any anxiety/depression issues as they occur. See what options for medication/therapy can be put into place.

If not feeling relief TRY alternate drugs approved by Dr or try different combinations of drugs to see if any relief can be found.

If Dehydration Occurs:
• Preferable: Home IV Therapy. Lactated ringers or glucose with saline. Instead of 24 hour hydration try for 1 bag over a 1 to 2 hour period, with a 6 hour break. I felt BETTER when the hydration went in faster vs slower.
• Consider using a PICC line for hydration, as the smaller IVs cause phlebitis easily for me and need to be changed more frequently.

If Dehydration is NOT a continuous issue, and ODT Zofran is not working as effectively, try a Zofran Pump. (This is portable and can be worn easily in taking care of Madison and going to work.)

If Nausea and Vomiting Continue excessively after 12 weeks:

• Steroid Treatments: Prednisone with a low taper rate of 5 mgs. This is a Cat B steroid. Other steroids used are decadron and Solu-medrol. Opt for the “safestâ€ÂÂ
Teddi
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
~ Baby Chuckles~ July 2013
teddi
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Bether's protocol USERNAME: BethersinMN

Postby teddi » Mar 13, 2006 9:34 pm

RIGHT NOW TO DO:

1. Keep working on Weight Watchers and your hour of exercise a day and get off what you can for weight. Goal is to lose 45. Get the rest off after the baby is born with exercise and Weight Watchers if you haven't lost it all due to HG.

2. Take Folic Acid. Get better about remembering.

3. Get some more comfy pregnancy pants.

4. Get finances in order.

5. Get filling done at the dentist before get prego. There is no way I can handle that when prego ish. Get Jus and Pat and Kev there too.

6. Schedule Pat for her mamo and get her in you won't feel like it once your prego.

7. Finish your licensing process before prego for daycare so you can start it up again after the baby. No later then Feb or March get licensed.

8. Keep trying to find out disability insurance.

Once get the BFP

1. Go into the dr. Make plan again with dr regarding iv home therapy and induction at 38 weeks.
2. Set up IV Home Therapy right away with Reglan and Zofran
3. Get Unisom for sleeping.
4. Get Fibercon
5. Drink water, zup or whatever you can tolerate
6. Eat small bites of whatever you can tolerate
7. Load up on lemon drops and sour apple jolly ranchers for the nausea
8. Go to the chiro for back problems this time
9. Have the massage therapist come out if needed
10. Have the cleaning lady out once a month or more if needed
11. Have some good books to read
12. Come to HER website for support from friends
13. Go in the Winnie the Pooh nursery you have just made and remind yourself the beautiful gift you will have in the end. Hold the baby clothes too and look at pictures of babies and watch the Baby Channel.
14. Remind yourself there is nothing you can't get through and that there is nothing worse then what you went through with the termination.
15. Remind yourself that God, Kevin, your parents, your babies in heaven, Patty and Justin and all your friends and family are pulling for you and the baby and that you will get through this and life will be back to normal after the baby is born and you will feel better.
16. Also keep reminding yourself this is only temporary that your main objective is to take care of you and the baby to get yourself down that yellow brick road closer to the wizard.
17. Tell yourself daily that you can do it.
18. Also a prayer to St. Jude now and then wouldn't hurt.


There it is.... Anything I forgot let me know..


Hugs,
Bethers
Teddi
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
~ Baby Chuckles~ July 2013
teddi
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Joanna's protocol USERNAME: Joanna CANADIAN MEMBER

Postby teddi » Mar 13, 2006 9:36 pm

So here is my revised medical protocol: (I have inserted the US drug names in brackets)

While TTC:

- Take 150 mg of B6 (Motherisk asked me to increase this from the 100 mg I had been taking)
- Take 1 mg of Folic Acid
- Take a multi-vitamin

Once Pregnant:

Medications:

- At the first hint of nausea, start taking 2 Diclectin in the evening. From what Caroline at Motherisk said, I understand that if you gradually put yourself on the Diclectin, you won't be as tired.
- If the nausea increases, Caroline will put me on an increased dosage. What this dosage will be and what time I take it will depend on when my nausea/vomiting is worst. The dosage of Diclectin that I will be on could be up to 12 a day.
- If this fails to work, take a 50 mg tablet of Gravol (Dramamine) via mouth or in suppository form 30-45 minutes before taking the Diclectin
- Add Maxeran (Reglan) 10 mg every 8 hours
- Add Ranitidine 75 mg twice a day
- Add Ondansetron (Zofran) - dosage to be determined when it is needed

Other remedies:

- Ginger 500 mg twice a day
- Colace and/or Metamucial for constipation
- Be tested for H.Pylori again. Interesting tidbit I learned from Caroline is that even if you test negative prior to pregnancy you can develop H.Pylori during pregnancy so best to get tested once pregnant.
- Try seabands again although I don't place much faith in them
- Can drink up to 3 cups a day of Ginger, Mint or Camomile tea

Hydration and Nurishment:

These are things that Caroline suggested. Some of them I'm not too excited about but I'll give it a try. Her focus is to get lots of fluid, protein and fibre into me. Cold and lukewarm foods apparently work the best for women with NVP.
- Cereals such as Optimum Power, Oatmeal, Flax etc
- Have lots of snacks available at all times such as nuts and seeds
- Drink Ensure (or subsitute lactose free milk or soy milk), make milkshakes (she sent me a bunch of recipes), eat Danon yogurt (I think this is the one with the cheese?) I really don't think I'll get very far with these. Milk completely turned me off last time and soy isn't appealing to me not pregnant! But try I must...
- This one is a good idea...make Jello with unflavoured pedialyte
- Dilute gatorade and try and drink that
- Slurpees and slushees
- And of course, ice chips!

For Pylatism:

- Spit lots (lol, and like we didn't know that one? )
- Mouth wash (I'd imagine you'd have to dilute it?)

For bitter taste:

- suck on hard candies

For smells:

- essential oils on a cloth
- smelling lemons

Well, that is it for now. I'm sure once I get pregnant, I'll get some more hints from Motherisk and I'll post them then! In the meantime, I hope this helps someone....

Joanna

Edited to correct my misunderstanding that I would begin on 4 Diclectin a day. I actually will only begin on 2 and then work my way up to whatever will address my symptoms
Last edited by teddi on Jan 31, 2008 11:08 am, edited 1 time in total.
Teddi
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
~ Baby Chuckles~ July 2013
teddi
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Chris's protocol USERNAME: Emmasmummy

Postby teddi » Mar 13, 2006 9:38 pm

Hi guys as requested here is what I have done to manage to stay out of hospital this time ... do not get this wrong though .. I am still nauseated all day but not as severe as my other pregnancies and the vomiting is well and truly controlled to 1-2 per day

This time I began B6 100mg per day 6 months to concieving ( previously 0 - 3 months)

I upped to 150mg the moment I got a pos preg test.

I began zof at the first suspicion of moderate nausea 4mg once per day at 5.5 weeks.

At 6 weeks I increased it to 4 mg twice a day and when I feel the nausea creeping up again even for one day I up the dose again ... now on 8mg twice per day and looking at upping to maybe a 4mg at midday.

I have eaten 6 small meals per day since pos preg test ... I devoured all my fav foods before it hit and now just eat whatever I can get in .. if I get too hungry I pay for it.

I only drink at least 1 hour after I have eaten and I make sure I drink it all .. it helps me to just down the whole glass and then lay down .. sipping seems to make it worse ... *drink ment* flavoured mineral waters are working a treat.


I have not done too much really. My only regrets are implementing the social aspects of my protocol too late as I swore I was not pg as I was not sick enough ... did not get all my house in order or my kids or get the stuff I intended to get for them. I did do some things, but truly just lived in denial about hg and the pregnancy.

The other regret is that since I had a m/c and this was my hardest time at ttc any of my children I focused too much on just getting that bfp and truly not caring about hg and saying I will deal with that later and then wishing I had hg to reassure me it was all OK. I think this lost all my focus on the hg altogether and that for me emotionally I was not prepared at all and am finding it hard to deal with some days ... wish I had still focused on hg rather than just the bfp and sticky baby.


My major thing is that I do not skip any meal as I know that will be the end of me if I do .. I force myself to get up and get a drink, snack etc ... I always feel just that tiny bit better after having it.

Other than nasty nausea I am doing Ok .... I have bad days of course but feel I am getting through this better again than any other pregnancy. I think I am just having to deal with the emotional mind games at the moment and I will be OK .... doing the whole why am I here again thing !!


Dh is away this week and I know the hg has reached it's peak so hoping I can stick to my plan above and up the zof if need be and take it very easy as much as possible .. MIL is taking my 2 elder daughters tonight for a sleep over so that helps as well. I now have my ironing lady back in force as well.

Take care and I truly believe that early intervention is the key to controlling vomiting ... the nausea is another battle but dealing with one at a time is fine by me.
Teddi
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
~ Baby Chuckles~ July 2013
teddi
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Jenny's protocol USERNAME: JennyK

Postby teddi » Mar 13, 2006 9:40 pm

I stole Robin's (rdevine10) protocol and adapted it based on my experience last time. In case it gives someone else ideas, here it is. Also, I'd appreciate any suggestions.
--------------
Prior to pregnancy
• B6, 50 mg 3x day
• Prenatal vitamins with folic acid
• Get short term disability and hospital insurance; authorize Mom to access all medical and insurance-related information so she can file the claims
• Negotiate terms of LOA from work

Upon Positive Pregnancy Test
• Make immediate appointment with Dr. McMahon. Determine when to hydrate and when to consider PICC. Get objective standard for when to call/go to hospital.
• Gingerroot powder, 250 mg 4x day
• Increase B6 intake to 25 mg 6x day. At worst nausea may take up to 200 mgs, not to exceed this dose for more than 1 month, as high dose may cause damage over a prolonged period of time. If oral pills are not tolerated, use sublingual which can be purchased from Vitamins for Less, 1-888-782-8482 (ask for Source Natural co-enzymated B6).
• Add Unisom, up 75 mgs a day. Comes in 25 mg tabs. May break into ¼ to ½ tabs to reduce drowsiness affect. Pair with B6 for best effectiveness.
• Have on hand colace, otc Pepcid, Gatoraid
• Call Caroline at Motherisk. 800-436-8477
• Call Kim (family friend who is high risk OB)

At first sign of Nausea
• Zofran, up to 8 mg 4x a day for a total of 32 mg per day. If oral does not stay down, consider IV or ODT
• Try yoga position that helped last time
• If hypersensitive to smell, keep cut up fresh lemons at bedside
• Test ketones to monitor dehydration

If Dehydration Occurs
• After initial hospitalization, arrange for home IV therapy if not significantly improved
• Request vitamins be added to every bag of fluids
• Evaluate whether a PICC is appropriate; if yes, try lactated ringers with vitamins first; only resort to TPN if LR's alone are insufficient
• Consider a zofran pump, IV zofran or ODT zofran

If Nausea and Vomiting Persist
• Consider TPN
• Try Category B drugs as suggested at http://www.hyperemesis.org/mothers/trea ... ations.php
• AVOID: Reglan, mirtazapine, thorazine. Last time side effects were bad and drugs did not offer relief.
• Also avoid Macrobid in the event of infection. It increased nausea and vomiting last time.
• Continue yoga position

Previous triggers to watch for
• All food smells. Remind family and friends that smells so faint as to be undetectable to them may make me vomit. Last time even walking by the pantry was a trigger. Joe and Annie may be limited to cold cereal and using the crockpot in the garage.
• Motion. Remind family and friends that someone sitting on my bed and even watching someone walk across the room were triggers.
• Sound, including music.
• Reading.
• Television.
• Flying. Don't even think about it.

Food
• Go with cravings, as they typically stay down longer and better. Last time Goldfish crackers and Icees (from Bob's Pizza or Target) were tolerated best.
• Do not follow the BRAT diet unless BRAT foods sound appealing. Toast hurts coming up.
• Suck on lemon drops
• Drink Ensure if tolerated
• Consider buying a kids' snowcone machine
• Eat foods that come back up easily
• Remember to TRY YOUR BEST to eat and drink!

Mentally
• Spend as much time with Annie as possible, doing activities to keep her happy and pass time quickly.
• Look at Annie's baby pictures as a reminder of why you are doing this.
• Stay in touch with friends and family as tolerated.
• Try to work a normal work schedule as tolerated, but do not hesitate to take a LOA if needed.
• Do your best to help out around the house with chores and meals.
• Focus on preparing for the new baby. After a heartbeat is found on the doppler, reward yourself with a new baby item each week.
• Accept help from family and friends. This means cooking, errands, babysitting, grocery shopping, laundry, housework, etc., and financial help from family.
• Keep Annie's life as normal as possible.
• Keep several videos on hand and new toys to amuse Annie if you are having a tough day
• Keep in constant contact with hyperemesis.org forums for support and advice
• Look forward to ultrasounds and heartbeats
• Find out gender, if possible, to remind yourself there' s a human being growing in there!
• Remind yourself daily you are a strong person and CAN do this.
• Remind yourself that the new baby will be worth this.
• Consider early induction again if still sick at 37 weeks
• Prepare for labor; arrange to have either Debra Heil or Judy Landecker present for birth
• Attend prenatal yoga as tolerated
Teddi
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
~ Baby Chuckles~ July 2013
teddi
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Sal's protocol USERNAME: SAL

Postby teddi » Mar 13, 2006 9:41 pm

Some of you will know that I have been hanging around with the ttc'ers for the last while! I finally got my protocol down on paper - so here it is. I'd appreciate any comments you guys have to make.

PREPARATION
Meds -
Take Vit B6 100mg and B Compex (contains folic acid and other vitamins necessary to metabolize the B6)
Eltroxin 150 mcg (underactive thyroid) get levels checked every 3 months.

General Health
lose 27 pounds (24 gone too date
Exercise 3 times a week
See Kinesiologist and follow her exclusion diet recommendations. Currently this is avoid wheat, dairy, bananas and msg.
Prepare folder with meds info for Ob i.e. Zofran

Other
Usual household tasks - clear out and stock Kids wardrobes for next 6 months.
Stock Freezer with family foods
Create 6 weekly meal plans and shopping lists to match (this has worked great - thanks Amanda for that idea)
Stock up on all meds (some are hard to find. I have got 10 boxes of Unisom from the USA - I hope it is enough!!!!!!!)
Get a fruit juicer and experiment with different fruit combos including ginger.

ON BFP
Tell you guys! (and dh of course )
Book early appt with Ob - to get Zofran script
Pack bag for hospital stay (then no thinking required if I do have to go!)
Pack overnight bags for kids (ditto)
Get haircut (smell of salon bothers me when pregnant)
Weigh myself and record it, so I'll have an accurate record of weight loss.
Book week off work for week 9 (worst week for me in the past)
Check Throyid function levels every 4 weeks. (these went crazy last time)
Up B6 to 150mg (then max 200mg for 4 weeks)
Start Unisom 25mg up to max 75mg per day.
Ginger root powder 500mg twice a day
Continue B Complex and Eltroxin
Mointor Ketones (have sticks for this)
Aim to take 2 rehydration drinks in every 24 hours

On admission
Iv fluids
Request Zofran (not done here usually) - if not use Phenergan again
Start Losec/omperazole - this reduced the bile vomiting for me in the past
Request Parentrovite - this was an IV multivit with a great feel good factor for a few days after it is given.
Suggest PICC line if indicated.

I have created (with the aid of dh) a chart to follow when taking the meds so that I won't have to work out what I am due to take. I can email to any of you if you pm me - as I'll have to send it as an attachment. It is currently in excell format but I can change it to Word if you need me to.
Teddi
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
~ Baby Chuckles~ July 2013
teddi
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Milli's protocol USERNAME: Milli

Postby teddi » Mar 13, 2006 9:47 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!
Teddi
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
~ Baby Chuckles~ July 2013
teddi
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Galit's protocol USERNAME: Galit

Postby teddi » Mar 13, 2006 9:48 pm

Hello Ladies,

I thought it might be helpful if I started a thread on a non medical protocol. This is a list of things I have found helpful. Obviously, not everything will apply to everyone, so just use what you want. If anyone has suggestions to add to this list I will be happy to come back to the original thread and add it, so that the list is complete on one posting.

galit



HG Protocol - Before you get pregnant or TTC

1) Get haircut for yourself, if you color your hair do it before TTC
2) Go to the dentist and get x-rays before you get pregnant
3) Cook extra food and freeze
4) Buy snacks in diff categories (salty, sweet, etc) to have on hand
5) Buy non perishable items in bulk so that husband (or you) will have less to shop for (eg. papertowel, toilet paper, paper plates etc)
6) Interview OB/midwife etc. for friendly HG medical support
7) Start taking B6, multivitamin (if you wish, if you can), folic acid and drink a lot of water
8) Write out your medical protocol
9) Look into alternative medicine in addition to medical protocol (only if you wish)
10) Call Motherisk if you would like extra info
11) Call your insurance company and find out your coverage for HG drugs, and home healthcare
12) (Optional) Look into your options of home health care companies (there is one that specializes in pregnancy, can't remember the name- edited - I believe it is called Matria)
13) If you pay the bills in your family try and set up as many as possible on an automatic withdrawal
14) Buy/borrow/make sure you have a small fridge or cooler where you can store cold drinks by your bed so you won't have to go to the kitchen
15) Buy any Birthday gifts/Holiday gifts for family and friends that you might need during your pregnancy
16) If you work, look into short term and long term disabiltiy as well as hospital insurance. Also you may want to consult with a lawyer about your rights in case your employer decides to terminate your employment while you are sick. See detailed post in Insurance and Employment Folder.
17) Save enough money to carry you through the HG
18) Let your friends and relatives know you are pregnant in order to get emotional and or physical support you might need.

If you have children:

1) DON'T WORRY, YOUR CHILDREN WILL NOT REMEMBER HOW SICK YOU WERE BUT THEY WILL THANK YOU ONE DAY FOR HAVING A GREAT SIBLING
2) Interview student babysitters for future use (if money permits)
3) Buy all clothes for children for the next season so that there will be less shopping while you are pregnant
4) Start a calender with all app. for children and yourself so that everyone has access to it and can see it
5) Write a list out of names of pediatricians, dentist, hair cutting places, favorite playdates, favorite kids foods etc. in other words, everything you take care of that your husband might not
6) Get haircuts for your kids
7) Take children to doctor and dentist app. if possible while you can
8) Interview cleaners for your house (if money permits)
9) Buy small toys, videos, computer games that are age appropriate. When you will be too sick to play with your child (for use with safe room) they should come in very handy.
10) Set up a safe room where you and your child can stay together
without you worrying about your child hurting him/herself (for younger children)
11) Buy extra birthday presents in case your child will be attending birthday parties while you are sick
12) Sign up your older children for afterschool programs to give you extra time to yourself when you get sick
Teddi
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
~ Baby Chuckles~ July 2013
teddi
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Location: SF Bay Area, CA

Postby bibliojo » Mar 13, 2006 10:42 pm

Thanks Teddi for doing this! I've been meaning to get all the protocols together in a more visible place but just have not have the energy/strength to do it. :?

Joanna
2 HG pregnancies
Lukas - February 2003
Katya - October 2006

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Postby Natalie » Jun 20, 2006 8:09 am

I edited out my prep post becasue it was not particularly helpful for anyone else besides myself back in 2005!
Last edited by Natalie on Jan 13, 2009 2:53 pm, edited 1 time in total.
2003 - DD
2006 - DS
2010 - DS
Natalie
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Another Protocol

Postby aussie » Dec 02, 2006 4:18 pm

Hi guys, I have spent a fair bit of time combining everyones protocols etc and making one for myself. I just sort of took into account everyones advice re doses of meds etc and used the ones that seemed most common. I thought I might as well post it. Pls note though the entire things is copy and pasted from others protocols so I am not taking credit for anything other than I copy and pasted.

I have not addressed the areas of planning around the house or re other children or mentally or anything just like that, just the physical aspects at this point. All I have done is given my family memebers the link to this site and said get familiar with it.

Ok here is what I have compiled:

FOOD

General Comments
Go with cravings, as they typically stay down longer and better.

Eat foods that come back up easily. Avoid those that do not.

Eat immediately each day. Eat to keep from throwing up.

Eat 6 small meals per day once pos preg test

My major thing is that I do not skip any meal as I know that will be the end

drink at least 1 hour after I have eaten and I make sure I drink it all .. sipping seems to make it worse

Eat some crackers before get up

Chew gum (trident cinnamon gum) (keeping saliva going stops nausea) or suck preggy pops almost constantly

Have lots of snacks available at all times such as nuts and seeds

Have my a/c on HIGH. don't gag as much when I'm cold.

Four main food groups that are often tolerated and eg’s of food for each.


1. SALTYS AND CRUNCHYS
- potato chips
- Whole wheat crackers more effective than saltines
- crackers - usually like Cheez-its, etc...something with a flavor of cheese or some extra salt-type flavor, etc.. Seems the more chemicals and preservatives (go figure?), the better!
- really well-done, or oven-baked french fries - extra crunchy type with not a lot of grease on them
- baked potatoes with lots of salt
- mashed potatoes with lots of salt
- tortilla chips
- pretzels
- salted peanuts/nuts
- chinese noodles
- celery sticks
- hard-boiled eggs with salt
- egg salad, minus onions!!
- brothy, salty soups


2. SWEETS AND DOUGH-YS
- cake, minus the icing
- PB & J sandwiches on fluffy white bread
- hard candies, jolly ranchers, lollies, etc...
- fruit, fruit and more fruit!
- sweet veggies - carrot sticks, etc...
- fruited yogurt
- yogurt smoothies
- orange juice
- pancakes
- french toast
- plain doughnuts
- cinnamon buns - sweet cinnamon flavored things of any type
- raisins and dried fruit
- jelly
- lightly buttered egg noodles
- *white sticky rice

3. SOURS AND TARTS
- apples
- lemons and limes - flavors of lemons and limes
- hard candies such as sour apple, lemon drops, jolly ranchers, sour grape, etc... help with nausea
- grapefruit
- oranges
- sometimes fast foods such as cheeseburgers, hot dogs, sausage sandwiches - with pickles on...be careful with these cravings though...
- hot peppers and other spicy hot foods
- mild peppers as well
- tortilla chips
- pretzels
- vinegar on chips/fries/etc...
-
4. BLANDS AND STARCHYS
- pancakes - no syrup, little butter
- toast - just have someone make the stuff outside! LOL!
- crackers (yep - but this time the sweet type like wheat thins, wheatables, etc... NOT saltines, people!)
- pretzels
- plain baked potatoes, little butter
- mushy fries from the oven - little grease, no salt
- mashed potatoes
- plain breads
- vanilla wafer cookies
- bland non-buttery popcorn
- plain lightly buttered egg noodles
- white, sticky rice
- some fruits - bananas, pears, peaches, melons

5. There is a group of its own. APPLES. People often crave apples.

DRINKS / LIQUID
- Make Jelly with unflavored pedialyte
- Dilute gatorade
- ice chips
- adding about 1 tsp of apple cider vinegar to every 8 oz of water, and sipping throughout the day and night.
- Slurpees, Slushies, Mr. Misties, Icees, frozen Coke.
- Ice cold Koolaid. Even better when served as shaven ice.
- From what I can see, the more food coloring the more an hger is likely to tolerate it.
- Sprite. Not 7up or others. Sprite.
- Any manner of flavored, usually a citrus is best, fizzy water.
- Orange juice...ice cold...maybe shaved ice form or popsicles.
- PEPSI ... nurse just told me today that for some reason, coke syrup (hate coke, so tried pepsi) and the bubbles helped calm the stomach... weird, but it's working so far.
- Vitamin Water" brand water. It tastes just like flavored water or juice, but it has FOLIC ACID! ELECTROLYTES! and other goodies infused in the water (CALLED Essential)
- Mineral water
- Flavored seltzers – lime / lemon
- Sweetened brewed iced/hot tea
- Smoothie
- Iced coffee or banana milk
- Instant breakfasts in popper
- grapefruit juice
- cranberry juice
- apple juice

MEDICATION
Want Perinatologist (high risk obstetrician)
General comments
If hypersensitive to smell, keep cut up fresh lemons at bedside

Zofran only works if very well hydrated. It is also dose dependant.

Zofrans patent in up in DECEMBER. Hosperia will be coming out with the generic brand that will actually be affordable - In Australia generic brand same price.

Unisom proven absolutely safe in pregnancy. Take with B6. Unisom is sold as a sleeping aid, it's really a antihistamine (there are several antiistamines prescribed for HG). The type you want it the sleep tabs not the gels. The tablets are blue. Take up to 3 tablets per day.

TTC
Take 150 mg of B6
Folic Acid- 800mgs
Prenatal vitamins with folic acid
Take a multi-vitamin
Detox as best you can
Stay hydrated, drink plenty of water, try to avoid caffeine
Exercise 3 to 5 times weekly

Positive test
One method of upgrading zofran dosage as not effective
1. tablets, 4 mg/dose up to 32 mg
2. tablets, 8 mg/dose up to 32 mg
3. ODT, 8 mg/dose, oral up to 32 mg
4. ODT, 8 mg/dose, vaginal
5. Z-pump
6. via picc or pic

Unisom and B6 at night at the first sign of morning sickness.

B6 – have 150mg but spread over the day in 50mg doses. At worst nausea take up to 200mg (not for more than one month on 200mg).

Unisom - Up 75 mgs a day (start at 25g). Comes in 25 mg tabs. May break into ¼ to ½ tabs to reduce drowsiness affect. Pair with B6 for best effectiveness. (Can also try benedryl (200mg), Ambien (5mg) or Meclizine (75mg)).

Ginger Root:- capsules up to 1000 mgs daily (can 2 x 500mg twice day)

Start taking (500 to 1000 mgs) Dandelion Root and/or Milk Thistle (1000 mgs) for increased liver function.

Start zofran at the first suspicion of moderate nausea 4mg once per day
One week later may have to increased it to 4 mg twice a day.
If feel the nausea creeping up again even for one day I up the dose again to perhaps 8mg twice per day and can look at upping to maybe a 4mg at midday as well. 32mg per day of Zofran is the very maximum.
* if due to massive cost of Zofran worried about money start on Maxalon first until not doing anything ((3x10mg per day)

Another option is 4mg every 4 hours or 8mg every 8 hours.

Increased nausea
Zofran – if pills don’t stay down try ODT. 8mg every 6 hours (max 32mg per day).

Can try acupuncture.

Switch from Unisom to one of the following: Meclizine- up to 75 mgs daily. Benedryl- 200 mgs daily in 25 mgs increments. Ambien- 5 mg tabs, may be split into smaller doses to reduce drowsiness. Dramamine- 50 mgs every 4 hours.

Dehydration
Monitor Ketones (have ketostix for this)

Aim to take 2 rehydration drinks in every 24 hours

After initial hospitalization, arrange for home IV therapy if not significantly improved

Add the following medications to IV:
Zofran
Benedryl
Pepcid or Zantac (but do Either at a smaller dose than normal)
Vitamins- B6 and multi
Phenergan

Instead of 24 hour hydration try for 1 bag over a 1 to 2 hour period, with a 6 hour break. I felt BETTER when the hydration went in faster vs slower.

Consider a zofran pump, IV zofran or ODT zofran

Evaluate whether a PICC is appropriate; if yes, try lactated ringers with vitamins first; only resort to TPN if LR's alone are insufficient

Consider using a PICC line for hydration, as the smaller IVs cause phlebitis easily for me and need to be changed more frequently.

Severe after 12 weeks
Steroid Treatments: Prednisone with a low taper rate of 5 mgs. This is a Cat B steroid. Other steroids used are decadron and Solu-medrol. Opt for the “safestâ€ÂÂ
aussie
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Joined: Nov 07, 2006 4:04 pm
Location: Australia

Postby IslandDreamer » Jan 21, 2007 10:48 pm

:hugs:
IslandDreamer
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Postby IslandDreamer » Mar 14, 2007 11:39 pm

These are great.
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Kelley's Protocol

Postby kelley2000 » May 18, 2007 9:10 pm

Here is my protocol so far:

Before TTC:

Get projects around house finished, organize house

Inform immediate family of our plans and ask for support with childcare/taking kids to school, etc.

Start B6 sublingual and try Unisom to see if drowsiness goes away. If too drowsy, stop taking Unisom, continue B6.

Discuss plans with evil manager at work to let her complain about her upcoming increase in workload!

Upon BFP:

Inform family, friends
Clean house thoroughly
Call OB for appt
Inform boss???
Discuss illness with dd, so they are prepared to see mommy ill

Once nausea sets in,
Request zofran po until moderate or severe vomiting

If still vomiting, switch to zofran pump as discussed with OB
Set up home IV fluid treatments if necessary

Still working on...

What to do at work... patient odors, shared bathroom between staff and patients

Applying for disability insurance, haven't heard yet

Long commute to work, how to handle

Alternative meds, or does my new insurance cover zofran??

I still have a lot to work on, any suggestions?


Kelley

Molly 7/21/01 NVP
Hannah 3/1/03 HG until 16th wk
Kelley

Molly 7/01 Bad MS
Hannah 3/03 HG until 16 weeks

Expecting #3 EDC June 20, 2008....it's a boy!


Image

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kelley2000
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Posts: 329
Joined: Apr 11, 2007 3:21 pm
Location: Rockford, IL

Postby Spark » Sep 11, 2007 1:07 pm

UPDATE: My baby that I prepared for with this protocol is here & a happy healthy 6 month old. My pregnancy with him was AMAZING. It was the best pregnancy I have EVER had! I ended up doing milk thistle consistently for months before. Upon BFP at 8DPO, I immediately started B-6/Unisom. I took 1 Unisom at night before bed. Then, I did B-6 spread out throughout the day along with milk thistle & wild yam root. My naturopath, adjusted my protocol by dropping the wild yam root. Amazingly, I didn't feel ANY nausea. I never had to increase my Unisom. I had all the 1st trimester symptoms just without nausea. At 12 weeks, I stopped the Unisom & didn't need it. I was really shocked and oh so thankful for the wisdom that I learned here. Thank you all!


Okay, here's my whopping long protocol that I've been adding to a file on my computer for about a year now. I've just repurposed a lot from other people. Thank you ALL for posting your protocols!

I'm not sure that we'll TTC in December or even January like we talked about. We might adopt. We might just hug the 3 kids we have. But, getting it in this file might just help someone else if not me. :hugs:

Any comments or suggestions for change... PLEASE let me know! :)

Links on the herbs I refer to:
Detox/Cleansing -- http://forums.helpher.org/viewtopic.php?t=3090
Milk Thistle -- http://forums.helpher.org/viewtopic.php?t=14755
Wild Yam Root -- http://forums.helpher.org/viewtopic.php?t=16085
False Unicorn Root -- http://www.regaininghealthnaturally.com ... Root.shtml


Post-Pregnancy:
Detox program

6 months pre-TTC:
Liver Detox

4-3 months pre-TTC daily:
Multivitamin
Milk Thistle 280 mg with at least 70% silmarin
B6 total of 150 mg /day taken am & pm with Vit C for absorbtion
Water with lemon (I keep a jug of actual lemon juice in my fridge & squirt into each glass)
Probiotics
Evening Primrose Oil Pre-O, Flax Seed oil post-O (Both are essential fatty acids)
Food enzymes when needed
Affirmation -- "When the time is for the highest good, we gestate our baby with good health and joy." I say this many many times a day.

Medication/Treatment Upon BFP
Increase Milk Thistle
50 mg B6 3 x a day (do not exceed total of 200 mg)
Food Enzymes after every "meal" if tolerated
Children's vitamins with added Folic Acid if tolerable
Wild Yam Root tincture up to 2 to 4 mL three times daily
False Unicorn Root tincture up to 1 dropper 3x per day
1/2 Unisom at night (up to 75mg antihistamine per 24 hours) with 50 mg B-6 or consider just benadryl w/ b6
Ginger Root:- capsules up to 1000 mgs daily (take it until you taste it)
Naturopath visit

If nausea increases:
Anti-motion sickness medications during day
(Benadryl or Meclizine - Cyclizine, Dramamine, Dimenhydrinate, Bonine, Antivert, Marezine)
Test vitamin levels in blood routinely
Pepcid or Zantac or prilosec
Compozine (nausea)
Zofran (start will pill, then try ODT if pills wont stay down)- up to 32 mgs daily. Try: 8 mgs every 6 hours. Do NOT delay taking this if the previous meds are not addressing the nausea and vomiting.
Consider steroids after 8-10 weeks

Upon Keytones in Urine or 5% loss of body weight:
IV's at hospital/office - Lactated Ringers or D5LR with 20 KCI. Consider Myer's Cocktail or Banana Bag.
Preferable: Home IV Therapy. Lactated ringers or Banana Bag. Instead of 24 hour hydration try for 1 bag over a 1 to 2 hour period, with a 6 hour break. I felt BETTER when the hydration went in faster vs slower.

*** If Can Not Keep Food/Water down for 3 days ****
NJ tube - sedated for insertion, Jevity with fiber

**** If Feeling Brain Fuzzy/Dead ****
Get vitamin levels checked ASAP


AVOID:
Raglan - allergic reaction
Phenegran - Not effective, possible allergic reaction

Motherisk- Organization based in Canada that helps Moms with Nausea and Vomiting in pregnancy. Also helps Moms in the USA. Website is www.motherisk.org Phone # is 800-436-8477

Hyperemesis Organization: Website that provides treatment options for those with HG and protocols, with medication information for Doctors. Also has a support forum for those with HG to ease some of the isolation, depression and misery that occurs with HG. (www.helpher.org)

*******Help Feed Us******
Thank you for helping me. I'll need to eat, but please do NOT mention specific foods as it can kill whatever inclination I have to eat. And, sometimes I might be hungry, but not have enough energy to call for someone, even if you have the baby monitor on. So, please check on me regularly. say to me -- "MY NAME, would you like Salty, Crunchy, Sweet, Sour or Bland?" Know that specific food cravings usually stay down. With HG, any food is good food.
Four main food groups that are often tolerated and eg’s of food for each.

1. SALTYS AND CRUNCHYS
- potato chips
- Whole wheat crackers more effective than saltines
- crackers - usually like Cheez-its, etc...something with a flavor of cheese or some extra salt-type flavor, etc.. Seems the more chemicals and preservatives (go figure?), the better!
- really well-done, or oven-baked french fries - extra crunchy type with not a lot of grease on them
- baked potatoes with lots of salt
- mashed potatoes with lots of salt
- tortilla chips
- pretzels
- salted peanuts/nuts
- chinese noodles
- celery sticks
- hard-boiled eggs with salt
- egg salad, minus onions!!
- brothy, salty soups

2. SWEETS
- cake, minus the icing
- PB & J sandwiches on fluffy white bread
- hard candies, jolly ranchers, lollies, etc...
- fruit, fruit and more fruit!
- sweet veggies - carrot sticks, etc...
- fruited yogurt
- yogurt smoothies (no lumps)
- orange juice
- pancakes
- french toast
- plain doughnuts
- cinnamon buns - sweet cinnamon flavored things of any type
- raisins and dried fruit
- jelly
- lightly buttered egg noodles
- *white sticky rice

3. SOURS AND TARTS
- apples
- lemons and limes - flavors of lemons and limes
- hard candies such as sour apple, lemon drops, jolly ranchers, sour grape, etc... help with nausea
- grapefruit
- oranges
- sometimes fast foods such as cheeseburgers, hot dogs, sausage sandwiches - with pickles on...be careful with these cravings though...
- hot peppers and other spicy hot foods
- mild peppers as well
- tortilla chips
- pretzels
- vinegar on chips/fries/etc...
-
4. BLANDS AND STARCHYS
- pancakes - no syrup, little butter
- toast - just have someone make the stuff outside! LOL!
- crackers (yep - but this time the sweet type like wheat thins, wheatables, etc... NOT saltines, people!)
- pretzels
- plain baked potatoes, little butter
- mushy fries from the oven - little grease, no salt
- mashed potatoes
- plain breads
- vanilla wafer cookies
- bland non-buttery popcorn
- plain lightly buttered egg noodles
- white, sticky rice
- some fruits - bananas, pears, peaches, melons

5. There is a group of its own. APPLES. People often crave apples.

DRINKS / LIQUID (Serve everything REALLY cold with a straw)
- Slurpees, Slushies, Mr. Misties, Icees, frozen Coke. Available at 7-eleven, Target, etc.
- Make Jello with unflavored pedialyte
- Dilute gatorade
- ice chips
- adding about 1 tsp of apple cider vinegar or lemon juice to every 8 oz of water, and sipping throughout the day and night.
- Ice cold Koolaid. Even better when served as shaven ice.
- Sprite. 7-up or Coke or Pepsi
- Any manner of flavored, usually a citrus is best, fizzy water.
- Orange juice...ice cold...maybe shaved ice form or popsicles.
- Vitamin Water" brand water. It tastes just like flavored water or juice, but it has FOLIC ACID! ELECTROLYTES! and other goodies infused in the water (CALLED Essential)
- Mineral water
- Flavored seltzers – lime / lemon
- Sweetened brewed iced/hot tea
- Smoothie (no lumps)
- Iced coffee or banana milk
- Instant breakfasts in popper (no lumps)
- grapefruit juice
- cranberry juice
- apple juice

Things to do:
Upon BFP:
Appt with specialist
Create 6 weekly meal plans and shopping lists to match
Line up potential food deliveries
Activities for children
Childcare arrangments
Ensure there are several boxes of baking soda in Fridge and make sure fridge is totally cleaned and disinfected
Dentist visit if needed
Clean the house

NVP:
Arrange food deliveries
Ziplock bags for vomit
Smells that nauseate - no heating of food in kitchen, move microwave or crock pot to garage, cook on stove only when I'm out of the house & then air it out before my return
Cut fresh lemons by bedside
Snacks by bed
Baby pictures of children to look at nearby or a tiny piece of clothing
Liquids - either hot or cold, sour or sweet
Test keytones
Pack bag for hospital stay (then no thinking required if I do have to go!)
Pack overnight bags for children
See ****help feed us**** list above
DS '01 - Mild HG till 16 wks, Lost 8% of bodyweight, no meds
DD1 '04 - M/S till 14 wks, lost 4% of bodyweight, no meds needed
DD2 '06 - Moderate HG 9 mos, lost 16% of bodyweight, limited meds, poorly managed by Dr :(
Each Child SO Worth It!
DS2 '08 - BEST PREGNANCY EVER! Sooo thankful! http://forums.helpher.org/viewtopic.php?p=288211#288211
Spark
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Location: Michigan


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