Hyperemesis Awareness Day!

May 15^th is Hyperemesis Gravidarum awareness day!  In honor of this day, I thought I’d share my HG story.  

I’d heard of HG before pregnancy, but only in passing.  I didn’t know much about it but figured it was a rare complication.  Although I knew my mom had a lot of nausea/vomiting during her pregnancy with my sister, I didn’t know of any other family members who struggled with severe Nausea/Vomiting of Pregnancy (NVP) or HG. 

My pregnancy was semi-planned. We had intended to get pregnant in November or December of 2009, so that I could have the baby around August. It was timing that worked well with my academic and work schedules.   Obviously, this didn’t happen for us.  Unsure whether a fall baby would work with my life plans, we let nature take its course; no cycle tracking or ovulation tests…just letting things happen when they did, and occasionally preventing when thoughts of finances and careers sent me into a panic.  There were tears and frustration.  Close friends had babies, and I cried for joy, jealousy, and longing.  Eventually, I chose to focus on becoming healthy, and began training for a 5k and looking for a post-internship job. 

In April, I suddenly felt a sense of sureness and peace.  On May 4th, I stopped by Walgreens on my way home from work, bought a pregnancy test and a Snickers, and by 10pm Jeff and I knew we were parents to be!  Over the next week we told family and reveled in our excitement. 

I’m not sure when the nausea started, only that I thought it was in my head.  Other friends confirmed this:  4.5-5 weeks pregnant was much too early to feel nauseous.  But the nausea grew.  And grew.  I do remember the first time I threw up: May 16^th. I was about 6 weeks pregnant, and we were heading to a Cubs game.  I spent the morning with my head in the toilet, internally debating whether to make Jeff call a friend to go, or to just make the best of it.  Advice: if you are barfing, riding the train and the El are not smart ideas.  Neither is sitting  in the Wrigley bleachers where strangers spill beer on you.  But I survived.

The following week, I managed to go to work every day, vomiting between clients and mentally willing myself to keep liquids down.  I tried every remedy known to man: crackers, tea, ginger ale, ginger snaps, sprite, vitamins, no vitamins, wrist bands, emetrol…the list goes on and on.  Some worked a little (I loved those wristbands), some made things worse (I still can’t look at a saltine without feeling queasy), but most did nothing but make me feel crazy, depressed, and nauseous.  That Friday I had my first ultrasound.  We had a healthy little bean!  I found out I had lost two pounds.  I also barfed in the parking lot. 

The week of May 24 was, quite frankly, hell.  I tried every single day to go to work.  Between having to lie down because the room was spinning, the time I spent barfing, and my inability to tolerate blowdryers (it was unseasonably warm), I would end up in tears each morning.  I finally called our office manager and explained myself, figuring she’d be more understanding than my male boss.  I was so blessed to have such a supportive working environment.  Sharon not only told me to stay home and take care of myself, but she had experience with nausea/vomiting after surgery and gave me extra things to try.  She also encouraged me to e-mail my boss and explain, and he was also incredibly supportive.  I still tried every day to go to work.  A couple of times, I made it in long enough to call clients to reschedule, do some paperwork, and explain to my coworkers why I was making their lives harder. 

Every day, I got home and called my OB’s office.  And every day I was treated like I was crazy, overreacting, and annoying.  I was assertive: I told them that I didn’t believe my symptoms were normal, and I wanted to see a doctor to see if I was dehydrated. I told them how I wasn’t keeping any food down.  How I wasn’t keeping any liquid down.  How the ginger tea didn’t help.  Yes, I tried crackers.  Yes, I’m trying small sips of water.  I was throwing up 7 or more times a day.  According to the Wii Fit, I had lost 5 pounds.  And still, the nurses told me, in no uncertain terms, that this was normal, and I was going to have to “tough it out” as women had done for centuries.   I asked to see a doctor for a note for work, and was told that they don’t write notes for morning sickness.  Pregnancy isn’t a disability.

Once Friday came, I had given up.  My husband was out of town, and I was supposed to be putting together flowers for my best friend’s wedding.  Instead of calling my doctor’s office, a call I knew would end in tears and no answers, I called my mom.  Finally, someone believed me!  This was NOT normal. This was NOT healthy.   Instead of placating me or telling me to toughen up, she came, picked me up, and took me to Urgent Care.  I hadn’t peed in over 24 hours. 

Thank heaven for the Edward urgent care in Bolingbrook!  For the first time, someone in the medical profession took me seriously!  They not only gave me sublingual Zofran (hats off to whoever invented THAT!), but gave me juice and made me stay until I had peed.

This is something strange about my HG experience: they repeatedly offered to transfer me to the ER for IV fluids, and I repeatedly declined.  The thought of having an IV panicked me…it’s like I lost all sense of survival.  If I could go back in time, armed with what I know now, I would have gone straight to the ER, and accepted that IV.  Dehydration seems to be, from anecdotal evidence, associated highly with depression.  There is also a viscious HG cycle: nausea and dehydration cause each other…so the more dehydrated you get, the more nauseous you are, then you’re more dehydrated and so on.  Of course, I didn’t know this at the time.  I thought about the cost, the $75 ER copay, my hatred of needles, and about how my mom probably wanted to get home and start her weekend.   So I said no.

Back at home, the Zofran started helping.  I made it through the wedding, despite the fact that I was the florist, a bridesmaid, and it was 90 degrees out.  I sucked on Wintergreen lifesavers, a suggestion from my aunt who had a hard time with morning sickness.  I even kept some food down.  It was Memorial Day weekend when I learned what I could eat (potatoes in any form, some bread, and iced tea) and what I couldn’t (meat, anything red).   I went to the doctor, who found I was spilling proteins into my urine (Ketosis – a sign that your body is digesting itself) and my thyroid was off the charts overactive.  I was signed up for biweekly blood tests for the rest of my pregnancy.  Fun times.

The next 8 weeks are a blur.  The doctors kept telling me to wean off the medication, I was still puking a couple of times a day or more, and it was miserably hot.  The insurance company  approved me for at-home fluids and a Zofran pump.  Still lacking in survival instincts, and worried about money because I was unable to find a job, I declined.  At my lowest weight I had lost 12 pounds since becoming pregnant…almost 10 percent of my pre-pregnancy weight. 

August 1, my contract with my internship was over, and I transferred to another department for very part time work.  Another interesting thing I learned about HG: stress is a huge factor.  Don’t get me wrong…I was still sick. I was still vomiting at least once a day (in spite of the fact that I was taking the max non-infused dose Blue Cross would allow, and knew the pharmacist at Walgreens by name).  But the depression, the daily struggle to just get out of bed began to lift as I caught up on sleep and my stress levels declined.  At the end of August, we had our “big” ultrasound.  The tech asked if I wanted to know the gender.  OF COURSE!  For me, knowing the gender gave the little parasite inside of me (that I thought of fondly on the best days, and cried to my husband that I regretted pregnancy on others) a name.  I could picture it in my head. I could relate to it. 

It was a boy!  I was surprised…the research I did, and my family history indicated that I was statistically likely to be having a girl.  We were so sure we were having a girl that when they said “boy,”  Jeff and I looked at each other in panic.  We had no names agreed on.  We had not decided on circumcision.  But we were so excited that we started calling him Jon Stamos and going through names.  We also found out that my mother-in-law likely had hyperemesis with two of her pregnancies, including my husband.  She was in and out of the hospital for hydration.  Both boys.  So I blame Jeff.  ;)

The fall of 2010 was a blur of very part time work, nausea, arguments with doctors (who tried to tell me I should taper down the meds), daily puking, tator tots, and iced tea.  Around 30 weeks pregnant, sweet relief came.  I went two days in a row without vomiting.  I had my first true pregnancy craving (huevos rancheros at 2am).  I could eat meat  again.  Life was good.   I had vomited daily for 24 weeks.  Of course, I still had nausea, still barfed occasionally, but it was “normal people” morning sickness.  Just 6 months too late. 

Between 30 and 35 weeks pregnant, I finally understood why people had more than one child.  My finally growing belly (I hadn’t gained any weight until 28 weeks) got me a little pity, and I could feel Levi moving around.  I could eat most food (although red sauce and salsa were huge aversions throughout the pregnancy), and I felt good.  I still had an aversion to water, which somewhat lingers 16 months after giving birth. 

Weeks 35-40, on the other hand were not so great.  The nausea returned, and I had some other random, annoying complications.  But Levi was born on his due date, 9 pounds, 12 ounces, and healthy!  He had literally sucked every bit of nutrition out of me.  I went home from the hospital having lost 18 of the 25 pounds I gained.  You read that right…I gained 25 pounds in 12 weeks.   It’s amazing what eating can do. 

I wish my story ended there, but I struggled with an even rarer form of hyperemesis: post-partum nausea.  It would come and go, but the nausea and water aversion would get so strong at times that I stocked up on pregnancy tests to ease my mind.  My immune system was also shot from months of malnutrition.  Before pregnancy, I had been on antibiotics one time in the previous 5 years.  After pregnancy:  4 times in one year.   My teeth were also shot, my gums were extra sensitive, and coffee still smells like skunk to me (yes, I still drink it).  

So where do we go from here, almost 2 years exactly since that first vomiting episode?  I’m constantly getting asked when we’re having another, and we’ve vacillated between trying again, adopting, and fostering throughout the past 2 years.  The current plan?  We may start trying in August.  We may apply to foster in August.  We’re not in a financial position for a private adoption, so it’s not on the table at this time.  We know we want more children, and that any path we choose has the potential for heartbreak, disappointment, stress, and most of all, joy.  So check back with me in August…

However, this was worth it all: