Monday, April 19, 2010

Morning, Noon, and Night Sickness--The Real Deal--Part Three

We've talked about the various kinds of morning sickness, and I've shared some thoughts from women who have experienced it.  Now we are going to talk about ways to cope with hypermesis gravidarum, or extreme pregnancy nausea.  Warning:  This is a lengthy post!

Medical Options
If you aren't really sick, you may be able to get by with some of the non-medicinal remedies.  If you are very sick, I would go to the doctor right away and see what is available for you.  Granted, doctors vary in their response.  Some offer help and prescriptions right away while some just give you unhelpful tips and tell you it will soon be over.  But it's worth checking to see if you can get some help.  Sometimes, with the worst cases, nothing will help, but there are lots of different anti-nause remedies to try, so hopefully SOMETHING will work.  Some of the commonly prescribed ones are: Zofran, Compazine, Tigan or the antihistamine Phenergan.  In Canada, Dicletin is commonly prescribed.

The medicine I have found to be most helpful personally is Unisom, or rather, doxylamine, an antihistamine originally marketed as a nausea drug, but now used as a sleeping pill because of it's drowsy effects.  Generic doxylamine works just as well as the name-brand Unisom Nighttime Sleeping Aid.  Some women are advised to take this with vitamin B6 and some take it, with success, during the day.  However, all vitamins make me feel even worse in the first trimester and taking a sleeping pill during the day totally knocked me out and left me unable to function as a mom.  So, it wasn't until I started taking JUST Unisom, and only at night that I noticed results from it.  My body is very sensitive to medicines and so taking 1/2 a pill (and the pills are tiny to begin with) seems to help me immensely.  After a super-nauseous day I will sometimes take 3/4 of a pill that night for the next day, but I notice I am a bit more groggy the following day.  Friends of mine who are not super sensitive to medicines take a full pill at night, which is still considered very safe for pregnancy.  I recommend taking it about an hour before you plan to go to bed and the sleepiness effects seem to wear off within 8-10 hours but the anti-nausea effect last about 18 hours.  I experimented one night with NOT taking my Unisom and I did feel a bit more energetic the next morning and got a lot accomplished but I could not stop dry heaving and gagging all day long!  I almost lost everything I ate and was dying for night to come so I could take my next pill.  So, it definitely helps me in a big way!  If you find yourself less nauseous, perhaps 1/4 or 1/3 of a pill would do the trick for you without leaving you too sleepy-feeling the next day.  If you are very nauseous try a whole pill at first.
Unfortunately, doxylamine doesn't work for everyone.  So, if it doesn't help, please check with your doctor about other options you could try to get some relief.

*Those of you who are nervous about meds in pregnancy, like I am, who want to go the most natural route possible are free to try other options first and consult your medical practitioners.  I'm not a doctor and I don't know your individual situation.  But I do share about Unisom here because it has helped me so much and is widely used by many women, so if you are at the end of your rope with nausea, it could be something that helps you.*

Non-Medical Coping Techniques

Some friends of mine who have 5 and 8 children, respectively, have suggested sea bands and probiotics to help curb nausea/stomach upset in pregnancy.  I tried both of these this time around.  In fact, I'm wearing the sea bands even now as I type.  I'm not sure whether or not either of these options have helped much, but they are worth trying, even if they only ease the nausea a little bit.

Preggie Pops, lollipops designed for women with morning sickness, do help a little bit when I'm at peak-nausea and don't feel like eating anything or don't have anything on hand that sounds appealing.  Certain flavors are better than others, but they are worth a try to keep in your purse for those emergency situations when you are running errands and dry heaving in your van.  I've also tried B-Natals but didn't like them quite as much as Preggie Pops.


What helps you will often depend on your background, what's available, what you love and consider a "comfort" drink.  Lemonade is something I gravitate toward in pregnancy, with fresh-squeezed being best, but since really sweet things make me the most sick, I water it down or omit the sugar.  Carbonated lemon water, or fresh-squeezed lemon in either icy water, or warm water have been lifesavers when I'm having a severe nausea-attack.

I really enjoy green tea, and though some sites warn against drinking much green tea in pregnancy, Tazo Green Ginger with Pear green tea has been about the only tea I can drink right now.  I've tried a variety of lemon and lemon ginger teas, but this one is my favorite and my "go-to" drink when I'm most miserable in the evenings.

If you can get a smoothie down, they can be a great way to get fruits and veggies in when you don't feel up to eating them whole or eating much at all.  Iced fruit smoothies or Lime Rickies often sound good to me when I'm pregnant.

When you suffer from morning, noon, and night sickness, drink whatever sounds good.  Some people say fresh-squeezed orange juice helps, but I have found the acidity of it makes me feel more sick.  So, go with what sounds good to you.  If you are like me and can't tolerate sweet juices, try watered-down cranberry juice.  I haven't had trouble drinking some milk so long as I have something to eat with it.  So, when we have pizza, which is VERY often, I drink milk with it.

Though lots of folks recommend ginger ale and/or Sprite for nausea, the high amount of sugar in it has made it difficult for me to drink.  So, not sweetened carbonated beverages are better for me.

Raspberry Leaf Tea, which I drank faithfully when pregnant with Ali, seems to help some women with nausea.

Ginger root tea--grate fresh ginger into a pot and boil with water for a while and then strain the ginger out and drink the tea, hot or cold.  It has a strong taste, so I have mixed it with cranberry juice or added lemon slices to make it more drink-able.  Ginger has well-known anti-nausea effects so this is one you're going to want to try for those desperate moments.


What are my "life-saver" foods that I eat when I am at peak nausea?  Tiny dill pickles often help kick the nausea for a few minutes.  If I'm trying to prepare a food but my stomach is angrily churning and unwilling to wait, a little pickle will really help until the food is ready. 

Saltine crackers aren't a cure for people with HG or bad morning sickness but they do help.  I find them to be MOST helpful when I make little sandwiches of them, putting chunky peanut butter or cheddar cheese in the middle.  On their own, sometimes they make a churning stomach worse.  But adding protein with them really helps them calm a tummy down.

Proteins have helped me the most.  I've read extensively that both proteins and carbs fight nausea.  While salty crackers or pretzels, wheat bread, and baked potatoes do help at times, the greatest relief comes from some hard-core protein.  I'm not usually a big meat-eater, but when I'm pregnant I tend to want steak more.  I have found that little chunks of steak or grilled chicken that are seasoned well give the Stomach Monster something substantial to gnaw on for a while.  If you are in a truly desperate place with nausea, try making up a bunch of steaks and cut them into tiny bites and have them ready in the fridge.  A few bites here and there throughout the day help keep your stomach happier than he would be without them!  I can't stand hot dogs, but I love veggie dogs, prepared just like a hot dog.  One day I was really hungry for them so I bought them.  It turns out that 2 veggie dogs have 16g of protein, whereas the all-beef hot dogs my hubby was eating had only 10 g per 2!

My friend Lora recommended I try Carnation Instant Breakfast drink because of the high protein.  I can't find a flavor other than chocolate and right now chocolate is the last thing my body wants (but when I'm not preggo it's the FIRST thing I want!)  If you can stomach it, it's a good idea.  In past pregnancies I have drank Boost shakes, because I was losing so much weight and needed the calories and vitamins they offered.  I've tried the Odwalla protein fruit drink but it had around 30g of sugar per bottle.  So, even though it provided 18g of protein, the sickly sweet taste left me horribly nauseous.

Good proteins to have on hand:
*If you can stomach them, eggs, fixed however you like them are a good snack
*Cheese sticks of different kinds--cheddar cubes, string cheese sticks, provolone slices, etc.
*Chunky peanut butter--I eat this straight from the can when my blood sugar starts to swing down and leave me feeling faint
*Peanuts, almonds, sunflower kernels, pumpkin seeds, etc.  Nibble on them throughout the day
*Some women swear that beans really help them curb nausea.  If you can keep them down, try refried beans with cheese, either alone or on tortilla chips.  Try making mild chili or bean salad to see if they help.
*Fish isn't something I can usually handle in the first trimester but if you can, try a tuna-sandwich or grilled salmon for a protein boost.
*Yogurt--if sweets bother you, you'll want to go with plain yogurt and add a little bit of fresh or frozen fruit in rather than buying the sugar-loaded store varieties.

Other snacks that help me sometimes:
Sour gummy bears
Dill or Vinegar flavored potato chips
Green apple slices
Fresh fruit of various kinds and berries
Big Red gum or Bubblicious Watermelon Bubble Gum

Comfort Foods

Certain things appeal when you are sick.  Maybe your mom always made you red Jell-o and chicken noodle soup when you had the flu.  Your body may crave those things simply because you have memories of comfort with them.  Here is a list of foods that have really comforted me this time through my sickness.  I still felt horrible AFTER eating them but going down they provided some relief.

Creamy mashed potatoes
Chicken Noodle Soup
Chicken brocolli rice casserole
Cream of wheat (made one bowl at a time in the microwave)
Wild rice casserole (my mom made for part of the Easter meal)
Banana cream pie
Homemade, warm-from-the-oven bread with butter
Butterhorn rolls
Favorites from local restaurants:
Cheddar cheese bagels with cream cheese
Cheese mix sandwiches at the sub shop
Dominos or Pizza Hut (I'm almost always hungry for pizza, so that's what we eat about 30% of the time!)

Eat whatever sounds good at the moment, even if it as weird as fish sticks and cheesecake.  This may mean lots of trips to the store for you or your hubby but it's truly the way to survive bad nausea.  If you can't get to the store easily, then buy a large assortment of things to have on hand so you can "shop at home" for something that might sound good.  I have found that instead of doing one grocery trip a week where I spend all of my money it is wise for me to spend $10-$20 at a time and save some for each day or two so I can buy things as I get hungry for them, including Dominos or McDonalds, etc.

Other ideas for coping with debilitating sickness:

1.  Wear a mask or bandana around your nose when changing diapers or taking out the trash.  If your hubby is home, ask him to do these chores for a while.  If you must do it, have a barf bucket handy and try not to breathe!
2.  Get plenty of rest.  Being tired can exacerbate nausea.  Get enough sleep so that you want to get up and greet the day in the morning.  For some this will be 8 hours, for others 11 or more.  If you have the option of napping, (first time moms!) take as many naps as you can!
3.  Don't be afraid to ask for help.  Don't be afraid to step back from certain commitments if you need to for a time.  If you have the means to hire a mother's helper to babysit or help you once-a-week or a once-a-day, do it!
4.  Find a good balance of staying busy, but not too busy.  Being too busy can push your body to it's limits and cause your blood sugar to crash or cause you to be extra-nauseous.  But then again, never going out on playdates or planning anything can leave you feeling despondent.  I continue to attend Bible Study and have gone to a few baby/bridal showers recently, and enjoy taking Ali to soccer and all of the kids to the park for playdates but we have cut out all of our usual walks and a lot of our errand-running because of my fatigue.
5.  If you are planning on becoming pregnant and think you will be sick, stock the freezer the day that test comes back positive.  I had planned on doing this, and the funny thing was, even though it was a totally unexpected pregnancy, I found out the day I was doing my March once-a-month cooking so I was still able to do it, even though it was a surprise.  Having a fully stocked freezer is a good way to start.  If you can't do the OAMC right away, then fill the freezer with frozen meals from the stores.  They aren't quite as good, but they are better than nothing and will keep your family from starving!
6.  Cook when you feel your best.  Because the Unisom is still in full effect in the morning, I feel least nauseous in the morning and most nauseous from 4-11pm.  So, my pattern has been to make a bigger meal for lunch, such as a freezer meal or something, and then we eat those leftovers for dinner.  I rarely, rarely cook in the evenings anymore.
7.  Survival Mode--It's not fun to let the house go to pot and the dishwasher sit idle and the laundry pile up and the floors get stickier, but during a season of nausea, all you can do is survive.  So, if that means PB and J sandwiches or Dominos for supper 5 days in a row and that the bathroom hasn't been cleaned in weeks and the sheets don't get changed on the beds, it's okay.  Do stuff as you can.  Sometimes I have the motivation and desire to stop just surviving and to mop and vacuum and get all the laundry done, but then I'm pooped out and have to take it easy the next day.  So, do what you can and just try to make it through.
8.  Good smells.  Light candles that have good (but not overpowering and heavy) scents, put lotion or body spray on that you like (here is the kind I use), have a bar of lavender, sage or pine soap handy so you can grab it and smell it when you have a nausea attack, take the trash out as much as possible (esp. diapers) to keep the house smelling fresh, and use reed diffusers to keep your rooms smelling fresh.  I normally don't use fabric softener but I can't tolerate the strange smell of my clean laundry anymore so I'm going to buy some Downy Lavendar scented dryer sheets tomorrow to help curb the smells.
9.  Avoid vitamins.  Your doctor may tell you otherwise, so do what you feel comfortable with.  In 4 pregnancies, I have seen how sick any kind of vitamin makes me, from Flinstones, to organic whole-food prenatals, to doctor-prescribed prenatals, to Emergen-C packets, etc.  I can choke them down in the 2nd and 3rd trimester, with food, and usually keep them down but they ALWAYS come up in the 1st trimester.  So, I have personally chosen to avoid going through extra barfing by not taking them.  I try to get some fruits and veggies and juices down along with my proteins during this intense season since I know vitamins and minerals are very important, but I don't worry too much about it because people have survived for centuries without vitamins.

Feel free to chime in with any tips you may have for morning, noon, and night sickness survival in the comments!


Thia said...

Another drink option, especially if you are throwing up, is gatorade. That is the only thing that kept me out of the hospital during the pregnancy with my son.
I used to carry around an open envelope of mint tea to sniff...

Lea said...

So I wasn't this sick when I was pregnant, thankfully! I had twins, so I was more nausiated than normal and it did last through the whole pregnancy but was definately not this sick. Anything other than beef for meat made me gag, so we ate a LOT of beef (poor hubby!) and cooking pork was the only thing that did make me puke!

One thing that helped me that you didn't mention was Goldfish Crackers. For some reason Oyster crackers (even the really cheap ones) were better than saltines too. I think I must have eaten 50lbs of gold fish crackers during my pregnancy!

I'm watching my SIL go through this right now and it's tough to watch and I feel a bit guilty for having had such an easy pregnancy in spite of a bit of nausea that I didn't enjoy at the time.

Thanks for sharing these tips and I'm going to pass them on to my SIL!
I'm praying for you and your little one!

Gabrielle said...

I find it fascinating that several things you and others have mentioned worked for me as well (although nothing was failproof!). Pizza always sounded delicious, I also went through a gummi bears stage, and there was an entire month where I kept Goldfish on hand at all times!

Gatorade and Powerade are both wonderful. I drank red Powerade like crazy, which my doctor suggested for replacing electrolytes that I was losing when I was getting sick. I'm an avid water drinker, but I never wanted it when pregnant, so Powerade was a good substitute, and for once I didn't have to worry about the added calories of a sugary drink.

Sarah C. said...

Hey Lindsey!
I thought I would share about a drink that has really helped me with all-day sickness in pregnancy:
It may seem strange, but it has helped A LOT with all day sickness during pregnancy. It may take some getting use to, but if continued, can help to ease symptoms and bring back the feeling of wellness. It is also low in sugars and naturally fizzy, which I really like!
The downside: good, raw, store bought kombucha is expensive and can be hard to find, especially in a small town (although, oddly enough, you can now get it in Dubois at a little health food store owned by a christian gal).
For this financial reason, even though I can get it where I am, I'm in the process of home-brewing my own in large batches to keep within our grocery is that good and that refreshing, and it is great to have on hand for nursing to keep up the supply! I recommend GT's Gingerade and/or GT's Original if you want to purchase some to try. GT's fruit juice flavors are also really good but may be a little higher in sugar. If your interested, it is worth something to look into.

Anonymous said...

I read your morning (noon and night) sickness posts back when you first wrote them--and when I wasn't pregnant--now that I am and experiencing a LOT of nausea and vomiting, it was a huge comfort to remember your blog and to revisit these posts. This is our first pregnancy and all of this is new to me--your suggestions and encouragement mean so much right now. Thank you for taking the time to write these posts even though you were in the midst of feeling so miserable. Your words really are making a difference for me!

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