More Pregnancy

Tonight I'm being sent across London to work at Camden ambulance station. For a grand total of four hours…
Last night was also fairly easy, with one laughable job. I'd just like to say, before telling you about this call, that I have nothing against people who are pregnant, pregnancy is fine, women are fine, it's just…well…sometimes it makes me cringe that the normal processes of pregnancy lead to us being called out as an emergency vehicle.

The patient was a 30 year old female who is 8 weeks pregnant. She has been suffering from normal 'morning sickness', so she went to the GP on Monday, then to the A&E walk in centre on Thursday where they prescribed her a medicine to stop her vomiting. Last night she wanted us called because while the medication was working, but she still felt nauseous – and couldn't actually vomit.

So she her husband called us as a 999 emergency call, and asked to be taken to a hospital out of our area because “she had a bad experience at Newham hospital”. She couldn't speak any English, and the husband didn't have the worlds best grasp of the language either – so I suppose that it may just have been that the patient didn't understand what was happening to her, perhaps she needed a translator service so that the information she was being given wasn't translated by her husband who, to be honest, wasn't the brightest bulb in the box. Or perhaps this young pair were just rather stupid…

What makes things worse is that they had a much nicer flat than me.

13 thoughts on “More Pregnancy”

  1. midwives also find the patients with 'hyperemesis' who reportedly are 'unable to keep anything down' annoying, when they are admitted to hospital, clerked by a doctor, have a variety of blood tests and a scan, venflon sited and IVT comenced – then ask for snacks, meals, and when does the shop open for sweets. They are inevitably discharged the next day, not having vomited once.

  2. Hyperemesis is truly horrible – I know – I had it for 4 months solid. I guess I was unlucky to have it that badly BUT it never occurred to me to go to hospital – least of all in an ambulance! What for? Your pregnant – that's what happens sometimes. I guess there are a small percentage of people that could have other complications as a result but even so, if you can walk and talk or as in my case drive and still be sick then hey – just drive there yourself if you are that worried.

  3. I wouldn't have minded so much if she had been suffering from hyperemesis – but she was instead 'suffering' from normal vomiting. Just your run of the mill morning sickness.

  4. I need to stop reading your site. The stupidity of some people beggar's belief!And why do they ALWAYS have better flats! What's that all about?

  5. Always look on the bright side Least she didnt puke on you, and you had practice with some obscure foreign language.Shame about the flat, still you'll be out of yours soon.

  6. That's really crap. I feel like martyr/supermum in comparison. Not that there will be a next time but if there was – I must call an ambulance next time! Only joking……..

  7. It's a tough call, being an ambo. I love your blog, and fully appreciate the daily frustrations you must endure at times. With this couple, it seems they just hadn't bothered to to the first basic thing you do when a couple first gets pregnant the first time – read, read and read some more about it! Don't be in the dark! Their ignorance must drive you a bit potty! Perhaps it was just a translation problem, but still… D'oh! hahaha. Thanx & Cyalayta,Mal :o)

  8. I am sorry to you were called out unnecessarily to a pregnant woman with morning sickness. Perhaps her behaviour is an end consequence of the often poor management of the early stages of hyperemesis by doctors and nurses. Treatment is not standardised and there is significant variation in how bad it becomes in terms of weightloss, dehydration and ketosis before hydration and or nutritional support are used. There are several groups of doctors in the world who are trying to get the rest of the medical community to lift their game in relation to HG, in particular to recognise it as a disorder of pregnancy. The American College of O & Gs released a clinical bulletin in April 2004 highlighting that the evidence used to support the long existing theory that it is psychosomatic is “highly questionable at best”. HG is viewed as causing the psychological symptoms seen. Speaking from personal experience, it is apparent to the sufferer early on that something is wrong well before sufficient debilitation has occurred to be considered important to many doctors. However a loss of as little as 5% of body weight raises the likelihood of a low birthweight child from 6% to around 30%. Many doctors allow you to lose more like 10% before acting. You have noted that antiemetics can reduce vomiting while nausea remains. Severe nausea itself is still a serious problem because its biology causes aversion to food beyond one's control(rat experiments) I expect this is impractical but if I were the woman concerned I would go to Professor Taylor's Royal Victoria Infirmary Newcastle upon Tyne as he heads one of the groups of doctors establishing best practice with respect to the use of corticosteroids in the management of HG. If you ever have some spare time is a useful website about HG. Early treatment of HG is vital as the more intractable it becomes the harder it is to manage.

  9. That is a really nice comment, and I've had a quick look at the page you mention and it is a really useful resource. I have a lot of sympathy for women who present with hyperemesis gravida, if only because I used to see them suffering when I was working in A&E. Thankfully it wasn't that common (although it seemed to come in runs of three, then nothing for a month).However, for the patient that I mention in the post, this was a simple, uncomplicated morning sickness – something that I may have needed to make more explicit in the post.

    And you don't have to tell me about the effects of anti-emetics, I spent a month on them during my PEP treatment – and it definitely isn't fun, although I found that eating made the nausea better…

    Once more, it's a great comment, and a great site – should I come across any patients with HG (who have some form of education, which is often unusual in my area), I'll point them in the direction of it.

  10. Because I live in a crap area, I seem to be constantly jealous of people who seem to have less common sense than me living in nice areas…Maybe if I had paid attention when choosing my career path, I'd be working for an estate agents (or something) making tonnes of money. Either that or a single parent teenage mum with a nice big council place…

    Jealousy is an ugly thing – but it keeps me warm at night.

  11. I had pretty severe hyperemesis but was also shamefully stubborn when it came to treatment. I was given 24 hours before I had to go to hospital. At that point even a sip of water would not stay down – or even just trying to move a short distance made me violently sick. I think alot of that was to do with the fact that it was affecting my blood sugar which made me very tetchy and quite confused at times. The symptoms reminded me of a particularly severe hypoglycaemic attack I had had in the past. By utter accident (and maybe it is completely coincidental) I discovered that self-medicating with a glass of coca cola (which I normally hate) was like a miracle cure – therefore leading me to believe that it was more my plummeting blood sugar caused by rampant hormones that was exacerbating the constant sickness. Maybe it's just my body's little clutch of idiosyncracies but I can thoroghly recommend a boost of liquid sugar to make you feel normal again. Needless to say all the vomiting recurred much later on with severe cholestasis so I guess all along I must have had a difficulty processing all the hormones. Thankfully, everything was ok although I have decided not to go through it again for all the above reasons!

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