Last May 15th was the First Annual Hyperemesis Gravidarum World Awareness Day, and with Princess Kate now suffering from this horrible condition, HG is back in the news.
It’s been more than 6 years since the birth of my 2nd son, and more than 6 years since I endured HG.
I’ve had 3 babies; pregnancy, though indeed a miracle, is not my idea of a fun 9 months. With 2 of my pregnancies, I was tired, queasy, irritable and vomited multiple times. I felt the sloshy, spinny, hangover-y feeling for several weeks but turned the corner around week 15. Most likely, this is what your experience with pregnancy and morning sickness has been.
As miserable as it likely was for you, morning sickness is not Hyperemesis Gravidarum. Not by a long shot.
My middle son’s pregnancy was a whole different beast entirely. I began vomiting when I was 6 weeks and 3 days pregnant with Tucker and did not stop until 3 days before I delivered him–in a spectacularly scary way–at only 36 weeks gestation. (You can read about Tucker’s arrival here:http:www.jtandtheob.com/2011_01_01_archive.html ).
And I do mean vomit. Constantly. Yack-counts, as I came to call them, numbered in the 20’s on a daily basis.
I threw up until I had nothing left to vomit. Once you work through any residual bile in your belly (which burns your mouth and coats your throat with ulcers), you wind up with the dry heaves, which cause small fissures in your esophagus and thus you vomit blood. I threw up until I had broken blood vessels in and around my eyes. I would wake up in the middle up the night to throw up. Hyperemesis is relentless. It is constant. There is no relief.
I threw up in Ziploc bags while driving my firstborn to school, which was pure torture. I threw up in parking lots, school restrooms, pharmacies, my OB’s office, the hospital. I threw up out of car windows at red lights, in every sink in our house, in the shower. Several times I threw up until I was completely dehydrated and slipping in and out of ketosis, where your body has gone into starvation mode and begins to break down fat instead of carbohydrates. Spilling ketones (+3 or over) wins you a trip to the hospital.
I learned the HG mantra of “easy down, easy up,” which means that since every single thing you swallow will revisit you within the hour, you want to do all you can to make the experience as tolerable as possible. I threw up Gatorade that still had ice chunks in it (an interesting experience, by the way, especially if your throat is coated with ulcers). Anything with carbonation hurt like a mother, but Chik-Fil-A sweet tea was easy. Toast? Not so delightful; it’s insanely sharp and pointy. Rice comes out your nose.
At 23 weeks pregnant, when I had not gained a single pound and my blood pressure was 90/50 and I had thrown up twice in the examination room with the doctor standing in front of me, my OB declared I had Hyperemesis Gravidarum, a life-threatening situation that affects only 1.5-2% of all pregnant women.
HG isn’t all about uncontrollable nausea and vomiting, but all of the other issues related to it hail from the terrible cycle: loss of more than 5% of pre-pregnancy body weight, dehydration and production of ketones, nutritional deficiencies, metabolic imbalances and, duh, difficulty conducting daily activities (such as standing upright).
Unmanaged, HG can kill you. Sufferers have no choice but to pump their bodies full of all kinds of medicines even if they swore they’d never take any medication while pregnant. The following are medicines I took while pregnant with Tucker: Reglan, Zantac, Compazine, Phenergan (tablets and suppositories), Tigan, Zofran, Tylenol with Codeine, Colace, Benedryl, Amoxicillin, Ambien and Percocet. The only thing that finally helped me break the cycle of non-stop vomiting for a spell was a perinatologist-prescribed, homemade concoction of Unisom and B6, a combination which basically produces a miracle drug (to HG’ers, at least) called Bendectin and which is not available in the U.S. Go figure: our FDA will allow petroleum additives in our food but will not allow a medicine known around the world to help alleviate the constant nausea and vomiting associated with a potentially life-threatening disease. That’s crazy.
When I reached 28 weeks and still had not gained a pound, I had a Matria Home Healthcare Nurse who brought a Zofran pump to my house. The machine sat in my fridge, its needles and catheters scaring the bejesus out of me. I cut a deal with her instead: we maxed out my oral Zofran dosage and if I threw up more than 4 times a day, I had to call her because it was mandatory to start the pump. My husband set his alarm and woke me up nightly to make sure I got the midnight dosage of the little dissolvable pill that cost–at that time–$32 a pop. I was taking 4 a day.
I wound up not being honest with the Matria nurse, clearly the low point of the entire torturous ordeal. I was lucky if I had only thrown up 4 times by high noon. Thankfully, about the time the Matria nurse came into my life, I’d connected with other women suffering through HG on the lifesaving Hyperemesis Awareness board. I do not know how I could have made it without them.
They warned me about the fine layer of fuzz that would grow all over my body, a mammalian defense mechanism to try to keep a malnourished body warm. They assured me that my fingernails would likely grow back even though they’d split and peeled off. They helped me find ways to avoid my triggers (certain random things that can throw you over a cliff so fast that you find yourself in the ER by sundown). Helpher.org taught me things I’d have never figured out–for instance, that Pepsodent Sensitive Toothpaste is the least flavored toothpaste out there, that unscented Aveeno products really are completely unscented (smells are a huge trigger for most HG’er’s), and that deodorant doesn’t really matter because it can’t cover the stench of the ketones you’re spilling.
They explained why bright lights and moving through shadows could crumble me in an instant. They understood why I had beach buckets in every room; they knew I wasn’t kidding when I said I had to crawl from room to room in my house. They saved me.
They taught me that fluids are key. Either you get more down than you toss back up (yes, involves a measuring cup) or you are hospital bound for an IV. If this means slowly eating a cup of ice chips as your “sticky” meal, then so be it (a sticky meal being one that has any component that stays down or sticks with you).
They taught me various ways to take my sublingual Zofran tablet, and they had page after page of methods to deal with the infamous impacting constipation that comes from maxing out on Zofran while being completely dehydrated. (As if HG weren’t incapacitating enough…)
They taught me that I was not alone and that I was not going crazy nor was I a wimp.
They taught me to trust that the HG would go away once I delivered my baby. They taught me that my baby was going to be one tough guy because he was enduring this–a limited food and nutrient supply, a dehydrated and fatigued and malnourished mother and a constant onslaught of medicines–during the most critical stage of his life, while he was in utero.
But, most importantly, they taught me that I am a fighter, one who will do all I can to protect myself and my babies. I learned to handle panic (a little, at least) by taking everything one step at a time and to be thankful for every good moment given to me.
My experience with Hyperemesis Gravidarum was miserable beyond words and I only had a moderate–not severe, at least in medical terms–case. There is no way I would have come out of it 29 weeks and 4 days later without such an unbelievable support network. My husband, my family, my spectacularly resilient oldest son, the Organization for Hyperemesis Education and Research, the HelpHer forums and my friends all helped me keep trudging along, one day at a time.
HG is no joke. Please, if you know any mom-to-be who is suffering through it, help her. The HER website is a rich resource for learning about the illness and ways to treat it as well as the signs that it’s time to head to the hospital. The site also provides discussion forums for sufferers and their families–forums which can provide crucial help and information at a time when the sufferer feels she’s reached the end of her rope. With much needed support, understanding and awareness, more research will be conducted on HG, and the day will come when we will understand what causes it and, more importantly, how to prevent it. And for any woman who has suffered through HG, that day will be just as joyous as her delivery day was.
J, T, and Theo B. 