What to do after vomiting:

From a hospital handout...

Coping with Vomiting

• REST. Get some fresh air, take a walk.
• Avoid places with strong odors
• Sip on tart juices: lemonade or cranberry juice diluted with water
• Drink fluids other than water. Drinking plain water may cause more vomiting.
• Eat candies or fruit with tart flavors: hard candies, mints, lemon drops. These help cut saliva and cover unpleasant tastes in your mouth.
• Salty flavors help settle the stomach.
• Try small amounts of sweet or cold foods: popsicles, jello, jelly beans, pudding, fruit, custard, yogurt, or ice cream.
• Do not take any over the counter medications to stop vomiting unless prescribed by your doctor!
• Stop prenatal or iron pills for a few days if they cause stomach upset or vomiting.

Foods to Replace Lost Nutrients:

I recently found a paper given to me by a nutritionist while I was hospitalized with HG, here are some foods you can eat to replace nutrients lost to severe vomiting...

Fluids: (Take 2 to 3 ounces)

• Juices
• Teas
• Lemonade
• Popsicles
• Sports Drinks
• Noodle Soups

Salt:

• Pretzels
• Noodle Soups
• Pickles
• Crackers
• Chicken Broth
• Tortilla Chips
• Potato Chips

Potassium:

• Avocado
• Potato
• Sweet potato
• Winter squash
• Kiwi
• Watermelon
• Banana
• Potato chips
• Vegetable juice
• Apricots
• Honeydew melon
• Cantaloupe

Magnesium:

• Broccoli
• Almonds
• Soy milk
• Wheat germ
• Peanut butter
• Sunflower seeds
• Whole wheat bread
• Bran muffin
• Spinach

Chinese Medicine???? Hmmmm....

Having graduated last year with my Master Herbalist Certification I am very curious about this study:

http://www.nvp-volumes.org/p1_21.htm

Effect of Chinese herbal medicine suppositories for hyperemesis gravidarum by using an index for nausea and vomiting of pregnancy.

"Chinese herbal medicines, which are considered effective and safe for
morning sickness and hyperemesis gravidarum in East Asia, present some
disadvantages when ingested orally, e.g., induction of nausea because of their
characteristic odour. Because of the above reason, we formulated and used
suppositories of Chinese herbal medicine extracts. The chief symptoms of
hyperemesis gravidarum are subjective, making it difficult to compare the
symptoms and evaluate efficacy of treatment. In the present clinical trial,
therefore, we categorised symptoms by severity and evaluated therapeutic
efficacy according to a questionnaire-based survey using the Index for Nausea
and Vomiting of Pregnancy.

It is difficult to evaluate hyperemesis gravidarum objectively, because of the fact that it mainly consists of subjective symptoms. Furthermore, the number of classes of the complaints considered to be symptoms of hyperemesis gravidarum is as numerous as 20. Based on the above background, the Emesis Index (EI) has been created, modified and used. The EI originally created chiefly consisted of three symptoms of high incidence and intense severity, i.e., nausea, vomiting, and appetite. The INVP, modified to include the symptoms of salivation and dryness of mouth and acetone in the urine, was used in the present clinical trial. The INVP is thought to be more useful than the EI for evaluating hyperemesis gravidarum.

Fluid therapy was combined in treating many cases. Suppositories alone were used in the majority of outpatients and in the inpatients who detested the odour of the fluid. These patients showed no particular problems, and the improving process of symptoms did not differ from the patients in whom fluid therapy was combined. In the patients in whom fluid therapy was used alone and in combination with suppositories, symptoms improved earlier at the time of combined therapy than at the time of fluid therapy alone.

Herbal remedies are recommended commonly for nausea and vomiting of pregnancy. Chinese herbal medicine suppositories appear to be a reasonable therapeutic alternative for hyperemesis gravidarum. A randomised trial is needed to confirm the efficacy of Chinese herbal medicine suppositories for hyperemesis gravidarum."

More HG Videos...

Hi everyone :P
I have added some new links to HG Articles... and have found some videos on You Tube:

http://www.youtube.com/user/pilkinton39

A New Zealand woman tells of her experiences with HG

More info on the current study at USC

Come on ladies... I did it! I know you have some spit to share...

Something New...

As promissed, if I found some new research I would post it! This research has some interesting findings...

Extreme nausea and vomiting varies among pregnant women from different countries
April 28, 2008 - Norwegian Institute of Public Health

Mothers born in India and Sri Lanka are three times more likely to suffer from extreme nausea and vomiting in pregnancy (hyperemesis gravidarum) than ethnic Norwegians.

This finding comes from Norwegian Institute of Public Health's study of 900, 000 first-time pregnancies registered in the Medical Birth Registry of Norway over a forty year period. Earlier studies reported that 90 percent of pregnant women experience some degree of nausea and vomiting, whereas 0.5 to 2 percent have hyperemesis gravidarum.

Due to dehydration, loss of important electrolytes, malnutrition and weight loss,
hyperemesis gravidarum could be life-threatening for mother and baby if left
untreated.

In the USA it is the commonest cause for hospitalisation during early pregnancy. The cause of hyperemesis gravidarum is unknown.

Vikanes, specialist in gynaecology and obstetrics at the institute's Division of Epidemiology, wanted to explore whether the mothers' country of birth affected the prevalence of hyperemesis gravidarum.

Vikanes is primary author of the paper

Large study on hyperemesis gravidarum, Vikanes and her colleagues collected data from the Medical Birth Registry of Norway, which since 1967 has recorded data on all pregnancies and pregnancy complications.

8,300 cases of hyperemesis gravidarum were recorded out of 900,000 pregnancies, giving an overall prevalence of 0.89 percent. Data on the mother's country of birth and education were recorded by Statistics Norway and linked to pregnancyinformation through the mother's unique personal identification number.

Socio-demographic factors such as marital status, country of birth, education, age and number of foetuses in each pregnancy were also studied.

"This is one of the largest studies carried out on hyperemesis gravidarum. In contrast to earlier studies we tested the quality of the data and therefore have confidence in our findings" says Vikanes.

Mothers born in India and Sri Lanka had the highest prevalence of hyperemesis gravidarum, followed by those born in Africa (excluding North Africa) and Pakistan by 3.2 percent, 3.1 percent and 2.1 percent, respectively.

Ethnic Norwegians, North Americans and Western Europeans had the lowest prevalence by 0.9 percent, 0.9 percent and 0.8 percent, respectively.

Maternal age between 20-24 years old, being married, carrying a female foetus or more than one foetus were all socio-demographic characteristics associated with a higher prevalence of hyperemesis gravidarum.

Need to study further "The difference in prevalence of hyperemesis gravidarum related to the mother's country of birth cannot be explained by differences in socio-demographic characteristics", says Vikanes. "We have to look for other explanations such as genetic factors, a change of diet or a history of infections. This topic needs further research to identify ways to prevent this life-threatening and distressing condition."

Reference: Vikanes A, Grjibovski AM, Vangen S and Magnus P. (2008) Variations in prevalence of hyperemesis gravidarum by country of birth: A study of 900, 074 pregnancies in Norway 1967-2005. Scandinavian Journal of Public Health 36: 135-142.

One Year Ago...

It's so hard to believe that one year ago today, April 17, I had a baby... it still trips me out when I think about it or look at his smiling face LOL

I look at him and I think about what I went through with HG. I was so miserable for so long with so many complications that it just makes me appreciate him more, so much more in fact that I am no longer going to spend time blogging here.

I want to cherish every moment I can and I want to spend as much time with him watching him grow and laugh and play and well, you know... he's growing up so fast.

If I find any new research or news I will certainly post it here, but I think I just want to be a Mommy.

I hope that the information I have posted in my other posts will help you or someone you know. I hope you will find hope in this blog. That it will help you keep the faith, know that HG is a very serious disease but that with proper treatment you can endure.

Always,
Raynie & Zane

Wow, Time sure flies...

It's hard to believe that my son,

the inspiration for my book and blog,

is going to be 1 year old already!

We are planning a great Luau for his special day...

My family is Hawaiian and it is custom to celebrate baby's first birthday with a luau, which is a traditional Hawaiian feast.

"The luau is the perfect expression of Hawaiian hospitality and signifies a celebration of what the Hawaiian spirit and lifestyle are all about. Historically, the luau was a celebration to the Hawaiian gods giving thanks for having survived long and often arduous ocean voyages."

If you've ever been to the islands, you probably have tried some local grinds... and that's what we have planned for our menu! Lots of food, lots of family and friends, music, and all the things a birthday party brings!

Children grow up so fast, I am cherishing every moment... and I can't wait to celebrate such a wonderful milestone... Zane's First Birthday!

Counting My Blessings...

One of my childhood friends lost his mother last week, she was 75. We grew up together... a group of us kids always hung out and I remember when the sun set everyone's parents had their own whistle to call us home LOL He lived up the street and I lived at the bottom.

Anyhoo, when we hugged, I cried... not because I was sad, but because I knew exactly how it feels to lose a parent. I was thinking how bad it hurt... the thought that you will never hear their voice, feel thier touch, never see them again... and it hurts, and I hurt for my friend.

The memorial service was at St. Francis of Assissi in our hometown. It was a beautiful service. I did not follow the procession to her final resting place as my personal feelings are that is a very private thing.

I prayed for my friend and his family and his Mom. I spent the rest of the day counting my blessings. I think my friend is lucky... he had his Mom in his life for 36 years. That's 12 years more than I got to have my Dad... I wish I had been that lucky.

You never know what life will bring. So today I said my prayers and was thankful for the gifts in my life... My family, My friends... and the Love of my Child who is the greatest gift!

Trying to understand God's purpose...

Hi all...
I haven't blogged or done any podcasts in a while, and well honestly... it is because

I AM IN A FUNK.

You may have had a similar experience, or are yourself in a funk as we speak.
Let me tell you why.

In the not so far off past I worked my way to a certain position in a certain industry and admittingly it was hard work, but in a fun industry. I was a pit boss at a Casino. I had worked my way up with Harrah's, furthered my education on my own dime, and had been working for the Grand Sierra Resort & Casino (formerly the Reno Hilton) before I was diagnosed with HG.
It was a good career and when I learned I was pregnant I was relieved that I had this great career that I could provide a good life for my child. It is the same for every single Mom out there... you want to provide a good life for your child, and have a great career... the best of both worlds.

When I was diagnosed with HG, my world was turned upside down! The disease forced my resignation from a job I loved. I had no medical insurance, no income, and a baby on the way. I also had bills to pay... 3 credit cards and a gas card which I only accepted because I wanted their free gas! (LOL) My credit was decent.

Fast forward to mid pregnancy, hospitalized for the 3rd time, my dear friend, Scott, back in Reno tells me the bills are stacking up (which when you are fighting for your unborn child's life and your own... is the least of your worries!) He told me when I feel up to it to try to write a letter explaining the situation and maybe they can work with me, he'd make copies and send them all out and see what happens.

I did and in hind sight I am thinking maybe I should have paid the extra whatever for the insurance all credit cards offer... the (to quote Chris Rock) "In case shit" insurance (LOL). I have never been hospitalized in my life, never had anything worse than the common cold or flu... so why on earth would I subscribe to an insurance that I will never use, that is just a scam to get more money out of most people?

BECAUSE!!! In case shit happens like me getting some RARE pregnancy disease!!! Whoda thunk???

Whatever! I was so over it as they charged me off as a "Bad Debt"... Yes, I am now in financial ruin. BUT! The story doesn't end there.

I knew when I got better and was able to at some point return to work, I would like a phoenix rise from the ashes and rebuild my life. I could go back to my career and clean up my finances and everything would be wonderful!

WRONG

Fast forward to the past few weeks...
I applied for and was offered a great position with one of the biggest casinos in So Cal! I was sooo happy! However, a few days later... bad news... they cannot approve my gaming license (nor will any casino in So Cal)!!! Why???? Charge offs and unpaid Medical bills. They said if I paid it off I was welcome to re-apply... ok, great... how do I do that without a job? and... the position I applied for is now going to "the second best candidate" because obviously I was the best candidate or they would not have made the offer!!!

So with that feeling of elation, my bubble was burst and I am now in a FUNK...trying to figure out God's purpose! As you can see it is disturbing my sleep, keeping me up at night... my son is finally sleeping through the night, and I am up at 3:28 am worrying about...
what the @%&! (expletive) I am going to do now!

I am angry. I was robbed. I was robbed of my health, robbed of the enjoyment of pregnancy, robbed of a family, robbed of future children, and now my career.

Ahhhh...the eternal optimist in me speaks...
There must be a REASON. I dont know what it is yet, but there must be.
I know with every fiber of my being that my child is the greatest gift in my life. He is the reason I smile every day. He was meant to be and my intuition tells me that the universe conspired to make sure he came to be...and here he is.

Maybe I was on the wrong path and this is how my path is changed, so I find the right one.
I remember a quote : "God's delays are not God's denials"
I tend to be quite impatient so... perhaps it is time to learn PATIENCE... it is a virtue after all (LOL)

My son is growing up so fast and he gets frustrated sometimes when he is doing stuff...and I always tell him "patience my son, patience is a virtue", I guess it is true... when you teach you also learn!

If you are going through something similar... here is what gets me through...
think back to your darkest hour... Mine was sitting in the emergency room all alone (they wouldnt let my Mom back with me at the time) and after suffering from HG for months... having the doctor tell me at that moment my life could be in danger from a pulmonary embolism, that I could die, and I needed to choose right then and there... my life or my child's? No parent should ever have to face that. I took a chance, must have been the "gambler" in me... but sometimes faith is strong medicine. That was my darkest hour, and here WE are... my son and I.

I guess what I am trying to say is... "Keep the faith" (haha...a Padres plug!) Something i am trying hard to do right now.

Thanks for letting me vent, I'll get over this funk and back to my task soon!

Spreading the word and maybe some HOPE...

http://www.newsreview.com/reno/Content?oid=612690

I was contacted by the Arts Editor from the Reno News and Review about my book, Letters to Zane. He was interested in my story and I am happy to say...

This week's issue: January 10, 2008 is going to help me in my efforts of spreading awareness for this terrible pregnancy disease!

I hope one day there will be better treatment to ease the suffering of so many women, and maybe even give us some concrete answers to so many questions we have especially... Why did this happen to me?

I would like to thank:
Peter Thompson, Arts Editor, Reno News and Review
Cherie Louise Turner, Writer
Todd Upton, Photographer
and
The Reno News and Review

Thank you for making this story available to your readers and helping me spread the word on HG!

Hypnosis? I said I was sick... not CRAZY!

Hypnosis in the Treatment of Hyperemesis Gravidarum
http://www.aafp.org/afp/990700ap/letters.html

TO THE EDITOR:
Patients with hyperemesis gravidarum are commonly seen by family physicians. Up to 90 percent of pregnant women have symptoms of "morning sickness," and some develop full-blown hyperemesis gravidarum.1 This condition often leads to serious risks for the mother and her fetus, as well as lengthy and costly hospitalizations. Medical hypnosis may be a powerful adjunct to the typical medical treatment regimen, and empiric studies of the efficacy of this treatment approach for hyperemesis gravidarum are well documented.2-3

In a study of 138 hyperemesis gravidarum patients who were completely recalcitrant to conservative medical treatment (consisting of antiemetic drug therapy, isolation by hospitalization and intravenous rehydration), 88 percent stopped vomiting completely after one to three sessions of medical hypnosis.4 Therefore, it may not come as a surprise that medical hypnosis has also been shown to be an effective treatment for hyperemesis secondary to chemotherapy5,6 and hyperemesis secondary to "motion-sickness." In my clinical experience with hypnosis in the treatment of 30 to 40 patients with hyperemesis gravidarum, symptoms fully remitted within three or four treatment sessions in the overwhelming majority of patients.

Hypnosis may effectively treat hyperemesis gravidarum in at least two ways. One component of the treatment mechanism is that, in a hypnotic state, patients may be induced into a deep state of physiologic relaxation. This decreases sympathetic nervous system arousal, and symptoms associated with hyper-sympathetic arousal tend to remit. Further, it is well established that patients often respond to hypnotic suggestions that are independent of sympathetic or parasympathetic arousal and, interestingly, responsiveness is often independent of the patients' conscious awareness or memory of the suggestion. Patients may be given both indirect and direct suggestions to relax their stomach and throat muscles, causing their nausea, gagging and vomiting to subside. By suggesting that muscle tension in the stomach and throat and/or nausea become a hypnotic cue either to engage in particularly pleasant imagery or to hold cognitions that mentally reframe the experience, the nausea can immediately subside.

Before embarking on hypnotherapy to treat hyperemesis, patients should have a thorough medical evaluation to rule out other diagnoses. The differential diagnosis for hyperemesis gravidarum includes the following: gastroenteritis, cholecystitis, pancreatitis, hepatitis, peptic ulcer disease, pyelonephritis, fatty liver of pregnancy, pelvic inflammatory disease, appendicitis and hyperthyroidism. Patients may also benefit from a psychiatric evaluation if psychiatric co-morbidity is suspected, in which case a referral to a mental health practitioner may be warranted. Finally, while in 1958 the American Medical Association declared hypnosis to be a legitimate form of medical treatment, it should be emphasized that only an appropriately trained practitioner of medical hypnosis should apply this treatment.

ERIC P. SIMON, PH.D.

Department of Psychology

Behavioral Medicine & Health Psychology Service

Tripler Regional Medical Center

Honolulu, Hawaii 96859

REFERENCES
Broussard CN, Richter JE. Nausea and vomiting of pregnancy. Gastroenterol Clin North Am 1998; 27:123-51.

Torem MS. Hypnotherapeutic techniques in the treatment of hyperemesis gravidarum. Am J Clin Hypn 1994;37:1-11.

Fuchs K. Treatment of hyperemesis gravidarum by hypnosis. Aust J Clin Hypnother Hypn 1989;10:31-42.

Fuchs K, Paldi E, Abramovici H, Peretz BA. Treatment of hyperemesis gravidarum by hypnosis. Int J Clin Exp Hypn 1980;28:313-23.

Redd WH, Andresen GV, Minagawa RY. Hypnotic control of anticipatory emesis in patients receiving cancer chemotherapy. J Consult Clin Psychol 1982;50:14-9.

Redd WH, Rosenberger PH, Hendler CS. Controlling chemotherapy side effects. Am J Clin Hypn 1982;25:161-72.

The views expressed in this letter are those of the author and do not reflect the official policy of the Department of the Army, Department of Defense or the U.S. Government.

The views expressed in this letter are almost as bad as "crackering". We dont need a Psychiatric Evaluation or visualizing pretty scenes in our minds... we need someone with all your edumacation and medical "expertise" to figure out HG and stop our suffering!

Maybe hypnosis would work for some, but I think this article makes it sound like it is all "in our minds" which no matter how many happy scenes I tried to think of my mind could not stop the physiologic junk that forced me to throw up everything including my own spit.

Subcutaneous Metoclopramide Therapy for HG?

http://www.nvp-volumes.org/p1_12.htm

"It looks like SMT is a safe alternative therapy for this condition, justifying prospective studies for an indication for nausea and vomiting associated with pregnancy," Dr. Barton said. "This agent could represent a new step forward in making pregnancy more comfortable and doing so outside the hospital setting."

For their study, the investigators prospectively collected and analyzed data from January 2000 through February 2002 on 426 women who had singleton or twin gestations and had reported 5 or more days of SMT.

What is metoclopramide?

Metoclopramide increases the rate at which the stomach and intestines
move during digestion. It also increases the rate at which the stomach empties
into the intestines and increases the strength of the lower esophageal sphincter
(the muscle between the stomach and esophagus).
Metoclopramide is used to
treat diabetic gastric stasis (slow
movement of the stomach), which causes symptoms such as nausea, vomiting, heartburn, decreased
appetite, and prolonged fullness after eating. It is also used to treat gastric
reflux or heartburn (the regurgitation of stomach acid into the esophagus),
prevention of postoperative nausea and
vomiting, prevention of nausea and vomiting associated with cancer chemotherapy,
facilitation of small bowel intubation, and to facilitate x-ray examination of
the stomach and intestines. (http://www.healthline.com)

"Fifty to 80% of pregnant women will have nausea and vomiting during a pregnancy," said lead researcher John Barton, MD, researcher and clinician at Central Baptist Hospital, division of maternal-fetal medicine, in Lexington, Kentucky. "And if it feels bad enough, or is perceived to be dangerous, it can lead to emergency room visits and sometimes hospitalisation. We wanted to see if these symptoms could be controlled using another antiemetic agent not yet indicated for SMT and if such control could impact the dislocation and costs of hospital visits."

Conclusion:
Hyperemesis gravidarum is a complication that occurs in a small percentage of pregnancies but accounts for approximately 78,000 patients annually. Historically, this condition has had high costs in loss of productivity, physical and emotional sequellae, and prolonged and/or recurrent hospital admissions. The use of home subcutaneous metoclopramide therapy appears to be effective, safe, economical, and a way to treat these woeful patients in a familiar, secure, and emotionally supportive environment, which may hasten recovery.

Outcome in these patients was very encouraging. In Group I, 195 (54.7%)
patients had resolution of their hyperemesis gravidarum. This improved to 640
(75.0%) patients in Group II. These are very positive numbers for a single form
of therapy. Historically, this success rate has been achieved with hyperemesis
gravidarum patients largely through the use of multiple therapies/agents in
sequence or in combination, normally requiring prolonged or recurrent
hospitalization. Worsening of the symptoms of hyperemesis gravidarum in spite of
therapy is common; however, it occurred in only 43 (14.3%) patients in Group I
and 59 (6.9%) patients in Group II. This is positive data to recommend home
subcutaneous metoclopramide therapy. The percentage of patients who discontinued therapy due to side effects remained low and fairly constant at 10.6% and 12.7%
in Groups I and II respectively

Interesting...

Hi All...
I wanted to share a couple new links I found:

http://www.stat.ucla.edu/~frederic/hg/
http://www.stat.ucla.edu/~frederic/hg/results/feb2001.html
http://www.stat.ucla.edu/~frederic/papers/hg.html

Apparently an HG study conducted in 2001/2002, just thought others may find it interesting.

In particular I think we all are VERY interested in the "reoccurance" of HG. I know I personally have been so traumatized by HG. I once wanted 2 or 3 children, but now.... I am too scared to have any more. I am scared that next time I will not make it. My life and my son's life were in danger many times over the course of this "experience", thats what I call it... not my happy baby belly days as it should have been!

So as far as this research could say based on it's limitations was the following:

3. Recurrence
From results of surveys of women with HG, one can find a
variety of statistics that appear at first glance to shed light on the question
of the recurrence rate. For example, about 40 percent of patients with HG are in
their first pregnancy, and about 45 percent of women with HG who have been
pregnant once before were treated in the hospital for HG in their prior
pregnancy.6, 7
A moment's reflection reveals that the above statistics are of
little value to the sufferer of HG who may be wondering what her chances are of
getting HG again in a later pregnancy. The only data that is directly relevant
to the recurrence rate of HG is longitudinal (i.e. data obtained by following up
on patients over many years).
Unfortunately, it appears that only one such
longitudinal study has been done on HG, and the study was very small and is now
potentially out-of-date. The study, done by J. Fitzgerald from 1938 to 1953,
examined just a few dozen women based in Aberdeen, Scotland.7 Nevertheless the
Fitzgerald study is still cited by many authors. It is important to realize
that, while numerous articles state that HG in a prior pregnancy is a risk
factor for HG in a subsequent pregnancy (e.g. 3, 6, 11), by and large the only
evidence upon which this claim is based comes from the Fitzgerald study.
Here
is a summary of Fitzgerald's recurrence data. Fitzgerald followed 159 women who
had HG in their first pregnancy. Fifty-six of these women then had another
pregnancy that was recorded by Fitzgerald, and nineteen women had two subsequent
pregnancies recorded by Fitzgerald.
• 27 of the 56 women had HG in their
second pregnancy.
• 7 of 19 women had HG in their third pregnancy.

I found some of the other results interesting, as well as saddening. If you take a look at the drug effectiveness table it lists not only drug effectiveness, but fetal loss as well. :( It makes me sad to think of going through HG only to lose your child or be forced to abort. There needs to be more research!