Coping strategies

It is rare to feel complete relief, but you may be able to manage some of the symptoms and help create the best environment you can whilst going through this debilitating condition. 

Becoming informed as possible on the treatments you can take can go a long way in feeling in control of your condition rather than having the condition control you.

If you are struggling, or you are worried about your symptoms, please get in touch with your maternity unit or GP. 

Track symptoms

It is a good idea to keep a diary or journal of your symptoms. You may see that you have a particular time of day where your symptoms are less and you could try to get more food and fluids to reduce the risk of you being admitted to hospital. You may also notice certain triggers which you could then try to avoid (see below for a section on common triggers and how to manage them). 

Here are some tips to try for eating and drinking. 

It is also a good idea if you can, to track your weight and your PUQE score - if not daily then a few times a week. 

Rest

The key for the hyperemesis sufferer is rest, rest, rest! If you have HG, you need to give yourself a break and know that normal service is not applicable.

It’s really important to emphasise how bad the nausea and vomiting is….The rise in GDF 15 [which causes hyperemesis]… is exactly the same thing that happens when you give people with cancer chemotherapy with platinum-based drugs which are known to be the most nauseating… and we give [those] people tons of preventive anti-nausea [medication]. And this is the exact mechanism – not just like it, the exact mechanism. So women who are feeling sick in pregnancy are feeling sick because it’s the exact same pathways are being activated as when you have chemotherapy for cancer - Prof. Sir Stephen O'Rahilly, HG researcher

HG can be episodic and you may experience periods of recovery and relapse. It might be that your medication works for a while and you feel able to do more, and the temptation when you do feel better is to rush around and catch-up with jobs that you were unable to do when you were too unwell.

But exerting yourself can make things worse again. It may be that an hour or two of childcare, or an afternoon in the office leaves you having to take to your bed - or broken sleep at nighttime means a worse HG day the next day. This is a classic cycle that many HG sufferers will recognise.

If you don’t have kids at home, just lie on the sofa! If you have children, do everything in your and your partner's power to sort out childcare – rely on relatives, creche, childminders and friends. Don’t feel guilty about needing help, you are very ill, and you would not be expected to carry on as normal if you were undergoing treatment that causes similar symptoms, such as chemotherapy.

The house may be a tip, there may be a washing mountain and the kids/your partner/work may have to fend for themselves for a while, but if you push yourself, your HG will get worse.

Avoiding triggers

Understanding and avoiding triggers can be key. Sensory stimuli like noises, bright lights and certain smells can be intolerable and it’s important to try and manage your environment to work around things that are challenging for you. You can try: 

• Minimise the use of scented products as much as possible. 
• Brushing teeth can be hard, but using a small (children’s) toothbrush and an unscented toothpaste can help. The sensitive toothpastes often create less foam, so these might help. If you can’t brush your teeth, rub them with a cloth.
• Reduce exposure to cooking smells where possible - close doors, open windows. Others in the household can eat in the rooms you spend least time in, or get cooked food dropped over or delivered if possible. 
• For smell triggers you can block out smells completely by wearing a swimming peg on your nose if you can tolerate it, or have a tissue handy with some essential oil that you can smell.
• Bright lights can be a trigger, so try having the curtains drawn and using a lamp during the day, or even just sitting in a completely dark room if any light is too much. And remember to adjust the brightness on any screens you use regularly, like your phone or laptop.

Coping with excess saliva

Excess saliva (hypersalivation or pytalism) is a very common part of HG but isn’t often talked about. It can be overwhelming and distressing to deal with, especially if you are dealing with unhelpful comments. There are some things we can suggest trying which may help, often people just need some coping tips as there is sadly very little medication available for this symptom.

• Carry a spit cup or cloth around with you so that you can get rid of the saliva without swallowing
• Sucking on boiled sweets or strong flavoured sweets can help with the taste in your mouth that comes as part of HG

A complication of spitting out excess saliva can be dehydration. 

If you are experiencing any symptoms of dehydration, then please let your healthcare professional know as soon as possible.

Thank you to our friends at Pregnancy Sickness Support for allowing us to adapt some of the content above.