Another protocol question

[babykismet]

It's me again, the "dim lightbulb". I was looking over my protocol and I noticed that I might be making dramatic steps in my last two steps. I went by what I read here at HER about the 5% and 10% prepregnancy weight loss rule to getting further help. Am I being too rash and rushing things? I know that I haven't listed steroids as an options. I had a false positive cushings disease test due to high cortisol last summer so I don't know if steroids are even an option for me. Sorry this is so long. Here it is.

MY PROTOCOL
**Do not give me Reglan, Compazine or Phenergan**

Pre-Conception:
1. See Dr and change seizure meds.
2. Visit Drs and go over this protocol with them. Get their input. h pylori testing?
3. B6 50 mg in a.m. and 50 mg in p.m.
4. Will stop all OTC meds.
5. Drink 6-8 glasses of water a day.
6. Exercise at the gym at least three times a week.
7. Prenatal vitamins... Rainbow Light.
8. Make appt to have teeth cleaned.
9. Get HG Kit together.
10. Start taking 5 mg of Folic Acid daily.
11. Buy Ketostix for ketones testing.
12. Do gestational diabetes testing to see where I stand.

Conception:
1. Positive pregnancy test – Unisom Nightime 25mg – ½ pill w/ 50 mg B6 3x's daily. Can up this to 1 unisom and 50 mg B6 3x's a day if more relief is needed. 250 mg of B6 and 3 unisoms is the max. Very open to trying sublingual B6. Make sure I have gatorade, salty snacks and Bryers or Schawns popsicles on hand.
2. Continue 5 mg of Folic Acid daily with seizure med.
3. Will start the Relief Band with the electrical current.
4. Zofran - Started at first sign of overwhelming nausea. Find out what max dose I can be given and if I can have an Rx on hand before I get pg. Will try meclizine, Kytril and Anzemet if Zofran loses its effectiveness since Zofran works just for vomitting NOT the nausea!! Keep Zofran doses evenly spaced during a 24hr period.
5. Start Colace for constipation.
6. Pepcid for heartburn.
7. At 5% prepregnancy weight lose, will get an IV fluids and Zofran Pump if ketones show during home testing... Zofran Pump-need to ask where I get this at
8. At 10% prepregnancy weight lose, do a PICC line with TPN... or NG tube...or Gtube...unsure of what I want to do at this point.

Thanks,
~Diana

[PamelaRose]

We've seen some ladies starting Zofran right away before nausea hits--that's one thing I would have tried. You can also consider combining Zofran with another med. Meclizine worked miracles for me, but there are many other options. As for determining when I'd do IV, PICC, I always went by vomiting, veins, and weight loss. I vomited on average every hour, and if I started more frequently, 2x/hour, then I knew I needed fluids. If I lost more than a pound in a day, I needed fluids. And the first time I blew a vein and had to struggle to find another usable one, I was signing up for a picc. That's individual--some vomit more and others less, some lose more weight and others less, some have good veins and others don't. If you have a picc already, they'll probably do TPN through it at first. You're doing great prep work!

[galit]

Hi there,

I was just wondering why your folic acid dosage is so high? Does it have anything to do with your seizures? I believe most prenatal vitamins (perscription) are 1 mg. There are apparently side affects (I can't remember what they are) if you take large doses unless you have a specific reason i.e. a previous baby with neural tube defect.

galit

[mammaclare]

Looks great. Did you tolerate Colace before? I, and I think some others, had terrible vonmitting from it.

Also, TPN can be very important for some, but has a good amount of danger with it too in terms of liver damage from the lipids and infection in the picc. Just be sre you are aware and comfortable with that. I lost close to 15% of my weight and TPN wasn't even considered until I reached 22 weeks with no gain. Then it would have been ng tube first, but thand GOD I gained at 21 weeks. And despite being sick (terrible all day nausea, and only eating about 6 foods all pg) and on Zofran the whole time Rory and I were fine and i started gaining 2lbs a week almost by 24 weeks.

Just my personal 2 cents on the TPN and what I learned from my peri.

Great and thorough protocol,though. Good luck!

[babykismet]

Thanks for all of the input. I will talk to my high risk doc next week about how we will determine my next step after the Zofran Pump. My last pregnancy I lost 8 lbs in one week. After a week on IV's, I started having veins blow. I guess I should have gone for the PICC or NG tube as offered to me. But at that time it was threatened to me because they said that I was trying to kill my unborn baby. If some of you remember my story from the HUGS site, my doc was away on a family emergency and I had three different on call docs during my 2 week hospital stay. They even sent in a psychiatrist to see me!! I was so angry to say the least! So I refused the PICC out of a sense of failure on my part. And I refused the NG tube because they refused to give me any seditives for while it was going in. My gag reflex is HUGE. And I take daily seizure meds so I didn't like the thought of having a tube down my throat. That is why I want to be informed this time.
I set my folic acid at 5mg because that is the recommended amount for a person on seizure meds. I am now on Topamax because of a reaction to my new, less dangerous for the baby, seizure med.
Again, thanks for everyones help with my protocol. The information is amazing!
~Diana