Tag Archives: symptons

Coping with Hyperemesis Gravidarum – mums speak out on severe morning sickness

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As news of the Duchess of Cambridge’s third pregnancy makes waves across the nation, we are reminded of the realities of morning sickness and its level of severity in some rare cases.  The UK’s leading support resource for mums to be Emma’s Diary, (verified by the RCGP – Royal College of General Practitioners), has spoken to several mums suffering from Hyperemesis Gravidarum (which affects 1 in 100 pregnant women) about their experiences, in a series of candid interviews.

Around 80% of pregnant women suffer from morning sickness (and despite its misleading name, it doesn’t just happen in the morning).  For some, like the Duchess of Cambridge, extreme vomiting triggered by pregnancy can be severe, even life threatening for those diagnosed with Hyperemesis Gravidarum (HG). In a bid to share their stories and raise awareness of this less common condition, these mums have spoken out to warn others that if you believe you are suffering from extreme sickness, not to be fobbed off by suggestions that ‘it’s normal’, because it might not be the case:

Bella Drew from Norwich in Norfolk said:

“My baby is due in just over two weeks time. The moment I first found out I was expecting, my heart filled with excitement but that was soon to be diminished a week later.  My experience of so-called ‘morning sickness’ started at around three weeks, I couldn’t keep anything down but I was told that was normal.  As my suffering worsened I was put on medication which didn’t really help in my opinion.  I had lost around two and a half stone, had sustained haemorrhages within my eyes from the straining while being sick. 

I was being sick every 15 minutes throughout the day and night.  I was bedridden and eventually I gave up.  I couldn’t cope anymore and I was admitted to hospital diagnosed with HG. Despite all of the recent media attention the condition is still massively misunderstood. I wouldn’t wish this debilitating illness on anyone and we really need to spread more awareness of the impact and symptoms of HG.” 

Emma Eaton from Gosport in Hampshire said:

“I am pregnant and am currently suffering with HG; I was also hospitalised for two weeks in my last pregnancy having almost died from starvation and dehydration.  I have been in and out of hospital numerous times during my current pregnancy to have IV fluids and IV anti-emetics to help control the symptoms. I have to take two different types of tablets to help prevent me from being sick as I have been physically passing out and collapsing – also knocking myself out in the process. I believe there needs to be much greater awareness of this life-threatening condition amongst pregnant women and those who are planning to have children.”

Gemma Edwards from Walsall in West Midlands said:

“I was diagnosed with HG with all three of my pregnancies which has left me with some long term health problems. I am losing my teeth due to the impact of the stomach acid because I was vomiting anything from 20 to 50 times a day. I was also hospitalised for weeks on end with ketoneuria (ketones in my urine – a sign of dehydration) and my veins kept collapsing, this condition made me very ill and my kidneys went into pre-failure meaning my life was at risk and also that of my children.  This is a very serious condition and more awareness of the long term health risks it poses is much needed.”

Many women who are diagnosed with HG say they can’t keep anything down. They can also lose a lot of weight and fluids and sometimes have to be admitted to hospital for re-hydration treatment as well as require antiemetic medication to stop the vomiting.  In terms of adverse effects on the baby, experts say there are usually very few unless weight gain continues to be poor during the second half of pregnancy; or indeed the symptoms are more severe over a sustained period of time.

Sufferers of HG reported:

  • Extreme fatigue
  • Muscle weakness
  • Weight loss
  • Depressed mood
  • Tooth loss
  • Kidney failure
  • Severe dehydration (with ketones present in urine)
  • Disturbed salts in the blood
  • Eye haemorrhages
  • Long term health issues

Dr Shauna Fannin FRCGP, Chair of the Editorial Board at Emma’s Diary said: “Every pregnancy is different and whilst pregnancy sickness is extremely common, Hyperemesis Gravidarum (HG) only affects 1% of pregnant women and is a condition at the extreme end of the pregnancy sickness scale. HG sufferers will vomit frequently and can become dehydrated very quickly so it is very important to seek urgent medical advice.”

Faye Mingo, mum of two and Marketing Director at Emma’s Diary said: “It’s really brave for these women to speak out and share their experiences with others.  What is apparent is a desire to build greater awareness on the topic of HG and to dispel any myths about what is considered to be ‘normal’, the message from most of the mums we spoke to is to trust your instincts and to keep pushing for medical support if you believe you or your pregnancy might be at risk.”

 

The Anxiety Journal Book Review

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theanxietyjournal

Anxiety is on the rise. In fact, according to mentalhealth.org.uk, in 2013 there were 8.2 million cases of anxiety in the UK. There has been an explosion in how many anxiety books are published and magazines are full of articles on anxiety and how to cope. In 2017 the House of Commons guidelines state that the maximum waiting time for NHS mental health services should be 18 weeks. It would be fair to say we have an epidemic on our hands.

The good thing about this is the normalisation of anxiety. It is easy to think you are alone when you have a health problem, but anxiety is normal and it is possible to get help. Not only from the NHS, but also from the plethora of books and articles on the subject. The Anxiety Journal is such a book. Full of great techniques and information, I was mightily impressed. The journal goes through every aspect of anxiety: what you may be feeling, symptoms, the different types of anxiety, self-care, triggers, quotes, exercises to help, CBT and how to leave the anxiety mindset behind amongst other things. It has a great resource list and beautiful illustrations by Marcia Mihotich. This is a great journal which is essential for anyone suffering from anxiety.

 

While some forms of anxiety are natural, even helpful, anxiety disorders can lead you into a spiral of stress and worry, and interfere with your everyday life.

Practical, supportive and uplifting, this is a journal for anyone who struggles with anxiety, whether in the form of phobias, social anxiety, generalized anxiety (GAD) or day-to-day worrying. Beautifully illustrated by Marcia Mihotich, The Anxiety Journal by Corinne Sweet encourages you to use CBT techniques and mindfulness exercises to help you better understand your anxiety and help you to achieve peace and calm.

Whether you’re awake at 4am unable to turn off those racing thoughts, or struggling to get yourself together before a presentation, The Anxiety Journal will help to soothe stress and reduce worry, identify negative thought-cycles, and provide you with techniques to combat anxiety wherever you are.

 The Anxiety Journal is available here.

 

Inflammatory Breast Cancer by Dr Kathleen Thompson

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breast cancer, cancer, information on breast cancer, inflammatory breast cancer

Have you read Heidi Loughlin’s blog? Heidi is a young mother who has breast cancer.

She was pregnant when diagnosed, so treatment was started with chemotherapy drugs which were relatively safe for her unborn baby. The birth was to be brought forward, when she would switch to more effective drugs.

However her cancer progressed quickly, requiring an earlier delivery than planned, to allow Heidi to start Herceptin treatment sooner. Devastatingly, her baby daughter died shortly after the birth, just before this Christmas.

Heidi has inflammatory breast cancer (IBC). Although rare  (1-4% of all breast cancers), it is important for two reasons— (1) it grows and spreads rapidly and (2) the appearance may mimic infection or injury (often there is no lump), and so breast cancer may be overlooked and life-saving treatment delayed.

IBC invades the breast skin, and blocks the lymph vessels within it. It tends to spread in sheets, rather than forming a lump.

This results in an unusual picture. The lymph blockages cause fluid build-up, so the skin swells and discolours, and hair follicles enlarge, forming multiple pits. The resulting skin resembles that of an orange (and is called ‘peau d’orange’).

However this classical appearance isn’t always seen either.

The breast may become red, hot and swollen, resembling infection, and if ‘mastitis’ doesn’t respond to antibiotics, IBC should be considered urgently.

Sometimes the skin appears bruised, or ridges or welts appear. There may be ulceration. Sometimes the nipple inverts or leaks fluid/blood, and there may be enlarged lymph nodes in the armpit or collar bone area.

If any of these changes occur, you must see a doctor without delay.

Because there may be no lump, and because it often occurs in younger women, with denser breast tissue, it may not be picked up on a mammogram.

Biopsy of the affected skin is key to diagnosis. AS IBC spreads early, PET or CAT scans of the body, and bone scans will also be needed.

The outlook for IBC used to be very poor. It is still not as good as for other breast cancers, but with modern treatment it has improved, and recent genetic research has yielded potential new hope.

Chemotherapy is usually started before surgery. Afterwards a full mastectomy is generally needed, removing more body tissue than normal, including armpit lymph nodes. Breast reconstruction isn’t normally possible until later on.

Radiotherapy follows surgery, then often more chemotherapy. If the cancer is HER2 positive, Herceptin will be given. If it is sensitive to female hormones, anti-oestrogens, either tamoxifen or an aromatase-inhibitor, such as letrozole will be prescribed.

Treating any cancer during pregnancy involves balancing risks to baby and mother, and, as in Heidi’s case, can involve bitter disappointments.

If you notice any unusual and persistent changes in your breast—not necessarily a lump, you must see your doctor without delay. Unless there is a good explanation for the changes, you should be referred to a breast clinic. Do push for this if you are concerned.

By Dr K Thompson, author of From Both Ends of the Stethoscope: Getting through breast cancer – by a doctor who knows

http://www.amazon.co.uk/dp/B01A7DM42Q

Further information:

http://storminatitcup.blogspot.co.uk/2015_12_01_archive.html

http://www.cancer.gov/types/breast/ibc-fact-sheet

http://www.cancerresearchuk.org/about-cancer/type/breast-cancer/about/types/inflammatory-breast-cancer

http://jnci.oxfordjournals.org/content/101/19/1302.full

Note: These articles express personal views. No warranty is made as to the accuracy or completeness of information given and you should always consult a doctor if you need medical advice

 

 

 

Help with Back and Pelvic Girdle Pain in Pregnancy

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newborn-216723_640Pregnancy is a life changing, joyous, emotional and exciting journey for most women. However, approximately two-thirds of women experience back pain and almost one-fifth experience pelvic pain during pregnancy. This pain often increases with advancing pregnancy, interfering with daily activities, work and sleep. Fortunately this condition is treatable, it is important to seek treatment sooner rather than later. Prompt diagnosis and treatment is key to successful resolution of symptoms.

The hormones released during pregnancy to prepare a women’s body to grow a baby and give birth, soften and relax the soft tissues of the body (eg. muscles, ligaments). This increased softening increases your joints’ range which means that they do not receive the same protection from the ligaments as before. It is this, coupled with the weight of your growing uterus that may cause backache or sciatica.

Symptoms of back pain and PGP

Back pain can be felt in the upper, middle or lower back. It is probably most commonly felt in the low back during pregnancy and can vary from an occasional ache to a constant sharp or nagging pain in any of these areas.

Pain in the pelvis is described as pelvic girdle pain (PGP), used to be known as symphysis pubis dysfunction (SPD), but this implied that only the pubic bone was involved, which is often not the case.

A range of symptoms can be described as PGP and they vary in intensity from woman to woman and even pregnancy to pregnancy.

The main symptom is pain;

  • pain over the pubic bone at the front in the centre
  • pain across one or both sides of your lower back
  • difficulty and/or pain walking, waddling gait
  • clicking or grinding in the pelvis with movement
  • pain when weight bearingWomen may experience pain anywhere in the pelvis or into the front of the thighs. These symptoms tend to increase and intensify with walking, standing, sitting, moving the legs apart, standing on one leg (think getting dressed into socks, underwear), climbing stairs and turning over in bed. Symptoms vary from mild to more severe needing support with crutches or a wheelchair.What causes back pain or PGP? For most women PGP is a mechanical problem; there is often asymmetry in the pelvis, with one joint becoming stiffer or more mobile than the others. It is more common in women with a previous history of PGP/low back pain. In approximately 9% of women with PGP the cause is purely hormonal and this tends not to respond to treatment.

When might back pain or PGP start?
it can start at any stage of the pregnancy, it may come on gradually or start quite suddenly. Sometimes symptoms will disappear or improve with rest.

How do I know if I have PGP?

Diagnosis of this painful condition is based on the location of the pain and by taking a careful history of your symptoms.

Will back pain or PGP affect my baby?

No, it will not affect your baby. However, it is important, however that the midwives caring for you are aware that you have back or pelvic girdle pain.

What can I do about PGP?
It is important to remember that whilst PGP is common, it is not normal, but is treatable;l Often resolving within a few treatments. Firstly, tell your midwife, or whoever is responsible for your antenatal care, and then seek treatment sooner rather than later. Prompt diagnosis and treatment is key to successful resolution of symptoms.

Meanwhile plan your day carefully, avoiding too many trips upstairs, remain active with the limits of your pain, avoiding activities that increase your discomfort. Rest is important, rest more frequently, try sitting for activities that normally require standing ie ironing. Try sleeping with a pillow between the legs, or use the pregnancy cushion known as ‘dream genie’.

What can I do about back pain?

Seek treatment sooner rather than later. Try to find a McTimoney Chiropractor who is experienced in treating women during pregnancy and ask them for a few safe exercises you can perform at home. Wearing support tights or a belly band can often give enough support and relief without having to resort to an actual back or belly belt. Try sleeping with a pillow between the legs or under the legs in early pregnancy when you may still be sleeping on your back.

A multi faceted approach is need to treating both conditions. After taking your medical history and examining your back and pelvis, treatment takes the form of gentle mobilization of the pelvis and spine where appropriate and sometimes acupuncture or soft tissue mobilization. This should be followed by gentle exercises and ergonomic advice. The McTimoney approach is gentle and safe for both mother and baby.

In one study, women receiving chiropractic care through their first pregnancy had twenty-four per cent shorter labour times and subjects giving birth for the second or third time reported thirty-nine per cent shorter labour times. In another study, the need for analgesics was reduced by fifty per cent in the patients who received adjustments. In addition eight-four per cent of women report relief of back pain during pregnancy with chiropractic care.

Finally, if you are experiencing back or pelvic pain, McTimoney Chiropractic treatment is a safe and effective way to relieve your symptoms, preparing you for the exciting journey of pregnancy and childbirth.

Article credit: Penny Henderson DC MSc MMCA FRCC
Chiropractor and Medical Acupuncturist

Active Chiropractic Clinic
Lister Surgery, 8 The Parade, St Helier, Jersey, JE2 3QP
and Quennevais Parade, St Brelade, Jersey, JE3 8FX

Tel: 01534 617987
Web: www.activechiropracticjersey.co.uk

 

 References

Interventions for preventing and treating pelvic and back pain in pregnancy Pennick et al 2007.Cochrane Review.

Pelvic Girdle Pain and Low Back Pain in Pregnancy: A Review.
Era Vermani, FRCA*; Rajnish Mittal, FRCS†; Andrew Weeks, MRCOG

© 2009 World Institute of Pain, 1530-7085/10/$15.00 Pain Practice, Volume 10, Issue 1, 2010 60–71

European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal. June 2008, Volume 17, Issue 6 pp 794-819

Vleeming A, Albert H.,Ostgaard C., Sturesson B,. Stuge B
Rosenberg Stacey Dr., Natural Pregnancy, Natural Baby.2008. GibsonsChiropractic.com

Henderson C., Macdonald S., Mayes’ Midwifery, A textbook for Midwives.,Thirteenth edition., 2004.,Bailliere Tindall

www.pelvicpartnership.org.uk 

 

 

Flat coke may be the cure for Kate Middleton’s morning sickness

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katemiddletonThere is a high probability that Kate Middleton will experience the same morning sickness as with her first pregnancy, say Alison Edwards – Senior Lecturer in Midwifery at Birmingham City University. In fact she has had to cancel some of her engagements already because of her acute morning sickness.

 

“Though there is an increased chance due to having the excessive sickness before she may well have an entirely different experience this time with little or no sickness.  Though there is no ‘cure’ for morning sickness (and certainly not hyperemesis) there are steps that can be taken to try to settle the unpleasant symptoms.”

 

“Though there are few sources of scientific evidence to support any ‘remedies’, making sure fluid intake is maintained is a priority. Flat coke has been found to help here as can arrowroot or ginger. Some women swear by travel bands.  Small low fat meals can help and avoiding anything spicy.  If the symptoms become excessive then medical advice must be sought as there are medications that can reduce the sickness and nausea; these do need prescribing however.

 

“Excessive morning sickness can make women unwell and certainly miserable, so plenty of support and rest are vital, especially if admission to hospital is required as Kate was last year. There are also support groups set up by women who have experienced hyperemesis.”

 

 

Jo’s Cervical Cancer Trust Host Girls’ Night Out For Cervical Cancer Prevention Week

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Jo’s Cervical Cancer Trust, the UK’s only dedicated cervical cancer charity, supported Cervical Cancer Prevention Week (20-26 January) in style with the ultimate girl’s night out last night. I went along with Frost writer and fellow actress Paola Berta. I had a great chat with sexpert Tracey Cox and uber glamourous showbiz journalist Zoe Griffin. TOWIE’s Lauren Goodger looked amazing in a studded leather jacket and black leggings.

I had an abnormal smear in 2010 so it is a cause that is very close to my heart. Girls’ Night Out host Zoe Griffin and author, Tracey Cox, shared their experiences of cervical cancer and cervical abnormalities with a celebrity audience to raise awareness of this preventable disease and urge more women to attend their cervical screenings.

Over 60 guests, including Embarrassing Bodies’ Dr Dawn Harper, Made in Chelsea’s Lucy Watson and TOWIE’s Lauren Goodger, joined the party. All guests were treated to goody bags with thanks to Lucky Voice, Vita Coco, Butlers in the Buff, Beverly Hills Formula, Walkers Sunbites, Blue Nun, Lauren’s Way and Ferrero Rocher.

Frost’s editor Catherine Balavage is in the pink, third from left.

Every day nine women are diagnosed with cervical cancer and three lives are lost to the disease. Cervical screening can help reduce these numbers and Jo’s Cervical Cancer Trust urges more women to attend as statistics show a worrying downward trend in cervical screening uptake. The cervical screening programme saves 5,000 lives each year in the UK yet 20% of women are not attending their test, and for girls aged between 25 and 29 this figure drops significantly to 1 in 3 – a worrying statistic as cervical cancer is the most common cancer in women under 35.

Robert Music, Director of Jo’s Cervical Cancer Trust, said: “The focus of Cervical Cancer Prevention Week 2013 is to raise public awareness by providing information about the causes of the disease and ways to prevent it. With the exception of a dramatic rise in 2009 following Jade Goody’s battle with cervical cancer, since 2002 figures[1] have declined year on year culminating in a 3% drop in screening uptake to 78.6% over the past 10 years. The more we can do to stress the importance of this life saving test the better.

“This year we have also focused on symptoms awareness and early detection as a study[2] we have commissioned shows that women are more likely to seek medical attention with common ailments such as a cough and cold, rather than with symptoms like abnormal bleeding which include bleeding in between periods or after sex.

“Jo’s Cervical Cancer Trust is thrilled to raise awareness of Cervical Cancer Prevention Week with the help of some friends and I would like to take this opportunity to thank our partners for their support.”

Paola Berta and Catherine Balavage

Author Tracey Cox added: “I was diagnosed with cervical cancer when I was 30 and had two cone biopsies as a result. It was picked up early, so I was lucky. But if I hadn’t been screened, I wouldn’t have made it to 32. It was an incredibly frightening experience and one most women can avoid if they get regular screenings. I’m delighted to be supporting Jo’s Cervical Cancer Trust important work in raising awareness and I’m constantly nagging friends to be vigilant about getting screened on a regular basis. It saved my life and it can save yours too.”

Author and celebrity blogger Zoe Griffin of livelikeavip.com said: “I was diagnosed with cervical abnormalities, but early detection meant I could treat the problem. When I opened the envelope giving me the all clear I felt a huge relief. It is essential that people attend their cervical screening test so that, like me, abnormalities can be treated before they turn into cancer.”

Dr Dawn Harper said: “Cervical cancer is a preventable disease thanks to cervical screenings so it’s absolutely vital that women keep up to date with their invitations. There may be nicer ways to spend your time but the test is painless and should only take around five minutes. I would encourage anyone who is overdue their screening to make an appointment now. Don’t put your health at the bottom of your agenda.”

For more information on Jo’s Cervical Cancer Trust visit www.jostrust.co.uk

Coeliac Disease: A Personal View

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It is just over six months since I was diagnosed with coeliac disease. Since then I have not intentionally eaten any gluten, a protein found in wheat, barley and rye. This means no warm French bread, no buttered crumpets, no tea cakes, hot cross buns, scones or pancakes; no Hobnobs, crackers or Twixes; no spaghetti bolognese, sausage rolls, pizza or soy sauce; no muesli or porridge, flapjacks or hot fruit pies. No Yorkshire puddings, gravy or stock cubes; no French Fancies, Battenberg or lemon drizzle cake.

Do I miss it? Well yes, painfully so. But as I frequently remind myself, there are far worse treatments to a lifelong disease than having to change your diet.

Coeliac disease is a genetic autoimmune disease. This means that eating the trigger for the disease – gluten – causes the body to attack itself. It blunts the villi on the inside of the small intestine, stopping normal absorption of food. Over time this can lead to osteoporosis, anaemia, diabetes, infertility or frequent miscarriage, lymphoma and bowel cancer. It causes severe digestive symptoms, mouth ulcers and tiredness among a long list of other symptoms, and is often misdiagnosed for years. Sticking to a strict gluten-free diet for life is the only treatment, but it is an effective one.

The strictness of diet doesn’t just mean avoiding the obvious suspects such as bread or pasta. It means using a separate chopping board to avoid gluten contamination, using a separate toaster or toaster bags, and checking ingredient listings for obscure additions such as wheat protein in ice-cream or yoghurt, or barley malt flavouring in chocolate bars (goodbye Snickers, goodbye Mars bars). Oats can be eaten by some people but they have to be specially bought, non-contaminated ones, as cereals are frequently milled together. Beer is also ruled out. Oh and chips are usually coated in flour before frying.

On the plus side, because of the higher cost of gluten-free food and the necessity of strict adherence to the diet, several items are available on prescription. Having just received my first load of bread, spaghetti, pizza bases, flour and more, I have found it entertaining to eat a packet of biscuits with ‘Use as directed by the doctor’ on the side. Four a day with a cup of tea?

Although there are gluten-free replacements for most foods, usually made of corn, rice, potatoes or tapioca, I do feel the absence of much loved foods, as may be apparent from the food list above. However, one of the most difficult things about the disease is other people’s reactions. Coeliac disease affects approximately 1% of the population but it is hugely under-diagnosed. This means that of that 1% only a small proportion know they have it. As a result the disease isn’t well known to many people, including those who run cafes or restaurants, and the medical necessity of the diet is often misunderstood.

When I have been offered something to eat at a social occasion, for example a cake at a party, and have explained why I can’t eat it, people’s reactions fall in to a variety of camps. As well as kinder or more helpful responses I have been scoffed at and told not to be so fussy, accused of health paranoia and self-diagnosing an intolerance (diagnosis is via a blood test and endoscopy if you were wondering), and have been taunted about how lovely something I can’t eat tastes.

Now this isn’t the worst thing in the world to put up with, but I do wonder how many other illnesses are treated with such misunderstanding at best and dismissiveness at worst. The rise of gluten intolerance and gluten-free diets through choice has created an increase in products available, which is great for coeliacs, but also a perception of faddishness or health neuroticism. Those with coeliac disease seem to get lumped in with this perception.

The other main obstacle is eating at cafes or restaurants. Some well-known chains have one or two dishes available, usually with some modification, but often it is necessary to phone ahead to check the menu or make special arrangements. It can be necessary to ask for something to be cooked in a separate pan to avoid contamination, or to check individual ingredients such as stock cubes. Personally I find having to make such requests embarrassing; if the disease were better-known, eating out would be much more enjoyable. The training of catering staff hugely differs. I have been assured in a top end restaurant that something will be fine for me “because all our food is organic” (erm…) or told that something is gluten free when, after several days of pain and tiredness, I can assure them it is not.

The leading charity for the disease, Coeliac UK, is holding an awareness week from the 16th to the 22nd of May. They’re asking people to go gluten free for a short period, to provide gluten-free options at their workplace or school, or to hold gluten-free dinner parties. You could also try looking, as an experiment, at the nutrition labels of your usual lunch or dinner to see how many times it contains gluten. Maybe have a look at what your alternatives would be if you had to give it up or had to provide an alternative for someone else. And next time you meet someone who explains they have coeliac disease, please don’t taunt them with a Jammy Dodger…

For more information on coeliac disease including symptoms please visit www.coeliac.org.uk.

If you would like to take part in the Awareness Week please click here: http://www.coeliac.org.uk/node/146078

If you would like to donate to Coeliac UK you may consider sponsoring a 10 km run I will be doing for them in July:
http://www.justgiving.com/AlexaBrown

By Alexa Brown, donate to her run here