Wednesday, 5 October 2011

Hyperemesis Gravidarum Pregnancy Two: Part Two - Admission to Hospital

As with my previous HG pregnancy I had been admitted to hospital less than twelve hours after being told by an out of hours GP that I did not need to be admitted. The previous time I had been given excellent treatment and had improved fairly quickly. This time was the opposite.

All the routine things were done such as taking my history, running through the treatment plan (which was as I expected having been through it before), patronising me with reassurance that I didn't need to worry because the baby would still get the nutrition it needed, inserting a canula (this time they only needed to go one size down) and doing various tests. Being dehydrated and having provided a urine sample at the GP I was unsurprisingly unable to provide another one. Despite the fact that I had drunk nothing, four hours later when I was finally given IV fluids they seem surprised that I was still unable to produce one.

In the evening I was offered a "warfarin" injection to reduce the risk of deep vein thrombosis which I declined. Warfarin is particularly dangerous to the unborn child but as I later found out when I obtained a copy of my hospital records it was actually low molecular weight heparin they were offering me and not warfarin.

My first anti emetic was finally given about twelve hours after I was admitted at around 11pm (although recorded in my notes as 7pm). Within a few hours I was feeling much worse so when I said I couldn't manage oral painkillers I was given the antiemetic intravenously. I managed to swallow the pain killers but was sick before the midwife had time to walk to the next person. Even though I had been admitted for hyperemesis nobody had thought to provide me with sick bowls but I had with me the yoghurt pots I had carried for the journey so was able to use one of them.

I was offered the same anti emetic (cyclizine) two or three times the next day (Thursday) but since it had made me worse, I said I didn't want it as it didn't work. Eventually one of the midwives told me that I needed to take it because if I didn't I wouldn't be given anything else. I told her that as I was pregnant I did not want to take unnecessary medication, that since the cyclizine did not work it was an unnecessary medication and that it was unreasonable to refuse to give me something else just because I wouldn't take something that wasn't working. She took my point and at 5.30pm I was given metoclopramide. Although there appears to be no record of this dose anywhere in my notes, when I requested a further dose at midnight I was told I needed to wait a further two hours as apparently it was eight hourly. I asked if there was anything else I could have and the midwife said she would ask a doctor for something else. Although I was awake most of the night due to the crying babies in the postnatal room next to the room I was in, I was not given any anti emetics until the next morning and my records say I was "sleeping" at multiple times through the night which presumably means that I was lying still with my eyes shut as one usually does when attempting to sleep.

After being given my "anti emetic" on Friday morning I was much worse again and on enquiry later in the day I was told I had been given cyclizine rather than the metoclopramide I was supposed to have been given (neither is recorded in my notes as having been given). This meant that instead of receiving three doses in 24 hours I had been given one dose, missed one dose and been given the wrong thing before being given a second dose of metoclopramide.

By now it was Christmas Eve and they seemed to be keen to discharge everyone regardless of how ill they were. One lady who was readmitted with sickness the day after me had been discharged prematurely the day prior to her readmission and another lady who had been in overnight and promised certain medication was then discharged with paracetamol - both commented that they just seemed to want to get everyone out without regard to whether they were ready just because it was Christmas.

Even though I was worse and had only consumed a quarter slice of toast and a few sips of orange juice since being admitted the doctor who saw me that morning had me taken off the drip and told me to drink a glass of water per hour with a view to me going home that afternoon. Although I knew it to be futile I did make some attempts at drinking but every time I had a single sip of water I vomited violently and was unable to make another attempt for some time. I was only actually sick six times that day but the frequent retching in between (which was just as bad - whether anything came out or not was a moot point really) made it impossible for me to consume anything. After three hours off the drip they realised I was becoming increasingly dehydrated again and resumed intravenous rehydration although according to my notes they still hoped to discharge me later that day.

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