Hyperemesis Gravidarum

Hyperemesis Gravidarum.  It took me two months to remember these words, let alone spell them.  I was diagnosed following my first ER visit at 8 weeks pregnant. The doctors refer to it as hyperemesis; the support groups refer to it as HG; my friends call it the Princess Kate Thing.  It doesn’t matter what you call it – it’s terrible.

HG is an incredibly rare and extreme form of morning sickness that can last through the entire pregnancy. Mine started at 6 weeks pregnant.  I couldn’t open my eyes without intense nausea and vomiting. I only moved from my bed to throw up. By 7 weeks, I considered terminating the very-much-wanted pregnancy because I couldn’t function. I couldn’t take care of my daughter, work, or keep down water.  My doctor’s office finally prescribed Zofran, which had no effect. By 8 weeks, I was crying for hours each day and dry heaving. My sister-in-law, a midwife in a different state, was trying not to interfere with my relationship with my doctors, but she finally told me to go directly to the ER for an IV. I’m so glad I heeded her advice.  I had thrown up 8 times that day, which at that time was a record for me.

At the ER, I was given two bags of fluids, as well as 4 different kinds of medications (Phenergan, Zofran, Benadryl, and something else that I can’t remember). All the medications were “Schedule C,” meaning that the doctors thought they were safe, but no real studies had been performed on the safeness of the medication in pregnancy.  It scared me, but I physically felt better. I was sent home with a cheat sheet: eat small meals, try ginger, and drink lots of water. Ha – was that supposed to be a joke? I also was given the Scopolamine patch to wear for nausea and told to supplement with Zofran.

The medications held for roughly 6 weeks. I would have two good days, and then throw up 3-4 times the third day. It was manageable. I could play with my 18-month old daughter, go to work most days, and even travel.  Then the patch stopped working. I tried to go to prenatal yoga, and I spent the first 30 minutes crying, and the second 30 minutes laying down nauseous. I hit a new record – throwing up 11 times in one day – and went back to the ER.  This time, I was given two IV bags with Reglan and Benadryl. I’m so thankful for modern medication. If this had been 100 years ago, I would have just died from my pregnancy. There was no way for me to counter the dehydration on my own.

In the weeks following my second ER visit, I tried everything. Sea bands? Sure, why not? Osteopathic manipulation? Okay. Some crazy brand of macaroons? Fair enough. If I had to get out of bed, I had a lemon with me that I continually smelled. My daughter imitated me by walking around constantly with her fake lemon from her play kitchen held to her nose. I kept taking the Reglan and Benadryl. I still had to take three weeks of medical leave from work, and I had to cancel the class I was teaching at the local university. When my daughter would look for me, she would look first in my bed. It broke my heart. My safe food was McDonald’s hash browns. Seriously.

Although Reglan is schedule B, it comes with an increased risk of depression and I had to warn my husband that I was on unofficial suicide watch.  I was already experiencing intense depression from HG. I was feeling worthless and like I just couldn’t get through this pregnancy. There were so many moments that I looked at my husband and said, “I can’t do this anymore.” My sister-in-law told me to call a therapist and I did. My therapist made home visits because I couldn’t get in a car without vomiting.  She asked me why I didn’t call earlier. My response was that I was just trying to survive.

My doctors discussed giving me an IV at home and a full-time medication pump. Eventually, they decided that it added too much risk. Luckily, right around 19 weeks, I started to feel a little better. My nausea decreased, and I stopped throwing up as much. I, again, went back to work. Some days were better than others, but I was functioning.  I still cried through my therapy appointments. I continued to isolate myself from my friends and family because I had nothing but sad news to share. But, for the first time, I started letting myself connect with the baby. I thought about names for the baby, and I received joy from the baby’s little kicks.

I’m in my third trimester now.  I’m only throwing up once a day, which I’ll take as a blessing. The nausea comes on suddenly, but it also goes away.  I lost my safe food a few weeks ago, but that’s okay. I’m actually able to keep other food down now. At 28 weeks, I learned that I was back to my pre-pregnancy weight.  I had gained back all the weight that I had lost through the first and second trimesters. The nurse who weighed me told me she had never seen anyone so excited to have gained weight.  She clearly had not met many patients with HG. I’m still taking Reglan and Benadryl, and I’m still going to therapy. I’m trying to let people in and be excited about this little baby.  It’s still hard.

I’ve actually found some good support through a private HG support group on Facebook “Hyperemesis Gravidarum (HG) Support by HER Foundation”.  I’ve never been one for support groups, but it’s really nice to have other people who understand what I’m going through. The other people on the site get what it’s like to feel like you have the flu for months at a time, all while growing a human, and often questioning whether it’s worth it. I’ve only posted twice; although I do respond to other people.  One of my posts was when I had thrown up all over my suit on my way to a trial (I’m an attorney). I cleaned myself off with baby wipes (no, it didn’t all come off), asked for strength, light, and love from my co-HGers on the site, then performed the trial, and actually won my case. The support group gave me exactly what I needed to get through that day.

I had a c-section with my daughter because she was breach. I want to Vbac with this little one. However, I have decided to schedule a C-section for 39 weeks.  For my mental health, I need an end date, and one sooner, rather than later. I’m hoping that this little babe comes earlier (my first came at 38 weeks) so that I can still Vbac.  It was a really hard decision for me to schedule the C-section, but I know that my mental health has to come first. This pregnancy has been so hard. I still remind myself daily that it’s okay to have made this choice.

There is no doubt that this has been the longest pregnancy ever. Some days have been devastating.  My husband and I have had to rethink our dreams for having three children. Nothing has been settled yet, but it makes me tear up just writing this. I envy the women on the street and in the grocery stores who tell me how much they loved being pregnant… and sometimes I even have to remind myself not to throw things at them.  The thing that keeps me going now is that sometime, somewhere down the road, I will actually hold a baby in my arms. And let’s be honest, it helps that some people in the HG support group have it worse off than me. Yes, I recognize it sounds terrible, but the truth is, I just think that if they can do it, so can I. HG is hard, but it’s limited to 9 months (or so I’m told).  There is an end date, and there’s an awesome baby to go with it.

If you think you are experiencing HG, get some help: 1) Go to the ER and get hydration; 2) Advocate for yourself with your doctors – some of them are better about HG than others; 3) Do your research, but take the meds; and 4) Find a therapist – you can’t, and don’t have to, do this on your own.  You got this Mama. I know it’s hard, but you got this.