Re: 2nd trimester nausea & vomiting (long)
From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Wed, 14 Jun 2000 21:35:54 -0500 (CDT)
Why not have the GI and the MFM talk and figure it out as a team?
HSM
At Wed, 14 Jun 2000, Amy wrote:
>
>>Has OB even tried any meds?
>--Phenergan supp. (mildly effective for 2 hours), Compazine (Made me
>feel horrible, mentally) and Reglan (made the problem worse.) Any
>suggestions? Anything I should ask my MFM doc or the GI doc I'm seeing
>to try or to look for? Will a GI doc even prescribe meds for me without
>talking to my OB?
>>At Wed, 14 Jun 2000, Amy wrote:
>>>
>>>The baby was exactly the right size on the ultrasound. My SLE
>>>apparently puts me at higher risk for IUGR so they are monitoring his
>>>growth. Does being so sick all the time also increase this risk? I am
>>>extremely frustrated because my doctors don't seem to be doing anything
>>>to try to help me feel better because they are trying so hard to find
>>>the cause of my illness. I saw the doctor Monday and told him the meds
>>>weren't working so he made me an appointment with a GI doctor friday and
>>>wants me to come back next Monday. I wish they would try another
>>>medication or something to help me feel better. Is it normal to be
>>>refered to a GI doc for these problems? I can't imagine that he'll be
>>>able to do anything for me without talking to my MFM docotors first.
>>>>1st thing I would like to see happen for you is for MD to find anti
>>>>nausea med to work for you. 2nd thing, push your liquids as much as you
>>>>can shove in. No it is not great to lose while pregnant, but how is
>>>>baby looking on u/s? Also suggest eating when you feel least nauseated,
>>>>and eating whatever you think you can hold in. If that means a peanut
>>>>butter sandwich and a coke at 2 AM, so be it. I hope this yucky stuff
>>>>gets better, I can really feel for ya hon!
>>>>
>>>>At Tue, 13 Jun 2000, Amy wrote:
>>>>>
>>>>>Thanks, Claudia for your empathy. The throwing up is driving me nuts
>>>>>and I walk a thin line between not wanting to eat because I know what's
>>>>>going to happen and knowing that I need to eat something for the baby to
>>>>>survive. I guess my questions are: What are the risks for the baby at
>>>>>this point if I keep losing weight and what can or should the doctors be
>>>>>doing for me at this point? On a side note--I had a renal ultrasound
>>>>>today and they said everything was fine.
>>>>>
>>>>>At Tue, 13 Jun 2000, Claudia Twisdale RN wrote:
>>>>>>
>>>>>>Yuck, nothing worse than throwing up! I had WAY MUCh vomiting with Miss
>>>>>>Priss #1, lost 13 pounds in 10 days, hospital for 6 weeks, etc. I was
>>>>>>tried on phenergan, Tigan, Vistaril, Reglan, and all did not work. Ended
>>>>>>up with thorazine. Finally got better after about 18 weeks. Not so
>>>>>>sure the nausea is coming from SLE, but kidney stuff may definitely be.
>>>>>>By the by, I am also in midst of SLE diagnosis, and doing the protein in
>>>>>>urine, etc. Only + is that i am not pregnant! Good luck
>>>>>>
>>>>>>At Mon, 12 Jun 2000, Amy wrote:
>>>>>>>
>>>>>>>Thank you in advance for your help with previous posts. I have another
>>>>>>>question. Two weeks ago, I was hospitalized for a kidney infection--the
>>>>>>>bacteria grew on two clean catch samples, but not in the specimen they
>>>>>>>got from cathiterizing me. The treated me for 60 hours with two
>>>>>>>antibiotics for pseudomonesis (sp). I initially had a fever and nausea
>>>>>>>and vomiting, but it went away mostly while I was in the hospital--the
>>>>>>>fever completely, the other mostly. Because the cultures were
>>>>>>>inconclusive, they believe I may have had a kidney stone (I have had
>>>>>>>four in the year before I became pregnant). They sent me home with
>>>>>>>percocet and phenergan. Two days after being released I became
>>>>>>>seriously dehydrated and returned to the hospital for I.V. fluids. (The
>>>>>>>vomiting returned with avengance). Since that time, I have had serious
>>>>>>>problems with nausea and vomiting. (I get sick about 20 times a day.)
>>>>>>>They've tried phenergan--it works for about two hours. They tried
>>>>>>>reglan and it actually made me feel worse. I went to the O.B. today
>>>>>>>and my urine showed +1 protein, trace amounts of ketones and there were
>>>>>>>red blood cells in it. I have lost 10 pounds since being weighed in the
>>>>>>>hospital and feel terrrible all the time. They ordered another renal
>>>>>>>ultrasound and are sending me to see a G.I. doctor on Friday. I asked
>>>>>>>the resident about the protein and blood in my urine and he seemed no to
>>>>>>>think it was a big deal, but the attending ordered a urine culture &
>>>>>>>sensitivity anyway.
>>>>>>>
>>>>>>>I should mention that I am 25 weeks pregant, have SLE (only one minor
>>>>>>>episode of kidney involvement over seven years ago.No problems with the
>>>>>>>disease until becoming pregnant, disease is under control according to
>>>>>>>my rheumatologist with the help of prednisone). I see a MFM doctor
>>>>>>>because of this and a history of infertility
>>>>>>>
>>>>>>>My questions are: What is the next step--What happens if I keep losing
>>>>>>>weight and what are the risks to my baby? and What should I be asking my
>>>>>>>doctors to do/look for in my care?
--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York
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