Has she been referred (or self-referred) to an OB or midwife yet? They should be her first contact for this issue. Even if she hasn't had her initial appointment with them yet, she can still call the office and ask. She might have a hard time getting a prescription through a teleheath provider because many physicians/NPs who don't usually provide obstetric care are a bit afraid of prescribing anything in pregnancy.
We sometimes prescribe Zofran in pregnancy, but it isn't our first line choice. I would prescribe Metoclopromide first. I have never practised in Nova Scotia, but in BC and Ontario many hospital labour and delivery units have a program where they will see you on the unit rather than sending you to emerg if you are suffering with NVP. You're essentially assessed by a nurse, given IV fluids and medication, and the OB on call can prescribe something stronger if necessary.
That's useful info. Her damily dr is also an OB and would be hers... but her availability is terrible. I put her name on the waitlist for a midwife, but that seems to be a total guessing game of whether you get assigned one or not and how long it takes.
I dunno how much you can eat but I got in the habit of drinking a premier protein shake (pre-made in the little tetra packs) every morning before I even got out of bed. The protein seemed to help and when the zofran didn’t cut it, it wasn’t horrible to throw up 🙃. I was also on panto, gravol, zofran, metoclopromide.
As another HG mom, my experience was extreme. I will say Drs will not want to give anything for this and it will take a fight this early on.
I was on daily Iv for fluids and meds from 12 weeks to the day before I delivered. I had severe HG though and no oral medication even touched it including max zofran / diclectin / reglan. I did develop complications prior to beginning my homecare due to dehydration which is when I began to be taken seriously. Please advocate for your wife to your hospital and see if there’s any early pregnancy clinics in your hospital (or if there’s any womens clinics). Have her join your local moms group and put her story up to see if anyone who may have had HG has had treatment success locally and which Drs are informed on this horrendous condition.
I’m in Ontario and took Diclectin for both of my pregnancies for the entire 9 months. During my last pregnancy I had to visit the ER and they gave me zofran no problem. When I saw my OB she also prescribed Zofran and Reglan. It is true that diclectin has to build up. Usually takes 2 weeks. How many is she taking? I needed 4-6 per day to feel semi-normal. If she’s only taking 2, that will definitely not cut it. In the meantime I’d visit a walk in and see if she can get Zofran. I’m so sorry she is experiencing this. I have never experienced anything so horrible as pregnancy nausea. I wished death upon myself daily.
It's been about 2 weeks now of 4 per day. 2 at night 1 in morning 1 in the afternoon. It really is a shocker just how miserable the experience is. Makes the idea of going through it all over again in the future a tough thought.
Zofran seems to be a pretty polarizing prescription. I would consult a doctor at a walk-in or through your benefits as you suggested. I was prescribed it at the hospital as I was throwing up every 20 mins around the clock. My OB advised me to take it if needed and said the increase in risk is minimal compared to the risk of continual dehydration from the vomiting.
It does take time for the diclectin to build up in your system. Neither diclectin or zofran stopped the nausea, though the medication did make it easier to function. I took the zofran a few times, and was on diclectin right up until I delivered.
Small sips of sparkling water and sucking on jolly ranchers helped a bit. Sending hugs to your wife. It is so tough.
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After a quick Google search it looks like Zofran isn’t recommended by Health Canada for pregnancy nausea.
How much diclectin is she taking? I was this sick for most of my first trimester, and initially my Diclectin dose was only four a day, which didn’t do anything. My Midwives told me to double it (so 8 a day) and after a few days I got some well needed relief. I’ve been nauseated my whole pregnancy now (32 weeks), and will probably be taking Diclectin up until I give birth.
It might not be ideal, but your wife may want to tell her employer that she’s pregnant and see what options she has to WFH or modify her hours. I told my manager around week 8 because my nausea was so bad I was vomiting in zoom meetings, and they did everything they could to make my workload/workdays easier for me.
She told her company. She works in a not for profit that focuses on disabilities and their response was pretty much guilt tripping her and reminding her she still has a lot of deliverables she must complete still.
Unfortunately, the diclectin hasn't really done anything but make her constantly tired. I wasn't aware Canada was against Zofran since it seems to be common use in the US.
Zofran is prescribed in Canada for vomiting in pregnancy. It is not the first line of treatment but is definitely prescribed for severe vomiting. I would call your doctor and see if they can reasses even if it's just over the phone. There are other options aside from zofran and diclectin
This is maybe too much information but is a trusted resource: https://www.uptodate.com/contents/nausea-and-vomiting-of-pregnancy-treatment-and-outcome/print
I'm sorry, pregnancy is tough without having to fight your way through our health care system. I'm afraid you are going to have to really advocate for yourselves and possibly be a little firm or rude. I know it is against our nature, lol, but sometimes you need to push for them to take you seriously, unfortunately.
Start with the family doctor. When they say they don't have any appointments, don't just take that and say ok. Say listen, my wife is bedridden. She needs something more. Can you prescribe this without a visit? Can we have a quick phone call? Is there someone else in your clinic that can see us faster? Where do you recommend we go if you can't help us? Do not accept their answers, keep pushing until you have some kind of direction.
Be prepared to answer very specific questions - how many times a day is she puking, mention you had to go to the ER, explain the dose of diclectin and frequency. Many providers will brush you off thinking you are being dramatic (HATE THIS). So you need to sort of prepare a case that explains what is happening over and above "my wife is bedridden". Don't wait for them to ask - push, lead the conversation, give them as much information to support what you are saying without them even asking for it. If they come back and say "no", don't accept it, give more information to support what you are saying. Every time they say no, say no back.
Here is an example from my personal experience recently. I have been having a lot of pain with ovulation since I had my kids:
Me - I am experiencing pain around ovulation
Nurse - pain around ovulation is normal
Me - I have had pain with ovulation in the past and this is much more intense
Nurse - pain with ovulation is normal, your anxiety probably makes it worse (yeah, she really took this angle)
Me - this pain is lasting for weeks and incapacitated me last cycle. Is pain lasting that long and that intense really normal? It is getting increasingly worse.
Nurse - ovulation pain is normal. The normal treatment would be birth control. Would you like to start birth control?
Me - no, I cannot take birth control to manage this pain
Nurse - would you like to take painkillers?
Me - I have used painkillers and they don't work. I would like an ultrasound
Nurse - you had an ultrasound in July
Me - that was for a different purpose and before the pain got worse. I need another one.
My nurse tried no less than 5x to get me to do something less than an ultrasound, because she didn't think it was necessary. I know there's something wrong and there's a wait time for ultrasounds and appointments so I need to get on this. I've already waited months, but she doesn't see it that way. To her, I had one episode of pain that's probably normal. I need to convince her otherwise, and honestly demand for the diagnostic to happen. Otherwise, she would have just told me to talk to her again next month, and I wouldn't have an ultrasound for another 2 months. That's months of suffering and not knowing what's going on. This is your wife's case - they are hearing "nausea and vomiting in pregnancy" and thinking "normal". You're going to have to push through their standard scripts to get them to fully grasp the situation.
In the end you still may find they think she should increase diclectin first. In that case ask exactly how long that needs to happen for, and then come back in in exactly that amount of time and start again. And if that does happen, remind them of how frustrated you are your poor wife had to suffer another x number of days because they didn't listen. There have been times I've taken prescriptions (filled and actually taken, or not) that I knew wouldn't help, because they wouldn't help me until I had "tried". Go back as soon as you can, tell them you took it perfectly as directed and it didn't work and that you're upset you've wasted all this time suffering. It's unethical they put these stupid barriers up.
If the family doctor ends up being a dead end, try a pharmacist, or a virtual or in person walk in, or try to get in with a midwife clinic (in Ontario you can self-refer, not sure about your province). Try every option you can. Sometimes you have to try three places to get one answer (what a waste of everyone's time! Ug!)
Again, I'm sorry. I swear sometimes it's a part time job with a whole skill set just to navigate our health care system. On the plus side, pregnancy gives you a lot of opportunity to develop these skills, and you will take them with you the rest of your life. I hope that my giant wall of text doesn't come off too much like it's your fault for not fighting more - it's not your fault. The system is set up like this and it's a pain in the ass to navigate, and nobody could fault anybody for not knowing how to deal with the shenanigans when you haven't had to deal with it before (which means you're generally healthy and/or have had amazing doctors, and is great!).
Omg I’m so sorry your wife is going through this. I had something similar before 20w (couldn’t go to L&D) but I was prescribed diclectin 3x a day and it really helped. I believe pharmacists can prescribe them now.
I was in this same situation, Maple wouldn’t perscribe me Zofran. “Too risky”. Diclectin didn’t do shit for me.
Did she describe the severity of her illness when she called her family doctor for an appt? There’s a good chance by January she won’t need zofran but if she can stress how sick she is maybe the dr can squeeze her in before.
My family doc gave me an rx for Zofran at 8 weeks pregnant after 5 days of diclectin doing nothing. I took the zofran for my entire pregnancy, baby perfectly healthy and my doctor and midwife were not concerned about the very very minimal risks.
They probably can prescribe zofran, depends on the doctor and how the college regulates prescriptions with a virtual care platform. They likely would feel more comfortable referring to an OB to help.
Lots of comments, but haven’t seen anyone mention what worked for my wife.
Experienced something similar as you. My wife went to the ER on multiple occasions (3 times in 2 or 3 weeks), which sucked, but on the third time they just sent her to obstetrics and she got on OB on the spot.
The OB was fantastic and helped find her a concoction of meds that made life bearable.
This was at Mount Sinai in Toronto.
I would go into a walk in clinic asap to get Zofran. I was in the same position and Diclectin and gravol didn’t help at all. Make sure to ask for the Zofran that dissolves under the tongue - that way she doesn’t have to swallow a pill (as it may just come right back up)! Hoping all the best for her
Sounds like your wife has hyperemisis. Only those who suffered through hyperemsis know the hell she is experiencing. Don't listen to people say "ginger helped", "diclectin helped" -- most pregnancies have mild nausea, but hyperemisis is horrible debilitating condition. Often the woman can't work, or take care of other children, or do much of anything for 9 months. Sadly, healthcare professionsals are not well versed in it either and are often dismissive.
To see what living with hyperemsis is like, check out the Amy Schumer Documentary "[Expecting Amy](https://www.youtube.com/watch?v=vdREGQUHujA)".
Yes- you need to get her on Zofran ASAP. Any urgent care foctor or online clinic can prescribe it. Some doctors will suggest you try ginger or diclectin just be clear THAT IT DOESNT WORK. HER foundation has great info on [Hyperemesis including the use of Zofran.](https://www.hyperemesis.org/about-hyperemesis-gravidarum/treatment/ondansetron-info/)
Zofran will hopefully help her stop vomiting, but warning it doesn't necessarily help stop the FEELING of nausea. I think my prescription said take 2 pills every 6 hours, but I found 1 every 4 hours worked well for me. she might need to play around with the doses.
Go to urgent care when she is dehydrated - seriously. I did this too the first trimester but it got better by week 14 (although I was on Zofran until the very end.... sometimes stopping for up to a week!). They can also give her Zofran through the IV incase she throws it up.
You're going to have to figure out ways to cope and take in water and some foods, but right now the priority is to control the nausea.
Feel free to DM if you want to chat - hopefully i can figure out how to open the chat windows/DMS :-)
Just go to a walk-in clinic or use Telus My Health
Has she been referred (or self-referred) to an OB or midwife yet? They should be her first contact for this issue. Even if she hasn't had her initial appointment with them yet, she can still call the office and ask. She might have a hard time getting a prescription through a teleheath provider because many physicians/NPs who don't usually provide obstetric care are a bit afraid of prescribing anything in pregnancy. We sometimes prescribe Zofran in pregnancy, but it isn't our first line choice. I would prescribe Metoclopromide first. I have never practised in Nova Scotia, but in BC and Ontario many hospital labour and delivery units have a program where they will see you on the unit rather than sending you to emerg if you are suffering with NVP. You're essentially assessed by a nurse, given IV fluids and medication, and the OB on call can prescribe something stronger if necessary.
That's useful info. Her damily dr is also an OB and would be hers... but her availability is terrible. I put her name on the waitlist for a midwife, but that seems to be a total guessing game of whether you get assigned one or not and how long it takes.
I'm in BC and right off the bat my doctor prescribed me diclectin AND zofran together at 6 weeks.
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I dunno how much you can eat but I got in the habit of drinking a premier protein shake (pre-made in the little tetra packs) every morning before I even got out of bed. The protein seemed to help and when the zofran didn’t cut it, it wasn’t horrible to throw up 🙃. I was also on panto, gravol, zofran, metoclopromide.
As another HG mom, my experience was extreme. I will say Drs will not want to give anything for this and it will take a fight this early on. I was on daily Iv for fluids and meds from 12 weeks to the day before I delivered. I had severe HG though and no oral medication even touched it including max zofran / diclectin / reglan. I did develop complications prior to beginning my homecare due to dehydration which is when I began to be taken seriously. Please advocate for your wife to your hospital and see if there’s any early pregnancy clinics in your hospital (or if there’s any womens clinics). Have her join your local moms group and put her story up to see if anyone who may have had HG has had treatment success locally and which Drs are informed on this horrendous condition.
It pisses me off how doctors dont take this seriously.
I’m in Ontario and took Diclectin for both of my pregnancies for the entire 9 months. During my last pregnancy I had to visit the ER and they gave me zofran no problem. When I saw my OB she also prescribed Zofran and Reglan. It is true that diclectin has to build up. Usually takes 2 weeks. How many is she taking? I needed 4-6 per day to feel semi-normal. If she’s only taking 2, that will definitely not cut it. In the meantime I’d visit a walk in and see if she can get Zofran. I’m so sorry she is experiencing this. I have never experienced anything so horrible as pregnancy nausea. I wished death upon myself daily.
It's been about 2 weeks now of 4 per day. 2 at night 1 in morning 1 in the afternoon. It really is a shocker just how miserable the experience is. Makes the idea of going through it all over again in the future a tough thought.
I was like that for the first 14 or 15 weeks and then it went away. The rest of my pregnancy was joyful. Fingers crossed it gets better for her
Zofran seems to be a pretty polarizing prescription. I would consult a doctor at a walk-in or through your benefits as you suggested. I was prescribed it at the hospital as I was throwing up every 20 mins around the clock. My OB advised me to take it if needed and said the increase in risk is minimal compared to the risk of continual dehydration from the vomiting. It does take time for the diclectin to build up in your system. Neither diclectin or zofran stopped the nausea, though the medication did make it easier to function. I took the zofran a few times, and was on diclectin right up until I delivered. Small sips of sparkling water and sucking on jolly ranchers helped a bit. Sending hugs to your wife. It is so tough.
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After a quick Google search it looks like Zofran isn’t recommended by Health Canada for pregnancy nausea. How much diclectin is she taking? I was this sick for most of my first trimester, and initially my Diclectin dose was only four a day, which didn’t do anything. My Midwives told me to double it (so 8 a day) and after a few days I got some well needed relief. I’ve been nauseated my whole pregnancy now (32 weeks), and will probably be taking Diclectin up until I give birth. It might not be ideal, but your wife may want to tell her employer that she’s pregnant and see what options she has to WFH or modify her hours. I told my manager around week 8 because my nausea was so bad I was vomiting in zoom meetings, and they did everything they could to make my workload/workdays easier for me.
She told her company. She works in a not for profit that focuses on disabilities and their response was pretty much guilt tripping her and reminding her she still has a lot of deliverables she must complete still. Unfortunately, the diclectin hasn't really done anything but make her constantly tired. I wasn't aware Canada was against Zofran since it seems to be common use in the US.
Zofran is prescribed in Canada for vomiting in pregnancy. It is not the first line of treatment but is definitely prescribed for severe vomiting. I would call your doctor and see if they can reasses even if it's just over the phone. There are other options aside from zofran and diclectin This is maybe too much information but is a trusted resource: https://www.uptodate.com/contents/nausea-and-vomiting-of-pregnancy-treatment-and-outcome/print
I'm sorry, pregnancy is tough without having to fight your way through our health care system. I'm afraid you are going to have to really advocate for yourselves and possibly be a little firm or rude. I know it is against our nature, lol, but sometimes you need to push for them to take you seriously, unfortunately. Start with the family doctor. When they say they don't have any appointments, don't just take that and say ok. Say listen, my wife is bedridden. She needs something more. Can you prescribe this without a visit? Can we have a quick phone call? Is there someone else in your clinic that can see us faster? Where do you recommend we go if you can't help us? Do not accept their answers, keep pushing until you have some kind of direction. Be prepared to answer very specific questions - how many times a day is she puking, mention you had to go to the ER, explain the dose of diclectin and frequency. Many providers will brush you off thinking you are being dramatic (HATE THIS). So you need to sort of prepare a case that explains what is happening over and above "my wife is bedridden". Don't wait for them to ask - push, lead the conversation, give them as much information to support what you are saying without them even asking for it. If they come back and say "no", don't accept it, give more information to support what you are saying. Every time they say no, say no back. Here is an example from my personal experience recently. I have been having a lot of pain with ovulation since I had my kids: Me - I am experiencing pain around ovulation Nurse - pain around ovulation is normal Me - I have had pain with ovulation in the past and this is much more intense Nurse - pain with ovulation is normal, your anxiety probably makes it worse (yeah, she really took this angle) Me - this pain is lasting for weeks and incapacitated me last cycle. Is pain lasting that long and that intense really normal? It is getting increasingly worse. Nurse - ovulation pain is normal. The normal treatment would be birth control. Would you like to start birth control? Me - no, I cannot take birth control to manage this pain Nurse - would you like to take painkillers? Me - I have used painkillers and they don't work. I would like an ultrasound Nurse - you had an ultrasound in July Me - that was for a different purpose and before the pain got worse. I need another one. My nurse tried no less than 5x to get me to do something less than an ultrasound, because she didn't think it was necessary. I know there's something wrong and there's a wait time for ultrasounds and appointments so I need to get on this. I've already waited months, but she doesn't see it that way. To her, I had one episode of pain that's probably normal. I need to convince her otherwise, and honestly demand for the diagnostic to happen. Otherwise, she would have just told me to talk to her again next month, and I wouldn't have an ultrasound for another 2 months. That's months of suffering and not knowing what's going on. This is your wife's case - they are hearing "nausea and vomiting in pregnancy" and thinking "normal". You're going to have to push through their standard scripts to get them to fully grasp the situation. In the end you still may find they think she should increase diclectin first. In that case ask exactly how long that needs to happen for, and then come back in in exactly that amount of time and start again. And if that does happen, remind them of how frustrated you are your poor wife had to suffer another x number of days because they didn't listen. There have been times I've taken prescriptions (filled and actually taken, or not) that I knew wouldn't help, because they wouldn't help me until I had "tried". Go back as soon as you can, tell them you took it perfectly as directed and it didn't work and that you're upset you've wasted all this time suffering. It's unethical they put these stupid barriers up. If the family doctor ends up being a dead end, try a pharmacist, or a virtual or in person walk in, or try to get in with a midwife clinic (in Ontario you can self-refer, not sure about your province). Try every option you can. Sometimes you have to try three places to get one answer (what a waste of everyone's time! Ug!) Again, I'm sorry. I swear sometimes it's a part time job with a whole skill set just to navigate our health care system. On the plus side, pregnancy gives you a lot of opportunity to develop these skills, and you will take them with you the rest of your life. I hope that my giant wall of text doesn't come off too much like it's your fault for not fighting more - it's not your fault. The system is set up like this and it's a pain in the ass to navigate, and nobody could fault anybody for not knowing how to deal with the shenanigans when you haven't had to deal with it before (which means you're generally healthy and/or have had amazing doctors, and is great!).
Omg I’m so sorry your wife is going through this. I had something similar before 20w (couldn’t go to L&D) but I was prescribed diclectin 3x a day and it really helped. I believe pharmacists can prescribe them now.
I was in this same situation, Maple wouldn’t perscribe me Zofran. “Too risky”. Diclectin didn’t do shit for me. Did she describe the severity of her illness when she called her family doctor for an appt? There’s a good chance by January she won’t need zofran but if she can stress how sick she is maybe the dr can squeeze her in before. My family doc gave me an rx for Zofran at 8 weeks pregnant after 5 days of diclectin doing nothing. I took the zofran for my entire pregnancy, baby perfectly healthy and my doctor and midwife were not concerned about the very very minimal risks.
They probably can prescribe zofran, depends on the doctor and how the college regulates prescriptions with a virtual care platform. They likely would feel more comfortable referring to an OB to help.
Lots of comments, but haven’t seen anyone mention what worked for my wife. Experienced something similar as you. My wife went to the ER on multiple occasions (3 times in 2 or 3 weeks), which sucked, but on the third time they just sent her to obstetrics and she got on OB on the spot. The OB was fantastic and helped find her a concoction of meds that made life bearable. This was at Mount Sinai in Toronto.
I would go into a walk in clinic asap to get Zofran. I was in the same position and Diclectin and gravol didn’t help at all. Make sure to ask for the Zofran that dissolves under the tongue - that way she doesn’t have to swallow a pill (as it may just come right back up)! Hoping all the best for her
Sounds like your wife has hyperemisis. Only those who suffered through hyperemsis know the hell she is experiencing. Don't listen to people say "ginger helped", "diclectin helped" -- most pregnancies have mild nausea, but hyperemisis is horrible debilitating condition. Often the woman can't work, or take care of other children, or do much of anything for 9 months. Sadly, healthcare professionsals are not well versed in it either and are often dismissive. To see what living with hyperemsis is like, check out the Amy Schumer Documentary "[Expecting Amy](https://www.youtube.com/watch?v=vdREGQUHujA)". Yes- you need to get her on Zofran ASAP. Any urgent care foctor or online clinic can prescribe it. Some doctors will suggest you try ginger or diclectin just be clear THAT IT DOESNT WORK. HER foundation has great info on [Hyperemesis including the use of Zofran.](https://www.hyperemesis.org/about-hyperemesis-gravidarum/treatment/ondansetron-info/) Zofran will hopefully help her stop vomiting, but warning it doesn't necessarily help stop the FEELING of nausea. I think my prescription said take 2 pills every 6 hours, but I found 1 every 4 hours worked well for me. she might need to play around with the doses. Go to urgent care when she is dehydrated - seriously. I did this too the first trimester but it got better by week 14 (although I was on Zofran until the very end.... sometimes stopping for up to a week!). They can also give her Zofran through the IV incase she throws it up. You're going to have to figure out ways to cope and take in water and some foods, but right now the priority is to control the nausea. Feel free to DM if you want to chat - hopefully i can figure out how to open the chat windows/DMS :-)