Dr. Brian Levine joins us on the podcast to talk about morning sickness – how it can impact your life (and your baby), what common treatment options are, plus a new, drug-free option called the ReliefBand that works – almost instantly!
Topics We Discuss in This Podcast:
Things Mentioned on This Week's Podcast
[Kristen] Hi, this is Kristen from NaturalBirthAndBabyCare.com and I am really excited to have Dr. Brian Levine here. He is a leading fertility expert and a practicing OB/GYN. He's the attending physician at the Lennox Hill Hospital, New York and practice director of Colorado Center for Reproductive Medicine in midtown Manhattan as well as being the technology editor of Contemporary OB/GYN. He's also a passionate advocate for the promise of consumer and professional technologies to improve clinical and patient outcomes, advising companies such as Apple, Samsung and Google. Welcome to the show Dr. Levine.
[Dr. Levine] Thank you for having me, I really appreciate everyone taking the time to chat about a really important topic.
[Kristen] What we're going to really focus on today is something that is on the top of most pregnant women's minds, which is morning sickness. Dr. Levine, can you share how many women are affected by morning sickness. I mean, we hear about the lucky few women who escape it, but is it true that most women experience some level of morning sickness?
[Dr. Levine] So I think that you're being very kind when you say the lucky few, because it's actually less than the few, it's actually 80% of all women who become pregnant have some form of morning sickness. It's actually really incredible that the #1 discussion I have with patients when they're planning a future pregnancy is “What am I going to feel like? Am I going to have morning sickness?” Then when people have early pregnancy, quite often they know before the blood test shows, because they just don't feel well. This is something that is both physiologic, the body does this naturally, it doesn't mean that there's anything wrong. This is also something that becomes part and parcel of being pregnant. It also leads to the #1 reason that people go to their OB/GYN in early pregnancy. Outside of bleeding, or spotting, is the management of morning sickness, or pregnancy associated nausea. The crazy number, if you want a statistic to hold yourself on is not only do 80% of all women deal with some form of morning sickness, if you think about the fact that there's somewhere around 350k pregnancies occurring in the United States, this means 1/4 million people a month are walking around nauseated because of pregnancy. That's a big number.
[Kristen] That is a big number, you're right. That's huge. Can you tell us how does morning sickness impact a woman's life? And, can it have an effect on her baby? Or, even the health of her pregnancy?
[Dr. Levine] This is probably the most common question that I get from people, which is, what does it all mean? What is morning sickness going to do to me, and what's it going to do to my baby? The first part is that morning sickness can impact your life because it doesn't happen in just the morning. The reason that people tend to have the most symptoms in the morning is because they have an empty stomach. They don't have anything there. As you know, all of your hormones get a little bit higher overnight, so as soon as you wake up in the morning, you have this nausea that just hits you when you get up out of the bed quickly.
But it can impact everything from your quality of sleep, to the quality of your workday. When you're tired and groggy, you're not as productive. It can make you feel run down. It can just make you feel cruddy. As you said in your initial comment, the lucky few who don't have it. I think that any woman who has pregnancy associated nausea, or morning sickness, and then gets a reprieve from it. Feels like they just won the lottery because it is such an awful feeling. The good news is that it's not a problem for the baby. In my clinical practice now of over 7 to 8 years, I haven't had to admit a patient of mine to a hospital in a really long time. I've admitted people because of hyperemesis, which is the extreme form where they can't stop vomiting, and someone is really sick. But, in general, if you have a physician that you can talk to, who you're partnered with, and you can talk about some great remedies to help control the nausea, there's no reason to be concerned whatsoever.
[Kristen] That's great. What you said is so true, at least in my experience. I've had 7 babies. It was never morning sickness for me, it was always all day sickness. With my 7th baby, my last baby, I actually didn't have any morning sickness. It was the first time, so it felt like a miracle.
[Dr. Levine] It's funny, people talk all the time about weight. People talk about how do you control weight up and down? Everyone's afraid to gain too much weight in pregnancy. So, I promise not to get personal with you and ask you how much weight you gained, but what people don't realize is that, you don't need to be focused just on how much weight you're gaining. With pregnancy associated nausea you need to be worried with how much weight you're losing. Someone like yourself who had full day nausea, your appetite goes down, you actually start losing weight, and that's a problem.
[Kristen] Yeah, and I think a lot of moms, that's what they're concerned about. I'll have moms who come to me who tell me I couldn't eat anything, and I'm dropping weight, and I started pregnancy underweight. I always encourage them, you need to talk with your doctor, or your midwife, because you need to get something working for you.
[Dr. Levine] You're absolutely correct.
[Kristen] We know that morning sickness can have a big impact. So what options are currently available for women seeking relief from morning sickness. And, what are some of the concerns that moms have with using medications or other things like that for treatment?
[Dr. Levine] I think we already defined the what, now the next thing that we're trying to discuss here is the how do you fix it, or the how. There are a lot of different ways to go at it. We have some unfortunate stories in the OB/GYN world of medications that we initially thought were safe years ago, but then proved to be unsafe. A famous one is thalidomide. So we had patients who took thalidomide then in the 70's they had all these children with complications. In the end thalidomide was a single drug that formed a single form of a pregnancy associated complication, but that checkered past of prescribing a pregnant woman a pill still resonates with every single patient I see.
Outside of any socioeconomic status whatsoever, patients don't want to be medicated in pregnancy. Unfortunately, no matter how much you talk about lifestyle modification, habitual changes, the American College of OB/GYN, which I'm a proud member of, still does recommend pharmacotherapy for these patients. The problem is the medications that we have are good, but people don't want to be addicted to a pill in pregnancy. So the medication that's out right now is called Diclegis. Diclegis is this medication that basically is a combination of an over the counter drug, Unisom, which helps you sleep at night, and vitamin B-6. Back in the day, years ago, this combination was available and was a medication called Bendectin. This medication was removed from the pharmacies in the United States for unclear reasons, but any time that a woman hears that a medication was removed from the FDA, and then re-released and repurposed, people take pause. They remember that thalidomide story and they say, wait a second, I don't want to be taking that pill again that's now rebranded and is associated with it. This is one of those things where people say I don't want to take the pill.
So what do I do, I tell them to take smaller meals. I tell them to try to sit up after eating. I tell them to try and make sure they stay well hydrated. Try to avoid spicy foods, fatty foods. The reason that morning sickness happens is really still unclear. There's one band that thinks that it's all due to the pregnancy associated hormones, the estrogen, the progesterone, those two really big pregnancy hormones, that cause relaxation of the top of the stomach, so you get that reflux.
What's interest is that if you look at the neurobiology or the neurological science the way that our brain communicates with the rest of our body, we're starting to understand now that morning sickness is almost just like motion sickness. Where it's actually a neural circuit or the nerves in your body that are kind of moving in rhythm and a pace that's just not normal. When your body doesn't know what to do, it freaks out. And the sensation it gets of that freak out is the nausea. That's why I've started introducing, in my own practice, patients understanding of their nervous system, and things like acupressure and neuromodulation. Which sound like really big words. Acupressure which comes from eastern medicine, neuromodulation which sounds like really techie, but the thing I do is I show them this thing called the ReliefBand, which has become a big part of my practice now, where I show patients, saying look, you can actually wear a bracelet and you can control your own nausea for once and all.
[Kristen] Okay, can you tell us a little bit more about the ReliefBand, and how it can help pregnant women?
[Dr. Levine] Sure. Everyone's talking about wearables right now, and so it's lucky that I don't have to make the sell for someone to wear something electric, or something electronic on their wrist. But the ReliefBand is a really simplistic genius device that essentially has a battery within it that's replaceable that stimulates a nerve within the patient arm and kind of gives feedback to the brain to say “I'm okay.” What it does is, it kind of helps send a signal back to temper the nausea.
It's incredible. Literally, the patient can put on this ReliefBand in the fits of morning sickness, and I'm sure you can remember this, when you feel like you're going to be dry heaving and retching. You could put this ReliefBand on the patient, show them how to do a proper startup of it, and within seconds, the beads of sweat dry from their brow, and all of a sudden they're saying, oh thank God. The ReliefBand is easy. In my opinion, every soon to be mother, or pregnant woman should have one, because morning sickness is not limited to just the first trimester. People can have nausea in almost every trimester. So all they need to do is kind of slip on this band, place it in the right place on the inside of their wrist, and then turn it on. And their nausea will go away. That's the most simplistic high level description of it.
[Kristen] That sounds incredible to me. Of course the question that moms are going to have is, is it safe for me? Is it safe for my baby?
[Dr. Levine] I tell people this all the time, that's great question, everyone says to me, I don't feel comfortable putting something that's modulating my nerves onto my wrist. Sounds like big words, but if I said to them you have no problem putting your cellphone in your pocket, and we don't even know what that's emitting. This is based on simple technology that's been around for over 20 years. Acupressure has been around for hundreds if not thousands of years. It's part and parcel of eastern medicine.
The whole idea behind how the ReliefBand works is that it just sends a signal back to the vagus nerve, which is kind of this big nerve in the body, and says to your body, you're okay. You're not taking a chemical, you're not doing anything that affects the uterus, you're not doing anything that affects your heart rate, I mean you're really just kind of dampening those symptoms and that center that deals with nausea. So to answer your question in short, yeah it's very safe. There's nothing that you can do to harm yourself by using it. The only thing you can do is by not using it correctly, is not get relief from nausea. And then ultimately you have all the complications we talked about before which is weight loss, which can be a problem in your pregnancy.
[Kristen] Yeah, okay. If a woman is experiencing all day nausea like you mentioned, and it can continue on throughout her pregnancy, which I will often have moms who shoot me an e-mail and say I'm in my 2nd trimester, or in my 3rd trimester, and I'm feeling nausea, is that normal? Is there a limit to how long she can wear the ReliefBand? Can this kind of be like her all day pal if she needs it?
[Dr. Levine] I think the biggest limitation is the battery. There's no medical limitation whatsoever. I think the batter can last, I tell people the battery should last you around 5 days. And so, 150 hours, 140 hours, somewhere around there. And there's a bunch of different levels 1 through 5, most people get relief from level 3. And basically that's just the amount of current that's stimulating the patients nerves. But no, there's no limitation, and no maximum safe dose of this. And if you don't feel comfortable, just turn it off, and see what happens.
It's incredible – I recently put one on myself, I actually suffer from motion sickness, and so I was in a cab, and I was reading my iPhone one day, and I got really nauseated. So I said, hey, wait a second, let's do an experiment on myself. So I put the ReliefBand on me, I felt a little tingle in my finger which meant that it was in the right place, and set to the right thing, and then I went back to reading my iPhone. It was incredible, I was actually able to pound out an e-mail in response. So it's gender neutral. It is age non-specific. It is safe for anyone and everyone. The thing is, at the end of the day, you're helping your patients grapple with a major impediment to daily life. In a safe, reproducible manner, that does not require a pill. Which, I think, in my opinion, is the slam dunk.
[Kristen] Yeah, I'm sure that the reception for the mom is probably a lot better. Like you said, I think that all pregnant moms are skeptical of having to take a medicine during pregnancy. So that's just wonderful, and then when you tell them that you tested it on yourself they're sure to appreciate that too.
[Dr. Levine] Let's be honest, we have over medicalized the most natural process possible. When you make women labor on their backs, in a hospital, with an epidural in place, it's highly medical, it's not the way that we all came from initially, right? I mean as we progress as a society we've become more and more invasive. The ReliefBand in my opinion is a way to become less invasive. We're not putting anything in your body, use it as a way to see if you like it. And it's so inexpensive, that I say to my patients, if you don't like it, it's not like you broke the bank. Because sometimes, these anti-nausea medications on the per month basis, will cost you dramatically more than you would have spent to have a ReliefBand with a couple of replacement batteries.
[Kristen] I'm also getting a lot of women writing to me with questions about severe morning sickness, and you mentioned this too. Can ReliefBand help even with cases of severe morning sickness, or be part of the treatment there?
[Dr. Levine] I think that you bring up a really important point, which is, I'm a guy, I've never been pregnant before, I never will be pregnant, I don't know what morning sickness feels like. Your experience with morning sickness and nausea is going to be different than every other woman's out there. So what someone calls severe, might have been mild to moderate for you. We're all different. So you need to understand that and appreciate that. So I think that regardless of your tolerance for nausea, and wherever you are, the ReliefBand can be part of your treatment plan. For some patients, it's all you need. For the patients that are more severe, I've actually found that by adding in diet control, diet modification, helping people understand how to do things, that helps. But at the end of the day, my favorite thing is, when patients come in and actually forget that there are settings they could go, up to 3, 4, 5. That's when I find that the patients have the most rewarding experience. Because we can treat their nausea with just what's on their wrist.
[Kristen] Yeah, so, that's great. Where can a woman get more information about ReliefBand? Also, if she wants to share with her doctor or midwife, is there information that you have for clinicians?
[Dr. Levine] I think right now they're working on, the company is working on getting materials to send out to doctors, but I just tell patients to go to http://www.reliefband.com/, I mean, go look on the website, and you can go take a look, and I'm happy to talk to any doctor who is unclear on how this works, or wants to be better educated about it. In the end of the day, I have seen such an improvement in my patients satisfaction just from helping them with their nausea, that I think that every doctor should know how to add this into their treatment paradigm. And even if you are a big fan of using medications, at least offer this non-medication based approach. Offer this approach to your patients so they have the ability to control their own nausea. It doesn't have to change your clinical practice, so go to http://www.reliefband.com/ and feel free to share my e-mail address with people, I'm happy to answer questions.
[Kristen] Okay. We can definitely mention that, I'll put all this information in the show notes, so they'll able to click right through and be able to get that information. Thank you so much Dr. Levine. I mean I'm so excited about this, I was really excited when your assistant Sheree contacted me about it, and even more excited the more I read about it. I think this is thrilling and wonderful, especially as a mom coming from more of that I want to be natural for my baby. But, do you have any closing thoughts that you want to share before we wrap up the interview?
[Dr. Levine] First of all, I want to say thank you for taking the time to chat with me about a topic that is probably under recognized and under discussed. I mean, think about it again, we opened this talk with 1/4 million people a month are suffering with this. If that was the flu, we would have done something much more than just having Tamiflu, and all these other remedies out there. But for once, I think we're offering patients the ability to have a natural approach to treating a natural condition. We're letting patients take control of their own care. The device is controlled by the patient.
We're giving women control over something where they feel like they've lost all their control.
To me, that's really important. I think that the ReliefBand story is giving people relief when they couldn't find it before, and not forcing them to be medicated with a pill, which they thought was the only option before. Thank you for giving me the chance to talk with you about this. I hope your listeners can understand that this is a viable option, and this is a realistic option, that's obtainable by almost anyone to help counter something that's pretty dismal and pretty frustrating.
[Kristen] Yeah, and it can just drag on and on and on too, so just some relief that's very empowering. That's awesome. Alright Dr. Levine, thank you very much, we will definitely have how exactly we can find out more about the ReliefBand in the show notes, and I appreciate you again being here.
[Dr. Levine] Thank you, I really do appreciate your time and effort.