Monday, October 27, 2014

HG Treatment Post 4: The Tips & Tricks

Living with "Robin"
This is the final post in my HG series on Zofran/Reglan Infusion Pumps.  To see the intro post, which will list all other posts in the series and link you to them, please go here.  If you are here because you are about to start a Zofran/Reglan Infusion Pump, don't worry!  For all the garbage that may come with them, it is by far better than the crippling illness that HG is.

So here is the last (planned) post in this particular series.  I am hoping to slap all the little tricks and tips in one place.  Both for ease and brevity of the other posts.  I suspect this one may get edited and added to a few times, so if you are reading this and have something you think may need added please mention it in the comments!

The tips are specifically about the pump and treatment of HG with the pump.  All other HG related stuff you can find in the search bar, in the menu bar or using one of the tag words over there on the right.  ------>

Medicine & Supplies:
  • Have a spot for all your non-refrigerated meds to keep them together.  
  • Have a spot for all your medical supplies (orbits, flushes, IV bags, alcohol wipes, etc ...).  
  • Have a spot in the refrigerator that is for YOU.  Your meds and safe foods or drinks if you can.  That way you only have to hold your breath and look in ONE place, disregarding all the vile foods your loved ones are still consuming.  
  • If you are on lots of prescriptions at once take pictures on your phone of each before any doctor appointments.  They always ask and I can't keep all this crap straight so I just whip out the pictures and can tell them all the details with little effort.  
  • You can take a demand dose of medication with the pump if needed.  Ask your doctor or nurse about it if you are having a hard time.  Just note that a bolus of meds can intensify any of your reactions to that medicine.  
You get lots of mail.  It just isn't FUN mail.

General:
  • Have a Notebook.  Just a special pad of paper for your HG stats and nothing else.  When you have to call your nurse they will want various stats on a regular basis from you.  These may vary on your needs (for example if you have BP issues or have GD they will need stats relevant to your stability with that).  For me they always wanted to know the following stuff:
  1. Ketones today
  2. Weight today
  3. Fluids drank in last 24 hours (regardless of what stayed down)
  4. Percent of pre-pregnant diet that I ate in the last 24 hours (regardless of what stayed down)
  5. Number of times I vomited in the last 24
  6. Number of dry heaves in the last 24
  7. If I was nauseous more than 6 of the last 24 hours
  8. How my infusion sites are doing
  9. How my IV sites are doing (if I have an IV in) and how many bags of fluids I have had in 24 hours
  10. Any reactions to the medication?  Headaches?  Feel baby moving? Anything worthy of me wanting to comment on it (like if I am in pain or having some kind of new weird symptom)
  • Having all of that ready to go in one place is valuable for both me and the nurse. I also have a document of it for my own records to take to the doctor.
  • I also keep any IV bag changes, pump changes times in there too so I can make sure my rates are what they should be.  For example, my IVs suck and die fast.  When I remember that I have a new bag at 7:00 AM I can do the math and see that there is a huge problem if I am barely a third into it by 1:00 PM.  
Constipation:
One of my bolus demands.  I am on the max does of meds I
can tolerate, so I generally do not do this much.  
  • Take something.  Ask, beg plead from your doctor for something medicinal to help if you are on Zofran it is simply irresponsible to take nothing for constipation.  
  • Use a stool under your feet. If you don't believe me when I say this well help, feel free to google "GI health and elevated feet or squatting" and prepared to be dazzled by lovely cross sections explaining WHY it works.  Personally, I'd be cool taking my word for it -- it helps.  
  • Suppositories hurt like a mother !@#$er.  The box won't tell you so, but OMfreakingG they made me want to die. 
  • Tucks pads.  Get them.  Keep 'em in the fridge for added coolness.  
  • Talk with your doctor or nurses about how bad it is getting, constipation is potentially very serious if you don't get relief in a reasonable amount of time and you may need medical help. 
  • Don't kill people when they tell you to eat watermelon and other water rich foods.  Categorize your shows of restraint here right with the people who "cracker" and "ginger" you and consider the money saved in bail as a nice savings for buying yourself something special after the baby is born.  
Site Issues:
  • If you are getting red welts, sore areas, warm areas, etc: Describe them to your doctor/nurse team to make sure it is nothing serious.  If it is "normal" then try heat and or ice to help relieve the pain.  Some people find greater help with one versus the other, some people need to alternate.  
  • My nurses recommend "warm moist heat" like a washcloth that was in really warm water.  I found this both annoying and uncomfortable/short lived.  I also dried my poor skin out this way even more.  So I used a rice sock, worked much better.
  • Benadryl can help site reactions, ask about it.
Day to Day with the Pump:
  • How do you sleep with it? I spoon it with it resting on a pillow that I cuddle with and curl around.  Some people leave it on a nightstand because the tube is pretty long. Some people hang it from their headboard somehow.  I also use a lot of pillows to prop myself into position so I don't roll.
  • Showering?  Easier to leave it off in my opinion.  This said keep those showers quick and careful.  Sit down if you can because you are likely weak and fainting-prone.  
  • Hurts to poke yourself?  You can go fast, you can ice the area before to numb it, or you can buy these thingies which I am told helps and fits the parts I have.  Double check before buying because they are nearly $30.  This video shows you how they work and it makes sense this would help if you have needle issues in particular.  
  • How do I wear it?  Pre-maternity clothes I just had it high enough that my pants were below it and it just came out from under my shirt.  Now that I am in maternity clothes, I turn the tubing to face up so that the tubing feeds out of the top of my pants.  I almost always wear my pump in the purse thing on my left side across my body.  So it hangs on my right shoulder cross my body with the pump is on my left side.  See the picture that I cannot believe I am putting on the internet LOL  (and no, I did not edit it, that is the selfie setting on my phone)

  • When the catheter is on my right side I just aim the tubing to my left so it still comes out my left side of my shirt to lessen the chance of the tubing getting caught on anything.
  • If your tubing gets caught it will terrify you at first, but its really not as big a deal as you think.  Chances are it will do nothing, but if it pulls it will just pop the snap piece from the tubing off, leaving the part IN you untouched and unharmed.  Just snap back on.
  • P.S. In the above picture of my 19 week pregnant gut you can barely see the lines left from the tubing resting against my skin and if you look really closely you can see little spots.  Those spots are my old Reglan sites.  Compared to the giant red welts and bruises that Zofran left me with my tummy looks about a million times better.  
That is everything I can presently think of.  If you have any questions please feel free to ask.  I do not have a PICC line and my IV is gravity fed, so if you have an IV or medicine infusion via PICC I cannot provide you with any BTDT ... yet. I might at some point, but I do hope to avoid it.  I will be working on a post or two about IVs and hydration soon too.  


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