2013-12-31

Letter sent to midwife service last week….

Dear Midwife service,

Having reviewed the medical notes in my blue folder, I feel that an important part of my pregnancy experience which may have ongoing consequences has not been represented.

I have experienced nausea since before my pregnancy was officially confirmed, which latterly became severe nausea which in its unmedicated state was present almost all of the time I was awake. Luckily I have not experienced any vomiting, and therefore my symptoms have been ‘of no clinical significance’ however they have had an extreme and significant impact on my wellbeing and ability to function:

  • I have gone from being an independent and self confident person to being barely able to look after myself and having to be accompanied to medical appointments because I am not able to travel alone or speak for myself.
  • I have gone from being an active person who swum a kilometre three times per week, to being essentially bed bound.
  • I have gone from running my own business to being unable to work, reducing my income to nothing.

I realise that pregnancy nausea usually clears following the first trimester, but the very early onset and the fact that my Mum suffered with this throughout her pregnancy leads me to have concerns that this might persist for me.

Having explained all of this to the midwife, I am concerned that no reference is made to my experience in my notes (outside listing Cyclizine as a medication taken) and that this is not reflected in the activity and mental health sections of my notes where I am represented as being active and in good mental health. I am not. I feel my mental health should be of particular concern, as my medical history shows I have previously had a significant depressive episode triggered by a physical illness.

In general it is disappointing for me that my pregnancy nausea has been so severe and yet has been treated so dismissively by the majority of the medical professionals that I have seen at NHS Lothian. My symptoms might be of ‘no clinical significance’ but they have had an immediate and extreme negative impact on my wellbeing, livelihood and personal relationships for which I have received virtually no support from the NHS. Particularly because I have a documented history of depression I am extremely disappointed and I do not feel that my mental health is being adequately supported at a time when I am extremely vulnerable.

I am therefore writing to request that information about my experience of nausea in pregnancy is added to my notes, and I have provided a table detailing my experience.

Kind regards,

Babymayme.

Table appended (reformatted for blog!)

Week: 1
Hours of nausea per day: n/a
Vomiting per day:
Treatment:
Activity: Minimal due to IVF
Mental state: Normal
Ability to work: Normal
Other: Frozen embryo transfer

Week: 2
Hours of nausea per day: n/a
Vomiting per day:
Treatment:
Activity: Minimal due to IVF
Mental state: Normal
Ability to work: Normal
Other:

Week: 3
Hours of nausea per day: 1
Vomiting per day: 0
Treatment: None
Activity: Minimal due to IVF
Mental state: Normal
Ability to work: Normal
Other:

Week: 4
Hours of nausea per day: 2
Vomiting per day: 0
Treatment: Ginger beer
Activity: Reduced
Mental state: Normal
Ability to work: Normal
Other:

Week: 5
Hours of nausea per day: 3
Vomiting per day: 0
Treatment: Ginger beer, eating little and often
Activity: Reduced
Mental state: Normal
Ability to work: Reduced
Other: Food and smells induce nausea

Week: 6

Hours of nausea per day: 10
Vomiting per day: 0
Treatment: Sea bands, eating little and often
Activity: None
Mental state: Low mood
Ability to work: Not at all
Other: No longer eating normal meals as food and smells induce nausea

Week: 7
Hours of nausea per day: 8
Vomiting per day: 0
Treatment: Promethazine
Activity: None
Mental state: Confused
Ability to work: Not at all
Other:

Week: 8
Hours of nausea per day: 8
Vomiting per day: 0
Treatment: Cyclizine
Activity: None
Mental state: Low mood
Ability to work: Not at all
Other: Fainted from sitting, protein in urine, GP prescribed Cefalexin

Week: 9
Hours of nausea per day: 3
Vomiting per day: 0
Treatment: Cyclizine
Activity: Max one activity per day, results in increased nausea and tiredness
Mental state: Low mood
Ability to work: Occasional, unpredictable, from bed
Other: Stopped taking IVF drugs (4xHRT and 2xProgesterone per day)

Week: 10
Hours of nausea per day: 3
Vomiting per day: 0
Treatment: Prochlorperazine
Activity: Max one activity per day, results in increased nausea and tiredness
Mental state: Low mood
Ability to work: Occasional, unpredictable, from bed
Other:

Week: 11
Hours of nausea per day: 3
Vomiting per day: 0
Treatment: Prochlorperazine
Activity: Max one activity per day, results in increased nausea and tiredness
Mental state: Low mood
Ability to work: Occasional, unpredictable, from bed
Other:

Week: Summary
Hours of nausea per day: Est. 287 hours of nausea cumulative, despite being medicated
Vomiting per day: No vomiting
Treatment:
Activity: Virtually no activity and essentially isolated for six weeks
Mental state: Low mood persists
Ability to work: Off work for more than a month with no income
Other: Could eat and drink throughout, weight loss 2kg, would not have been able to care for dependents (i.e. other children) since week 5

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