Help!

[nrusssell34]

My wife is in dire need of help, and I don't know what to do. She had HG with the first pregnancy and spoke to her new ob/gyn before we tried for the second. We felt confident that he would aggressively treat her condition. Sure enough, it hit sometime during her 6th week. He gave her zofran ODT, which worked in the past, but it was of no use. He tried Tigan suppositories with the same effect. She has adverse reactions to Phenergan and similar medications, so those two things (note: that didn't work) were all the doctor would prescribe.

During her third visit to the hospital, we met with another doctor from her group who tried giving her steroids, benadryl, and thorazine. The steroids worked while she was in the hospital, but her doctor wouldn't write a new prescription for them, so back in the hospital she went. During that stay, she received too much Thorazine, and had a reaction to it, so she could no longer take that. For her migrane, she was given nubain. The first time she received a dose, but the nubain alone made her woozy and nauseous. The second time she received a dose, she also had some benadryl and the cocktail of the two made her feel normal; she could eat and sleep peacefully.

The problem? The doctor won't write a script for nubain. They attempted a PICC line, but her veins rolled and they sent her home with IM zofran and benadryl. At this point, she was at her last straw. She felt like the doctors weren't fully appreciating the severity of her sickness; she had even made mention of thoughts of doing harm to herself, just wanting to make it end. That night, she had taken a knife to her wrist; she only broke the skin before calling to me, so I calmed her down and then called the doctor to ask for direction.

I told him what she had done, stated that none of the medications (with the exception of the nubain/benadryl combo) she received were of any use, and told him that if she didn't receive treatment, things would only get worse. He told me that he wanted her to go to the ER and to be admitted to receive treatment to get her back into the state of mind where she could make a decision about what she wanted to do (i.e. terminate the pregnancy). I took her to the ER, expecting her to be admitted to the maternity ward and receive the medication that would put her back into the right frame of mind. What does he do? He orders zofran (which hasn't worked this entire time) and puts her on 24 hour watch.

We left the hospital, stating that we could take medication that doesn't work at home. There isn't a word strong enough to describe the anger we're feeling right now. We know there's a medication that will make her feel better, but the doctors won't provide it. We feel like they're not taking her seriously, and they lie to us to get her into the hospital. We're pulling her medical records and taking her care elsewhere, but I don't know what else to do for her. She abhors the thought of terminating the pregnancy, but no medication that the doctors are willing to prescribe will alleviate her pain. She is constantly nauseous, still throws up multiple times every day, can't sleep, is sore all over from the vomiting and injections... can anyone help her?

[aaronsmommy]

Nubain is a narcotic pain medication. It usually causes nausea (that's why you'd give the benadryl with it), but I have never heard of it helping nausea. It is also very addictive to both your wife and her baby if used in more than just a sporadic manner. It's perfectly appropriate that they don't want her on it, and although I'm sure she doesn't mean this, but going in to the hospital asking for it is going to look to the staff like she is a drug addict and is doing this all as "drug seeking behavior" Going to another doctor and asking for it is going to make that impression stronger.

That doesn't mean there isn't something else out there for her nausea, and that she shouldn't try to get help for it. It was more likely that the benadryl was the key medication. Maybe it was the IV administration that was key, or maybe it was a higher dose than she was getting after that. Also, some people do well with a relative of that called vistaril. Or maybe it was just that she finally got well hydrated at around that time and that what she really needs is IV hydration at home.

The standard course of steroids for hg is 2 weeks, the experts will warn to use caution about using them for over a month, but it certainly sounds as if she could be on them longer, and some people have been on them the whole pregnancy (certainly not without risks though).

They can put an PICC line in with ultrasound guidance, and there are other central lines they can do, or try an NG too. Here's a thread that talks about some of those options
http://www.helpher.org/forums/viewtopic ... light=picc
and you can follow the links to more about the ng. The zofran pump would certainly be a lot kinder on her than IM injections, that just sounds cruel. What dose of zofran is she on?

If sleep is a big issue, a lot of us have done well with Ambien, and some find that helps with the nausea too. Remeron is an antidepressant that makes people quite sleepy, and helps with nausea - it has been used only a little in pg, but would seem to target all of her symptoms.

Your wife obviously needs some help, and she may need to find a new doctor to get it, but you are all much better off looking for something other than nubain.

Good luck!
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[BrandiJK]

(((((((((((((Hugs)))))))))))))) I don't know as much about medication, but I do know I am sorry for all you are going through. It does sound like she needs a new doc, perhaps the hospital who had treated her could recommend a good doc?

I hope things begin to look up for her. It is hard, we all know, esp. when different meds work for different pg's.

[Atsie]

I am so sorry you and your wife are going through this. Where abouts do you live? Someone might have an idea of a good place to go for help near you.

How much Zofran was she on? COuld she take the benedryl with it and see if it works?

I agree that your wife is in a very fragile state right now, both physically and emotionally. I think you need to find a Dr to listen and help you both. THere are options of meds to be taken together (I found Diclectin only worked if I took it with Maxeran) that might work.

Good Luck!

[teddi]

I agree 100% w/ Aimee. Nubain = narcotic, pain relief. It might knock her out and/or give temporary relief (ie a mild "high"), but you could NOT use that long term, uh uh, no way. Bad for her & baby. Addictive.

Are you using Kaiser? The meds sound like thier formulary.

I had bad reactions to Phenergan (BP crashers, knocks me waaay out). HOWEVER, I DID have IV compazine and didn't react the same way to that. If she was admitted (ER or inpatient), it might be worth a shot to try compazine.

Also, perhaps try 8mg dosing of Zofran alternating w/Reglan (Zofran first thing in am, 4 hours later Reglan, then 4 hours later Zofran) (has she tried that?). The combo did prove helpful for me (though eventually it would stop, but ANY reprieve it is worth it). Make sure it's the 8MG, not 4.

I think she needs a PICC or NG tube. It certainly can't hurt and is worth a try.

How long was she on the steroids (you didn't say how long she was in the hospital)? Can the Dr do her a 2-3 week regimen? She COULD do that at home. If it helped, she should do it.

Please pursue the Visatril option. You can also try Meclizine, which did provide me some help, its OTC, you don't need a script. Up to 25mgs a day.

[teddi]

A few questions:

How many weeks is she now?

What state are you in (city too if you are comfortable w/that), perhaps we can get you paired w/a buddy?

How often is she needing IV fluids?

[Alison]

It has been a few days now since your post. How are things going? Just wondering, have you tried Bendectin (AKA: Dyclectin, B6 & Unisom)?

You mentioned that there was a dr. who was open to prescribing what you want... Remember, dr.'s are like anything else... you can change them if they are not working out.

My 1st pg, I changed dr.'s in mid-stream of my care. Both the Dr.'s were in the same core (group of 4-6 in an office) and the 2nd one worked out MUCH better.

Let us know what is happening and keep in mind that there are MANY women here who have a world of experience with all kinds of drug combos, etc. So, options can change from person to person.

I have to say, it is GREAT how you are taking a firm stand for your wife! It takes a great husband to do that, don't back down - no matter what! Someone WILL listen to you, you just may have to go through a few to get to that person.

We are here for you and your wife. If you are able, read to her what you find here. Maybe she can post her thoughts and feelings through you which will help her get them out to others who understand.

You did a great job finding this site. Keep checking in when you can for more info. We are always here!

Alison

[Terri]

For her migrane, she was given nubain.

Find another doctor! Call the hospital that gave her the nubain and ask for recommendations. I go to a neurologist for my migraines, maybe you could find a neurologist to consult with a more sympathetic OB.

I consulted with a perinatologist who said that Immitrex (for one) has not been shown to increase birth defects. I have had three migraines so far (I'm at 12 weeks) and have used Immitrex and Percocet to get rid of them.

As I've said somewhere else, the only thing worse than HG, is migraines and HG together.