Tuesday, May 23, 2006

Morning sickness

I've had reason to review my knowledge of morning sickness recently. Most women get this to one degree or other in pregnancy in the early stages of pregnancy. Most don't require treatment and it usually settles around the three month mark.

Some don't settle however. I suspect those women probably don't enjoy being pregnant as much as they were hoping to.

A few unfortunate souls suffer hyperemesis gravidarum. That is more serious and sometimes requires hospital admission, especially if the mother becomes dehydrated. But there are degrees of hyperemesis. Someone close to me has it at the moment (in my completely unbiased and objective opinion). I thought she would require admission last week, but luckily we've avoided that.

The constant nausea and repeated vomiting brought on dehydration and an extreme malaise and lethargy. She is currently not working, which is just as well because I don't think she would be able to anyway. This week, she is coping a bit better. In part this is due to the phenergan
she has been using on and off. The only trouble with that is it causes sedation and gives her a headache, which in turn makes her feel nauseated.

See the problem there?

There are other drugs which help some people: prochlorperazine, metoclopramise, cyclizine. None of these drugs are licensed for use in pregnancy related sickness. But numerous studies have been performed which have not shown any adverse effects on the baby. The Prodigy
website was one which I have found helpful as a revision, though it hasn't helped Mrs Brown very much. She is trying accupuncture, having already (unsuccessfully) tried the accupressure bands you can buy in any pharmacy. Accupuncture has not been shown to be helpful in 2 randomised controlled trials. But if it helps her, I'm certainly not going to argue.

So in case you've come across my blog because you're suffering from pregnancy related sickness and you've googled it, here is my suggested managment plan:
  1. Sip frequently, don't drink large volumes. The quicker you drink a large volume, the more likely you are to throw up. Try using a straw.
  2. Drink and eat whatever you feel like. Don't worry about whether the baby is getting enough vitamins because your previosuly healthy diet has been reduced to mashed potato and baked beans. The improtant thing is that you avoid dehydration and manage to get food in to yourself. The baby will take what it needs from you, at your expense.
  3. If you can't stop vomiting, seek help from the health professional of your choice. Midwives may have some sensible suggestions. GPs certainly will and can prescribe certain drugs (though be aware that many GPs will prefer to avoid them if they can).
  4. Try having some sort of bland carbohydrate before you get up (crackers or toast).
  5. Don't get hungry: nibble snacks throughout the day and see point 1.
  6. Rest. You're not superwoman, and the world won't fall apart because you're knackered. If you have other things that need looking after (like other kids) enlist help from family and friends. Do not try and do it all yourself. You don't have to.
  7. Despite the fact that most alternative therapies have not been shown to be of benefit, that doesn't mean they won't make you feel better. Any cynical GP (like me) who says anything other than "If you say it helps I won't argue" shouldn't be told (as long as it won't do any harm of course).
  8. Ginger in various forms may help. Of course, it makes some people worse.
  9. If you're prescribed medication, please use it. We don't prescribe for fun. You never know, it might help.
  10. See points 1 and 6 again.
And here's Russell's management plan for husband's/boyfriends/whatever:
  1. Be sympathetic. Its not nice. Jokes will not go down well and do not make your wife/partner/girlfriend/lover feel any better.
  2. Cuddles are good, but don't squeeze. You will regret it.
  3. Try and think ahead of yourself. Keep fresh water handy. Try flavoured electrolyte replacement or rehydration salts (such as dioralyte). Buy crackers.
  4. If you're worried, seek help. That can be your Mum, her Mum, your doctor, her midwife, anyone you like. If you don't ask, you won't get.
  5. Wash up before you go to bed. You won't have time in the morning.
  6. Don't feel guilty. Its not (just) your fault. Two people had sex. At the same time however, accept any and all criticism with that stock phrase: "Yes, dear."
  7. Don't forget to tell her you love her either. That will help, because the way she is feeling, she is unlikely to love herself at the moment.
  8. Just because she isn't eating her broccoli doesn't mean you shouldn't.
  9. Beer and whiskey smell. You should be aware that women with pregnancy relates sickness are often made worse by certain odours. Ask first.
  10. Remember, things will get better. (Probably in about 18 years.)


Simon Bandy said...

Russ buddy,

Jen always kept bread sticks with her! in her handbag, In the car, in the kitchen, in the lounge, in the bathroom, I mean everywhere!!

Vitamin B6 is especially essential and try Ginger buscuits.


Heather Wright said...

Hi Russ,

I had to nibble on digestive biscuits constantly, especially while commuting from Eastbourne to Worthing. My "morning sickness" was multiplied by any travel. Also, brushing me teeth was the quickest way to send me hurling, I had to not touch anything but my teeth with the toothbrush and often in frustration would just opt for mouthwash or rubbing toothpaste on with my finger. :-/

Send my love to Mrs Brown.


Anonymous said...

Other tips:

Despite the awful fact that brushing the teeth makes me retch (I'm 12 weeks pregnant), clean teeth makes a big difference. Using a very small (baby) toothbrush helps a bit.

Carrying strong mints (or boiled sweets, if I can't get the mints) is also useful. Taking one at the first twinge of nausea gives me about 5 minutes to get my feet up for a minute, sip some water (cool, but not icy cold), and have a cracker. This makes the nausea go away for quite a while.

Oddly, celery sticks are also really good -- they clean the teeth off a bit and the strong flavour distracts me.

Anonymous said...

I lived on crackers for a bit. My OB also recommended those seasickness bands. They're a kind of bracelet which applies accupressure. It apparently works for some & has no side effects & is safe in pregnancy. At the very least, it couldn't hurt.


Kim said...

You're a great guy!

And every single thing you said is true....first baby was hell from 6-12 weeks gestation.

My boss thought I was faking it.

Russell Brown said...

An update

Cyclizine works wonders.....

Pete Wright said...

At the risk of lowering the tone, when I read that you were recommending the Prodigy website I figured you'd discover strange soothing anti-vomit effects associated with FireStarter.

Sarah F said...

Hahaha, oh my word! I laughed so much at the 'tips for the guys' at the bottom, it briefly took my mind off how awful I've been feeling for the last few days!

Men are amusing creatures, they really do try hard as well. They've got it made really, what with being able to pee standing up and not having to deal with pregnancy symptoms...

....I'm coming back as a man.

manda said...

oh, man, i totally empathize! i tried that psi anti-nausea/morning sickness wrist band and i swear, it really helped. think i got it from a site called goodtobeyou. i recommend it to every mom-to-be!

DesireE said...

Probably too late but can't help myself and have to say how GREAT job accupresure did to my and my morning sickness. It's a life saver. Some details on my blog below: http://defeatmorningsickness.blogspot.com/

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Morgan said...

There is a brand new product that just came out called Tranquil Tummy. Crackers + Ginger! Works WONDERS!

No medicine needed. Just a few crackers does the trick and the nausea is gone!


bellamama said...

I don't like to eat any drug in my morning sickness. But my doctor prescribe me B6 vitamin. It helpful for me. Thanks for your article!

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