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January 11, 2014 5:20 PM   Subscribe

I am 10 weeks pregnant, and have developed these sudden and excruciatingly nasty headaches when I heave. Any thoughts on how to help and what might be going on?

YANAD, YANMD, I have called my nurses... and their advice in the moment was pretty much useless. I do not have a history of headaches.

About three times in the last two weeks, I have suddenly had a violent puke in the morning. By "suddenly," I mean "was calmly walking into the living room and had to turn and bolt" -- hence my inability to prevent them with my anti nausea pills (hydroxizine, which helps lessen general nausea if I have it). When I throw up, I IMMEDIATELY get the worst headache ever: I have to squeeze my head and moan for like 15 minutes. This headache then basically lasts all day. It lessens maybe a little bit, but I lie in bed with a cold cloth for like 12 hours straight.

When I called my nurses yesterday, several hours after the onset, they said to take some caffeine. I had two sips of Diet Dr. Pepper and had another puke. (Oddly, the headache lessened while I was puking.) I felt like I couldn't take painkillers all day because I worried I'd throw them up again -- and at any rate, I'm only supposed to take acetaminophen. I finally got around to taking some anti nausea pills, and ate some saltines, but I am still very dehydrated and low energy today.

Obviously, this can't continue.

So has anyone dealt with this before? Any techniques or other interventions I could use to lessen the pain that don't involve trying to swallow something? I think my threshold for "go to ER" was being dehydrated, whether from puking or otherwise, but I don't know how I would have moved (or what they would have done) if I'd tried to go during the headache portion. (My husband is here and taking good care of me.)

posted by Madamina to Health & Fitness (19 answers total)
Dehydration always exacerbates headaches for me, especially in the first trimester. Water tasted gross to me, but I found Gatorade delicious.

If you can't keep anti-nausea pills down, I'm pretty sure there are suppositories available.
posted by chiababe at 5:25 PM on January 11, 2014

Yep. Dehydration did this for me to me too.

Congratulations though!

Try to be as hydrated as you comfortably can.

This too shall pass.
posted by taff at 5:31 PM on January 11, 2014

You say in the morning- how early? Shortly after getting out of bed? Are you eating/drinking before you get out of bed (set up a little morning snack on your nightstand before bed!)? And are you getting out of bed very slowly? I would recommend both of these things- lie/sit in bed for awhile after you wake up, eat your snack, drink your juice, and let it digest a bit before you get out of bed.
posted by ThePinkSuperhero at 5:48 PM on January 11, 2014 [1 favorite]

Dehydration, plus you can have something stronger than Tylenol. Talk to your doctor. I took useless Tylenol for months before I mentioned it ruefully to the OB, who immediately said, "oh, I can prescribe you something better!" Good luck.
posted by chocotaco at 5:54 PM on January 11, 2014

Prescription pain meds (i.e.) narcotics can be used during pregnancy, but they are category C whereas Tylenol is category B, which is as good as it gets. Other people don't like how narcotics make them feel - side effects tend to be much more of an issue than with Tylenol. These are the reasons why people choose to avoid narcotics in pregnancy.
posted by treehorn+bunny at 6:16 PM on January 11, 2014

I used to drink a Gatorade instead of caffiene and that helped (maybe do one every morning to see if it helps?). Also, I eventually got prescribed fioricet - my doc said Tylenol is basically a placebo for headaches.
posted by dpx.mfx at 6:31 PM on January 11, 2014

Ok, for me the pregnant vomiting was so powerful I was breaking little capillaries all over my face and neck. I frequently got a headache after. I stopped trying to puke in the toilet and started carrying a bowl/bucket when I felt sick. I threw up a lot in the kitchen sink because it was easier to get to and I could stand. If I didn't try to fight it and let the vomit come out however it usually helped lessen the pressure of the heaves. It also helped when I wasn't bending over the toilet increasing pressure in my general head area. The biggest biggest help though was sucking on preggie pops or sour jolly ranchers and eating all the time. It's the worst to feel the need to heave but also starving at the same time. I'm so sorry! Hope it gets calmer soon!
posted by Swisstine at 6:41 PM on January 11, 2014 [2 favorites]

Sounds like you might be dehydrated. At my doc's office they had me do a quick pee test to determine if I was dehydrated enough to need IV fluids.

Suppositories for anti-nausea are an option, but I prefer oral dissolving tablets of Zofran. Tiny pill that dissolves under your tongue.
posted by MadMadam at 6:44 PM on January 11, 2014 [1 favorite]

Pregnancy can trigger migraines in women who have never had them before, unfortunately. The nausea and vomiting can be symptomatic of migraine as well as the headache, especially given the time frame you describe. Definitely agree that staying hydrated to make sure it's not dehydration is your first line of defense. I think you may need to try several tactics to see what works for you.

For treating migraines while pregnant, I find that a cold, full sugar coke helps (something about the caffeine and the sugar - diet isn't the same) I also use those air-activated stick-on heat pads on the back of my neck - it helps with the tension. Friends of mine swear by an ice pack on the forehead instead. A warm (not too hot! dangerous to the baby) bath can also help. Lying down in a dark room is ideal - sometimes i can sleep them off. My best friend likes to use eucalyptus or peppermint oil on her temples. You could look into a magnesium suppository if your OB is ok with it. There are also anti-nausea drugs that melt in your mouth, basically, so you avoid the need to have to swallow water and keep it down for 15 minutes. I think there's a melt in your mouth version of zofran, which I've used throughout my pregnancy. I have photosensitivity with my migraines so I have definitely resorted to wearing sunglasses indoors at work to help with the glare of the overhead lights and computer screens.

And congratulations!
posted by data hound at 6:45 PM on January 11, 2014

I usually wake up and listen to the radio for 10-15 minutes, then wander into the bathroom and pee/move slowly before I take a shower and finish getting ready. These have actually happened near the end of that cycle; one was caused by a gag reflex while brushing my teeth, but I don't know what set off the one yesterday.

I do have a designated bedside bucket, yes. I keep ginger chews and saltines at the side of the bed, and I eat a piece of string cheese if I can. I haven't actually had a lot of nausea, though; these are like turning on a dime.

I have some leftover hydrocodone; if that's okay, do you think that might help the pain? I thought that wasn't the right kind of drug for a headache (but then neither is acetaminophen...)

Dissolvable Zofran sounds like a thing of beauty.
posted by Madamina at 6:58 PM on January 11, 2014

Hydrocodone is definitely not the first line treatment for headaches, but it is a more powerful pain reliever than Tylenol alone. Hydrocodone (at least in the US) is essentially always a combo pill with acetaminophen in it too. - this is the generic version of Vicodin or Norco. It is category C (very important to understand what it means that something is category C versus B). Many people experience nausea with it, particularly if it is taken on an empty stomach. You should ask your OB before using narcotics in pregnancy.

Dissolvable Zofran is wonderful! When they make it over the counter someday, I'm going to lose a lot of business. :-)

There are also rectal suppositories of drugs like Phenergan and Compazine that many women use for more severe nausea and vomiting in pregnancy.
posted by treehorn+bunny at 7:15 PM on January 11, 2014

Were you a caffeine drinker prior to pregnancy? Can you have your spouse bring you both a coffee and a glass of water (or orange juice, or gatorade) first thing? I felt like death in my first trimester because I gave up on coffee. Caffeine withdrawal will give you both headaches and nausea, and that time spent sitting in bed listening to the radio might be exacerbating things.

I thought that wasn't the right kind of drug for a headache (but then neither is acetaminophen...)

Acetaminophen works great for headaches, in my experience, including the migraines I get which are frequently accompanied by (or crop up when I have) nausea. There's no reason not to try it if you're in pain.
posted by PhoBWanKenobi at 7:55 PM on January 11, 2014

How's your blood pressure?

Be sure to tell your doctor about the headaches when you see him next.
posted by aryma at 9:26 PM on January 11, 2014 [1 favorite]

Nope, I was not much of a caffeine drinker before. Never drank coffee, and while iced tea was my beverage of choice I'm still only drinking maybe one every couple of days (same rate).

Blood pressure is surprisingly quite low, although I hear that's a pregnancy thing too. I'm usually in the 120/80 range, occasionally up to 140/something, but the last couple times (including one about an hour after one of these episodes) I was at 90/50 or something. This despite the fact that I'm eating saltines and cheese like they're going out of style.
posted by Madamina at 6:15 AM on January 12, 2014

I just read the article "Symptoms of Torn Artery Are Easy to Miss" in the health section of the New York Times. Pregnancy, vomiting and headache are all in there.
posted by LiverOdor at 7:10 AM on January 12, 2014

I'm usually in the 120/80 range, occasionally up to 140/something, but the last couple times (including one about an hour after one of these episodes) I was at 90/50 or something. This despite the fact that I'm eating saltines and cheese like they're going out of style.

That's pretty normal for early pregnancy--it happened to me, too (now, in the late third trimester, my BP is back to it's usual normal).

I just read the article "Symptoms of Torn Artery Are Easy to Miss" in the health section of the New York Times. Pregnancy, vomiting and headache are all in there.

Vomiting and headache are both completely normal side effects of pregnancy, though. A much likely culprit would be low blood sugar, hunger, or dehydration. Try drinking something before you get up, see if that helps. There's a good chance, though not a guarantee, that any morning sickness and headaches/migraine will disappear by the start of the (awesome awesome) second trimester. I was just commenting to my husband that I can't remember the last time I got a migraine. Hope that's a bit of a comfort, at least!
posted by PhoBWanKenobi at 9:01 AM on January 12, 2014 [1 favorite]

I've never (and will never) experienced pregnancy, but from what I've read, morning sickness might have something to do with low blood sugar (which I am very experienced with). There are sugar pills, but also sugar gels (which I'd suggest since you might have trouble chewing/swallowing a large, chalky tablet). LevelUp is a new brand that I haven't tried (never tried any gels, actually), but it has 15g sugar, which is usually the recommended dosage for hypoglycemia (low blood sugar). The tablets have 4g, I believe. Maybe keeping some gels on your nightstand and slurping one down immediately upon awakening will help. Should give you 30-45 minutes before you need to eat something. Disclaimer - that's how it works for me, but YMMV due to pregnancy. At least this will keep (or get) your sugar up first thing and you have a little window of time. I also take zofran for anxiety-related stomach woes, and I can confirm they do work, they do dissolve without any liquids, and they are worth their weight in gold. They do have a taste, so be prepared if you have a pregnancy-induced taste altering/sensitivity thing. Generic is Odansetron RDT, I believe. Gatorade is a good choice for keeping electrolytes up. Even better is coconut water, but I'm told it tastes like gym socks.
posted by msbadcrumble at 6:57 PM on January 12, 2014

I think you should try eating something like a banana before you even get out out of bed or right after you get out of bed immediately followed by sips of water.

Then do everything else. Not eating right away triggered heaves and worse nausea. The headaches are probably dehydration.
posted by zizzle at 7:44 PM on January 12, 2014

Still barfing, even after eating a banana and sitting quietly (damn yooooou), but no headache today.

Talked to my nurse when I went in today and she said the main thing they worry about is dehydration. Eating is not great right now, but I'm at work and not dying, so I guess this has to be "acceptable" for now.

Hydration: it's a good thing.
posted by Madamina at 11:34 AM on January 15, 2014

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