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Hyperemesis Gravidarum (HG) is a condition at the extreme end of the pregnancy sickness spectrum. It affects only 1% of women with pregnancy sickness and is extremely unpleasant for sufferers. It is important that you seek medical advice if you are unable to keep any food or fluids down as you can become dehydrated very quickly when suffering with HG. Below are some basic tips for surviving hyperemesis gravidarum, however, the list is by no means exhaustive and many women develop their own individual coping strategies. Our Forum is full of women who have been through pregnancy sickness and hyperemesis in its various severities and can offer a wealth of information on coping strategies and tips for surviving; please join us there to access instant support and information from women who 'know'.
The key for the hyperemesis sufferer is rest rest rest! Hyperemesis gravidarum is an episodic condition with frequent periods of recovery and relapse. The temptation when you do feel better is to rush to catch up with the jobs that you couldn't do when you were too ill, but this is a sure-fire way to cause a relapse. Don't think you're somehow a wimp because you can't so much as do a bit of housework before having to take to your bed again, this is absolutely classic and most HG sufferers will recognise this. If it's your first baby, just lie on the sofa and enjoy not vomiting for a change. If you have children, do everything in your power to sort out childcare - rely on relatives, nurseries and friends. Don't feel guilty about needing help, you are very ill and you would not be expected to carry on regardless if you were undergoing treatment that causes similar symptoms such as chemotherapy. The house may be a tip, there may be a washing mountain and the kids/your partner/work may have to fend for themselves for a while but if you push yourself your vomiting will get worse. If you have HG you need to give yourself a break and know that normal service is not applicable.
Avoiding Triggers of Nausea
Many women find that sensory stimulation such as noises, moving visual images or bright light, strong smells and even the movement of air from an open window can all trigger vomiting. At all costs avoid triggers of nausea. Strong aversions to various foodstuffs and food smells are common in most if not all women suffering HG. For some the slightest thing will trigger nausea, including even the sight of food or hearing someone talking about it. Many women ﬁnd that once they have thrown up a certain food, they cannot bear the sight of it again until the HG improves. For some women an aversion can have such a strong association that they still cannot eat certain things even after the pregnancy. Cooking smells are often unbearable so avoid cooking as much as possible and make sure that windows are open and you are far from the kitchen while it is going on.
Avoid becoming dehydrated. If you can't tolerate drinks, try sucking ice cubes made of juices, or sipping very slowly through a straw. Try freezing half a bottle of mineral water and then topping up with fridge cold water, this keeps the water freezing cold for hours. Bottled mineral water may be more palatable than tap water. See Eating advice for more suggestions of ways to take fluids. If this doesn't work, then be prepared for a hospital admission, don't try to ﬁght it - if the GP says you need to be admitted you must go. An intravenous drip and having antiemetics injected can give you days/hours of respite that are so important not only to your physical welfare but your mental well being too.
Avoid thinking ahead more than the next few days. Torturing yourself with 'I have 20 weeks of this left to go' is not helpful. Take each day at a time and at the end of each day recognise that it is another one done and one less to do again.
Lying alone in bed or on the sofa can be boring and depressing. Get yourself some DVDs of your favourite TV shows or ﬁlms, preferably comedy to try to lift your mood. If watching TV makes you nauseous, try radio or get some talking books. If you have friends who can come over for a while and just be around it will help a lot with the loneliness and isolation that many sufferers feel. If you are okay to talk on the phone, call friends who are at home during the day and can spare you time for a chat. If you would like a call from someone who has had HG and knows exactly what you are going through, see our Support Network. Text support from a fellow sufferer can be absolutely invaluable at getting you through each day and helping you feel less alone.
Some women have found self hypnosis to be helpful for coping with the symptoms, ask your GP if they know of a medical hypnotherapist. Hypnotherapy is sometimes used to help women through labour so your midwife may know of a practitioner. See Alternative Remedies for more information about hypnotherapy as well as accupressure, ginger and other alternative therapies. For some sufferers they feel that by trying the alternative therapies on the market they at least feel proactive and you can respond to concerned friends and relatives who are trying to help by suggesting these thing that you have in fact tried them.
Practical Tips - HG survival kit
- To tackle the first aim, you should always carry something to eat with you. What this is will depend on what you are able to eat at the time but suggestions include bananas, cereal bars, nuts, dried fruit, bread, crackers, peanut butter sandwiches and crisps. Often you will spend most of the time too nauseated to eat, then hunger will strike very quickly. This is your window of opportunity to eat something and if you miss it, you may well be unable to eat anything again for the rest of the day. Your normal pattern of hunger at mealtimes will probably disappear so you won't be able to wait for set breaks such as lunchtime, or you may find that you can't eat at lunch but become ravenous well before the next scheduled break. If this is a problem at work, you should speak to your employer about allowing you to eat at your workplace or take breaks as it suits you. Missing out on food during your hunger window can bring on a relapse which may see you incapacitated for days afterwards and can make you so nauseous that you throw up on an empty stomach, so it is very important to always have food to hand.
- Sudden vomiting is a hazard of HG so it is advisable to be prepared. You may not always be somewhere with a toilet or sink, or you may vomit while on the way there. Some women have an HG emergency kit that they carry around with them. This includes a bag for the vomit (tried and tested suggestions are airline type paper bags and jiffy bags and nappy bags), wipes, tissues, plastic bags for disposal and a bottle of water for mouth rinsing afterwards. Unpleasant though sudden vomiting is, cleaning up the car/carpet/office just adds to the misery and leaves a smell which may make you more likely to be sick later. Being prepared can help you retain a sense of control over your situation as well as minimise unpleasantness and embarrassment.