Reducing the risks while bed bound
An inevitable part of HG is the miserably excessive amount of time spend in bed. People who have never been bed bound often make ignorant comments about how nice it must be to just stay in bed all day but those of us who have ever spend more than about 3 days in bed due to an illness or injury know what utter nonsense that it!
The reality is that after about 48 hours of being in bed that place we think of as a heavenly sanctuary of comfort and rest turns into a hellish cave of pain, isolation and utter misery. Forward about 6 weeks of being in bed, (that's over 1,000 hours) and the bed is actually hell on earth! On top of that, the smell of the bedsheets can be stomach turning, the light flickering through the crack in the curtain can seem like it's torturing you with it's playful flicker which triggers yet more bouts of vomiting. The sound of your house become intimately ingrained in your mind and can start to play tricks on you breaking the long lonely silences all alone in your squishy prison cell. And for some women, six weeks is just the start... nine long months, 36+ weeks, that's over 6,000 hours!
But on top of all that there are actual, genuine dangers of being bed bound for so long.
DVT and PE
Deep Vein Thrombosis (DVT) is a blood clot which can form in your legs or pelvis and if breaks off from the vein and travels to your lungs it can cause a potentially life-threatening condition called Pulmonary Embolism (PE). Pregnant women are already at increased risk of DVT due to various changes in your body during pregnancy, such as increase blood volume, and the dehydration women with HG experience increases this risk even more.
It is important you try to reduce the risk as best you can within the limits of what the condition allows... obviously, if you could get up and walk about for a bit each hour then you wouldn't be bed bound in the first place! If you are admitted to hospital you may be given an injection daily to combat the risk and you may be provided with special knee or thigh high stockings to wear. You can take these home and continue to use them if you want and if you are too ill to do the following risk-reducing steps then it is a good idea to keep them on.
Switch between bed and a chair or sofa on a regular basis if you can
Getting up and walking around your bed or house as often as possible
Do simple leg exercises such as flexing and extending your foot, rotating your foot in circles.
Stretch your thigh muscles (hamstrings) while lying in bed – raise one leg in the air as high as you can (up to a 90 degree angle), pull the leg towards your body gently and hold for 30 seconds. Release gently and repeat with the other.
From a lying position bring one knee to your chest, hold for 15 seconds and release slowly, repeat with the other.
Ultimately for the women with severe hyperemesis all of those above prevention measures may seem impossible and you should discuss your risk with your GP or midwife if that is the case. They may prescribe compression stockings at home for you (then again, they may not... my GP laughed at me in my second pregnancy when I raised my concerns and wanted advice, they're not all like that though).
Knowing the signs and symptoms of DVT and PE is very important for bed-bound pregnant women and should you experience any of the following symptoms then get rapid medical assessment, call your GP or 111:
Pain like a heavy ache, swelling or tenderness in one of your legs (usually your calf). The pain may be worse when standing or walking.
Red or noticeably warm areas on your leg, particularly at the back of your leg below your knee
Swelling in one area or on one leg
For symptoms of DVT see a doctor as quickly as possible.
Sometimes a DVT won't have any symptoms and you could suffer a PE with no prior warning. The symptoms to be aware of for PE are:
Breathlessness, either coming on suddenly or gradually
Chest pain, which may be worse when you inhale (breath in)
For any of the symptoms of a PE you need to call 999 for an ambulance.
Pressure damage to skin and soft tissue happens when you lie or sit in one position for a long time so that the blood supply to the pressure point is reduced or stopped and a wound starts to develop. They start as painful red patches but can rapidly become open wounds. Areas particularly prone to pressure damage include your heals, sacrum, shoulders, head and really just any bony bits.
Dehydration and poor nutrition increase your risk of pressure damage to tissue and reduce healing too. They are unlikely to get significantly bad for HG patients, except in the most extreme cases, and once you are able to get up and about a little the risk will drop significantly, but in the meantime it's important to be vigilant if they start to develop.
To reduce the risk of pressure damage try to change position regularly (every two hours or more frequently) and try to make sure there aren't creases in the sheets where you are lying. If you are very concerned or are developing pressure sores, which start as red patches that don't go white (blanch) when you press on them, then speak to your doctor or practice nurse.
Pregnancy pillows can help you get comfy in a variety of positions and may help in your effort to change positions regularly.