So Your Misses Got Hyperemesis (Gravidarum)
Chapter 6: IV Fluids For Hyperemesis Gravidarum
Part 8: Tips for IV Treatments with Hyperemesis Gravidarum
If your wife’s hyperemesis gravidarum is so severe that you need to rely on IVs, know that it’s a challenging time, but it is possible to get through it.
In the following lines, I’ll share tips and guiding principles that helped us cope with this new routine. Follow these to help your wife receive IV treatments during her pregnancy with hyperemesis, reduce her pain, minimize risks, and prevent dehydration
Tip 1: Find a doctor who specializes in high-risk pregnancies
I’ve said it before, and I’ll say it again — if you haven’t done this yet, you absolutely need to find a doctor who specializes in high-risk pregnancies, understands the dangers of hyperemesis, knows how to help you, and isn’t afraid to prescribe the medications and treatments your wife needs.
If you find a high-risk pregnancy specialist who doesn’t understand hyperemesis or its severe impact and doesn’t give you what you need, keep looking for another physician.
Tip 2: Find professional and empathetic nurses you trust, and insist on receiving care only from them
Most people need a nurse’s assistance only once every few months, for a blood test or a specific treatment. In a pregnancy with hyperemesis gravidarum that requires regular IV treatments, you’ll need a nurse’s assistance several times a week, or even daily. And let me tell you, the nurse’s job won’t be easy at all: she’ll have to insert a cannula into an exhausted woman suffering from nausea, with flat veins from dehydration, arms sore from previous IV’s, low energy, and a bad mood.
Because of all these reasons and many others, you’ll need excellent nurses by your side. Nurses who can find veins even in complex cases, who don’t need to puncture the arm multiple times to insert a cannula. In addition to skill, the nurses who care for your wife must also be compassionate enough to support a woman with hyperemesis and all that comes with it.
Not all the nurses we met were skilled or sensitive enough. It took us a little time to understand the importance of the nurse’s level of expertise for my wife’s care. Once we understood this, whenever we encountered a nurse who didn’t feel right for us, we politely requested someone else, explaining that we needed someone with a specific skill set. If you don’t find a sufficiently skilled nurses team at your local clinic or hospital, look elsewhere. Don’t be shy, and don’t feel awkward. If you don’t feel good about the nurse treating you, ask for the one who does. Your wife’s well-being is the most important thing right now, not the feelings of a nurse who isn’t the right fit.
Fortunately, the clinic we went to had a women’s health center with an exceptionally skilled nursing staff. Most of the time, they managed to find veins despite my wife’s semi-dehydrated condition. They understood her physical difficulties and even the trauma that triggered her injection-related anxiety attacks. They were great with needles!
After we began coming to the clinic every two days for regular IVs, the nurses took the initiative and learned more about hyperemesis to provide better care for my wife. After a few months, they were the ones who suggested transitioning to a PICC line to ease her experience (more on PICC line for hyperemesis gravidarum later).
Beyond professional respect, we connected personally with the nurses. Before transitioning to the PICC line, we wrote them a heartfelt thank-you letter to express our immense gratitude, which I included at the end of this part. Without a doubt, the nurses who supported us throughout the week were among the people who helped us the most during this challenging time.
This is the Thank-you letter we wrote to the nursing staff in the clinic that took care of my wife’s IV’s for several months. We gave it to them in our last IV session before my wife had a PICC line installed, for the last part of our hyperemesis pregnancy:
Dear Nurses,
Today seems to be our last IV treatment with you. We’ll still see each other, but not as before. So this feels like the perfect moment for us to pause and say - thank you, thank you, thank you from the bottom of our hearts ❤️!
We looked forward to this pregnancy and went through a long journey to get here. It turns out getting pregnant was only the beginning, and life had planned a unique pregnancy for us that would require ongoing medical support. Our fortune was that we had you angels as our medical team!
So we’d like to take this opportunity to say to you…
❤️ Thank you for your exceptional professionalism. If we had to get pricked every two days, it’s worth it only with you!
❤️ Thank you for your listening, understanding, and having a genuine desire to help.
❤️ Thank you for all the great advice you’ve given us along the way.
❤️ Thank you for your initiative and willingness to learn more about the condition and how to treat us better.
❤️ Thank you for the smiles, the gentle touch, the kind words, and consideration.
…Just, thank you!
The kindness and help you’ve given us over these past months are truly extraordinary. Because of you, this pregnancy has been significantly easier than it could have been. Knowing we’re in your good hands has provided us with the peace and reassurance we needed to get through this challenging time.
Our love and thanks to you all
Tip 3: A Day with IV Fluids is a Day with IV Fluids – Don’t Make Other Plans
One day, when we were just beginning our IV fluid routine, my mother asked me to drive her to a medical appointment. I knew we had an IV day scheduled, but it’s hard to say no to my mom.
Unfortunately, my decision to help her came at a cost. Instead of taking my wife to her IV fluids session first thing in the morning, we arrived at the clinic two hours later than planned. In those two hours, my wife became significantly dehydrated. The nurses struggled to find a vein, so she had to be poked multiple times. When they couldn’t successfully insert the IV, they sent us to the hospital, meaning that while my wife was in advanced dehydration, we had to endure the hour-long process of traveling to the hospital, checking in, and waiting for a nurse, who also couldn’t find a vein and had to call in an anesthesiologist to finally place the necessary line.
It was a terrible day. My decision to take on a big task on an IV day turned out to be a mistake, even though it came from wanting to help my mom. That decision led to severe dehydration for my wife, which could have put her and the baby at risk, and she had to endure multiple attempts at finding a vein just to get her IV fluids.
This was the last time I planned anything other than being with my wife on an IV day. You shouldn’t plan anything else either. An IV session and everything surrounding it can take time—sometimes 5-6, or even 8 hours. This is because as your wife receives more IVs, it becomes harder to find veins, it hurts her more, she may need breaks, the fluids flow slower, and more. You might even need the help of an anesthesiologist to locate veins, which can add to the wait.
So do yourselves a favor – don’t make other plans on an IV day.
Tip 4: Break the Cycle – What to Do If Your Wife Arrives for IV Treatment Dehydrated
In hyperemesis gravidarum, there’s a cycle you want to avoid at all costs. If you do find yourselves in it, it’s best to break out of it quickly. Here are the main points of the cycle I’m talking about:
- Dehydration encourages vomiting.
- Vomiting, in turn, increases dehydration.
- The more dehydrated the body becomes, the flatter the veins get, making it harder to locate them and insert a cannula for IV fluids to counteract the dehydration.
- And so, the cycle continues—dehydration promotes vomiting, which further dehydrates, making veins harder to find and worsening dehydration.
In other words, if your wife loses too much fluid and starts to dehydrate, it becomes much harder to help her with IV fluids than if she arrived before dehydration set in.
So, how do you break this cycle? The best way, of course, is to avoid getting into it. Make sure you get to the clinic early for IV fluids, insist on receiving 2 liters a day, and return the next day for another 2 liters.
If your wife arrives at the clinic dehydrated and the nurse is struggling to find a vein, it’s time to encourage her to try drinking, even though it’s difficult. Water makes veins pop out more, making it easier for the nurse to find a good vein and start the IV, breaking the cycle. If your wife can drink, water is ideal, but if not, encourage her to try anything else liquid—cola, soup, tea, an energy drink… anything that can bring some fluids into her body and make the veins more visible.
In one instance when my wife arrived at the clinic severely dehydrated and couldn’t manage to drink, one of the nurses had her suck on a bit of sugar with her finger. The nurse explained that sugar can have a similar effect in making veins pop. She said a hard candy could have a similar impact. I’m not sure if it’s scientifically proven, but it worked for us that day.
Tip 5: Get to Know Your Wife’s Veins
It may sound a bit morbid, but it’s really worth learning how your wife’s veins are structured and how they behave.
If you’re settling into a routine of IV fluids, her veins are bound to get fatigued at some point. This means that the more IV treatments she receives, the harder it will become to locate a good vein for the next day’s IV. Her arms will fill with spots where she’s already been poked; they’ll become more painful, and the IV flow will slow down—which will make IV days longer and more exhausting as time goes by.
In fact, one of the reasons we decided to give my wife IV fluids every other day rather than daily was to allow her veins some time to heal, so there’d be viable places to insert the needle (although, I’ll admit, if we had known better, we would have gone for 2 liters of fluids every day).
To manage this challenge better, it’s recommended that both of you become familiar with your wife’s veins. Try to learn the layout of her veins in her arms, keep track of where she’s been pricked recently, note which veins had a slow fluid flow, and where the IV flowed smoothly. Also, remember which veins tend to be less painful on certain days.
The more you learn about your wife’s veins, the more active a role you can play in managing her IV routine—guiding the nurses on where to find a good vein or where to avoid. Keep in mind that medical staff changes from shift to shift. Even if one day there’s a nurse who knows your wife well, the next day might bring a different nurse unfamiliar with her situation, who may end up poking her multiple times to find a suitable vein.
In other words, your knowledge and awareness of your wife’s veins can spare her a lot of pain and frustration and make daily IV sessions much more bearable.
How to learn about veins? First of all, keep your eyes and ears open. Observe what the nurses are doing, ask questions to get a better understanding of the veins and how they work, and even take notes or make simple sketches in a notebook.
Also, pay attention to hand positions and angles that allow the IV to flow better, in terms of both speed and comfort for your wife. Any knowledge you can gain about her veins will work in your favor
Tip 6: Protect Your Wife's Veins with a Thinner Cannula
As I’ve mentioned, one of the biggest challenges with regular IV treatments is the wear and tear on veins. The more IVs your wife receives, the more worn and painful her veins become, making it harder to insert the cannula and slowing down the fluid flow. When getting IVs every day or two, keeping her veins intact is a huge challenge.
So, how can you protect her veins despite this? One effective approach we discovered was to request the use of a thinner cannula.
During the months we had regular IVs, we learned that there are different types of cannulas, each with a different thickness, designed for different patients and situations. Each thickness is marked by a different color.
Most of the time, nurses use thicker cannulas for adults to allow faster fluid flow. In the hospital we visited, this was a pink cannula, 1.1 mm in diameter, which at that point had become painful for my wife.
One day, in an effort to reduce her pain, one of the nurses suggested using a thinner cannula—the kind typically used for children. So, we switched to a blue cannula with a 0.9 mm diameter. The improvement was immediate. Inserting the cannula was less painful, it was gentler on her veins, and the flow rate wasn’t significantly affected. From that point on, we insisted on the thinner pediatric cannula for every IV, and it was one of the best choices we made to help protect her veins in the long run.
Note: The colors and sizes of cannulas may vary in your hospital or clinic. Always consult with medical staff before requesting a different cannula size
Tip 7: The Anesthesiologist, the Unsung Hero
An anesthesiologist… I knew that such a specialist existed, but I’d never quite understood why someone would dedicate their entire career to putting patients to sleep. I discovered their importance during my wife’s journey with IV treatments, as her veins became tired, punctured, and flat, often requiring multiple attempts from the nurses to locate a viable vein.
One day at the hospital, the doctor caring for my wife couldn’t successfully place an IV and called in an anesthesiologist.
The anesthesiologist arrived, examined my wife’s arms, focused, and managed to insert the cannula in one attempt. And it didn’t hurt my wife too much either. How did this miracle happen? It turns out that one of the skills anesthesiologists specialize in is finding veins for IVs—a critical ability when treating patients with severe conditions, like cancer, who need frequent IV treatments. This skill proved essential for my wife’s IV treatments during her experience with hyperemesis gravidarum.
Once we realized the value of anesthesiologists and their expertise, we started to rely on them more. If my wife was dehydrated with flat or painful veins or if the nurse couldn’t place an IV after one or two tries, we immediately asked for an anesthesiologist to work their magic.
If you’re in a situation where it’s difficult to place a cannula for your wife’s IV, I highly recommend requesting an anesthesiologist. Hospital staff may not always think of this solution, so it’s essential to take the initiative and ask.
Tip 8: Find the Right IV Drip Rate
One of the fascinating aspects of hyperemesis gravidarum is how it can make almost anything a trigger for nausea. Every smell, movement, even eye contact or posture can set it off. For my wife, even just looking at her smartphone for a few moments or watching me walk around would trigger nausea.
Surprisingly, we discovered that even a fast IV drip rate could bring on nausea. Initially, we couldn’t pinpoint the cause, as the medical staff wasn’t familiar with nausea from a rapid IV drip. But eventually, we realized that the drip rate was the culprit, and we began to find the right speed using the IV roller clamp.
If your wife feels nauseated during IVs, there’s a good chance it might be due to the rate at which fluids are entering her body. Ask the nurses to teach you how to control the drip rate, and experiment until you find the right speed for her.
Patience is crucial here, as slower IV rates can make the treatment longer. For us, adjusting the speed meant that getting two liters could sometimes take 6-7 hours.
Remember, make sure to adjust the drip rate only with the medical staff’s approval and after your wife is safely out of any risk of dehydration.
Tip 9: Be Your Wife’s Ears and Voice
When we’re in pain, it’s hard to focus. During a pregnancy with hyperemesis gravidarum, your wife is enduring constant, intense suffering.
At your hospital or clinic visits, stay attentive to conversations with the medical team. You may often need to listen, remember, and understand the instructions from her caregivers, so you can relay them to her later when she’s more alert.
Likewise, on days when she’s receiving IVs, you may need to speak on her behalf, explain her needs to the staff, and ensure her treatment is administered correctly. Being her advocate and support during this time can make a big difference in her care
Tip 10: Get Comfortable in the Clinic or Hospital
If you’re entering a routine of IVs as part of a pregnancy with hyperemesis gravidarum, you’ll be visiting the hospital or clinic multiple times a week. My advice is to start feeling comfortable in these places.
I accompanied my wife to nearly all her IV sessions. That meant many hours outside the house and a lot of missed workdays. I had to find a way to make our IV’s time more pleasant and productive.
I used the time in the clinic or hospital to catch up on work, spend quality time with my wife, or even take a nap. We found a small room in the clinic that was unused and turned it into our regular office. I would bring my laptop so I can work or we would watch a movie on Netflix, or just rest.
So if you’re also looking to make the long hours of IVs during hyperemesis more productive or enjoyable, find a way to feel comfortable in the clinic or hospital