As most of you know, I have had a very difficult start to this pregnancy that culminated in my recent eight-day hospital stay. Thankfully, I am approaching the critical period where most hyperemesis gravidarum sufferers start to improve significantly, and I hope to return to a somewhat “normal” life and get to enjoy the second half of my pregnancy!

 

Although I have received the prayers and well-wishes of all my friends and family during this difficult time, I have also come to realize very quickly that most people are completely unfamiliar with hyperemesis. Although there are countless websites with valuable information on the topic, I wanted to share my top five pieces of information about hyperemesis gravidarum in order to help people understand this debilitating condition that affects only about 3% of pregnant women.

 

1. Saltines and ginger ale don’t work.

 

Although 70-80% of pregnant women will experience some morning sickness throughout their pregnancy, predominantly in the first trimester, it can usually be lessened with some dietary changes such as avoiding spicy or greasy foods, staying away from food aversions, trying ginger and peppermint products, not letting yourself get too hungry, drinking ginger ale or soda, and eating a cracker or something small before getting out of bed in the morning. There are also a variety of products on the market to help with morning sickness now including hard candies and motion sickness bands designed specifically for pregnant women. Unfortunately, a woman facing hyperemesis will not be affected by any of these remedies. The nausea and vomiting is extreme and uncontrollable. It is not related to eating certain foods or avoiding greasy and fatty foods (in fact, for many hyperemesis patients, things like Coke and fast food hamburgers seem to be “safe” foods). One day a certain food will be “safe” and the next day it will cause a woman to vomit for hours. Please, if you encounter a woman struggling with hyperemesis, do not try to force feed her saltine crackers and ginger ale.

 

2. The condition does not end at the end of the first trimester.

 

Morning sickness usually doesn’t extend beyond the fourteenth week of pregnancy, but hyperemesis does. For some, it eases up around week 20, and for many others, it lasts the entire pregnancy. The causes of hyperemesis are unknown, but it is said to be related to the body’s reaction to the surge in hormones. For many women, their bodies never adjust to the hormonal changes of pregnancy.

 

3. The condition isolates you from your normal life.

 

As I gradually became more ill, I had to take a leave of absence from my job. On most days, it is a difficult task even getting out of bed. Managing my normal household responsibilities such as taking care of our pets, helping Logan with schoolwork, cooking, working on my online class, and cleaning the house are now unbearable. Hyperemesis makes you ultra-aware of smells and certain smells can be a major trigger for nausea. For a few weeks, I couldn’t walk down the hallway of my own house without gagging. I try to keep lemon slices with me now to mask household odors and alleviate some of the nausea. If I’m woken up out of a deep sleep, my nausea is instantly triggered. I haven’t been able to go to my gym in months. I can’t spend time with my friends like I used to because it is exhausting and not fun to be the person that can’t eat anything. I wake up each day feeling like I’m failing in my roles as employee, mother, wife, daughter, and friend.

 

4. The dehydration is both dangerous and unavoidable.

 

One of the first out-of-the-ordinary pregnancy experiences for me was my visit to Urgent Care to receive fluids and anti-nausea medicine through an IV. The dehydration caused from the nausea and vomiting became worse over time, and I have returned to Urgent Care for the procedure fourteen times over the last 3 months. Dehydration causes dizziness, lethargy, confusion, headaches, drops in blood pressure, and a high pulse. Dehydration during pregnancy is dangerous and needs to be treated immediately. I am grateful to the Urgent Care doctors (who now all know me by name and recognize me when I come in) who have taken me seriously each time I’ve come in saying I don’t feel well.

 

5. There is no simple answer to finding the right combination of medicine.

 

Although it is advised that pregnant women avoid all medication during pregnancy, hyperemesis patients often cannot go this route and survive. I need to be on a strict schedule of taking Zofran every six hours in order to control the nausea enough that I can eat. Most doctors refused to even give me Zofran in the first trimester because of a supposed potential risk of birth defects. It was only after my condition deteriorated so rapidly that they realized Zofran was necessary to keep me alive. Over the last few months, I was prescribed many medications to control the nausea and migraines, including Diclegis, Propranolol, Imitrex, Tylenol 3 with Codeine. In the hospital, where they gave me the most intensive treatment thus far, I was given Reglan and Phenergan for the nausea, both of which I now know I’m allergic to. They gave me a large dose of steroids in order to try to jump start my appetite. Unfortunately, that didn’t work either, and now I’m stuck tapering off Prednisone at home. What ultimately worked for me in the hospital was receiving IV fluids, taking Zofran and Pepcid through an IV, and finally receiving Total Parenteral Nutrition (known as TPN) through a PICC line, which is a catheter that goes from my upper arm to a vein near my heart. TPN is a nutritional formula that allows a patient to receive the nutrients needed to survive while bypassing the normal digestive organs. Receiving TPN is ultimately what revived my body enough to be able to tolerate some foods and liquids again and allowed me to leave the hospital. Even so, they left the PICC line in for now so I can more easily receive IV hydration treatments as needed. All of these interventions are risky during pregnancy, but I know that if I become nutritionally depleted any more than I was, I will not be able to survive the rest of the pregnancy.

 

Perhaps the only silver lining when it comes to hyperemesis gravidarum is that it tends not to affect the developing baby. Most women have adequate nutritional stores within their body to provide the baby with whatever it needs as it grows and develops. In the hospital, I got to listen to my little guy’s heartbeat each day and it gave me such relief to know he is strong while I am not. I can’t wait to meet the little one who is making me so sick, and I know when I hold him next May, this temporary illness will all be worth it.