The European Medicine’s Agency (EMA) released a Pharmacovigilance Risk Assessment Committee (PRAC) update to the manufacturers of ondansetron in July which makes 3 dramatic, incorrect and misleading statements:
- Ondansetron is suspected to cause orofacial malformations
- Ondansetron should not be used in the first trimester
- Women of childbearing potential who are taking ondansetron should consider using contraception
Good research starts with a good question. Researching questions which are not helpful or relevant to either patients or medical staff providing treatment is a massive waste of resources! But how can we find out what the most pressing questions for research are?
I received an email last week from a GP who was concerned about prescribing ondansetron off license during pregnancy. They through it was contraindicated in the BNF for use in pregnancy and while the local hospital said it was fine to use they still felt nervous about it. I thought I would publish my reply for other GP’s who might have the same question and also for women who want to discuss the evidence base behind this drug with their own doctor.
Sometimes in science, two separate discoveries happen at the same time and combine to make more than the sum of their parts. This is the case with a discovery published in late 2017, and another in March 2018, both of them in the Nature group of journals.
For those of us working entirely immersed in the hyperemesis gravidarum world, (namely myself and Karen Lodge in the Pregnancy Sickness Support office working alongside each other, her answering the helpline and my engaging in research activity and education for healthcare professions) there can be periods of time where we really feel the impact of the work we are doing and we go home at the end of the day knowing that so many women in the UK are getting really great care and support for their HG, in part thanks to the work that we’re doing from our little office in Cornwall.
You’re making a list and checking it twice… but what do you get for the HG sufferer in your life who can’t leave the house, is triggered by smells and cant eat much apart from a tiny bit of toast?
It may sound dramatic to say that at times I feared that my daughter might just fade away out of her life in front of my eyes, and in modern times I don't think this would happen.....but I'm sure I am not alone in struggling to believe during those years that life would ever be normal again.
You have a patient (not a pregnant women) who is being sick, perhaps post-operatively or due to chemotherapy or an acute condition like appendicitis, viral meningitis or so on. You suspect they may be getting dehydrated and are deciding if you should give them IV fluids. What criteria would you use to assess for dehydration?
After a very difficult start to the year Me and my HG Heroes are heading off into the Canadian Wilderness for 10 days to enjoy some much needed family time.
My glow was more a shade of pond green algae rather than the pregnant lady radiance I had hoped for.
It’s amazing how you know early on when everything's about to change and not just because your boobs are massive, it all proceeds with a puke.
In celebration of Fathers Day yesterday i asked Ian to write a guest blog to raise awareness of what it is like for husbands and partners supporting their wives/partners through HG.... Here's to the Joy of HG
Dr Tony Nicoll of Dundee, Scotland, is my medical HG hero! He is an extraordinary person and I am delighted that he recently won a gold award in the ‘Outstanding Individual (Non-Clinical)’ category of the NHS Tayside Staff Appreciation and Recognition (STAR) Awards. I struggle to imagine that there could possibly be a more deserving winner.
For those of you new to my blog I'm currently undertaking a PhD in Health Studies focusing on hyperemesis gravidarum to help further the international research efforts. PhD's are fairly long and arduous processes and a hell of a lot slower than my usual pace of churning out surveys of women's experiences and so on. But, the research produced is of a far higher quality and therefore has a much greater impact on the world of evidence based medicine.
Here is my next vlog in the 'Questions with Caitlin' series all about the questions i have received and the research available to answer them...
I have always found explaining Hyperemesis Gravidarum to people quite difficult, they hear the words vomiting and pregnancy and then move on, as if of no significance…. lots of women suffer with sickness in pregnancy, right? Only when I wrote a small description of my experience of having hyperemesis on Facebook did friends and family start to see that it is a lot more than just vomiting in pregnancy.
I've suffered severely with HG myself several times and know all too well the devastating impact of both the physical and mental symptoms. I believe HG changes a woman. Surviving it requires finding great inner strength and it leaves an emotional scar that only another sufferer understands.
I had only very vaguely heard of HG before my first pregnancy, a friend of a friend type story about someone who was so sick she lost weight. I remember giving it barely a passing thought, thinking she sounded lucky to have not put weight on.
Following on from my series of HG Heroes recognising partners, healthcare professionals, friends and employers making a massive difference to hyperemesis sufferers i will be spending the next few weeks highlighting the vital work of the Pregnancy Sickness Sickness Support Volunteers.
I worked with a team of media experts to further develop my media skills including my interview technique. It was a great day and allowed me to consolidate the journalism training i did about 5 years ago.
It’s taken over a year to actually sort out a meeting but it’s finally happened… on Wednesday I flew to Ireland for the first meeting of a group of people who are soon to be the Trustees for Hyperemesis Ireland, a charity to support women and families affected by hyperemesis gravidarum in the Republic of Ireland.
