HG support in Victoria BC?

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HG support in Victoria BC

Postby Mellymum » Feb 09, 2009 1:31 am

Hello ladies,

Hey!!! some of you live nearby (I live in Victoria)!!! Having survived my first HG pregnancy (happy to report that my DD is now 19 months), I'm starting to consider TTC for #2. I would love to find out more information from local HG survivors about their experiences with care received in the area. Did any of you have a great doctor that was up on the HG research? I feel like I need support from a health care provider as it just wasn't there for me the first time around.

My HG was so poorly managed with no continuity of care ... so much so that I lost over 25% of my body weight (dropped to 98 lbs) and was admitted to hospital three times... I was so incapacitated that I couldn't seek out appropriate care and just seemed to go between my midwife, emergency, my family doc (who doesn't even do maternity care) and walk-in clinics. Fortunately for me, my HG stopped at 15 weeks and at that time I was able to gradually wean off of my medications and just see my midwife. This time around I would love to have a doctor that has experience treating patients with HG.... but I don't know how to find one! Any help will be appreciated.

You have no idea how happy I am to have found other women in my area that have gone through this. 19 months after having my baby, I still think about my HG and I don't think I have recovered from the trauma of it... I fear my next pregnancy, but know that it could be "9 months of hell, for a lifetime of happiness" (I say this to myself over and over again - it was written by another HG survivor).

Thanks so much,
Melanie
Mellymum
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Location: Victoria, BC, Canada

Postby bibliojo » Feb 10, 2009 10:01 pm

Hi Melanie! I've split your post off from the original thread just so that more people will see it. It likely wouldn't have gotten many views where it was.

Anyway, welcome! I'm glad you've found us! I'm just across the water in Vancouver but I do know of a couple ladies on the island that will hopefully be able to be of some assistance to you in finding a doctor. (I could recommend someone here in Vancouver but highly doubt you'd want to take the ferry across for OB appts! The thought of a ferry and HG together - :sickfast: !!!) I don't know if you've seen this but here's a list of questions you can ask potential doctors to see if they will be suitable: http://www.helpher.org/mothers/referral ... doctor.php

One thing that I can recommend is contacting Motherisk. They have a nausea and vomiting phone line (1-800-436-8477) and they will ask you your past pregnancy experience and suggest things that you could try to do differently to see if it helps. They are also conducting a study on Diclectin right now where if you don't have drug coverage for Diclectin they will cover the cost of it! (a good deal because Diclectin sure is expensive when you take multiple pills a day for months on end!!)

Out of curiousity, what did you take with your first pregnancy? We could maybe help in suggesting what other medications you could try or treatments to push for.

I understand the fear of HG looming large over your head. Even when I was pregnant with my first I knew that I would have to face HG a second time in order to have a sibling for my child (something I was quite determined to have) and the 3 years in between pregnancies I lived in dread of that day when the HG would hit again. I hope that with having this community to support you and a more knowledgable doctor it won't be as bad for you as it was the first time!
2 HG pregnancies
Lukas - February 2003
Katya - October 2006

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Postby Mellymum » Feb 11, 2009 1:58 am

Hi Joanna, Thanks so much for making my post more visible. Really great to hear from you.. unfortunately the ferry would definitely be out of the question! As you put it: :sickfast:
I'm finding so much comfort from this website... just knowing I'm not alone.

This time around, I'm really trying to be proactive and seek out all the care that I can before TTC. I'm worried about how it will be for my daughter if I have HG again. ... but I really want her to have a sibling. It's one thing worrying about how I'll handle it again, but it's even harder worrying about how it will affect my daughter if I am sick.

Also, thanks for the info. I just read your post about the typical Canadian HG treatment and mine was very similar:

I started with 8 Diclectin per day, then after one week ended up in Emergency, was admitted for 3 days (IV fluids, started with Gravol (without success), then Maxeran and Ranitidene by IV). Released before I was stabilized and told to take a Gravol by suppository in order to continue taking the Diclectin, Maxeran and Ranitidene orally. Gravol didn't work at all for me ever. Of course the cycle continued and, again a couple of weeks later, back in emergency, same story, released too soon... the third time, however, I was kept 4 days and stabilized first and taking meds orally BEFORE I was released. I was also given a prescription for Ondansetron, which I only took twice when it was really bad and it seemed to be the only med that actually helped. The other meds really weren't doing much... but I was reluctant to take Ondansetron because the doctors seemed very reluctant to prescribe it, which made me concerned over the safety of taking it during pregnancy.

I do consider myself lucky as once I hit 16 weeks, I suddenly felt better (not completely, but a huge improvement). I was so weak from the weight loss and still not completely up to par, but it took me about 3 months to wean off of all of my medications. The remainder of my pregnancy was completely a breeze and I happily gained healthy weight! I'm normally an active and fairly average sized person, but to give you an idea of how poorly managed my HG was, by 16 weeks, I was so emaciated that I could place my hands together and they would fit around the largest part of my thigh. I recently read that once a woman loses more than 10% of her body weight she should be put on a PICC line and feeding tube! Have you heard of this recommendation? I had lost over 25% of my body weight without even mention of these next steps.

I might consider taking Ondansetron from the start next time, but do you know where it rates on the risk scale? Any medication/treatment recommendations will be much appreciated. I should mention that last time all the meds were covered under our extended health insurance, so fortunately, the cost isn't a barrier.

Thanks again!
Melanie
Kamryn 06/2007 - Severe HG
pg with Severe HG, EDD 11/2010
Mellymum
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Joined: Jan 03, 2008 12:59 am
Location: Victoria, BC, Canada

Postby bibliojo » Feb 11, 2009 1:52 pm

Ah yes, your pregnancy sounds a lot like how I was treated with my first pregnancy - gravol, maxeran, rantidine and diclectin (although I found the 4 Diclectin a day didn't really help me at all so I stopped it) I wasn't offered the ondansetron as it was 2002 when I was pregnant and ondansetron really hadn't made it's way into Canada as HG treatment yet. The gravol and diclectin help with the nausea (or are supposed to! We know that isn't always the case with HG!), ranitidine with the acid reflux and maxeran simply speeds up the digestion process. So really, it often doesn't help you feel a whole lot better. With ondansetron it is most useful in helping stop the vomiting cycle although it does help some ladies with the nausea too. I took Ondansetron twice a day with my second pregnancy and it was a much better pregnancy - lost just under 10 pounds vs 20 with my first. With my first pregnancy I was hospitalized twice, 4 days each time and had multiple trips to the ER for rehydration. The second time I only had to go for fluids a couple times as I was better able to manage at home.

Ondansetron is regularily prescribed in the states for HG and has been for a number of years now. It goes by the name Zofran so if you ever wanted to do a search of the forums for more info on people's experiences with Ondansetron, key in Zofran. Here is a link too to a study motherisk did on the safety of Zofran: http://www.ncbi.nlm.nih.gov/pubmed/1532 ... t=Abstract Granted it is a smaller study, but my OB was willing to prescribe Ondansetron after reading it and looking into other reports on it. And that's great that you have coverage for the Ondansetron because it's darn expensive!! My second pregnancy cost in the region of $7000 not including lost wages from taking time off from work during the first and second trimester.

As for the PICC lines and the NG/NJ tubes they really aren't seen very often in Canada. There are a couple ladies on this site - one in the Okanagan that did have a PICC line - so if you are interested in learning more about them I can alert them to this thread. The treatment in the US is a lot more progressive than here in Canada. I probably should have had a PICC line too with my first pregnancy but they just don't seem to have that level of intervention here - yet. I do think doctors in Canada are becoming more knowledgable and agreeable to try new treatments like Ondansetron but I think there's still alot of progress to be made unfortunately.

Do you have family nearby where you are? Or a good group of friends that would be willing to help you out when you are pregnant? Help from others is a huge blessing to have when you are pregnant the second time and have a little one to be responsible for.

I'll watch to see if the Island ladies respond to this thread too to see if they can give you some input on doctors. If they don't I'll alert them to this thread. This folder doesn't always get a lot of views and so they may not have seen it.
2 HG pregnancies
Lukas - February 2003
Katya - October 2006

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Postby Cin » Feb 12, 2009 10:09 am

I just saw this.

I live in Victoria, BC, and would be happy to help you throughout TTC and pg.

Unfortunately, I did not have HG here -- I did mine in Yellowknife, NWT. But I know some docs and I think I could help you find appropriate care.

I would love to meet you while you are still well. :D PM me and maybe we can meet!

Cindy
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Mom to Alex, 12 -- NVP
Isaac, 10 -- NVP
Naomi, 8 -- HG
Edward, 4 -- avoided clinical HG through aggressive pre-emptive treatment and pure luck (aka medicated fluffy)
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Postby Maria'sMommy » Feb 12, 2009 8:53 pm

Welcome to the boards! I just moved to QC from Victoria/Duncan in July. We used to live in Shawnigan Lake so I can give you a bit of advice. However, most of my care was done in Duncan so not all of the this may be relevant to you.

1. Avoid midwives. I used the midwives in Duncan and they were terrible at crackering me. However, they were good at getting me Ob appointments more quickly than I was able to do on my own. If I could do it all over again I'd try to get in with an Ob right from the begining. You're going to need more care than a midwife is equipped to deal with. In BC midwives can only prescribe diclectin. You need an Ob that is liberal with the prescription pad.

2. There are 3 Obs in Duncan. Dr Luc Beaudet is wonderful. I think I spelled his last name correctly, but if not he's the only male Ob in Duncan. I only saw him once but he seemed very proactive. He convinced me to add Ondansetron when I didn't think it would help me much. I was primarily nauseas, but didn't vomit much. He also talked about doing more interventions if the Ondansetron didn't help enough. He's also much more caring than the other Ob I saw. I highly recommend him. I also got good care at the Duncan hospital. However, if you live in Victoria, getting to Duncan while HGing is likely not a good idea.

3. Call Motherisk. They are wonderful. I also got good responses from my Drs/midwives when I would say, "Motherisk suggested we do x." If Motherisk said so, they were more than happy to oblige.

4. If you're looking for an Ob recommendation there is a women's health acupunture clinic on Hillside, across the street from the Hillside mall. They may be able to recommend someone. I can't remember the name of the clinic, but you should be able to find them in the Yellow Pages. If not, let me know and I'll see if I can track them down. Their office is on the 2nd floor above the McDonalds. I went there several times for treatment while HGing and they seemed to know a fair number of women with HG in Victoria. They also did hospital visits and offered reduced rates if you needed frequent treatments. If your insurance covers acupuncture I would definately give it a try. It won't cure you, but it may help enough to allow you to eat something the day of the treatment.

Ondansetron is totally safe and the most effective thing I tried. Despite barely eating until I was well into my 2nd trimester and taking pills like candy Anna was 10lbs 2oz at birth. She's an amazingly strong baby. I comment all the time on how it seems as though she was already one month old when she was born. I took 7 diclectin, 30mg maxeran, 300mg zantac and 24mg ondansetron for several months and none of it seems to have hurt her.

I totally understand the dread you're feeling about TTC. In fact, one of the reasons my girls are fairly close in age is that I just wanted to get the second pregnancy over with. I also didn't want Maria to remember me being sick. DH has his vasectomy a couple of weeks ago and I wanted to throw a party to celebrate. I'm so happy I'll never have to deal with HG again.
DD 2006 - NVP
DD 2008 - mild/mod HG
Maria'sMommy
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Joined: Nov 30, 2007 1:21 pm
Location: Victoria, BC

Postby Mellymum » Feb 13, 2009 1:13 am

Thank you ladies!

I loved my midwife for the labour & delivery and post-partum care - it was amazing. I did get quite a bit of crackering from her though, but she was also pretty good about saying I should see a doctor for more aggressive drug treatment. Unfortunately, that's where the ball was dropped in my case. So, this time around I want to have a GP and OBGYN already all set-up ahead of time, just in case. I would like to try to have a midwife again in case my HG does improve (like it did last time), but I know that I can't count on any similarities between the pregnancies.

Maria'sMommy, thanks for all the info. I think that Duncan is just a little too far for me, but maybe I will contact that OB to see if he can recommend anyone in Vic. It's very encouraging to hear that someone has had a good care experience on the Island!

I think I may know of the acupuncture clinic you referred to - I did start seeing an acupuncturist there a while ago, but I felt a little unsure about pre-emptive HG treatment.... I'm really interested in your experience with it during pg though. The acupuncturist suggested coming twice/week when the HG is bad - and I can't imagine even getting there that often let alone lying there for the treatment. Not to sound harsh, but it seemed a bit like a cash grab? In the "throws" of it though, I will definitely try it... Of course the logistics of being driven there etc., still elude me, but even a lessoning of the nausea would be beneficial.

I'm so obsessed with HG right now. It's weird... I think I really blocked it out for the first 6 months after having my daughter and then I think I may have suffered from a mild form of post-traumatic stress at that time (purely self-diagnosed! ...I wasn't debilitated from memories of it or anything, just thinking about it in the middle of the night and not able to fall back asleep and really grieving the glorious pregnancy that I didn't have). Anyway, that went on for a little while and then over the past year, I've been trying to think about it rationally and convince myself that I can do it again for the sake of giving my daughter a sibling.

Maria'sMommy, you're wise to space your babies close together so that your firstborn won't remember. I now wish that I had done that too... maybe before she was even mobile... and still napping twice/day. Oh well, hind sight is 20/20. I kept thinking there's no way, not yet! Well, now it's probably even harder with a non-stop toddler that will break my heart with questions and comments about mummy being sick. AAARRRRGGGGHHHHHH!!!! .... oh well. After it's all over, there will still be a beautiful little baby and all the sickness can begin to slowly move behind us.
Kamryn 06/2007 - Severe HG
pg with Severe HG, EDD 11/2010
Mellymum
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Posts: 18
Joined: Jan 03, 2008 12:59 am
Location: Victoria, BC, Canada

Postby Maria'sMommy » Feb 19, 2009 7:42 pm

I mentioned the accupuncture clinic b/c it's the only place I can think of that sees HGers in Victoria regularly. If anyone would know of better/worse Drs in Victoria I bet they would. I bet they would also make house calls for you. The woman I saw there mentioned she was also treating someone 3x/week at Vic General since that woman obviously wasn't able to make it to the clinic.

I only went for treatment 3x in my last pregnancy. The first 2x I felt much better afterwards and was able to eat semi-normally for the rest of the day. I also had more energy and was able to do slightly more than lay on the floor and wish I were in a coma. However, both times I way overdid it and then felt worse the next day. The third time I went I was in a fragile emotional place. I'd had enough of being sick. I was tired of being poked (blood draws and accupunture) and no one seemed to understand how hard it was to still be sick and not have any end in sight. I cried through the whole treatment and left feeling discouraged and embarassed. That treatment didn't work at all. There's obviously some kind of mental component, but hey, whatever works right?

If your insurace covers it, I would definately give accupuncture a try. Mine doesn't cover it at all and at $70/treatment I couldn't really justify going on a regular basis. Plus I hated being poked. I ultimately decided that I was better off with just my meds. I agree that it is a bit of a cash grab and I totally understand if you don't want to try it.

Having the girls close together wasn't without its own challenges. Even at 17 months old Maria was still old enough to understand that Mommy didn't feel good. She really wanted me to play with her, but all I could do was lay on the floor of her room. Without my ever asking she started bringing me a pillow and blanket whenever I did this. It broke my heart.

I totally understand the dread you're feeling right now. I think I ate everything that wasn't nailed down in the time between finding out I was pregnant and the start of HG. Every meal felt like my last.
DD 2006 - NVP
DD 2008 - mild/mod HG
Maria'sMommy
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Posts: 119
Joined: Nov 30, 2007 1:21 pm
Location: Victoria, BC


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