Dear Dr. Roach: I have just returned home after visiting my daughter and her husband. She is pregnant and has a rough time keeping food down. When I was pregnant with her, I was queasy, but I never threw up.
How common is this?
She has an OB doctor, and she’s scheduled to visit him. I’m worried.
What are the dangers of this?
Dear L.M.: More than 50 percent of pregnant women are nauseated in the early stages of pregnancy, and many of them throw up. It’s popularly called morning sickness, a misnomer if ever there was one. The nausea and vomiting of pregnancy can happen at any time of the day. It’s probably due to a rise in estrogen or human chorionic gonadotropin — two hormones whose levels increase in pregnancy.
Some women develop hyperemesis (HI-purr-EM-uh-siss) gravidarum (grav-uh-DAR-um), nausea with vomiting so extreme they become dehydrated, lose weight and put the health of the fetus in jeopardy.
For morning sickness, things reach a peak at the ninth week of pregnancy. By the end of the 12th week, 60 percent are much better, and by the 20th week practically all have recovered.
A high-carbohydrate, low-fat diet quells nausea and vomiting. When pregnant women feel hungry, they should snack. Crackers make a good snack. An empty stomach is prone to nausea. Large meals make matters worse. Smaller, frequent meals are best. Ginger in capsules often keeps the stomach quieted.
If vomiting is out of hand and if the woman is losing weight, she has to see the doctor promptly. The doctor can prescribe medicines to calm the stomach. She might need hospitalization for intravenous feeding. No pregnant woman who is vomiting frequently and losing weight can waste time in temporizing. The stakes are too high for her and her baby.
Dear Dr. Roach: I’ve been told that PSA readings can rise if the tests are done in 48 hours of riding a bicycle, having a digital examination or having sex.
My GP wanted me to have the PSA test immediately after my annual physical examination, which included the digital examination. Fortunately, I delayed the test for a week.
I always wonder why the three conditions above are not provided to patients prior to testing in order to get more accurate results in men.
Dear B.A.: All of these activities can temporarily raise the PSA level, but the level of increase usually is quite small (less than half a point for people with low to normal PSA levels) and thus is unlikely to make a difference in the decision of what to do with the PSA result. It generally is not necessary to avoid these activities before a routine PSA test. However, if the level is borderline as to whether to do a biopsy, it is reasonable to refrain from these activities for two to three days before a retest.
Email questions to ToYourGoodHealth@med.cornell.edu.