When Morning Sickness ISN’T Normal
Morning sickness is a universally known side effect of most pregnancies, and many people are aware that it can strike any time of day and sometimes be severe. Even so, most have the idea that morning sickness is nothing more than a minor nuisance for mothers-to-be. Few, however, are aware of the debilitating condition,hyperemesis gravidarum , or HG, which is marked by severe nausea and vomiting, weight loss, dehydration, and in the most severe cases places the mother’s life in jeopardy.
More than morning sickness
Anyone who has had morning sickness knows that it’s definitely no picnic. But, how can you tell when morning sickness isn’t normal? According to Stephanie Devane-Johnson, a midwife with Triangle Ob/Gyn in Cary, North Carolina, morning sickness historically signifies a healthy pregnancy, and many practitioners believe it is a result of rising HCG levels during the first trimester.
However, when “a pregnant woman can’t hold down water, can’t eat a cracker without throwing up, gets dehydrated, and is throwing up seven days a week and several times a day, we definitely have a problem,” says Devane-Johnson.
Red-flag symptoms she looks for include severe nausea and vomiting over the course of several days, dehydration, weight loss, feeling faint, and an inability to perform daily tasks. If a woman is experiencing any of these symptoms, she needs to notify her practitioner immediately since she could be suffering from HG. “Women should not feel [that] HG is a right of passage! This is not something that a woman should try to just tough out,” says Devane-Johnson.
While many behavioral and over-the-counter treatments exist for general morning sickness, HG sufferers often require more extensive, prescriptive treatments and sometimes hospitalization.
The first thing a woman should do if her nausea and vomiting gets out of control is to contact her practitioner since letting HG go for long periods of time is often physically damaging to the sufferer and can also be downright dangerous to both the mother and the pregnancy.
Often, practitioners prescribe medication such as Phenergan, Zofran, or Reglan. Also, an HG sufferer may need to receive IV fluids, and some very severe cases may require multiple or long-term hospital visits and/or a subcutaneous pump to maintain regular dosing of medication.
While this little understood disease is a nightmare for both sufferers and loved ones, it can be treated with the right amount of communication between patient and practitioner, support from family and friends, and the right kinds of medication.
- Persistent nausea and vomiting over the course of several days or weeks
- Inability to keep food or liquids down
- Dehydration- infrequent urination, dark urine, presence of ketones in urine, dry mouth, sunken eyes, dry skin, intense headache
- Weight loss or inadequate weight gain
- Dizziness, fainting, seeing floaters
- Inability to participate in normal activities
- Vomiting blood or bile
- Support- frankly explain realities of HG to friends, family, and workmates; seek assistance in daily activities; connect with other HG sufferers and become well-versed in the condition
- Diet- do not eat and drink simultaneously; eat frequent, small meals; stick to mild, easy-to-digest foods; eat crackers first thing each morning before getting out of bed
- Sea Bands- over-the counter; commonly used for motion sickness and nausea; applies pressure to inside of wrists at classic acupuncture site for nausea
- Ginger- Can be taken in pill form at 250 mg. (consult with your healthcare provider before using) or in liquid form as ginger ale but check the ingredients list; not all brands contain real ginger.
- Phenergan- prescription; also known as Promethazine; can be administered rectally, orally, or as I.V.; side effects include drowsiness; generally effective, but not good alternative for those who have to stay awake; lasts 4-6 hours
- Zofran- prescription; also known as Ondansetron; generally administered orally or as I.V., though sometimes by under-the-skin pump for very severe cases; has been shown to be addictive if abused; very effective but expensive; lasts about 4 hours
- Reglan or Maxeran- prescription; also known as Metoclopramide; administered orally, as I.V., or under-the-skin pump; often used in conjunction with other anti-nausea medication; lasts about 6 hours
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