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Journey into the world of hyperemesis gravidarum...
30Oct 13

HG Hero - Dr Stephen Granier, Whiteladies Medical Practice

HG Hero - Dr Stephen Granier


HG veteran Natalie Farrell has nominated Dr Stephen Granier, the GP that cared for her during her last pregnancy four years ago. Having been through two previous hyperemesis pregnancies in London and Bristol, of Dr Granier's care Natalie says “He just blew me away with his care – I thought it was outstanding.

Natalie's pregnancy was horrendous. By week ten she had already tried combinations of at least ten anti-emetics and been in and out of hospital countless times. It is a story many of my readers will be familiar with, but not so many will have a tale of compassion and care to tell, which ultimately made the horrors so much more bearable. So what was it that Dr Granier did that made such a difference to Natalie?

Well, for a start, between weeks six and nine, the worst points for Natalie, he never made her come in to the surgery to see him. He was confident to talk to Natalie on the phone and to assess her symptoms by trusting what she was telling him. Natalie says “Dr Granier is the only GP who has never made me actually go down to the surgery to 'prove' how ill I am in person!”, a common issue reported by hyperemesis sufferers.

“At the start of week six, we worked out an HG management strategy on the phone together. If I got to +2 ketones on the Ketostix, I would call him, he would call the ward and I would go in for fluids.” Natalie says. “He believed me and how ill I was. He trusted me that I knew what I was doing having been through it twice before. He never questioned how sick I was. This strategy worked like a charm, it wasn't all stressful for me, he smoothed the way so I could get the care I needed when I needed it. Just what every HG sufferer needs!”

As so many of you know and I have written about previously, being believed is really crucial and makes such a big difference to the sufferer.

Dr Granier advocated for me too. He liaised with the medical team treating me while I was in hospital. I can't even remember the name of the consultant, which shows how memorable his care was!” Natalie recalls. At twelve weeks the hospital registrar wanted to stop her steroid treatment well before the sickness was controlled. However Dr Granier advocated for her and arranged to continue the prescriptions until the sickness was controlled enough to come off them safely.

Well you all know my views on the need for advocacy for HG sufferers and I really think that healthcare professionals should take a more active role in speaking up for patients. I see it as a key element of professional nursing though sadly it doesn't happen enough.

Natalie goes on to describe how Dr Granier empowered her in her own care particularly around tweaking medication doses based on what was working and what wasn't. He never questioned the safety of the medications to her – a common strategy of healthcare professionals which is highly unprofessional and serves only to add to the stress of the patient. Instead he checked with hospital colleagues and ensured all bases we're covered with appropriate blood tests and ongoing monitoring.

Natalie goes on to describe more ways that Dr Granier helped “He gave care over and above what is expected of a GP. On one occasion he was away from the surgery yet ensured I was able to contact him if necessary. That way, if I had needed to go in for fluids, it could easily be arranged... I mean seriously, that is something else. He wasn't even in the office and I could still contact him. Amazing!”

“He was at all times sympathetic, caring and supportive. He was genuinely concerned for my physical and emotional well being.” says Natalie.

On top of this excellent care, Natalie recalls that Dr Granier was also humble and gracious, genuinely not appreciating that his care, which comes as standard, made such an incredible difference to the suffering of one woman. This was confirmed to me with recent email communication with Dr Granier as I contacted the surgery for permission to use his picture. Although delighted with his HG Hero recognition he states “I do not feel that I deserve special attention as I was just doing what I would ordinarily do for someone going through such a difficult experience”

“YAY!” for the Dr Granier's of the world, though few and far between they are slowly but surely making compassionate and kind care “ordinary”, as it should be. And although they can't help all the sufferers of the world they can certainly make the world of difference to some.

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Absolute star, when Nat was very ill for ages, in and out of hospital. WIthout him, I don't think we would have coped as a family, and Nat would have been much more poorly - few doctors seem to know how to treat HG, and yet it can be seriously debilitating, even fatal...
The New Zealand Bit, 30th October 2013

Wow! What an absolutely amazing GP! It almost makes me cry with relief that there are some healthcare professionals out there leading the way forward in care of this manner. What a truly deserving HG Hero!
Amanda, 30th October 2013

I expected to have horlbire morning sickness like my sister did with all her kids. I never got it. I did however get some even more fun things that I didn't expect. I had heard of the heightened sense of smell but, I could smell EVERYTHING like it was inside my nose. The smell of cooking ground beef made me want to barf. Then there were the nose bleeds, lightening crotch my little name for the shooting pain when the baby kicks your cervix, the numbness in my legs due to the baby pushing on a nerve, and my personal favorite was getting shingles a few weeks after giving birth both times. The leg numbness was the worst with baby #1. By month 7 I couldn't stand or walk for more than 15 mins at a time. Lightening crotch was super awful with baby #2! But, that made sense when I found out he was breech. Ahhh the joys of pregnancy .lol!
Shama, 28th December 2014

24Oct 13

Ginger capsule anyone?

As anyone who has suffered with pregnancy sickness to any degree at all knows, there are various products on the market which claim to relieve the symptoms of “morning sickness”. I'd like to review just a few of these products as I've tried them all – I just need to be careful I don't get sued...
 
Acupressure wrist bands – I have worn these continuously for a total of 27 months of my life and I have permanent scars on my wrists from the pressure damage they caused. I first bought a pair in the hope they might relieve my symptoms. Ha ha ha, as if! Various hard core medications weren't helping, as if applying a little pressure on my wrists would cure me! For those not actually bed bound they can serve as a beacon for co-workers to spot the pregnancy early as you're presumably not travel sick whilst sat at your desk and for the first few days they are quite uncomfortable. So why did I carry on wearing them? Because they do have one benefit – they shut people up who ask if you've tried them and show that you are at least "trying to help yourself" to those ignoramus's who think you just need to get some fresh air and a positive mental attitude.
 
Strange flavoured ice lolly's which are meant to help – Well these actually made me spew up! So I'm fairly confident in my assertion that they don't work, at least not for everyone. The flavours really are strange! A far better investment would be an ice-lolly mould which you can make your own, pleasant flavoured, ice lollies in.
 
Aromatherapy wrist role on type things – I must admit I bought one of these things and the smell was quite pleasant. I can't say it helped with the nausea or vomiting but it was one of the only smells I could tolerate and if inhaled right from the bottle helped to drown our other horrid smells – one important tip though – discard after pregnancy! I found mine in a draw the other day and took a sniff, major flashback!!!
 
Ginger capsules – Okay so there is a body of evidence that says taking ginger extract in capsule form 1000mg per day may be helpful for nausea and vomiting in pregnancy. In reality, as if throwing up wasn't bad enough, ginger extract is actually quite burny on the way back out. It also repeats like a bitch! If you're just nauseous though there's no harm in trying – well, we assume there is no harm in trying, I'm not actually aware of any well conducted studies which have assessed the safety of ginger in pregnancy!
 
Hypnotherapy– For hypnotherapy to cure pregnancy sickness or hyperemesis gravidarum they would need to have a psychological cause. I'm sure you all know my opinion on that! I did however try a bit of hypnotherapy to help me cope with emetic episodes, which by spew number #1,500 were pretty traumatic. The theory was much like hypnobirthing – that I would self hypnotise to get me through the painful and unpleasant vomit sessions. I explained this clearly to the chap who came to my house and took our money. But he was DETERMINED that the cause was something from my past and he could cure me and couldn't understand why when asking me when it started I couldn't go further back than the start of week 6 in my first pregnancy – ummm.... when it started!!! So that was a fairly massive fail, I just felt angry, upset and ripped off after!
 
The problem with all of these “cures” is that they ultimately undermine the condition. If your sickness is so mild that one of these might help then really is it worth spending the money on? It's likely to pass by week twelve anyway and is probably only for a short time each day.
 
If your sickness is so severe that you are thinking about splashing out on these things and subjecting yourself to the discomfort of tight bands round your wrist, disgusting flavours, potential side effects from horse sized capsules or enduring an hour long session with a hippy, then they probably won't work anyway. And if you are reaching the stage of not being able to eat or drink and are pretty much bed bound then these "remedies" are outright dangerous if they are delaying women seeking proper medical attention.
 
The thing that upsets me about these products is they imply there is a cure for a condition which there isn't and they also imply that women who take medication in pregnancy don't really need to because they could use these alternatives instead. The idea that any woman wantsto take medication in early pregnancy is insulting and ignorant – believe me, if these things actually worked no one would resort to medication but the reality is before we had modern anti-emetics and IV drips women simply died – the idea that they wouldn't have if they had known to chow down on some ginger or press firmly on their wrists is a joke... Just not a very funny one.

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Thanks for this post.
Lisa Rusczyk, 3rd November 2013

You're very welcome! So many women feel like these things "ought" to help and they should persevere with them... I hope to give women a voice and to let them know that just because everyone swears by something doesn't mean it actually works!
Spewing Mummy, 6th November 2013

22Oct 13

Great Minds Think Alike

Completely independently both the HER foundation and I started our HG Hero awards – when we realised there was an amusing flurry of emails. “Oh no, please don't think I copied your idea!” came from both sides and we decided that great minds think alike and that both series should continue simultaneously as all HG Heroes around the world should be shouted about and bigged up.
 
Little did I know at the time that I was myself in line for an HG HERo award! The email this afternoon from Ann Marie brought a tear to my eye - A little bit because it's really great to have your hard work recognised and I am utterly honoured to receive such an award - but mainly because right there above me is my friend and colleague Heather Miranda.
 
Heather truly is an HG Hero. She is the most committed and dedicated volunteer in PSS and works tirelessly to support women suffering. She emailed or text me every single day while I was pregnant with Orla. She is suffering herself at the moment to provide a sibling for her little boy. I am ashamed to say I only text her every few days, although luckily I know she has a whole team of other women repaying her kindness.
 
Heather also raises awareness and funds for the cause, self funding materials and putting vast amounts of time into awareness stands and packs to post to hospitals and sufferers. Here is an information stand she put together earlier this year
 
Awareness and fundraising pack by Heather Miranda
 

 

Heather humbles me – she reminds me why I do what I do and she inspires me to do more. I may only text every few days but I think of her every day and put her dedication on a pedestal to fuel my ambition for this cause. I'm so glad that she is being recognised, internationally, for this work and am grateful to the HER foundation for both our awards, they are truly appreciated and will give us the lift we sometimes need when things can seem just too much.  
Heather Miranda - HG Hero
PS. I know my blog has been rather "soppy" of late, apologies - I'll aim for amusing next time ;)

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Its thanks to you blogs and website that have helped to keep me going through the tough times and know I am not alone. I have made a promise to myself that next year after baby is born I will raise some money and be a volunteer. Its the least I can do for this charity. Thank you Caitlin :)
Natalie Morley, 23rd October 2013

Ah Natalie, thank you so much for your comment. It's so great to know that our message is reaching those who need it and letting them know they are not alone. It will be great to have you on board with PSS and thank you for reading and sharing my blogs.
Spewing Mummy, 23rd October 2013

19Oct 13

HG Heroes - Al Johnson

Rachel Johnson from South East London has nominated her husband to be recognised as an HG Hero. They have been together for nearly six years after meeting through work in France and got married two and a half years ago. Al has supported Rachel through two hyperemesis pregnancies, never wavering in his support or questioning her random requests for frozen peach squash or skull crush candy.

Al has recently survived their second round of hyperemesis which consisted of eight months of washing out buckets and bins, and glasses and bowls. Seven and a half months months of him helping Rachel in and out of the shower, administering clexane injections to prevent deep vein thrombosis and helping with everything around the house. Al advocated for Rachel and fought for her rights, obtaining additional medication which a consultant prescribed yet the GP refused to give. For two and a half months Rachel was on crutches and Al was there, comforting her when she was in so much pain she couldn't function. He then went on to be a hero in labour, delivering their son's head alone when he couldn't find a healthcare professional in the hospital before help eventually arrived.

Their son is now nine weeks old and adored by his 4 year old sister. Rachel says “Al is my hero, my strength and an amazing dad too.”

YAY for Al, and all the partners like him!



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15Oct 13

Hyperemesis Education and Research Foundation

Caitlin Dean and Ann Marie King 
The Hyperemesis Education and ResearchFoundation (HER) are celebrating their 10th Birthday this week. To say I am grateful to them is an understatement of the highest degree.
 
My son Alfie exists because of the HER Foundation. Their website and forum was just about the only source of information, help and support back in 2007 when I was first struck by hyperemesis gravidarum.
 
Between HER and the brilliant book by Ashli Foshee McCall, Beyond Morning SicknessI was empowered and enabled enough to go through my second pregnancy to have Patrick.
 
The achievements of the HER foundation have been instrumental in my passion and dedication to create a similar orgnaisation in the UK and despite Pregnancy Sickness Supporthaving been established a whole year earlier, 11 years ago this month, a lack of findable web presence meant that during both these horrendous pregnancies I never found the UK Charity here to support me in my darkest hours. In fact, it was thanks to the HER website that I finally stumbled on PSS before trying for our third – So I have them to thank for Orla too and for introducing me to the PSS. For that I know many others are grateful too.
 
In May this year I took a trip to the states to meet with Ann Marie and Jeremy King, founding trustees of HER and I am looking forward to seeing them again in March next year. Between the HER foundation and PSS we now provide international support for women suffering across the world and the power to raise awareness of this condition is simply mega with our voices united.
  • Hyperemesis Gravidraum is NOT a normal part of pregnancy, it is a severe complication.
  • Lets scrap “morning sickness” - PREGNANCY SICKNESS is on a spectrum.
  • Women need to be treated appropriately, effectively and with kindness, compassion and dignity.
  • Research is VITAL
  • Women should not HAVE to terminate their wanted babies because of a lack of treatment and support.

    International HG Advocates outside the Whitehouse

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14Oct 13

Mental Health and the legacy of Hyperemesis Gravidarum

Back in the 1930's around the time of psycho-dynamic theory development the mad, excuse the pun, idea developed that women with hyperemesis gravidarum were mentally ill and that the excessive, life-threatening vomiting was down to a subconscious rejection of the foetus. This coincided with a drop in the death rate from the condition thanks to the incredibly wonderful development of intravenous fluids. But not dying, combined with ridiculous theories about women's mental states lead to abominable treatment plans where women were literally locked up, prevented from seeing family and left to rot in their own vomit having had sick bowls removed and nurses told not to help them clean up.
 
Thankfully, on the whole that kind of stuff doesn't happen any more, although thanks to staff shortages it isn't uncommon for women in hospital to have to dispose of their own vomit bowls.
 
Even more thankfully, the idea of a psychological cause has been utterly disproved.
 
However, there can be no denying that hyperemesis gravidarum can causemental health issues for the sufferer. The prolonged suffering of continuous, unrelenting nausea and vomiting. Vomiting which in itself can be violent, painful and unpredictable. The isolation of literally months in bed with only minutes a day of company from your partner who is at work the rest of the time, or caring for other children. Unable to read, speak on the phone, watch TV or gain any respite from focusing on the crippling nausea, the humiliation that comes when vomiting results in urinating on the floor or in your bed or the knowledge you haven't showered in weeks – well it's hardly any wonder depression can ensue.
 
Peri-natal depression is not uncommon. I certainly was depressed during pregnancy as a direct result of HG. I was luck though that it didn't last beyond pregnancy because for many women peri-natal depression leads to post-natal depression and that can be far more serious than many people realise – ultimately for some it can be fatal.
 
Post Traumatic Stress Disorder (PTSD) can also be common after a hyperemesis pregnancy. It's hardly surprising if you look at the causes of the condition – prolonged exposure to an extremely stressful situation. Well, lying in bed for weeks or months vomiting on every movement and thinking you are dying is pretty stressful. Flashbacks are common with this as is emetophobia and food or pregnancy related anxiety and panic attacks. PTSD too can be terminal and should never be underestimated.
 
Luckily though these conditions are treatable and the first thing you must do if you think you are suffering is to admit you need help. Then get help! Don't just ignore it and hope you'll get better. If you are reading this and think a loved one is suffering then you need to seek help for them. Talk to them and express your concerns but if you are met with resistance and denial then don't be put of getting help for them.
 

 

Below are some links to organisations that many be able to help. If your GP or midwife were helpful then you could try them for a referral to a local service. Post-natal depression tend to be well recognised and supported these days and you will hopefully be met with empathy and kindness if you seek help for this. Unfortunately though, peri-natal depression and HG related Post traumatic Stress Disorder tend to be a little less recognised, it's improving, but if your first attempt to get help fails then try, try and try again using the avenues below. Ask your partner to help explain things and show him the post onAdvocacy which can be applied to advocating about anything really. But above all, get help. It's bad enough you suffered in pregnancy – don't let the legacy of HG ruin any more of your life – take control and get help!
 
Mind is a national charity supporting all mental illness, they can provide help in a crisis and give further advice about help local to you. - http://www.mind.org.uk/ 
 
Black Dog Tribe is a social networking platform for people with mental health condition. They offer support and help and a safe community. http://blackdogtribe.com/
 
PANDAS offer help and support for pre and post natal depression and I've met the woman who runs it... she's clued up on HG. http://www.pandasfoundation.org.uk/
 
Through the links page on their website I found The Perinatal Illness UK charity which offers support and help for all mental or emotional illhealth during and after pregnancy - well worth getting in touch with if you need help. http://www.pni-uk.com/
 
Finally, I'll say it again - DON'T SUFFER IN SILENCE - GET HELP!

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Thanks for this and I am suffering with depression due to HG pelvic girdle pain and painful bladder. It is so hard to get through each day. I've done 6 months so far and the sad thing is even when I've given birth I will have to go back to work fulltime after 3 months just hope this is all worth it because I don't see much joy at the moment :(
Natalie Morley, 14th October 2013

Oh Natalie, I'm sorry you are suffering so much and I wish you could know now how worth it the end result is but sadly it's nearly impossible to see at this point. Please make sure you get support via PSS and the links I've posted above. There are a number of forums you can access for the various conditions which will help you to pass the days. I know going back at 3 months seems so unfair but you might actually find that by then you'll be pleased to get back to the real world for a bit each week. Unfortunately, a lot of women find the first few months with a new born quite isolating in itself and after months of HG anyway return to work can be a welcome respite. Please don't wait too long to get help - the sooner you do the more chance of avoiding PND you have. X
Spewing Mummy, 14th October 2013

11Oct 13

HG Heroes - Dr Tony Barnie-Adshead

How could I do a series of HG Heroes without profiling one of my top heroes, Dr Tony Barnie-Adshead! This handsome octogenarian has dedicated years of his professional life to researching the cause of pregnancy sickness and is a founding trustee of Pregnancy Sickness Support. He now provides daily support and hope to women at their most desperate moments.
 
Dr Tony Barnie-Adshead
As a young GP in Nuneaton he cared for a woman with hyperemesis who then limited her family to one child, unable to face it again. Determined to find out what was causing HG he started his research. Luckily Tony instilled his passion for the subject on a Junior GP within the Practice, Dr Gadsby (another Hero to be profiled soon) and together they spent years researching the cause of pregnancy sickness and HG, collecting blood samples and looking into the effect of the hormone Prosteglandin E2.
 
His important research is now available on the PSS website for the world to see although he would desperately love an enthusiastic young doctor to hand over the mantle to and continue this study. His other work has included conducting extensive literature reviews in order to profile the entire condition and all the various elements and effects of it. Tony has written vast amounts of the PSS website and edited the rest.
 
Along with his ongoing academic work Tony also answers the PSS helpline, checking the answer phone twice a day so that sufferers never have to wait long when in need. He can take a number of phone calls a day from desperate women needing support and help – he's been doing this for years and luckily for us he is still going strong.
 

 

I'm not sure I can adequately describe my deep personal and professional respect for Tony in a blog post. His passion to change things for the better for women with HG is intoxicating and inspiring. His dedication has been instrumental in my own determination to improve care and support. He and his wonderful wife Rosemary are some of the loveliest, kindest people I've ever known and I am honoured to call them not just my colleagues but also my friends. I can not thank them enough for all they do for HG sufferers worldwide.

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This comment has been removed by the author.
Helen Hendy, 12th October 2013

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Helen Hendy, 12th October 2013

Hear, Hear! Tony is most definitely an HG Hero if not THE HG Hero!!! Also one of the nicest people I have ever met - legend.
Helen Hendy, 12th October 2013

As regards her name, I thhguot that she was never a Kate in real life, but always a Catherine , and it's just tabloids that have always called her that. But I could be wrong, since I'm not an avid royal watcher (though I am hugely pro-royalty when it means an extra bank-holiday). Anyway, as a fellow not-a-Kate who hates it when people get my name wrong, or swap the K for a C, I have generally tried to refer to her as Catherine (and discovered that a particularly stupid cow-orker didn't know that was her real name). What I didn't like about the tone of most of the newspaper reports was the way that they imply that HRH has now fulfilled her function, like a prized heifer or endangered panda. As a woman, her only duty is to get preggers, and without sprogs her life is meaningless.
Titi, 28th December 2014

08Oct 13

In sickness and in health - tips for right plonkers!

I rather gave partners the benefit of the doubt in my last post. And rightly so, the vast majority of partners are hugely supportive of their loved ones and feel desperately lost in their quest to help, wishing they could share the burden of, or take away complete, the sickness for her.

 
But lets get real – some partners are right plonkers!
 
So if you're a plonker but would like to redeem yourself try some of these tips on how you can be less of a plonker and help your loved one:
  1. Put your piny on and do some housework – and I mean without moaning or calling your mum! (and that includes the toilet – you put some toilet cleaner in, leave it for a bit, then scrub with the toilet brush – found next to the toilet – and flush, job done and brownie points earned!)
  2. Do without curry for a few months – you STINK the next day
  3. That goes for fags and beer too, well, in excess anyway. I'm sure you gave up smoking back when you where trying for the baby anyway didn't you – it messes your sperm up!
  4. Go and have a w*** - don't worry, you're not “dissing” her!!!
  5. Don't stop out late getting smashed and expect her to sort the kids out in the morning while you spew up and say “don't know what you're complaining about, chucking up's not that bad”
  6. Cancel your lad's weekend – I don't care if it's fishing, walking, raving, barbecuing or any other testosterone fuelled “me time” she has been isolated, lonely and longing for the weekend all week while you've been busy at work, not spewing up – in the scheme of things it's a minor sacrifice and you can rearrange for a few months time... or just miss it... big deal.
  7. Don't take the mood swings personally and don't EVER shout back – just take it for what it is, her hurting and upset and lashing out at the closest thing to hand.
  8. Do text her from work, tell her you love her and support her and how great the future will be. Get her whatever she asks for and do it with a smile on your face (if appropriate).
  9. Do spend your evening lying in bed with her even though you'd rather be downstairs playing on the X-box. She may not be much company but she will appreciate yours.
 
It's a bit sad that I've had to write this post really. But all of the above are from real life examples from women I know or have supported. A couple of them (the more minor ones) are from my own experience – My husband is human after all and nine months is a long time to go with out curry and beer! But he was great at texting and just sitting with me in the evenings.
 
Unfortunately some, otherwise healthy partnerships and marriages don't survive the hefty trial of nine months with HG, it's pretty intense. Resentment created at this crucial time in a changing relationship, as a couple become a family, can eat away at the foundations. But luckily, those that do survive and where the partner has been supportive, tend to thrive with a “we survived that – we can survive anything” mentality.
 
Partners – follow the above guidelines and you'll be just fine – who knows, perhaps she'll nominate you as an HG Hero!

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04Oct 13

On Advocacy - a post for partners

As those of you who have been through it know it is very hard to advocate for oneself when you are barely able to speak for throwing up. Hyperemesis Gravidarum can come on very suddenly and in a matter of days take a woman from the happiest moment of her life, when she got a positive pregnancy test, to the absolute worse moment of her life to date when she hasn't stopped being sick for days and is genuinely fearful for her life.
 
It can be overwhelmingly scary and with such mixed emotions. Women can feel utterly lost and confused by what is happening – surely this isn't “normal morning sickness”. It's bad enough after a few days but after weeks and weeks of unrelenting nausea and vomiting few women have the strength to talk, let alone fight.
 
And that is where our partners can come in. In this post I hope to give partners (and by partners I'm referring to anyone in the main carer role, mothers, sisters, friends etc.), some tips about how to advocate for the sufferer.
 
Doctors can be kind of scary can't they? If you are not from a medical background then the chances are you look up to doctors and all their knowledge and have them on a bit of a pedestal. And rightly so – to a degree. They have been through years of education and training. They must be cleverer than the average person to have qualified and they know a damn sight more than you about anatomy, physiology, pharmacology, how the NHS works and so on. But they are not experts on EVERYTHING. They can't be, they are human. And remembering that will help empower you to have a rational discussion with them.
 
So, some practical tips for advocating for your loved one:
  1. Go in with a good attitude. Don't assume that the doctor will be dismissive and don't assume that you will have to “fight” for treatment. If you are reasonable then they will have a hard time explaining why they are being unreasonable.
     
  2. Prepare yourself in advance. Take notes in with you, in particular about her symptoms, your concerns and any questions.
    For example:
Symptoms:
How many times a day is she vomiting?
How much fluid and food has she kept down in 24/hrs?
How often is she weeing?
Has she lost much weight?
If she can't get down the stairs for dizziness and vomiting then note that down.
Is movement, sound and smell triggering vomiting?
Your concerns: What are your main worries? That she is severely dehydrated? That she has lost so much weight? That she is bedbound and getting sores or at risk of DVT? That if you leave her alone to go to work that she may fall down the stairs because she is so dizzy and weak? That you are both going to lose your jobs over this?
Questions: Is it safer to take medication or not? If she is not being admitted now then at what point should you be concerned that she needs to go to hospital? What signs and symptoms should you look out for that things are more serious? What is the best route for speaking to the GP, can you email or phone to speak to them? Could you help by monitoring her ketones at home? Could the nurse teach you to give her intramuscular injections of her meds for times that she can't manage oral ones? Is there any other support you can get with this? (well, you know the answer to that – PSS).
 
  1. When you first go in, explain that your partner is finding it difficult to speak due to the symptoms and you would like to explain what's been going on. If he/she seems put out then go on to explain that just getting to the surgery has been a real struggle and she really would prefer you did the talking. He can always confirm that with her.
     
  2. Using your notes as above explain that while you were both prepared for a bit of “morning sickness” and know it's a normal part of pregnancy you really don't think this severity is normal and you think she has Hyperemesis Gravidarum. Explain that whilst you had hoped to have a nice natural pregnancy, without medication and so on you really feel that she needs some treatment as the symptoms are so severe. You understand they aren't licensed for pregnancy but feel that when looked at from a risk/benefit perspective you both think the time has come to accept that she needs treatment.
     
  3. Now assuming your doctor has reacted really well and is being kind and pro-active, ask for a plan going forward. He doesn't need to agree to more medication or anything yet but he needs to let you know what symptom severity to look out for and when to come back if things don't improve. If he is sending you home rather than hospital then ask what he would like you to monitor, ie. Fluid intake/output, weight loss, ketones in her urine - he can prescribe ketosticks for this or you can buy them yourself online Ketostix Reagent Strips Ketone - 50 strips
Hopefully by following these steps you will develop a good working relationship with your GP and feel that you have managed to help your loved one by getting her treatment and support. But what if it doesn't go to plan as above. What if despite your careful description of her symptoms and your concerns you are met with “It's normal” or “No medication is safe in pregnancy”.
 
Well if the doctor is trying to claim it is normal then ask at what point they would consider severe nausea and vomiting to not be normal and what level of dehydration they consider acceptable for a pregnant woman.
 
If they give you grief about taking medication in pregnancy and claim it isn't safe and you might be damaging the baby. Ask for the evidence base for such claims and point out that there is far more evidence that not treating HG effectively has greater risks for the baby and mother than treating with medications for which there is no evidence of adverse foetal outcomes (you might want to write that down).
 
Remember that GP's generally don't know what the next patient to walk through the door is suffering with until they sit down and tell them. HG is not particularly common with many GP's seeing one or two cases a year and they can't keep up to date with all of the research about every condition. So try to be sympathetic to that, perhaps sign post them to the charity pages about treatments and perhaps offer to give them some time to look into the options, you could phone back in the afternoon or pick a prescription up later.
 
Recognise too that getting the treatment right can be a case of trial and error so always ask for advice on how long to give the medication to work and what to do if there is no improvement, or she gets side effects or deteriorates. GP's can feel frustrated if a patient is expecting a cure from them when there is no cure to give. Accepting that there is no cure, yet, and that you need to look to “manage” the condition will help no end.
 
The aim of the game is to build up a team feeling with the GP make it clear you want to work with them to help your partner and don't expect a quick solution from them.

Ultimately though, if you don't feel you've been treated well or got the help you need then ask to see someone else. Go out to reception and ask for another appointment with someone else. If you have the strength and feel you have grounds you could ask to speak to the practice manager or make a complaint. But keep it in perspective. Getting help for you partner needs to come first.
 
Don't forget, PSS have a helpline number you can call, leave a message and one of the Charity doctors will call you back: 024 7638 2020

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01Oct 13

FaceAche verses Forums

Facebook has lots of pros about it for organisations like Pregnancy Sickness Support. But recently for me it's become more FaceAche than FaceBook.
 
I cannot deny that social networks have enabled Pregnancy Sickness Support to grow so dramatically over the last couple of year. I have been able to network with sufferers and interested healthcare professionals which I would otherwise never have found. It is also a useful tool for promoting the charity and our work, raising funds and generally raising the profile of the condition.
 
During pregnancy Facbook (FB) was wonderfully supportive and massively reduced the isolation and misery of months in bed.
 
But, and it's a big BUT... It is NOT the place for seriously ill pregnant women to seek medical advice and information! Yet an awful lot of women do, and many of them go on to take the advice from these random internet strangers. In the last couple of years I've even witness women offer to post their prescription drugs to each other – crazy!
 
The sad truth is that the reason women are looking for info from FB friends and on twitter is, more often then not, because they have been let down by their health care professionals. The ones with the good doctors and midwives go to them. But when you have found the strength to go and seek help from professionals and are fobbed off with “It's normal and you mustn't take any medication in pregnancy – try ginger” then, naturally, you turn to the large online community of peers who know it's not normal to be that sick, the meds they are on are fine and ginger is a load of b*******.
 
In response to the increasingly worrying content on the facebook group yet recognising this need for women to seek online peer support, 24/7, PSS have set up a forum on their website for women to get support and information instead. It is run by our volunteers who not only have training but also have direct access to our medical experts and can provide accurate information about treatments. We have a number of nurses and doctors as members of the forum and you can see who are registered volunteers from their avatars.
 
I want to implore women suffering, not only from HG but any condition which is often misunderstood or under-appreciated to not just take the advice of strangers on a social network – seek proper information from the charity supporting the condition, from experts in the field, from trained healthcare professionals – there are good ones out there and we can help you find them.
 
Use facebook for what it is intended for – socialising, support and friendship. By all means go on and have a moan about what an awful day you are having or how the smell of you partner is making you sick or the fact that your doctor was really unhelpful. Be empowered by the united voice of hundreds of women with a shared experience. But for goodness sake, when it comes to actual medical advice don't go on Facebook!
 
 
If you are in the USA the HER Foundation also have a forum: http://www.helpher.org/forum3/
 
In the Netherlands they have a support forum also: http://www.steunpunthg.nl/phpBB/
 

 

Women from other countries are welcome on all the forums but bear in mind that information about treatment will be country specific.  

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About Me

I am mother of three beautiful children and wife to a fantastic and supportive husband. I am a nurse, a farmer and a trustee for Pregnancy Sickness Support. I love working hard and spending time with my kids.

About this blog

Information and support for pregnancy sickness and hyperemesis gravidarum. Views are my own and do not represent those of any other organisation. Information provided here should not be a substitute for medical advice. My aim is to raise awareness and encourage sufferers to know they are not alone.

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