vomitous_throwaway

My wife has had CVS/Abdominal Migraines for the last 12 years (we were dating as teenagers when it started). I thought I'd share a few tips I've learned from cleaning up more vomit than you can...well, it was a lot of vomit.

1. Get a prescription for protonix. This won't cure you, but it will reduce the acidity of your stomach acid, which is really key for someone who is vomiting all the time. Less damage to your esophagus, throat, teeth, etc.

2. Identify your triggers. CVS is a kinda/sorta migraine in some ways, so treat it like a migrane: Are there any foods, activities, or environments that trigger attacks? Some triggers can be avoided, others are just a part of life. For my wife, plane travel was a big trigger, and it was easily avoided. Less traveling, but she'd just vomit for a week whenever we went anywhere, so it was an easy tradeoff.

3. Make a list of things that help. It could be having a fan on, having the lights off, having a wet washcloth, soothing music, etc. Then, when you are having an attack, try some of the items on your list. When you're in a bad attack, it can feel hopeless, and you can feel so weak that you can't do anything to help yourself. Also, it's a good list to give a helper, so they do things that actually might help.

4. Ignore the well-meaning advice of people who think it's like a flu, that you're bulimic, or some other idiocy. You'll have people tell you that you need to walk it off, or get outside during a bad attack, or that it's all in your head. Just nod politely and move on to something that might help.

5. Strive to continue your daily life. This is actually easier for you while you're in high school than it will be later (and I know it sucks!). Go to college. Explain it to your advisor, your counselor, and your professors ahead of time, so that they know what's up if you just don't show up one day, or if you run out of class in the middle of a lecture. People in high school can be cruel, but remember that there are many great and understanding people out there too. Ignore the assholes, find people who will treat you well, don't be ashamed to tell people about what you're going through.

6. It might take a long time, but CVS can and probably will eventually go away. For my wife, that happened when she got pregnant with our first child. Hasn't had an attack in the two years since then. Hormonal changes often cure this stuff, and since you're fifteen, you have a few left to look forward to. (Obviously, DON'T GET PREGNANT TO CURE YOUR CVS. That would be a stupid idea, and you might be a male, which would make it an even stupider idea.)

7. Accept that this might be your life for a while, and do the best you can within those parameters. I can't tell you how many people insisted that we keep looking for a cure after meeting with doctors for years and years. If I had a dollar for every time someone suggested the Mayo Clinic, I'd have like five dollars. Again, I suggest a politely nod and ignore them policy.

If it helps, this stranger on the internet knows what you're going through, and just how horrible and debilitating it can be. I also know that you can still have a great life and achieve great things while suffering through this. My wife graduated with honors from an ivy league school, and is getting a PhD right now to help people make better choices in their medical care. You can succeed even while you have that terrible taste in your mouth.

A bit of what you say is good advice. Some of it is just laziness and inefficiency. Most of it is you living up to your username.

Look, my sister in law is an ER nurse, I get that you're overworked, have to triage on your feet, and deal with crazy shit all the time. I appreciate what you do immensely.

Could you also try being a caring person and try a little empathy? Do you know how much it would have helped us to have an ER doctor who tried to help instead of trying to discharge us?

It's a great idea to come up with a plan to treat CVS. How about you help out with that? You seem to think it's just too much effort to come up with a plan on your own, so why don't you write a one paragraph note to the GPs yourself, with the suggestion you've given? It's kind if your job to coordinate with the GP and check the patient's history as you evaluate them.

The fact that you say there are "very rarely" electrolyte abnormalities is just symptomatic of both your sloppy treatment and your shitty attitude. Let's say you're a CVS sufferer who has been vomiting for five days straight. You haven't been able to hold down any food or water for half that time. Are you supposed to perform a home test to check your electrolyte levels? Maybe you'd suggest going to your GP, but what if it's Friday afternoon? Should you wait three days? It is not ideal for the patient to come in, but neither is it ideal to wait. It's your job to check that, not to scold patients for fearing for their health.

Further, how many GPs in your area are set up to give IVs? Probably not many. For us, it was a choice between trying to get in to a cancer treatment center, and trying to get an IV from an ER. The cancer treatment center was better, but sometimes we had to wait up to a week to get in. Do you think CVS patients should try to schedule their attacks? I get the feeling you may not have gone two days in a row without any liquids. I'm not suggesting you try it, but if you had, you'd know that the dehydration alone makes you think you're near death.

When my wife was pregnant and suffering from CVS, it was incredibly important that she got IVs to stay hydrated. We scheduled IVs, but sometimes she got an attack on a Friday evening. I guess you'd suggest she go without liquids for more than 48 hours? These situations are what the ER is for, even if it means you don't get to treat patients that have more black and white outcomes. Yeah, we came in sick, and we left sick, but that doesn't mean we didn't need to be there. Don't blame the patient if you can't cure them.

Finally, you display some really sloppy thinking in your note on cannabinoid induced hyperemesis. Are you suggesting that a patient with CVS is more likely to suffer from it than others? You're confusing cause and effect, and betraying the fact that you let your biases affect your treatment. Do you scoff at cancer patients with positive top screens too?

I'm glad that you recognize that you're "drjerk." Please try to do something about it other than venting in an online forum.