Thursday, January 10, 2008

Spreading the word and maybe some HOPE...

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
The Reno News and Review

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

Monday, January 7, 2008

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

Hypnosis in the Treatment of Hyperemesis Gravidarum

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.

Department of Psychology
Behavioral Medicine & Health Psychology Service
Tripler Regional Medical Center
Honolulu, Hawaii 96859
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.

Saturday, January 5, 2008

Subcutaneous Metoclopramide Therapy for HG?

"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
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
, 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. (

"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."

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


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

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.
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!