Thursday, 10 February 2011

Dealing with heartburn

As I'm sure you know by now, what has been a pretty uneventful and enjoyable pregnancy has been blighted for weeks by unrelenting heartburn and more recently, acid reflux and sickness. I can't remember exactly when it started, but it was definitely before we went to Barbados and that was when I was about 22 weeks, so I can say I've been suffering for roughly half of my pregnancy.

I thought I'd dedicate this blog to what its been like, all the solutions I've tried to help me manage it, and why I finally gave in and went to the doctors. To begin with, it wasn't too bad. I noticed it was happening after I'd eaten or drunk anything citrus based, so I stopped eating satsumas and cut out orange juice. Then I noticed fried foods were causing me some discomfort, so out went the fried eggs and KFC's in favour of scrambled eggs and grilled chicken. Interestingly, when we went to Barbados, all my symptoms stopped even though I was drinking orange juice and fried fish - so when we came back I recreated the holiday diet down to the last detail, but still my symptoms returned.

I read all my pregnancy books, checked various websites, spoke with my midwife and other people I know who had suffered with heartburn (pregnant or not) and began following the list below in an attempt to get things under control:

1. Food avoiding:
This is the first thing anyone suggests in order to deal with heartburn and acid reflux symptoms. Common foods leading to heartburn include:

- fried/greasy foods
- dairy products
- chocolate
- peppermint
- caffeine
- alcohol
- spicy foods
- citrus foods
- carbonated drinks
- black pepper

I cut out ALL of these. No chocolate, no diet coke, decaff coffee, I switched to soy products instead of dairy, no spice, no pepper, just bland boring bland bland bland. But I found it didn't matter what I ate, I was still suffering. Even dry bread caused immense discomfort.

2. Eat little and often
This is especially recommended during pregnancy due to the limited amount of space your stomach has. Linked to this is not eating and drinking at the same time in order to prevent the stomach stretching too much. I found that drinking a small glass of water first thing in the morning was making me sic, most probably because my stomach had shrunk so much overnight.

3. Leave 3-4 hours after eating before lying down.
This is another common solution suggested by doctors, particularly if you suffer from heartburn during the night as I was. The rationale behind it is that remaining upright prevents excess stomach acid leaking back into the oesophagus and allows gravity to help everything go the right way preventing discomfort. Surprise surprise, this didn't work for me and I would lie awake for hours, or wake several times in the night in absolute agony. I also tried propping the head of my bed up on a stack of books, about 6-8inches high, and elevating my upper body up on several pillows to try and keep gravity on my side, but this didn't seem to help either.

4. Antacids
Of course, I tried over the counter remedies, although my choice was limited a little due to the fact I'm pregnant and some antacids, particularly the stronger ones are unsuitable for pregnant women. I'm pretty sure that everything I could have tried, I tried. Gaviscon, Rennies, Tums, own brand versions, double strength versions, liquids, tablets, you name it, I tried it. NOTHING worked. If it did, it would give enough relief for me to fall asleep, but I couldn't get through the night without any pain, or it would stop the discomfort for long enough after lunch to let me do some work without wanting to be sick, or rip my insides out.

5. Lying on your left side
I have no idea what the rationale is behind this one, but I found that if I lay on my left hand side, my discomfort was reduced enough to allow me to drop off to sleep. Much of the time. I would wake during the night because I'd rolled over onto my right side which seemed to make things much worse.

6. Homeopathic remedies
Many people think this is a massive waste of time, but I was at my wits end, and wanted to exhaust every possible option before getting a prescription, as I was concerned about the safety of taking something for several weeks during my pregnancy. I consulted a homeopath who was recommended to me by the lady who ran our birthing course, and she spent over half an hour on the phone with me asking me all sorts of questions about my symptoms, my diet and lifestyle and my personality in general. She recommended taking something called 'Nux Vom' before every meal -a small sugary pill dissolved under the tongue and also sent me a flower essence (with Brandy as a carrier) and instructed me to have 7 drops morning and night.
I did this for 2 weeks and nothing happened. If anything, my vomiting got worse - I'm not sure many people can stomach drops of Brandy first thing in the morning - and having a sugary pill before my meals often made things taste a bit weird. It might work for some people, but it wasn't for me.

7. Proton Pump Inhibitors
This was the last resort - a prescription from the doctors. I was reluctant to go to the doctors until I felt that I'd tried everything and wanted to wait until as late in my pregnancy as possible because I was concerned about the effects of taking anything long term on the baby. At 36 weeks I went to my GP who had seen in my maternity notes that I'd been suffering for quite a while, that things had got worse and that all the advice and suggestions given to me by the midwife didn't seem to work. She was concerned that the vomiting was getting worse and was worried about the effect that may be having on me and the baby as we obviously weren't getting enough liquids or nutrition as it was all going down the toilet instead. She prescribed Rantidine. 1 pill twice a day, so I have one in the morning and one before bed. The first few days it was amazing. I slept horizontally for the first time in MONTHS, I ate dinner without being sick, I woke up and got through the day without vomiting once, I could have a drink with my food and it not result in agony or a trip to the bathroom. Those first few days I felt like a normal person again.

However, its been a week now, and I've noticed some of the old symptoms creeping back. Lying on my right side at night causes mild discomfort, as does drinking too much, having dairy products, or eating too much. Yesterday, I couldn't keep a thing down and I don't know why. My symptoms are no where near as bad as they were, I can sleep, I can get through the day without wanting to to cry or starve myself or pull out my insides, and theres not long to go at all until baby is here and hopefully everything goes back to normal. If it gets any worse within the next week then I'll go back to the doctor, but I know the only other thing she can give me is much stronger and possibly a little riskier. I'm sure I can stick it out for another 3 weeks or so!!

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