Hyperemesis Gravidarum

This blog entry does not explain why we chose adoption. I felt the call to adopt before I even met my husband. On our first date, I told him about my dreams to adopt a child. My struggle with HG in my pregnancy with my son was merely a reason for us to choose adoption sooner than we had planned.

*Trigger warning: This blog entry contains detailed descriptions of my struggle with HG, and the possible results of HG on others. It mentions both the symptoms and side-effects of HG, and makes mention of pregnancy termination.*

HG is a silent monster that can cause malnutrition, depression, isolation, dehydration, kidney failure, fatigue, pica, underweight babies, ptyalism, and can even lead to the termination of a wanted pregnancy in some cases. In other words, it can be devastating.

For 36 out of 40 weeks, I suffered from HG. So what is it? What is this horrible illness that can lead some women to do the unthinkable- to end pregnancies that they tried for, prayed for, and dreamed of? It’s extreme morning sickness. How lame does that sound? That’s the tip of this mammoth iceberg.

The first morning I experienced HG was at 4 weeks into my pregnancy with Little. They didn’t even know for sure if I would have a viable pregnancy. I had no history of miscarriages or ectopic pregnancies, but from the first day of conception, I’d been experiencing extreme pain in my lower right side, near my ovary. So my doctor wanted to do an ultrasound to rule out an ectopic pregnancy. She was certain based on my completely sporadic and irregular periods that I was 6 weeks along. I was certain I was not.

I woke up the morning of the scheduled ultrasound and felt dizzy. Brushing my teeth made me feel nauseated and I couldn’t walk without holding onto the wall in the hallway that led to our bathroom. I ran in and crouched on my knees and vomited in the toilet. Behind me, my husband said lightly, “Things must be moving along okay because otherwise I guess you wouldn’t be experiencing morning sickness…” I took it as a comforting sign as well. I ate some crackers and brought a Sprite with me to the doctor’s office.

However, I didn’t feel better as the day went on. In fact, I felt worse. And I continued to feel worse. My “morning sickness” felt more like food poisoning, and for any of you who’ve had food poisoning, you know it’s worse than any old hangover or stomach bug. But this was normal, right? This was the sign of a viable pregnancy.

At the doctor, they confirmed that it was not an ectopic pregnancy, but sent me home thinking my body had a miscarriage known as a “blighted ovum”. In other words, the embryo is lost so early after conception that your body reabsorbs it quickly. A gestational sac may be present in the uterus, but there is nothing else. They sent me home to wait. I was scheduled for another ultrasound four weeks later to make sure everything had “cleared out” as the nurse put it on the phone.

HG Rock Bottom

Two weeks later, we went out of town. I was starting to show ever so slightly, and had to keep my pants unbuttoned… but I “wasn’t pregnant”. At our hotel, I woke up feeling sick again. I threw up, hoping that would help. Before I could leave the bathroom, I was sick again. And again. And again. And again. For twelve hours, I lay on the bathroom floor of our hotel room, shaking and retching. I knew something was wrong. I called the doctor, who wouldn’t speak to me.

I begged her nurse for something to take that would help me keep from vomiting. The woman laughed at me. She told me I was being dramatic, and that I simply needed to leave the bathroom. She suggested perhaps it was the smell in the bathroom itself that was making me sick time after time, and if I simply got out of the room, I would feel better.

I tried. I didn’t make it to the bed.

I called again, this time more desperate. She sighed heavily and recommended I eat some
crackers and drink plenty of water. She suspected I was dehydrated at this point from “allowing” myself to get so sick.

So I tried to drink. With one sip of the water, my body rejected it. This time what I was throwing up was bright green and tasted bitter beyond anything I’d ever tasted.

I called again. I asked her about what I was now throwing up. I told her I thought it was bile. She sighed out of frustration and said, “It’s just what’s left in your tummy after you’ve thrown everything else up. If you would get something in there and quit calling me, and give it a chance to stay in there, you wouldn’t be throwing up bright green things!”

Fifteen minutes later, I passed out. My husband was very worried. We were in San Antonio, at a hotel near the Alamo downtown. He carried me out to the car, gently set me in and rushed to an emergency clinic in downtown. A nurse came out with a wheelchair for me. I slipped in and out of consciousness while waiting to be seen by a doctor. I remember them trying to get me to stand up to check my blood pressure, but I couldn’t. A kind nurse propped me up against her body while they looked me over. My blood pressure was dangerously low.

Immediately I was rushed into a room and given an IV of fluids. I fell asleep, at last relieved to be taken care of and listened to. The doctor checked my keytones in my urine. They were exceptionally high. He was concerned and kept me for a few more hours. He explained to me that I was in the early stages of renal failure due to severe dehydration. He didn’t know what was wrong with me, but he did say it was “beyond morning sickness.” He checked my hormone levels and confirmed that they were right in line with a woman at 6 weeks pregnancy. I told him about the blighted ovum. He was stunned, and went to check the hormone levels again. He ran a pregnancy test which confirmed that I was -still- pregnant.

I called the nurse at my doctor again. She stated that “sometimes women want to be pregnant so badly, they trick their bodies into believing that they are. You could also be experiencing the last bit of hormones from your pregnancy. Your body jumped into pregnant mode but then there was no baby. Sometimes it can take a while for that to wear off.”

I told my emergency room doctor this. He told me to find a different doctor at home.

Dr. Devine, No Pun Intended

Back home two weeks later, I did. At my first visit with my new (amazing!) doctor, Dr. Devine (and she is) she took one look at me and said, “You are suffering from Hyperemesis Gravidarum. It is a rare pregnancy related illness that causes excessive vomiting, nausea and dizziness during pregnancy.” She also found my son’s heartbeat.

She deduced that the first doctor (the one I cut ties with) didn’t see him on the ultrasound because I was only 4 weeks pregnant, NOT 6 as she had assumed. At 4 weeks, she explained, they wouldn’t be able to see a fetal pole without the most advanced ultrasound technology (which she had). There he was. Moving his arms and legs. His little heart was just pounding away.

I was so relieved to not only have confirmed what I knew, that I was indeed still pregnant, but also to have a diagnosis for my illness. In my heart, I knew that pregnancy shouldn’t feel like this. I knew something was different and wrong.

For the next seven months of my pregnancy, I relied on a closely monitored cocktail of prescription drugs to keep me from vomiting to the point of dehydration and malnutrition, and to keep me pooping. On a bad day, I would vomit up to 14 times a day. On good days, the dizziness and low blood pressure still kept me confined to my bed, but sometimes I could make it as far as the living room and then crash on the couch. Nearly once a week, I would have to go to the hospital for IV fluids. I tried my hardest to drink enough water and sports drink to keep up with my vomiting, but sometimes nothing could hit my tongue without initiating my gag reflexes, and it was then that I relied on the IVs.

My son was completely healthy, but his placenta was robbed of vital nutrients in the earliest weeks of my pregnancy due to the HG. As a result, he was starving in there. Every tiny thing I could eat (bland baked potatoes, toast, rice, sometimes a peanut butter sandwich) went straight to him, but it wasn’t enough. I tried everything I could to give him the nutrients he needed to survive. Since I couldn’t stomach a prenatal vitamin, I would take several children’s chewable vitamins a day. I would drink Carnation Instant Breakfast every morning with my bland toast. I would consume at least 1 (I could barely stomach more than that) Boost, a supplemental nutrition drink.

He was diagnosed as IUGR. Intra-Uterine-Growth-Restriction. I had to go in for ultrasounds and non-stress tests twice weekly…in a town 30 miles away. My mother used up nearly all of her vacation time being my chauffeur. Every Monday and Wednesday, my mother would drive 45 minutes to pick me up, then we would go to the doctor to make sure my son was growing as best he could, and she would take me back home. Some days I loved her for it, and other days I grew weary of the situation and became frustrated with her for it. She would grow frustrated too, but mostly she was a saint.

The Drugs

I relied very heavily on a drug called Zofran, which is mostly given to chemotherapy patients to deal with the side effect of nausea and vomiting. It triggers some kind of chemical in the brain which stops you from vomiting. It’s a powerful drug that can cause severe constipation. I was admitted to the hospital twice for long stays due to intestinal impactions as a drug side effect.

I would take the Zofran first thing in the morning, often around 5:30, to be sure I had it in my system before I was officially “up” for the day. It dissolved in my mouth, and at first taking it would trigger me and I would end up extremely sick. However, somehow my body adjusted and while I still couldn’t stomach most foods, I could handle the sick taste and chalky feel of the medicine that gave me some semblance of normal. I would take it every four hours for the rest of the day and into the night.

Without it even for one hour, and I would vomit uncontrollably.

Each bottle, which lasted me anywhere from 4 days to a week, cost $40. I remember not getting my prescription refilled once, and having to call my mother to pick it up for me. My mother in law also was called once to get me my medicine.
I also took Reglan (which I would never recommend), Phenergan, Colace, Pepcid, Miralax, Vitamin B6, Unisom, Ambien, Milk of Magnesia, Fleet enemas, and a variety of probiotics off and on during the entire pregnancy.

Psychological Effects

Unable to go anywhere or do anything, I was left extremely isolated. The isolation led to depression. The depression led to dark thoughts. With HG, it’s nearly impossible to form a bond with the baby growing inside of you. That baby is foreign, distant, and the cause of your illness. Dehydration messes with your mind in ways little else does. You can have vivid dreams, even hallucinations without water in your body. I hallucinated often in moments of dehydration. I saw visions of people breaking into my house, creatures in the night, horrible things. I lived for eight months as a traveler lost in the desert with no water and no food and the worst case of food poisoning you could ever imagine.
Some women are led to believing that the only way out of this hell is through termination. I know wonderful Christian pro-life women who suffered at the hands of HG and couldn’t take it. They couldn’t find relief with the drugs or the experimental medicines. They knew they were dying, and their only way out was through termination. It’s a haunting reality.

Let me say this. I just want it to be clear that I am very pro-life, but it needs to be said that HGers sometimes feel that the only way through this hell is down the path of termination. This fact just shows how awful this illness truly is. Our son was planned, we prayed for a baby, and I’m a pro-life Christian…And yet…The depression from being sick doesn’t help. Even In my darkest moments, I wrestled with the idea. Either I wanted to die (I thought about it at night) or I wanted a miscarriage. I can’t say I ever really thought about termination in an active sense, but I thought about how relieved I would be if I miscarried.

Isolation and Family

The isolation from not being able to move doesn’t help either. And dehydration with malnutrition causes us to make blurry decisions. But perhaps worst of all fr me was the lack of understanding from family and friends. I had some friends and family who would call me and ask me why I couldn’t just try getting up. “You haven’t been out of bed in weeks,” they’d say. “Perhaps if you just got up and tried to go about your regular routine, you would see that you do feel better…”

Well meaning family called all day and night, trying to cheer me up and trying to encourage me to just get up. Some thought that if only I could just start the day off right, and not live in fear of getting sick, then I could somehow conquer this. But the phone itself was a trigger. It caused anxiety when it would ring, which would lead to nausea. Talking on the phone somehow messed with my vertigo and made me sick as well. It was a double-whammy, so I wouldn’t turn it on.

I also had family and friends show up at my door to try and make me feel better. I think some thought it as in my head. I could barely get out of bed on most days, so hearing the doorbell ring when my husband wasn’t home was like a death-march for me. I’d sit up, throw up in a trash can by the bed, make my way down the hall usually stopping twice to get sick again, and then run to get sick one more time before opening the door. But, the doubters were probably right, I was just torturing myself to be silly…

My husband was an absolute saint. I resented the hell out of him for being healthy. I would see him eat and hate him for bringing that food with it’s smells into our house. The smell alone was often a trigger for me. I was often times verbally abusive to him, taking out my rage and sickness and exhaustion and anger on him. This was OUR baby, that we equally wanted and tried for, and yet I was being punished for it while he endured NOTHING. Well, not nothing. I made sure of that…It was horrible for us both.

My mom and mother in law were life savers. My mother in law would cook for us, and we would freeze the food to eat on for the rest of the week. Most  of the time I couldn’t keep it down (or handle the look or smell of it), but it was a life saver for my husband, who is not a total oaf in the kitchen, but wasn’t able to create a menu for nine months.

My mother was my savior. She sat with me for hours, she cleaned up my vomit, she scrubbed a stain in the grout of our tile in the bathroom that just wouldn’t come up. She spent more than half of her vacation days taking me in for doctor visits three times a week. She brought me food or fruit smoothies when it occasionally sounded good. She took off work to clean out my coffee maker one day when my husband forgot to turn it off. I called her crying because the smell wafting down the hall to our bedroom was more than I could handle. She came in, cleaned it out, and left. She gave back rubs and allowed me to talk or cry for hours in my darkest moments. She also is the one who found Ashli and the Help HER foundation.

Worth It

My story sounds bad, but it is mild compared to some. I know of women who can’t keep any food down whatsoever, and a PICC line in their body is their only source of nutrition and hope for survival.

All in all, I gained only 7 pounds in my pregnancy. I began at a petite 117 pounds, and weighed 124 the day before my scheduled c-section.

My son was born full term at 39 weeks and 4 days weighing only 4 pounds, 12 oz. He was 19 inches long. All the nurses thought he was a preemie and were very surprised that he was allowed to sleep in my room instead of NICU. I grew tired of having to tell them all that he wasn’t preemie and was absolutely healthy. He latched onto the breast like a champ, and nursed until he was 15 months old. He quickly gained in weight and has had no ill-effects resulting from his earliest weeks and months of life.

Although I never bonded with my son during my pregnancy, I’ve never loved anything or anyone so much in my entire life. My husband I quickly became friends again (after some time of trial and error trying to get me back in control of our household again). I’ve found that’s very common for women with HG. They can’t bond with the object that makes them sick, but once they’re here, they love their children fiercely. Perhaps the suffering makes us love and appreciate them more than if we never had to suffer to get them here.

The night before my c-section, I couldn’t sleep from excitement. My husband was thrilled at the idea of becoming a daddy, and I was thrilled at the idea of my illness being cured. I had grown to think of my pregnancy as some kind of disease, and March 2 was my liberation day. I was dreaming of all I could do the next day. All the food I could eat. All the places I could go. Grocery shopping again. Cooking again. Reading again. I couldn’t wait. In the recovery room, tears rolled down my cheeks as I thought about lunch. And then they brought my sweet baby to me. I actually asked my husband, “This is for me?” As though he was a special bonus gift. I guess I’d forgotten that I was getting an amazing, beautiful baby out of this deal.

I’ve had hateful women who don’t understand what I went through, what WE went through, tell me, “I’ve experienced miscarriages, and I would give anything to have any pregnancy, even yours…” But I’ll say this: I don’t envy anyone’s experience. I’m not bitter about what I went through. I always ALWAYS knew in my heart that God was calling me to adoption. I didn’t know why. After my son, I knew the “why”. So please don’t take me as some bitter person who is angry at thhe world of healthy pregnancies. Please don’t sit back and think, “That ungrateful woman! At least she got to have a baby.” Because I know. I know I got to have a baby. I have a beautiful baby. I suffered for him. I prayed for him, worried over him, and am grateful for him more than anything else in my life.

And the baby we adopt will be beautiful too. He or she will come to us through suffering as well. And prayer. And worry. And doubt. And temptation to end the entire process. But I know that perseverance has beautiful, wonderful rewards. And that will then become another chapter, just like Little’s, in our big book of how we all became a family.

Choosing Adoption

I feel like an alien sometimes talking to adoptive parents and agents. So many of them have carried the pain of infertility, and I can’t quite relate. I didn’t experience infertility. But I still can’t have anymore babies. My reproductive system is fine. But my body can’t handle pregnancy, and my mind couldn’t possibly handle it. Sure, I could go back on the cocktail of drugs, stay in bed for nine months, lose weight and my hair, have the ashen skin, the red eyes, and have to send my sweet son into daycare because I can’t care for him…All so he can have a sibling…a biological sibling. Given that, it’s safe to say “I can’t have anymore children.”

Don’t get me wrong. Many survivors of HG choose to go through the process again for another child. This is a very personal choice, and one that I don’t judge. I just want to put my story out there in the hopes that others who have gone through this terrible storm and think that they couldn’t possibly do it again may get some hope from reading my experience as an HG mother going through adoption.

I want this blog, and my journey to show other women with HG who have made the decisions that I have to not feel alone. I want to be here to say that if you want more children, but you can’t put yourself through that hell again, that’s okay, and you aren’t alone, or any less of a parent. You can love an adopted child as much as biological child, and an HG pregnancy is very comparable to the pain of the adoption journey. I hope this blog will be an encouragement to many HG warriors out there. Thank you for joining me in this journey…

Kat