Next step after pump?

A place to discuss all things treatment-related. Medications, IVs, midlines, PICC lines, NG tubes, sub-q pumps, home health care, etc. Also includes alternative and homeopathic remedies including NAET, vitamins, liver detoxing, and more for active HG and TTC preparation.

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Next step after pump?

Postby Beth » Sep 07, 2004 9:26 pm

Hi all, wish I had some good news, but...the pump has helped, definitely, but I'm still losing weight. Ketones are back to moderate, am waiting to get another bolus dose, then probably hospital for fluids tomorrow first thing (don't have anyone to take me tonight). I'm so tired of this, and worried for the baby, haven't kept anything down today at all! Doesn't help that I didn't keep my pain meds down, the leg pain is really bad, can hardly walk right now.

So, after the pump, what comes next? Do they have to do a central line in order to give nutrition? How does all that work? Sorry for stupid questions, my brain stopped functioning a while back, I think. Is there anything less drastic that may get me over the hump here? Was doing so well up to a few days ago, don't know why it's gotten bad again, must be something I'm doing wrong.

Don't know what else to do, tired of laying on the bathroom floor, feeling guilty about not doing everything I should be doing right now. Just needed to rant, I think. I'll feel better tomorrow, I hope.

Hope everyone is doing ok out there...
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Postby bibliojo » Sep 07, 2004 11:42 pm

Hi Beth,

Sorry, I don't have any information for you on options after the pump, but I just wanted to encourage you. I'm sorry that you are feeling so awful, but try not to think/worry about all the you should be doing. Resting is the best thing for you right now so don't feel guilty about being "lazy." You're growing a baby inside of you and that takes a lot out of you! I hope that you feel better soon. I'll be thinking about you.

2 HG pregnancies
Lukas - February 2003
Katya - October 2006

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Postby HGx3 » Sep 08, 2004 12:03 am

Hey Beth.
Hopefully with the use of the pump you will start getting to the point where you can eat enough food to keep from losing weight. You dont have to eat a lot, just try to eat high calorie itemsFOODMENT like milkshakes or ensure. Of course, if you are still actively vomiting, I do NOT reccomend the milkshakes.

If you continue to need hydration, the next step might be a picc line. They can put nutrients in your iv bag and for some reason you stop losing weight. i LOST 30 lbs with pg 1 and 2, but with pg 3 I only lost 10lbs, but was more sick!!! My doc said it was all the fluid......???

Anyway, hang in there, how far along are you?
Hope the pump turns your situation around.
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Postby BlueEeyore » Sep 08, 2004 5:36 pm

I currently have a PICC line in and I am receiving all my fluid and nutrients that way. If you want to know more about it, let me know.

As for your ketones, you MUST increase your fluid intake somehow. That will eliminate your ketones. Ketones can add to your nausea.
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PICC line and TPN?

Postby Beth » Sep 09, 2004 10:58 am

Hi, I'm home from hospital again. They admitted me this time, my potassium was low, gosh that burns going in! Tried the pill, but threw it up. Threw up twice on the way home, then again in the car when I had to go out, a few more times after that, when does this stop??? Gross, having to clean up too. Sorry if I'm being too graphic, but if I can't talk about it here, don't know where I can go...

Dr is talking about setting me up with home IV hydration. Does that help? Seems I do ok for a while, then hit a downward spiral and can't climb out on my own. He says that if I need to go to TPN, he would need to transfer me to a high-risk specialist. I love my dr! Don't want to lose him, but now I'm hearing that dehydration can cause pre-term labor and other problems, so I'm scared.

DH is coming home from Europe early to look after me a bit. Thank goodness for good friends, one came over, fed the animals, visited with me in hospital, then went to the store, too. Don't know what I would do if I didn't have such wonderful people in my life.

Hoping that something stays down today, I really hate going in for fluids. I have zero energy, can't do much but chat on this silly computer and play games right now. Gosh, I've had enough.

Can someone out there explain about TPN? Is it done at home? Does a nurse come each time? I hate to ask, but have a feeling that if I continue to lose weight, there may not be a choice here. I had such high hopes for the pump, maybe if I can just get fluids on a regular basis...

Sorry so long, just needed to vent a little.
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Postby MamaLily » Sep 09, 2004 4:18 pm

Beth -

Hi. I'm sorry to hear that you're still so sick. My thoughts are with you...

Having IVs at home is a good idea when you are so dehydrated. I'd definitely prefer someone coming to my house instead of going to a hospital or ER. TPN is a form of nutrition that you will receive through your veins in a line of some kind (PICC line, central line, etc.). The line will be placed and left in there for as long as you are needing the fluids/nutrition. Lots of HGers have PICC lines for hydration and also for nutrition.

Has your doctor mentioned that it might be worth trying steroids? I was on home IVs and zofran and everything else you can think of, but I didn't stop losing weight untiil I was put on steroids (at week 11). It really might be worth a try. Please let me know if you want more information about them...

Also, I hope you will consider an NG tube instead of a PICC line if you are in need of nutrition. I had an NG tube for 6 weeks and it saved me! I'm planning on having the NG tube again in any future pregnancy. In fact, my new perinatologist (who knows A LOT about HG) said that it might be a good idea to consider an NG tube early on, to prevent my body getting so dehydrated/malnurished. The NG tube is put down your nose, past your stomach, and into your small intestine. I received all the nutrition that I needed (calories, vitamins, fat, fiber, etc.) through the tube. The risk of an NG tube is displacement, which is definitely a smaller risk than the risk of infection with a PICC. Also, the NG tube keeps your digestive tract working, which is preferrable.

As you can see, I'm VERY pro-NG tube. Let me know if you want more info or want some links that discuss why an NG tube should be tried before a PICC. I'm sorry if this is way too much info!

I really hope you start on your road to feeling better! I'll be thinking about you!

- Anna
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Postby BlueEeyore » Sep 09, 2004 4:42 pm

My TPN is a 3 liter bag of fluid that contains fats, proteins, and sugars. I attach it to my PICC line at night and it runs 10 hours overnight. There is actually a pump that delivers the medication, rather than relying on a gravity drip. To the TPN, I inject vitamins.

If you are getting a TPN or are doing IV hydration for long, I really recommend a PICC or similar device. Getting IVs poked in you all the time isn't fun.
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