It is Mother’s Day as I write, and I am watching from the couch, as my two beautiful daughters are playing in their playroom. The five-year old is attempting to “babysit” her one-year old sister (her gift to Momma), and the youngest is having none of it. One would think that such daily sibling dramas make pregnancy seem like a thing of the past, but, for my husband and me, pregnancy memories linger long, because I had something innocently referred to as “HG”.
Prior to conceiving our first child, Zack and I assumed that whenever we were ready, pregnancy would happen. Then, we’d enjoy the exciting months of a growing belly, followed by the miracle of childbirth and parenthood. However, reality intervened. For two years, we struggled with infertility. We downloaded every fertility app, purchased stock in ovulation kits, took my temperature every morning, charted, and scheduled sex as a second full-time job. While the later may sound fun to many, those who have walked this path know that the spontaneity, romance and excitement of it quickly goes out the window when the fertility app, thermometer, and calendar are involved. Keeping a sense of humor is essential, and we somehow managed to do that during this phase of our journey in pursuit of the dream of having a family. By the time we moved forward with IUI’s, and eventually to IVF, we were confident that GETTING pregnant would surely be our biggest obstacle.
The sheer joy and excitement of finally getting a positive pregnancy test lasted exactly twelve days. At five and half weeks pregnant, almost two weeks after finding out everything we prayed for was coming true, I became nauseous, which quickly progressed to active vomiting. At the time, we laughed and joked that this was what we had wished for, and we and assumed that my fairly constant sickness was natural and would get better with time. My mother suffered similarly for about 3 months with all three of her successful pregnancies, and she assured me the misery would end after the first trimester.
“At seven weeks pregnant, the magnitude of the sickness did not seem normal.”
At seven weeks pregnant, the magnitude of the sickness did not seem normal. It was after searching the Internet that I first heard the term “Hyperemesis Gravidarum” (HG). The nausea was so bad that there were days when I could barely get dressed in the morning and was not able to hold down food or water. I began carrying disposable emesis bags with me to and from work, after arriving at school one day covered in vomit, and with bile dripping down the outside and inside of my car door. I had just started a new special education teaching job in a school district in Maryland. I knew no one, and was extremely concerned about making a good first impression with my new colleagues. Nothing says, “Hire of the Year,” like a vomit-caked blouse! Despite it all, I tried hard to hide my condition, even as the beautiful baby we had spent years trying to conceive seemed like nothing more than an alien, sucking the life out of my body. Meanwhile, poor Zack was baffled as to what to do. None of his friends told stories like this about their wives!
At 8.5 weeks pregnant, we were forced to announce our pregnancy, as it was impossible to conceal my sickness any longer. As the early weeks wore on, the unrelenting nausea and vomiting became worse. Dehydration made it difficult for me to think clearly. Malnutrition made it nearly impossible to get out of bed. This all led to anxiety, depression, and fear of what was happening to me and my precious baby. My OB, referred to me by my infertility doctor, was less than impressed when I managed to drag myself into his office for my first visit, emesis bags in tow. He begrudgingly prescribed Zofran and was unenthused when I called later, asking for an increased dose because I still was not able to keep anything down. At my next visit, curled in the fetal position on the exam table, whimpering, and taking shallow breaths to try to hold back another retching episode, he explained to me that pregnancy was not a disability and that he could not sign the necessary paperwork to excuse me from work. As I am a plus-size mom, he was unconcerned about my weight loss. At this point, a healthy Amanda would have told this doctor exactly where to shove his stethoscope and walked out. But I was too sick to respond.
“Some of the most interesting objects I vomited in included, a tissue box, my husband’s coffee, and cereal box (still full of cereal).”
Over the next six weeks, the pharmacy of IVF drugs that had consumed my dining room was replaced with various containers of anti-nausea drugs from my skeptical OB. I could not work, could not eat, and could only drink tiny sips of extremely cold Coke. There were several visits to the hospital for IV hydration, along with home health care visits to attend to my 24/7 subcutaneous medication pump. Throughout this period, it was a struggle to keep from fearing that my beloved baby, and I, might not survive. The days crept by, one retching episode after the next, and my stomach slowly grew, as the rest of my body shrank. I did not read because I couldn’t concentrate. I rarely watched TV or scrolled social media because the movement of the screens made nausea worse. Mostly, I would listen to movies and books on tape while I lay, with eyes closed, in my darkened bedroom. I much as I longed for human interaction, I dreaded going downstairs, because movement and kitchen smells often induced immediate vomiting. I came to dread vomiting, because my body would contract so hard that it caused me to wet my pants. Each morning began with the important decision of whether to vomit in the toilet and pee on the floor, or pee in the toilet and vomit in the closest basin I could grab. Some of the most interesting objects I vomited in included, a tissue box, my husband’s coffee, and cereal box (still full of cereal). But at least the vomiting had a beginning and an end; it came and it went. NAUSEA. NEVER. ENDED. I began to wonder if I would ever feel normal again. I worried that I would not be able to care for my baby, and that this horrible feeling would never go away.
At 21 weeks, I finally had a couple of “good” days. This meant that I was able to keep down not only cold Coke, but my mom’s homemade applesauce and sliced apples. I could sit up long enough to search the Internet for more information and for a new OB, and make some phone calls. The fact that I felt decent enough for long enough to complete this task was a huge victory. But it was challenging to find an OB who delivered at the hospital I wanted, and who wasn’t affiliated with my current demon doctor, and who would take a mother already half way through her complicated pregnancy. Basically, I cried on the phone until one nurse took pity on me and really listened to my story. Then, I cried tears of relief when she called me back to tell me the doctor had agreed to take me on as a new patient.
“…my baby girl was healthy, growing, and worth fighting for, and she gave me hope that this truly would end.”
The second half of my pregnancy was better, partly because I had some decent days as reprieves from the horrible ones, but mostly because I finally had a doctor who was kind, knowledgeable and proactive. This new OB did not cure me, there is no cure, but she believed me. She wrote the paperwork for a leave from my job. She kept me medicated and hydrated, scheduled extra scans to give us both peace of mind that my baby girl was healthy, growing, and worth fighting for, and she gave me hope that this truly would end. As many mothers with Hyperemesis Gravidarum do, I developed pregnancy-induced hypertension, that progressed into pre-eclampsia. In the final weeks of my pregnancy, in addition to the unrelenting nausea, less-frequent vomiting, and general end-of-pregnancy discomfort, I started to swell like a water balloon due to edema.
Finally, at 37 weeks, my precious baby girl was delivered via C-Section. I vomited throughout the entire procedure. I had mastered the art of vomiting at this point, but being paralyzed from the chest down added a whole new level of complication. My OB was shouting at the anesthesiologist to get the vomiting under control because she was trying to cut a moving target. But there was no controlling it, so the anesthesiologist stroked my head, held the emesis basin and whispered calmly in my ear that my baby was almost here. Zack, a science teacher, was fully engaged in the surgery and had his head as close to my open uterus as he could get. I heard him yell, “Holy cow, I see her butt!” Then, in an instant, our sweet baby was here. Ten perfect little fingers and toes, big round blue eyes, and a face that made my heart melt. I recognized her from her many ultrasounds! Almost as quickly as she arrived, the nausea left. In the recovery room, I begged for water. I just wanted gallons and gallons of water. Within hours post delivery, I felt so good that I was out of bed, with an irrepressible smile on my face. In two days, I strolled slowly to the cafeteria with my husband, and felt better than I had for over eight months. In the end, all of our hopes and dreams materialized into a healthy, happy little girl. She is worth every single battle to get her here, and then some!
I spent three years after her birth terrified of another pregnancy and determined to learn everything I possibly could about Hyperemesis Gravidarum, its causes, its treatments, and the likelihood of experiencing it again. I joined HG forums on Facebook, participated in HG studies, and connected with HG moms around the world to help raise awareness. So, I knew, going into a second pregnancy, that I had about a 90% chance of having Hyperemesis Gravidarum again. In fact, many women have it worse with each subsequent pregnancy. I also knew, however, that information is power, that I had a supportive and capable medical team, a support network of family and friends, the blessing of time because I resigned from my job and could, therefore, engage in better self-care strategies, and most importantly, I knew that no matter the challenges, the fight would end with the most beautiful blessing- a healthy baby.
My second pregnancy was also an HG pregnancy, but it was a markedly improved experience. My doctor trusted me (and I her), she was willing to try medication protocols that other HG women found successful, and she initiated proactive treatment early on, and did not wait to be reactive. With early treatment, I was able to eat select foods throughout my pregnancy, stay hydrated without the use of IVs, and perform the most basic daily self-care and care for my 3-year-old daughter. Zack and I now have two delightful daughters, who we cannot imagine life without. However, there will be no more children in our future. We know our family, our marriage, our finances, and my health cannot withstand another 8 or 9 months of HG.
The latest research shows that HG is linked to two genes. However, more research and awareness are needed. Knowing that my daughters may suffer this disease makes it that much more important to me to find out more. If you believe that you may be suffering from Hyperemesis Gravidarum, or know someone who may be, please do some research, be kind, and trust the sufferer. Hyperemesis Gravidarum is not simple “morning sickness”, it does not end at 12 weeks, it is not a psychological condition, and it is not something the mother caused or can control. It IS a serious and potentially life-threatening medical condition that many medical professionals still know very little about.
Reactive treatments often consist of the same drugs given to chemotherapy patients to curb the vomiting, and administering fluids for hydration. Current proactive treatments include large doses of antihistamines, as well as anti nausea meds. If you know someone who is suffering from Hyperemesis Gravidarum, offer to help her, don’t judge her. She is fighting one of the biggest fights of her life, both for herself and for the precious new life growing within her. If you think you might be suffering from HG, reach out to our doctor, do not be afraid to ask about it.
For some further reading on Hyperemesis Gravidarum
Meet Amanda L.