Can you look this over quick before I bring it to the OB?

[k2bdeutmeyer]

Whole story is HERE.

 

I'm waiting on a call back from the OB office's triage nurse to give me "permission" to make a same day appt with the OB today. Mornings are my best time (though still miserable), so I figured before the nausea totally took away my ability to think, I'd try to put together a concise synopsis of events that will hopefully help her to see the whole picture and "get it". I intend to bring it with me to the OB and present it to her when I request a better plan for treating this.

 

Here's what I have. Thoughts?

 

IVs/Rehydration:

9/23 - 2L, Mag, Zofran - 1 stick (ER)

9/28 - 1L, Zofran - 3 sticks (office)

9/30 - 2L, Zofran - 3 sticks (ER)

10/2 - 2L, Zofran - 1 stick (office) - almost used foot

10/4 - 2L, Zofran - 1 stick (IC)

10/6 - 2L (1 w/vitamins), Zofran - 2 sticks (2nd with u/s) (IC)

*permission for PICC line requested

10/7 - 1L, Zofran - 1 stick with u/s (IC)

*IV from 10/6 infiltrated 200CC into infusion

 

*IC = infusion center

 

Weight:

Starting weight: 145lbs

9/28: 141lbs

10/2: 137lbs

10/6: 134lbs

 

Symptoms:

-Extreme nausea 24/7 - prevents eating/drinking & causes vomiting when attempted

-Vomiting: Good day = 2-3x, Bad day = vomiting green bile - often hourly

-Dizziness/lightheadedness

-Weakness

-Protein & ketones (80mg/dL - 160mg/dL) in urine

-Dark/concentrated urine & decreased output

*concentration & ketones are despite IVs

-Frequent headaches

-Inability to even perform self care tasks

-Very interrupted sleep due to nausea/vomiting

-Dry, cracked, bleeding lips

-Sensation like UTI

 

Medications: (in order attempted)

B6 & Unisom - vomited anyway

Zofran ODT - vomited anyway

Reglan - vomited anyway

Phenergan (suppositories) - caused burning, cramping, and was expelled

Benedryl - unable to ingest

 

IV Zofran - sometimes allows for ingestion of small amount of food/drink

 

Goals:

1. Get and remain hydrated consistently.

2. Clear ketones consistently.

3. Increase ability to eat & drink on a regular basis.

4. Stop weight loss.

5. Improve quality of life (sleep, self care, reduce discomfort, etc).

[extendedforecast]

Looks good to me. :grouphug: I'm sorry you're having so much trouble getting your OB to take you seriously.

[Jan in SC]

The only thing I would change is to the IV Zofran. I would remove sometime. The OB might see that and think that there is no point, if only helps every once in a while. I would say -

IV Zofran- allows for ingestion of small amount of food/drink

[k2bdeutmeyer]

The only thing I would change is to the IV Zofran. I would remove sometime. The OB might see that and think that there is no point, if only helps every once in a while. I would say -

IV Zofran- allows for ingestion of small amount of food/drink

 

Even though the truth is that it doesn't always? I thought it did. Saturday, I was able to eat some, but it was a struggle. Yesterday, I couldn't choke anything down & was miserable!! I felt worse when I left than when I showed up.

 

I'm willing to do whatever it takes to get her to listen & do something!!

[Stratford]

I'm so, so sorry you are having to go through this. I agree with PP and removing the "sometimes." And keep requesting a PICC....nobody should have to be stuck this many times in such a short period of time. Maybe they would consider the zofran infusion pump for you? I know a few people that have had good results (i.e. more consistent relief) with it.

 

I think you should take your excellent and concise synopsis to your OB and then puke on her shoes. :grouphug:

[Sun]

I'd be hesitant to keep the 2-3 times per day on a good day part in there. How often do you have "good" days? That 2-3 times per day is what she's going to see, and she already sees you as a mild HG patient--unless you're having as many good days as bad, I'd leave it out. I'd also change "often hourly" to just "hourly"--unless that's really stretching the truth.

 

I also agree with vomiting while you're there. I'd be very tempted to force myself to swallow a small amount of water, knowing that it would make me vomit while in the office.

[Catwoman]

I agree with everyone who said to eliminate the "good day" parts. I hate to say it, but you need to make this doctor believe you, and you won't achieve that if you don't make it seem like you are sick as a dog 24/7.

 

:grouphug::grouphug::grouphug:

[Caitilin]

I think you should take your excellent and concise synopsis to your OB and then puke on her shoes.

:iagree:

:grouphug::grouphug::grouphug:, mama.

[Annie G]

 

I think you should take your excellent and concise synopsis to your OB and then puke on her shoes. :grouphug:

 

:iagree:

It's reasonable compensation for you doing your OB's job- you summarized this so perfectly and that saved her time and effort. You've earned an opportunity to barf on her shoes. And if you do barf on her shoes, try not to break out laughing at the thought of coming back and telling us all about it.

[sunnylady303]

I think you should take your excellent and concise synopsis to your OB and then puke on her shoes. :grouphug:

 

:hurray: I think that is an excellent suggestion. I haven't commented before but I have been following your struggles and it seems so very horrible to make a pregnant lady feel worse than she needs to. You don't have to be near as miserable as you are which is clearly taking its toll on you and your family. I hope she listens.

[JenC3]

Good advice already:

Don't mention 2-3 good day stuff

Puke on her!

You need a pump of this stuff!

 

:grouphug: and good luck!

[momto3innc]

I think it might also be helpful to write how little you're keeping down. Like show how much nutrition you're actually keeping down. I would assume if a doctor saw in black and white an insanely small amount of food taken in (and kept down) it might help to really realize the severity of what your body is missing out on.

I think I would also take out the "good days" because from what it has sounded like on here, that is not so often but a doctor might see that and assume that those are 4 or 5 days a week and you're just bothered by 2-3 bad days. Really, I don't mean to lie, but to do what you need to do to make sure the severity is seen since it really hasn't seem to have been so far. I tend to want to seem somewhat together at places like doctors even when I'm not. I would not make any effort towards that (maybe even make your appointment at when you typically feel your worst).

Make sure it is obvious how truly miserable you are.

Hope it goes well!

[trlt]

I had a zofran pump and it made my quality of life so much better. I was miserable until ob put me on that and I finally could function. I hope you get what you need because I know how horrible it is to feel that way. I hope your ob listens to you!

[mamajag]

I think you should take your excellent and concise synopsis to your OB and then puke on her shoes. :grouphug:

 

I had HG with my first 2, and it took me puking bile on my OB's brand new white Nike shoes for him to get with the program. The second case he took me for my word and gave me Rx for both Phenergan and Zofran and as needed IVs. Bile does NOT come out of tennis shoes, or so I have been told.

 

OP, I don't know how you get someone to take you seriously. I had IVs in the office and once he came to my house (weekend and I didn't have insurance yet for the first child).

 

Can you get your husband to come with you? I know with my medical issues if I'm not being taken seriously if my husband comes with me and gets all "this is what is going on" the issues disappear with a quickness. :grouphug:

[Grover]

:grouphug: good luck. BTDT and it was not fun at all :-(

[LittleIzumi]

I would also take out the good days and just put vomiting up to (the max #) times per day. I would also explicitly state that you cannot keep down even a single swallow of any liquid or solid. As currently stated it sounds like it's just hard to eat/drink, but not impossible. I would also add with the Iv Zofran that it is the ONLY thing that allows you to consume anything by mouth, period. You've told us all this but it's not clear in your summary.

[In the Rain]

All I can think of to add would be an example of exactly how much and what food you are eating in a day. :grouphug: I hope you get the help you need. :grouphug:

[LittleIzumi]

All I can think of to add would be an example of exactly how much and what food you are eating in a day. :grouphug: I hope you get the help you need. :grouphug:

 

:iagree: It sounds like are eating, just because it's not quite clear. If you eat nothing, say that very clearly and plainly.

[Scuff]

I'd be hesitant to keep the 2-3 times per day on a good day part in there. How often do you have "good" days? That 2-3 times per day is what she's going to see, and she already sees you as a mild HG patient--unless you're having as many good days as bad, I'd leave it out. I'd also change "often hourly" to just "hourly"--unless that's really stretching the truth.

 

I also agree with vomiting while you're there. I'd be very tempted to force myself to swallow a small amount of water, knowing that it would make me vomit while in the office.

 

:iagree: I threw up all 9 months with this last one. Many days I threw up bile and much more than 2-3 times. 2-3 times was normal for a good day, for me, too. But you sound much, much, much worse than I was. I was miserable, but I never needed an IV (though sometimes wished for one-it sounded much easier to just pump it into my veins!) and was not nearly that dehydrated. It seems to weaken your case.

[Pink and Green Mom]

*permission for PICC line requested

 

-Vomiting: Good day = 2-3x, Bad day = vomiting green bile - often hourly

 

-Dizziness/lightheadedness

 

-Weakness

 

-Inability to even perform self care tasks

 

QUOTE]

 

 

my thoughts:

-permission for PICC line - if I recall correctly you asked for a PICC line. The way it is written would make me think the doctor/hospital asked you to consider a PICC line and you refused. I would change it to: "I asked for a PICC line to make receipt of fluids easier and was denied for no apparent reason and with no further discussion." (if that is true).

 

-if true, I would change to vomiting:... to "every time eating or drinking is attempted" and get rid of the bad day/good day

 

-I would add the word "extreme" to dizziness and weakness

 

-to inability to perform self care, I would include something like "...or engage in any day-to-day activity."

 

My children are adopted, and I have never been pregnant, so please excuse my ignorance. Must you see an OB for dehydration (I honestly don't know the answer)? Since your OB is being such a pill, could you go to a general practitioner (or better yet the ER) since you are dehydrated? I cannot imagine it would be good medical practice to let anyone, let alone a pregnant woman, get so severely dehydrated and lose so much weight.

 

I am so outraged on your behalf. :grouphug:

[sunnylady303]

And please update us when you can!!

[In the Rain]

And please update us when you can!!

 

:iagree: I'm wondering how it went. :grouphug:

[justLisa]

:iagree: I'm wondering how it went. :grouphug:

ditto

[Harriet Vane]

:lurk5:

[k2bdeutmeyer]

Just posted an update HERE :)

 

Thanks for checking in!!!

[Pink Fairy]

I hope all went well. :grouphug:

 

I wish I had read this before. I spent six months on bedrest, three of those in the hospital, and dealt with a baker's dozen of doctors and nurses. Above all, be confident and tell them exactly what you want. Bring medical literature to back up your requests. Be firm but insistent. Have an advocate there for the times you are too sick to advocate for your baby and yourself.

 

Hang in there. :grouphug: