Severe Morning Sickness

When I was pregnant, I didn’t experience any morning sickness.  I have heard of some women who experience it with the one pregnancy but not the other.  Some, like Kate, the Duchess of Cambridge, however, suffer from severe morning sickness known as Hyperemesis Gravidarum.

What is Hyperemesis Gravidarum?  It literally means “excessive vomiting in pregnancy”. Hyperemesis starts early, usually before week five of pregnancy.  

Signs and symptoms of hyperemesis gravidarum:

• Severe nausea and vomiting
• Food aversions
• Weight loss of 5% or more of pre-pregnancy weight
• Decrease in urination
• Dehydration
• Headaches
• Confusion
• Fainting
• Jaundice
• Extreme fatigue
• Low blood pressure
• Rapid heart rate
• Loss of skin elasticity
• Secondary anxiety/depression

In some cases it is so severe that the woman has to be hospitalized.  Hospital treatment may include:

• Intravenous fluids (IV) – to restore hydration, electrolytes, vitamins, and nutrients
• Tube feeding:
  • Nasogastric – restores nutrients through a tube passing through the nose and into the stomach
  • Percutaneous endoscopic gastrostomy – restores nutrients through a tube passing through the abdomen and into the stomach; requires a surgical procedure
• Medications – metoclopramide, antihistamines, and antireflux medications*

Some women might require bed rest but not too much.  My cousin’s wife needed bed rest for both of her pregnancies.  Other treatments include herbs such as ginger and peppermint; homeopathic remedies prescribed by your doctor;  hypnosis and Acupressure.  The pressure point where you can reduce nausea is located at the middle of the inner wrist.  It’s three finger lengths from the crease of the wrist between the two tendons.  When you locate it, you press one wrist firmly at a time for three minutes.  Sea bands can also be used and are available at the drugstore.

Before trying anything, always consult your doctor. For more information on hyperemesis gravidarum you check out HER (Hyperemesis Education & Research) Foundation.

Two things you ought to know:  your baby isn’t at risk.  William and Kate are parents of three beautiful, robust children.  In a post, a woman suffering from HG, gained only 12 pounds by 41 weeks pregnant gave birth to a 7.5 boy which is average.   She cautions mothers not to assume that because the Duchess of Cambridge suffered from HG during all three of her pregnancies, it means that you will every time you’re pregnant.

Studies vary, but most find that women have a good chance of experiencing HG in future pregnancies. Statistics suggest over 50% will have it with each pregnancy and those with more than one experience of HG have a greater risk of experiencing HG in future pregnancies. It also seems to occur in similar patterns and severity, though it is not always consistent. Those who have mothers, grandmothers, or sisters who have had HG will often have at least some nausea and vomiting during pregnancy – HER Foundation

Don’t let these studies discourage you, Moms.  Hang in there.

Sources:  American Pregnancy; Baby Center

Administering Medication to Parkinson Patients on Time

Lately, *Wendy is plagued with the fear of losing her mother.  Granted her mother *Marian had lived a long and happy life but Wendy was not ready to lose her.  Marian was in her seventies.  She celebrated her 75th birthday a couple of months ago.  Wendy and her sister *Lauren had taken her out for lunch to celebrate.  In the past, Marian celebrated birthdays, Christmases and every Mother’s Day at her home or at one of her daughter’s home.  However, everything changed when she was diagnosed with Parkinson’s.  She couldn’t remain in her home after she fell.  She was a widow and had been living on her own.  She had to sell her home and move into a nursing home.  It took time for her to adjust to living in a room and having to depend on nurses to change and bathe her and do the things she used to do for herself.  It was hard to give up her independence.

She was still able to go and spend time with her children and grandchildren but lately, it was becoming increasingly difficult for her to move around without the wheelchair.  She had gone from using a cane to a walker and now to a wheelchair.  She had fallen several times.  Once Wendy went to visit her and was horrified to see the ugly bruises on her arms.  Marian fell because she tried to do things on her own when she should have called for help.  The nurse would go into her room and find her on the floor.  Thankfully, she hadn’t had any serious falls but Wendy worried about her.  She had heard stories of elderly women breaking their hips and suffering other serious injuries from falls.

Just recently, Wendy received distressing news.  Her sister Lauren informed her that their mother was not responding well because she hadn’t been given her medication that morning.  The last dosage was the night before so she was supposed to get the next one around 7 in the morning but the nurse hadn’t given her.  When Marian’s regular nurse found out two hours later, she decided to wait until 11 to give her her medication.  Lauren was livid.  She demanded to know why the nurse waited instead of giving her mother the medication right away.  As Wendy listened to her sister, she felt sick in the stomach.  Their mother had been without her medication for 15 hours.  She was lying in her bed, with her eyes closed.  She was aware that her nurse was in the room and was responsive but she couldn’t do anything except lie there.  Her nurse kept checking on her to make sure she was okay.  She was relieved when Marian woke up.  Marian’s doctor told the nurse to try to get the medication into Marian which she kept trying to do until she succeeded. The doctor said that it could take 24 hours for Marian to recover as a result of not getting her first dosage that morning.

The Administration at the nursing home acknowledged that two gross mistakes had been made.  The first nurse should have given Marian her 7:00 a.m. meds and her regular nurse should have immediately given her the meds at 9:00 when she realized that she hadn’t been given her first set of meds instead of simply waiting for the next set.  The director assured Lauren that they were taking measures to make sure that this never happened again.  They plan to follow up with the first nurse who neglected to give Marian her morning medication.

Wendy was thankful to God for watching over her mother who is okay.  Tears came to her eyes as she imagined her mother lying there with her eyes closed, unable to do much else and how it could have been much worse…

How many other Parkinson’s patients like Marian do not receive their medication on time?  According to an article written on the National Parkinson Foundation website, hospitals can be danger zones for people with Parkinson’s.

Hospitals are usually a safe haven for people with serious illnesses, but for people with Parkinson’s disease (PD) going to the emergency room or being hospitalized can be a nightmare, because their condition is more likely to deteriorate due to inappropriate care and the anxiety of being in an unfamiliar environment.

Parkinson’s patients are often afraid to challenge a hospital’s medical staff, because they assume that they know what they are doing, but many may have little or no knowledge about how to care for someone with Parkinson’s, said Dr. John Morgan, assistant professor at Georgia Health Sciences University.

Three out of four people with Parkinson’s do not get their medication on time when they go to the hospital, which can cause serious complications even death, said NPF’s National Medical Director Dr. Michael Okun. Even more alarming is that research shows that the majority of hospital staff do not know which drugs are unsafe for Parkinson’s patients, and they do not understand Parkinson’s disease.

People with Parkinson’s must take their medication on time, especially those with moderate and advanced Parkinson’s who are taking frequent doses of levodopa, a common Parkinson’s medication, Dr. Morgan said. “If medication is not taken on time, they can become stiff, rigid, tremulous and unable to move and prone to falls, etc. Even one hour off of a scheduled time can make a big difference,” Dr. Morgan explained.

There is no cure for Parkinson’s, but medication helps control symptoms by increasing the levels of dopamine in the brain. Dr. Morgan emphasized that medications should be taken 30 minutes to an hour before meals or an hour or more after meals, because the protein in food can inhibit the absorption of the medication into the body. If a person eats too close to their scheduled medication time, Dr. Morgan said it is better to eat a low-protein meal rather than delay taking medication.

The article mentions that one hour off of a scheduled time can make a big difference.  Wendy’s mother had been 15 hours off her scheduled time.  Another article states, “Medications must be administered on time to promote consistent therapeutic blood levels and prevent disabling symptoms. A delay of even 5 minutes can cause the patient to suddenly lose the ability to move, walk, and speak^.”  If Wendy and Lauren wanted to, they could sue the nursing home for gross negligence and failing to administer the proper help.  Marian should not have gone through what she did.  She was in a facility that was supposed to take care of her.  Their negligence could have cost Marian her life.  For now, Wendy and Lauren are hoping that this doesn’t happen again.

Want to get involved in raising awareness for Parkinson’s?  Here’s how.

*These are not their real names.

Source:  http://www.parkinson.org/About-Us/Press-Room/NPF-In-The-News/2012/November/Hospitals-can-be-a-danger-zone-for-people-with-Par; http://journals.lww.com/nursing/Fulltext/2011/03000/Administering_medications_for_Parkinson_disease_on.24.aspx

Women and Heart Disease

Believe it or not, the number one killer of women is heart disease, formerly thought to be a “man’s disease”.

What is heart disease? 

Your heart is a muscle that gets energy from blood carrying oxygen and nutrients. Having a constant supply of blood keeps your heart working properly. Most people think of heart disease as one condition. But in fact, heart disease is a group of conditions affecting the structure and functions of the heart and has many root causes. Coronary artery disease, for example, develops when a combination of fatty materials, calcium and scar tissue (called plaque) builds up in the arteries that supply blood to your heart (coronary arteries). The plaque buildup narrows the arteries and prevents the heart from getting enough blood (Heart & Stroke Foundation).

Why does heart disease affect women?  Women are more likely than men to have coronary MVD. Many researchers think that a drop in estrogen levels during menopause combined with other heart disease risk factors causes coronary MVD.  The disease affects women differently than it does men.  This can cause many women to be misdiagnosed.  Here are the differences:

• For women, heart disease symptoms may be subtle – but when a heart attack
  strikes, women are more likely to die than men. Women are also at twice the risk
  of death following open heart surgery, compared to men
• Heart damage is more likely to occur in women when the small blood vessels become obstructed from plaque.
• Women are also more likely to maintain heart function after a heart attack, unlike men whose heart muscle becomes weaker; 38 percent of women die from heart attack, making heart attack more lethal for women than men.
• Women are also more likely to have a second heart attack within six years of their first one, unlike men.
• Women are also less likely than men to have obstructive coronary artery disease.

Women are also more likely than men to have a condition called broken heart syndrome. In this recently recognized heart problem, extreme emotional stress can lead to severe (but often short-term) heart muscle failure.  Broken heart syndrome is also called stress-induced cardiomyopathy (KAR-de-o-mi-OP-ah-thee) or takotsubo cardiomyopathy.

Doctors may misdiagnose broken heart syndrome as a heart attack because it has similar symptoms and test results. However, there’s no evidence of blocked heart arteries in broken heart syndrome, and most people have a full and quick recovery.  Researchers are just starting to explore what causes this disorder and how to diagnose and treat it. Often, patients who have broken heart syndrome have previously been healthy.

Women’s College Hospital in Canada where I go offered the following differences between the sexes and the effects of heart disease:

Women Tend to Develop Heart Disease at a Later Age

Women tend to develop heart disease later in life because they are often (though not always) protected by high levels of estrogen until after menopause. Men’s risk of developing heart disease increases in their 40s. A woman’s risk of heart disease becomes similar to a man’s risk about 10 years after menopause.

Women Experience More Silent Heart Attacks

Women experience more silent heart attacks than men. That is, a woman may not know she has had a heart attack. Women are also more likely to have a single artery narrow whereas men tend to have multiple arteries narrow.

Women Are More Likely to Be Suffering from Other Health Problems

Women are more likely to be suffering from other health problems, such as diabetes and high blood pressure, when they have heart problems.

Women Do Not Always Get the Health Care They Need

Heart disease is under-detected in women. Once women do seek treatment, doctors do not always recognize their symptoms as the symptoms of heart disease. Women are also less likely to be referred to a heart specialist, to be hospitalized, to be prescribed medication or other treatment, or to be referred for exercise testing. As a result, women do not always get the health care they need.

I find it unsettling that women are not always getting the health care they need when they seek treatment for heart disease.  They should receive the same considered as men.  They should be referred to a heart specialist or hospitalized or given whatever care they should be entitled to.  It’s time for women to stop being under served and under treated.  In the mean time, educating women about their risk of the disease and how to take control of their health so that they can reduce that risk.  Whenever I go for my annual checkup, my doctor always orders an ECG for me.  Although I just read that ECG tests are not recommended by a government backed panel.  Read article.  Heart for Life has information on screening and heart tests on their website.  Check them out here.

I read that young women can have heart disease too.  Even though heart disease among women becomes more common after menopause, it affects younger women.  Every year in the U.S., heart disease kills about 16,000 young women and accounts for 40,000 hospitalizations in young women, according to the American Heart Association.  Young women may experience symptoms of a heart attack and fail to recognize them as such for the following reasons:

• They thought they were too young to be having a heart attack.
• They had atypical symptoms that lasted for more than a day.
• They chalked up their symptoms to other conditions, not to a heart attack.

African American women are more at risk for heart disease than Caucasian women. And, if an African  American woman has a heart attack, she is 69 percent more likely to die of that  heart attack than a Caucasian woman.

Don’t be discouraged.  The Heart & Stroke Foundation assures us that heart disease is preventable and manageable.  They say that our defense is controlling the risk factors that could lead to coronary artery disease, such as high blood pressure, high cholesterol, diabetes, smoking, stress, excessive alcohol consumption, physical inactivity and being overweight.  Here are healthy heart steps we need to follow:

• Be smoke-free.
• Be physically active.
• Know and control your blood pressure.
• Eat a healthy diet that is lower in fat, especially saturated and trans fat.
• Achieve and maintain a healthy weight.
• Manage your diabetes.
• Limit alcohol use.
• Reduce stress.
• Visit your doctor regularly and follow your doctor’s advice.

Let us take action today.  Let us keep our hearts healthy.

Women tend to think that breast cancer is their biggest health threat. And while it’s important, heart disease remains the No. 1 killer of women, even young women. But that message just hasn’t been fully recognized – cardiologist Nicea Goldberg, MD, director of the Women’s Heart Program at NYU Medical Center and author of the new book Complete Woman’s Guide to Women’s Health.

Sources:  http://www.womensheart.org/content/heartdisease/heart_disease_facts.asp; http://www.webmd.com/heart-disease/features/women-and-heart-disease-key-facts-you-need-to-know; http://womenshealth.gov/publications/our-publications/fact-sheet/heart-disease.cfm; http://www.oprah.com/health/Facts-About-Heart-Disease-for-Women; http://www.reuters.com/article/2012/07/30/us-ecg-heart-idUSBRE86T1EE20120730; http://www.nhlbi.nih.gov/health/health-topics/topics/hdw/; http://www.emaxhealth.com/1020/heart-disease-affects-women-differently-men; http://www.womenshealthmatters.ca/health-resources/heart-health; http://www.modernmom.com/article/women-and-heart-disease-getting-the-right-health-care;  http://www.webmd.com/heart-disease/news/20080502/younger-women-miss-heart-attack-signs; http://www.heartandstroke.on.ca/site/c.pvI3IeNWJwE/b.4007287/k.4ACF/Heart_Disease__What_is_heart_disease.htm