No more jello please
July 22, 2012 1:36 PM   Subscribe

Any tips for living with chronic nausea while waiting for the doc?

Memorial day weekend I was scratched by my cat and ended up with a systemic pasturella infection along with it in my knee. Had surgery and about 6 weeks of antibiotics (IV ceftriaxone followed by PO Cipro). I've had nausea constantly. Infectious disease doc was pretty sure it was from the antibiotics and took me off. The infection is gone. The nausea is not. I've been off the cipro almost 2 weeks now. I saw the ID doc on Friday and she changed me from Zofran (mildly helpful) to Phenergan (also mildly helpful) and added Prevacid thinking it was an acid problem (no help at all).

I'm seeing a GI consult in my future, which is painful as I'm uninsured. Until that happens and someone can figure this out how do you live with nearly constant nausea.

I can barely eat and have lost almost 30 pounds since getting sick. I'm living on jello, popsciles and gingerale for the most part. Real food makes me vomit. I'm also on Cymbalta (for depression and fibromyalgia) and Klonopin (anxiety) which have never caused me problems.

I'm tired and run down. I have no energy. I can feel myself spiraling down into depression so I'm trying to keep my mind active since my body can't.
posted by kathrynm to Health & Fitness (46 answers total) 3 users marked this as a favorite
Cipro was incredibly damaging to my body and my digestive system. You may have systemic issues from the Cipro like I did and something that helped me cope in the interim was dosing up on acidophilus and plain, unsweetened yogurt. Obviously, this may not be a good fit for you as you mentioned real food isn't staying down, but every little bit can help. I'm so sorry you have to go through this. Thinking of you.
posted by These Birds of a Feather at 1:43 PM on July 22, 2012 [2 favorites]

Ginger helps with nausea. Get more stuff with ginger.

Focus on hydration and nutrition rather than food. I used to routinely make carnation instant breakfast, often putting one to two packets in about four ounces of milk instead of the recommended eight. I sometimes did that twice a day.

You also might try getting those anti seasickness "bracelets", which are really more like elastic bands. They really help with seasickness and are not expensive. It is worth a shot.
posted by Michele in California at 1:45 PM on July 22, 2012 [3 favorites]

I'd up the ginger to stuff that's got a higher concentration, like Reed's or the Ginger People products. In my experience, normal ginger ale you get in the grocery store doesn't work nearly as well.

Sorry you're going through this. Sending good thoughts.
posted by emkelley at 1:54 PM on July 22, 2012 [1 favorite]

Dry roasted peanuts helped me when I was on an IV infusion of antibiotics for a dental abscess.
posted by Carol Anne at 1:55 PM on July 22, 2012

i had pretty bad nausea for years. marijuana has been the only long lasting fix with acceptable side effects that i've found.
posted by nadawi at 1:56 PM on July 22, 2012 [5 favorites]

You may have reactive dysmotility. You may have an imbalance of intestinal flora as a result of the antibiotics. Perhaps both.

Ginger chews, ginger tea, and even ginger ale help me, as does taking an over-the-counter probiotic. Frequent small meals and liquid meals help. Reading or watching TV while eating helps distract me.

Best of luck with this. It is super debilitating.
posted by Sidhedevil at 1:56 PM on July 22, 2012 [2 favorites]

I came in to recommend marijuana also. Nausea is one of the more common medical ailments it's used to treat.
posted by hermitosis at 2:02 PM on July 22, 2012 [2 favorites]

First of all -- I presume they have checked for this, but you don't mention it in your question. Is there any possibility you could be pregnant? What you are describing is exactly how I felt at the beginning of both my pregnancies.

My strategies for getting through that phase were ginger chews, an herbal blend called "Morning Sickness Magic," lots and lots of teeny tiny meals (like, a single saltine), giant doses of B-6, and Unisom. Yes, the sleeping aid. It helped quite a bit. A friend of mine with hyperemesis gravidarium (severe nausea of pregnancy) got Reglan, first by IV and then orally, which she said changed her life.
posted by KathrynT at 2:05 PM on July 22, 2012

Not super healthy, but the thing that really helps me with nausea (associated with pancreatitis) is sucking on Jolly Ranchers.

I hope you start to feel better very soon.
posted by 3T at 2:15 PM on July 22, 2012

Seconding nadawi and hermitosis.
posted by vorfeed at 2:16 PM on July 22, 2012

Have you tried OTC Pepcid and Zantac? (At least the standard dose versions are OTC in US.) One or the other could be very helpful for the nausea, or not, but won't hurt to try. For different people, one will work better than the other. For food, try Ensure Plus or Boost Plus nutrition drinks ("Plus" versions only). For food, have you tried simple cheese crackers with peanut butter like these (any brand)? And Yogurt - most all are marked "low fat" but don't get the "light" type. And Ice Cream, again not a light type.

All of these have been helpful in my recent experience for similar symptoms and do not set off symptoms of nausea. IANAD.

Best wishes to get fully well soon.
posted by caclwmr4 at 2:25 PM on July 22, 2012

Mostly agreeing with everyone. But when I had similar problems, my GI had me on very specific acidophilus for two months after antibiotics stopped. It took a long time. MeMail me if you want me to look up which strains she required.

Also, maybe try keeping something in your stomach (saltines), no matter how much it seems like it'll make things worse. That often works for me, ymmv.
posted by crankyrogalsky at 2:27 PM on July 22, 2012

Nthing ginger. I learned on Mythbusters that it is the best way to treat nausea - and it really does work (I get bad motion sickness due to first person games, but if I take some ginger I don't get super nauseous) . If the thought of eating ginger makes you queasy, they sell ginger tablets that you can just swallow.

Also, even though you said your meds weren't giving you any problems before, I am thinking that maybe because you have an empty stomach all the time they are making you queasy. Or maybe the combo of medications is doing that and it's making your stomach unhappy.
posted by littlesq at 2:30 PM on July 22, 2012

Are there acupuncturists there? Can you afford to see one? I would absolutely try that if possible. Probiotics might also help (on preview, like crankyrogalsky said). Nthing ginger (GingerPeople, ginger tea, or ginger extract in pill or liquid form, maybe). Try peppermint tea, too. And if there's any way you can get your hands on marijuana, that will help, but I realize that may not be an option where you are.
posted by désoeuvrée at 2:30 PM on July 22, 2012

Nthing what everyone else has said. I haven't seen it mentioned yet but I find peppermint helpful for nausea too and have been known to live on Altoids when traveling by sea.
posted by wwax at 2:33 PM on July 22, 2012

I think time - if you were on antibiotics for 4 weeks it might take your body a while to bounce back. I would give it a few more weeks before you get seriously worried (as long as it is JUST nausea, and not actually vomiting or similar).

In the meantime, I would suggest drinking some ginger beverages, like ginger ale or the Stash makes a fantastic lemon ginger tea.

If you are losing a worrying amount of weight, drink some high-calorie drinks. When I was on medication that made me too sick to eat I would drink slim-fast. I might only be able to manage half a can at a time, but I'd stick it in the fridge and two hours later I'd finish the rest. ...there are probably better drinks than slim-fast, but that's what I chose at the time.
posted by Lt. Bunny Wigglesworth at 2:33 PM on July 22, 2012

Candied ginger, also delicious in general, or maybe that's just me.

Especially if you haven't been eating much, try to eat a little at a time over an extended period. Like... a cracker. Five minutes later, another cracker. Five minutes later, another cracker. Possibly all day. When I had medication-related nausea for awhile, that was pretty much the only way I could manage to get enough calories in a day not to collapse, and even with that, yeah, I was totally wiped all the time and felt moody and horrible. But while I'm generalizing from the whole experience, the less I ate, the more upset my stomach got. So it turned into almost a game: One spoonful of yogurt and then I could watch a movie. (I'm not sure the yogurt stuff really helped, but especially with ABs, it's a good idea.) A couple grapes, and I could take a long bath. The part I dreaded, followed by something nice, because none of that stuff seemed anything but vile just then.

Once it got to the point where I could hold down more than a spoonful, then it was "a quarter of an Ensure". And then half. Seriously, that stuff tastes vile but there's a reason they give it to people who can't eat normally. Try to start getting more things that aren't just straight sugar (or white flour) once you possibly can. It works as a stopgap, but the sugar highs and crashes only make you feel worse when it's going on long-term.
posted by gracedissolved at 2:37 PM on July 22, 2012 [1 favorite]

Have you tried Ensure? It's a drink, so you might be able to keep it down, and it's made specifically for people who are having trouble getting adequate nutrition from normal methods. It tastes pretty mild and it also packs a pretty good nutritional punch, particularly in terms of the calories you get from a single small bottle. When I've been nauseated for long periods of time and couldn't eat much else, I could still drink Ensure sometimes (make sure to put it in the fridge first, lukewarm Ensure isn't bad exactly, but it's a lot better chilled), and if you can stomach it, it'll give you more nutrition than popsicles and ginger ale at least. It's not a diet drink, so it often gets stored in a sort of random aisle in the pharmacy section of the supermarket. I find it most easily in Walgreens, actually. Anyway, good luck. It's really hard having a stomach that won't cooperate with you.
posted by colfax at 2:37 PM on July 22, 2012 [2 favorites]

FWIW, whenever I've had severe nausea and couldn't seem to keep anything down the one thing that seemed to agree with my stomach was plain saltine crackers. Or pretzels. Something about the baked dough plus salt seemed to fill my tummy without making me want to .... you know. Best of luck to you, hope you feel better very soon.
posted by Oriole Adams at 2:41 PM on July 22, 2012

If the nauseau is due to the antibiotics disrupting your gut ecology, you can do a lot more than just consume yogurt/probiotic sources, though that is a good place to start. And time alone won't heal it. Time and "luck" might. Or time and research into what you need to replenish your damaged gut.

Some things that helped me: organic yogurt, lots of lettuce, coconut oil, sea salt, aloe vera and four months or more of stringently limiting yeast in my diet. This was after being on antibiotics and multiple other drugs for months and months. Coconut oil does good things for gut flora. Organic yogurt has more varieties of flora than other yogurts typically have. The gut is lined with mucus and salt is a critical component of healthy mucus.
posted by Michele in California at 2:51 PM on July 22, 2012

I hate to chime this in but maybe some medical marijuana cookies, they have done wonders for my uncle.
posted by ibakecake at 2:59 PM on July 22, 2012

Lots of good advice above, I came to add Psi Bands, which are worn on the wrist in the region of an acupuncture point which has been proven to have great results against nausea (one of many studies). They're available online at Amazon, etc and I've also found them at REI or travel stores among motion sickness offerings. They're far more effective than similar wrist band competitors. I think that's because they're sturdier, stay in place and apply pressure more effectively than bands that are elastic.
posted by quince at 3:28 PM on July 22, 2012

I just came off of 24 hours of very bad nausea due to migraine, I can really sympathize. And short term I second the saltines, pretzels route (my 'go to' is toasted white bread). Ginger is also excellent, I like mine in tea form, I also get a lot of relief from peppermint tea. But if I am really nauseated, I can only drink carbonated sodas, and then some ginger ale is the ticket.

Definitely agree with the probiotics route -- even if it is not the cause of your nausea, it is really important after you have taken antibiotics to build up your intestinal flora and immunity -- I go for the real stuff, kefir, miso, yoghurt, anything fermented. I have made my own kefir and yoghurt, very easy and has much better flora than the bought stuff. Good luck, nausea is one of the worst sensations.
posted by nanook at 3:33 PM on July 22, 2012 [1 favorite]

I find that sucking on peppermints and/or chewing ginger chews works wonders when I have nausea.
posted by xingcat at 3:44 PM on July 22, 2012

Seconding the Ensure. Ginger is great -- but when it doesn't work and you're too sick to eat, you should have something. Unlike a lot of meal replacement shakes, Ensure makes drinks specifically for people who are struggling to get enough nutrition. The serving sizes aren't too big, and the taste is fairly nonoffensive.

Also, how would you feel about a cream soup? Cream soups, since they're pureed, are easier for some people to handle since they're liquid and don't have chunks in them. Many cold cream soups can be made with yoghurt rather than cream if cream is too rich or if you want the benefits of yoghurt. (I'm about to eat an avocado cream soup because there are lots of calories in there. It's basically just avocado, vegetable broth, and yoghurt pureed together with some spice -- fairly mild and easy on me since it doesn't "feel" greasy or fatty or otherwise ugh.)
posted by Kutsuwamushi at 4:01 PM on July 22, 2012

as far as protein-- are nuts a possibility?
I found when I had pregnancy-related nausea that foods that didn't have a smell were better than ones that did. I ate a lot of dried fruit and unsalted nuts.
posted by tuesdayschild at 4:09 PM on July 22, 2012

One of the best tips a doctor ever gave me, when I was so sick I wasn't able to keep down water, was to take a sip every 5 minutes. Just a tiny sip, not enough to get me sick; but frequently enough that I wouldn't get dehydrated.

When I was on a medication that made me seriously, seriously nauseous (Haldol) I figured out I could keep down a cracker; but half a sandwich, and I wouldn't keep it down.

So, my recommendation is for tiny, tiny meals, in little bitty spaced out intervals. Some ideas for tiny meals:

-one nut

-sip of almond milk (one of my faves when I'm sick, high in protein, not as gross or hard to digest as real milk)

-one spoonful of rice crispies in almond milk

- tiny square of a piece of toast; seriously cut out 1/8 of a piece of toast and forget about the rest of it

-one spoonful white rice; you can probably get an Asian restaurant to deliver

-one sip broth/soup

-one noodle

Seriously, DON'T TRY TO EAT THREE NOODLES. DON'T TRY TO EAT A BOWL OF CEREAL. The secret is spacing it out to a tiny, tiny bit of nourishment your body doesn't even realize is there. Even if you only manage to choke down a piece of bread and it takes you an hour and a half, well, that's 100 calories you wouldn't have had otherwise.
posted by Juliet Banana at 4:14 PM on July 22, 2012 [2 favorites]

Another traditional nausea remedy not mentioned yet is COLA SYRUP. Most drugstores have it, but it may be in the back or on a bottom shelf, so ask if you don't see it. Ginger and peppermint both actually irritate my stomach, but cola syrup helps. Cola soft drinks generally don't.
posted by Corvid at 4:32 PM on July 22, 2012 [1 favorite]

Definitely not pregnant. Ginger capsules didn't really help, nor does ginger ale. I drink it because at least I can get some liquids in and any other soda makes things worse. Water seems to make me more nauseous.

The ID doc is more worried about dehydration than calories. The weight loss, while welcome (I'm obese) is not the way I want to do it.

Marijuana is not an option as I'm living with my father while I look for work and there is no prescription stuff in Ohio.

We have some oyster crackers so I'll try nibbling on those every few minutes.

At this point I'm ready to cry again. I'll call the ID doc again tomorrow because I can feel that I'm getting dehydrated again and I seriously don't want to end up in the ER again (the last time it took 4 sticks to get an IV in).

Thanks everyone for your ideas.
posted by kathrynm at 4:43 PM on July 22, 2012

I take a medication (Baclofen) that increased my motion sickness, and I also have a long daily commute. Consequently, I'm eating ginger candies every day.

My favorite is one called Ting Ting Jahe Ginger Chew. It comes in small, cigarette-sized boxes, and the bags above. The only ingredients are ginger, sugar, and corn starch. The candies are made in Indonesia. You should be able to find them in any Asian grocery store. (They may also be called Sina Ginger Candy)

If you're not used to condensates ginger, it's REALLY powerful. However, you can also take 1 to 3 pieces and dissolve them in boiling water to make a ginger tea.
posted by spinifex23 at 4:56 PM on July 22, 2012

Really really sour lemonade really helped me with nausea during my two pregnancies (I see that you aren't pregnant). I would make it myself by squeezing the juice of one lemon into a glass, with a couple of spoons of sugar, then fill the glass the rest of the way with water. After that, I could generally eat some real food.

I don't know if it's woo or true, but someone told me that your brain can't process sour tastes and nausea at the same time. So really sour things sort of cancel out the nausea, if you will. Anything vinegar-y, lemon-y, etc., might help. I know I personally got very tired of ginger, fast.
posted by fancyoats at 5:01 PM on July 22, 2012 [1 favorite]

Also, if ginger doesn't work, or if you can't tolerate it right now, I've also drank really diluted Gatorade when nauseous and dehydrated. My body seemed to tolerate that a lot better than plain water.
posted by spinifex23 at 5:01 PM on July 22, 2012

I have a couple of friends with HG (Hyperemesis Gravidarum) and they say B-vitamins (especially B-6) and Unisom, when taken together, can really help with nausea too.
posted by fancyoats at 5:06 PM on July 22, 2012

A salt water bath can help hydrate you even when you can't keep anything down. Coconut oil can be absorbed through the skin. It is high in medium chain triglycerides, which the body can use directly without digesting them. This is part of why it is helpful for gut issues. Salt and oil are both important to one's abity to stay hydrated. Start with the bath, immediately. Dehydration also causes nausea. So effectively treating it might help you eat again.
posted by Michele in California at 5:24 PM on July 22, 2012

Home made yogurt (its easy and cheap) made into a smoothie might help. I gained a bunch of weight when I started making my own!
posted by fshgrl at 5:39 PM on July 22, 2012

Cipro and my kidney stone surgery screwed me for about two months. I felt carsick constantly. Docs kept giving me pregnancy tests. I basically drank peppermint and ginger tea. I also took phenergan and that OTC liquid nausea medication (worked the best).
Anyway, after I reluctantly let the doctor treat me for an ulcer (didn't seem to have most of the symptoms), I felt
Much better.
posted by KogeLiz at 5:49 PM on July 22, 2012

If you've lost 30 lbs since Memorial Day and still can't eat, and you don't have insurance to cover a whole slew of medical studies, you need to visit an ER. Seriously. You very much need to find out exactly what's going on - now, not a few weeks from now - and, without insurance, you'll be given only the very minimum of interest in your problem until it reaches the point where there's no choice but to admit you to a hospital and find out what's going on; by that time, you could be in very serious trouble.

I know ERs are having trouble with people using them for minor complaints, but, obese or not, a 30 lb weight loss and continuing inability to eat or drink is NOT a minor complaint.

Get thee to a hospital, now - and make it clear just how sick you are when you get there.
posted by aryma at 6:12 PM on July 22, 2012 [2 favorites]

Can you drink Gatorade? That really helps me when I'm nauseated like this.

If not Gatorade, try Pedialyte. Or the Pedialyte Popsicles.

Have you been tested for diabetes? Apparently people with diabetes are more prone to gastric dysmotility.

A weird trick that helps me whenI'm too nauseated to drink water comfortably is to drink it through a straw with my eyes closed. I have no idea why that helps me, but it does.
posted by Sidhedevil at 6:33 PM on July 22, 2012 [1 favorite]

Dry carbohydrates, very dry carbohydrates, in tiny amounts. Usually what I'm telling folks is to get some saltine crackers (just a few), chew them slowly with some tiny sips of water (not a lot of water - you will get more sick). Don't try to drink a glass of water ... looks like you already figured that out.
Don't worry about water. Fluid is good, it doesn't have to be water.
Nausea can be such a vicious cycle if you have an empty stomach.

Vitamin B6, 25mg 3 times a day, seems to help some people a lot. Of course, this involves keeping a pill down.

You can also try Reglan (metoclopramide) for nausea, though it's harder to find in some places. That's another prescription medication, in a different class from zofran and phenergan.

Pedialyte is great. Tiny sips of apple juice. Ensure has solid calories and is liquid. Really, don't even worry about water right now if it makes you sick, fluid is the #1 most important thing. Tiny sips. If popsicles are good, keep it up.

If you can keep down Jello, can you keep down pudding of any kind? tapioca pudding, rice pudding, etc? Any kind of broth?

You can try changing up the temperature of your drinks. Sometimes trying something while it's cold helps, sometimes trying stuff at exactly room temperature is what you need.

You're right to be concerned about the dehydration aspect - you can live, miserably, without food for a long time, but dehydration is much more serious (and will compound nausea).

I am so sorry you're having this - if Zofran isn't doing it for you (were you at the max dosage)? then you have some serious, serious nausea to contend with. When you were hospitalized, did they give you medications through your IV for nausea? did it help?
posted by circle_b at 7:07 PM on July 22, 2012

I've never found commercial ginger products to have much effect, but ginger tea definitely has helped me with nausea in the past. (To make: fill a small saucepan with water, add in several slices of fresh ginger. Boil for a while - 20 minutes? Until it tastes gingery when you taste it with spoon. Add whatever sweetener you like, and drink.)

The only other thing i can think of that might help is acupuncture, or here's some info about using acupressure on yourself to relieve nausea. (It couldn't hurt to try?)
posted by Kololo at 7:36 PM on July 22, 2012

You poor dear! This is such a hard thing to deal with.

Anecdote: my aunt had hip surgery in early May, followed by weeks and weeks of nausea. 40 plus pounds of weight lost, 2-3 re admissions to the hospital to try to get it under control. CT scans, ultrasounds, endoscopies, colonoscopies, gall bladder SURGERY...still vomiting. During the last admission she needed a dose of Benadryl for an allergic reaction she was having, and that ended the nausea. Like turning off a faucet.

That was about 4 weeks ago and she is still working to get her appetite back and to enjoy food again. She is only starting to gain the weight back. She started on antidepressants a couple of weeks ago, and I think they are helping with the appetite and enjoyment of food.

So, for my money, try some IV Benadryl.
Hang in there, and don't give up! This WILL get better!!!
posted by SLC Mom at 11:00 PM on July 22, 2012

After surgery a couple years ago, I developed chronic nausea and pain. I also take Ondansetron (generic Zofran). The form of Zofran you are taking may be helped with a quick-dissolve pill that goes under the tongue (sublingual). I have found that taking the hard pill doesn't work as well as the sublingular pill, perhaps because of how fast it acts. This is great when riding the bus, for example, when my nausea can suddenly kick in. Ask your doctor or pharmacist.

Marijuana can help with the nausea and can also compel hunger, which is satisfied by eating. So you may get additional benefit here. It's just difficult to dose reliably, because there are no industry standards for strength or relative measures of active compounds. If MMJ is an option for you, consider it.
posted by Blazecock Pileon at 1:15 AM on July 23, 2012

It came to mind that wasting is something you definitely would want to talk to the GI specialist about, in conjunction with treating the nausea.
posted by Blazecock Pileon at 2:41 AM on July 23, 2012

Sea-Bands are good because you don't have to ingest them. They work on the accupressure points on your wrists. My friend's daughter is using them for intense morning sickness. Give them a try.

Cipro totally gutted me when I took it, it's worse then the disease I think.
posted by Ruthless Bunny at 6:23 AM on July 23, 2012

It is really difficult to get doctors to take significant unintentional weight loss seriously if you're already at a high body weight. This is shitty but true. My own doctor, whom I generally dig, was all "I wouldn't worry about the weight loss because you're in no danger of being underweight" and I was all "Hello, my gallbladder and pancreas don't know that," so.

If I may, I would suggest that you give equal emphasis to the other ways this is affecting you (dizziness, lack of energy) and cite the unintentional weight loss as a metric, rather than as a problem to be solved, because unfortunately a lot of docs will take even a dramatic unintentional weight loss as a plus rather than a minus for a patient with a high body weight.
posted by Sidhedevil at 9:35 AM on July 23, 2012

Seconding asking for sublingual ondansetron. The swallowing type did absolutely nothing for me, but the dissolving type was just about the only thing that worked on my own nausea.

It's hard when the doctors don't know what's going on. If you have a trusted friend or family member who can advocate for you when you go to the ER, definitely take them with you. It's hard to explain things when you feel so awful, and medical staff will take you more seriously if someone else is there as well (unfortunate, but true, in my experience).

With an ongoing and possibly complicated medical situation, if it's a hospital outside the information network of whatever healthcare provider you sought out before, I find it helpful to write out and print off a page (or three--they can be kind of bad about returning them...) that contains a bulletpoint list of what has been happening to you in sequential order. That way when the doctor finally comes in, you can manage to communicate the gist of your entire situation quickly and effectively, and they can take the paper with them for notes. If you get a med student, they will absolutely LOVE this. Their natural inquisitiveness hasn't been beaten out of them by pessimism inducing experience yet. If you can find an academic center with a teaching hospital (OSU, etc) that may be helpful, as well.

I hope you get better soon. Being able to enjoy delicious food was something missing from my own life not so long ago, and I remember those feelings all too well.
posted by Estraven at 2:02 PM on July 29, 2012

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