My story and some questions

[querida]

I've read through the posts here in 2nd Trimester HG, and I haven't seen these questions answered yet. Forgive me if I'm asking the same old "newbie" questions that everyone asks.

I'm 15 weeks today. This is my second pregnancy, but my first with HG. With my son (age 5), I had some plain ol' morning sickness in my first tri, throwing up about twice a day and eating like a pig in between times, but it went away after my 12th week and the rest of that pregnancy was pure magic. This time around, I've been fighting HG since week 5, and weeks 7-12 were pure hell. I missed 6 weeks of work, and spent the entire time laying in bed (when I wasn't in the ER getting an IV), because I simply didn't have the strength to do the least thing. I'm back at work now, but I still don't have my usual strength and energy back. My doctors (family doc, OB, and ER doctors) were writing "hyperemesis gravidarum" all over my medical forms, but no one ever told me what that meant (and they still haven't). I just thought it was medical lingo that meant I was throwing up too much. Everyone treated me as though I were just a big wimp. I don't know how many times doctors and nurses and family members would try to "explain" what morning sickness was, and how normal it is, and how I should just eat some soda crackers and try to fight the urge to vomit. Puh-LEASE! I've known from the beginning that this pregnancy is a whole different animal from my first.

So, anyway, my questions. I lost 15 pounds in weeks 6-8 (I was 134 pounds to begin with), and I still haven't gained any of that weight back. I've been on Zofran since my 10th week, and it helps me control the urge to vomit. It doesn't help the nausea or give me any appetite, though, and I have an aversion to EVERYTHING. So, basically, I'm eating in between dry heaves. I was taking 8mg twice a day, but for the past 2 weeks, I've needed to up my dose to 8 mg three times a day. I switched OBs a month ago, because my other doctors just weren't giving me the care I need, and I'm scheduled for my second OB visit with the new doctor next week. I'm wondering if I need to be concerned about the weight issue yet. I don't want to go on tube feeding if it's not necessary, and I don't want my new doctor to think I'm some kind of hypochondriac, but I want to be sure my baby is getting the nutrients it needs. My fundal height is measuring about 4 weeks smaller than it should be (it measured at 10 weeks last week, when I was actually 14), so I'm getting worried. What would be the best way to talk to my doctor about this, so that he doesn't dismiss my complaints as nothing, but doesn't just strap me up to a feeding tube and put me on more bed rest? (I'm the sole breadwinner for my family, and I really can't afford to miss any more work.)

Thank you so much for any input and advice you can give.

Carmen

[emily]

I don't think the weight loss is anything to worry about. You lost about 11% of your bodyweight, which can happen with HG. I lost 15% myself in less than three weeks. Anyhow, I never did gain back all of the weight that I lost before I delivered and my baby was 9 LB 12 OZ and the day I went into deliver I was under my weight at my first prenatal appt. Also, keep in mind, if you are still dehydrated, you can still not have all your water weight. But by all means, if you have any concerns I would talk to your Dr. . That is what they get paid for!

[mammaclare]

My perinatologist said that I needed to show a gain by around 22 weeks or we would talk NG tube (she doesn't like to use TPN in a PICC). I gained at the 20/21 week mark for the first time. There are actually many healthy pregnancies that don't see a gain until the 18-20 week mark. I think you are okay for now and your baby will leech from you what he/she needs.

Great for being on the max of Zofran-sounds like you have a good doc. Maybe you can give his/her name to the forum so that we can get the doc added to the list of good HG ones.

Make sure that you are hydrated as this makes the Zofran work better.

Glad to meet you, sorry it had to be through a crappy HG pregnancy!

[MamaLily]

Carmen -

Hi and welcome! I'm so happy you have found us here...I know that this forum will make a HUGE difference for you during this horrible HG pregnancy. The women here are simply amazing. And we are all here to support you through this. HG is so hard to get through, but it's so worth it!

I have a few questions for you: have you tried any meds other than Zofran? Have you ever been put on a combination of meds? When you feel dehydrated, how do you get fluids?

Most HGers find that Zofran alone does not take care of vomiting AND nausea. I think the maximum for zofran is 32 mgs per day - and you are taking 24 mgs a day? Maybe the extra zofran would help. There is a great "Sticky" in this 2nd Trimester folder that talks about your options for combining Zofran with Unisom and B6. This works for a lot of HGers! Or you could combine zofran with meclizine, benadryl, phenergan, reglan, etc. Have you ever tried reglan before? My perinatologist said that reglan basically helps food move faster through your stomach, so that you are able to digest more before you vomit. If you can keep some foods down, it might be worth trying! On this website, there is a great list of meds that HGers commonly use. Please read it and take it to your doctor's appointment, if you think it will help. http://helpher.org/mothers/treatments/medications.php

If you don't find any help from these other meds, you are definitely at a good spot in your pregnancy to try steroids. I was put on steroids at week 11 and they helped stop the weight gain for me. They were not a "miracle drug" at all, but they definitely helped.

I am a great supporter of an NG tube. With any future pregnancy I may have, I will consider getting a tube placed sooner (before week 11, like last time). If it comes down to this, it's probably your best option for proving nutrients to you and your baby.

What food are you able to keep down? How much liquid per day? It could be that you are dehydrated and need fluids more regularly. Have you talked with your doctor about this?

Feel free to ask as many questions as you want...that's what we're here for! Let me know if you want any more info about anything. Hang in there!

- Anna

[mom2matt]

Hi and welcome, I just wanted to add my 2 cents. I had severe HG with my son 2 years ago...I lost 20 lbs and gained 1 lb with the whole pregnancy. He was a 'thin' new born, but by all accounts healty.

I have since learned (again this is just my story)..babies WILL take what they need, YOU will be the one suffering...at 26 weeks is when nutrition becomes 'more important' to a fetus, according to my dr. its a major growth period..
I wonder why the aversion to PICC and TPB..it has saved me and the twins...I can at least 'hook up overnight' and no-one really has to know I have a IV in my upper arm + I dont need ANY needles as long as its in!!!.. Is an NG tube thru the nose (I really dont know)..but what ever works do it...ITS TEMPORARY..and SO important.

Congrats for seeking out support, [u]get a good team of DR to support you as well[/u]. Its bad enough feeling as utterly lousy as we do in this time of our lives...and feeling like a burden on family and friends...everyone needs to be more EDUCATED on this "DISEASE OF PREGNANCY" and for the nay sayers..."hang in there, dont be a wimp"...tell them kidney and liver failure are not a joke, so malnutrition and dehydration go hand in hand. I just get so upset when HG sufferes are told..come on...so dont give up..find what works.

HOPE YOU FEEL BETTER!!!
shlby
Matt 2 yrs HG5W-Deliv
Twins due 1/05 HG5W

[MamaLily]

Carmen -

Well, I have to admit that I've never heard doctors explain that meds are supposed to make us so unconscious that we don't know we're nauseated. I'll have to ask a pharmacist about that next time! I thought the point of the drugs is to fight the nausea - and the sedative factor is just a side effect!

Anyway, you mentioned that you have some vertigo with this pregnancy. I definitely think that you ought to try meclizine. It's an over-the-counter medicine that is used to fight motion sickness. And HGers have tried it with some success at fighting the nausea that Zofran can't fight. You can get meclizine from a pharmacist without a prescription. I know that Pamela used it with good success - I'm sure she'd be happy to answer any questions you may have about it. If I ever have another pregnancy, meclizine is the first drug I plan on trying! Please look into it...it might be a great option for you!

Have you tried waking up during the night to take Zofran, so that you stay on a regular schedule? There was no way I could have any lapse in taking zofran...even an hour or so was not good! Maybe taking it around the clock will help you stay on top of the HG a little bit better.

Have you tried taking steroids? I think they would help you so much! Do you need some info about them? Has your doctor talked with you about steroids? Many doctors don't know that they are an option for HGers, but they really can make a difference! I don't know what I would have done without them.

As far as food goes, I think you are doing okay. Keeping eating whatever will stay down! And you've already learned to follow your cravings and to stay away from aversions, so you're ahead of the game.

Hang in there!

- Anna

[MamaLily]

Carmen -

AAAH! I don't know what is going on in this thread. It showed a post from me under your name and now I think some of the posts have been deleted!

I'll try to get things straightened out...in the meantime, please keep us posted and let us know how things are going for you.

- Anna