Hyperremesis Gravidarum is only experienced by approximately 2% of the population in the western world, making it rare, and is generally described by the medical world as “severe morning sickness leading to extreme weight loss and severe dehydration that in extreme cases without treatment can become fatal”. Yep, that’s right, it can be deadly if it isn’t treated correctly and while many of us mums would jump at the chance to lose a whole heap of weight in a short period of time I can honestly say from personal experience that this is not the way to go about it and it’s downright nasty to experience it!
In this blog post I will be sharing my own experiences with Hyperremesis Gravidarum, my goal is to help promote awareness of this condition and to let others experiencing it know that they are not alone. The one thing that I would have loved to have when I went through it was a support network of other mums-to-be who were experiencing it too, to know that I wasn’t alone and that I could get through it and survive and find a way to eat properly and drink enough without vomiting like normal people do.
For those who have never followed my pregnancy journeys on BellyBelly.com.au in the forum there (under the forum name of JennaJayen) or on one of the many pregnancy and parenting groups on Facebook that I have been in and am currently a member of here’s my experiences of Hyperremesis Gravidarum, shortened to make it quicker for you to read, otherwise this could easily turn into a novel (warning, this will be rather long so make yourself a coffee/tea/hot chocolate/cold drink, sit down in a comfy chair and make sure you have a yummy snack on hand).
I have had 3 full term pregnancies, and in each one I experienced this awful condition called Hyperremesis Gravidarum.
Essentially from very early on until approximately 18-22 weeks into my pregnancy I would vomit repeatedly every morning, in the afternoons, after a drive in the car, in the middle of a drive in the car, in the evenings, after eating food, while brushing my teeth, while on the toilet, in the shower, in the middle of the night if I smelt something funny... basically it could be set off by anything at all and once it began it would not stop for at least 30 minutes, and the worst part was that I had no control over it at all.
Between 18-22 weeks of my pregnancies it would start to decrease and mostly disappear for a while.
In my first pregnancy I managed to get a break from it for 10 whole weeks before it started up again at 28 weeks gestation. I was in heaven for those 10 weeks, and then was brought smack bang right back down to earth when it started up again and continued until my son was born at 41 weeks and 5 days gestation by emergency cesarean.
In my second pregnancy it began at exactly 4 weeks and 2 days gestation, the day after I got the first positive pregnancy test. I was bummed, it sucked, it was horrible, I felt awful and for a while there I even wished that I wasn’t pregnant and whinged and whined to my husband that I “was never having another baby ever again” (yeah, I didn’t stick to that obviously as I now have 3 beautiful children earthside). Finally it stopped for a while at around 20ish weeks, and started up again around 27-28 weeks, woohoo! 7-8 weeks without vomiting continuously every morning and afternoon! I was overjoyed until it came back again.
Sadly I had discovered that I was allergic to Maxalon (the most common anti-nausea drug given to women here in Australia) the day after my emergency cesarean with my first child (it made me projectile vomit everywhere and that is not something that I would recommend when you’ve just had major abdominal surgery and your belly is only being held together by a series of dissolvable stitches) and it was the only option given to me to treat the vomiting at the time with my second child so I couldn’t take it.
It wasn’t fun at all and during that pregnancy I had lost 16kg by the time I was 16 weeks pregnant and had been admitted for fluids for dehydration 3 times by that stage, and I felt horrible, weak, was regularly dehydrated, got sick very easily and was hospitalised at least once a month to get fluids pumped into me, and was diagnosed with Gestational Diabetes at 30 weeks to boot, and believe me throwing up regularly with Gestational Diabetes is not fun and it can stuff up your blood sugar levels for the rest of the day which results in either having to give yourself insulin injections when it raises your blood sugar levels above the limit (hyperglycaemic) almost every day of the week and needing to keep some glucose jelly beans or other lollies with you at all times for the occasional morning where it made your sugar levels drop down to the dangerous really low (hypoglycaemic) levels.
Then with my 3rd full term pregnancy I got lucky in the beginning, while I had the nausea from 2 days before I had my first positive pregnancy test (I had nausea start literally 7 days after ovulation, with the first positive pregnancy test at 9 days after ovulation, this I know as I actually know the day she was conceived lol not many mums can tell you the exact day that they conceived their baby unless they went through IVF of course) it was easily manageable by avoiding the foods that triggered it and the vomiting itself didn’t start until just after 7 weeks gestation. I had thought that I would finally get lucky and have the “perfect” minimal sickness pregnancy (yep, I do really consider a no vomiting pregnancy to be the “perfect” pregnancy for me) but I was of course wrong. I did get very lucky in my choice of general practitioner (GP or general doctor) at the time however who took me seriously when I told him I was vomiting most of the day (and nearly vomited in his office while talking to him) and happily prescribed Zofran (ondansetron, an anit-nausea drug used by cancer patients undergoing chemo and radiation therapy to help with the nausea) in a 4 wafer pack (you stick them under your tongue and they dissolve quickly and start providing relief in about 5 minutes) that was actually covered under the PBS scheme which meant that I would only have to pay $5.60 per 4 wafers instead of the $89.90 that a pack of 10 wafers cost (the 10 packs were not covered under the PBS scheme unless you were actually a cancer patient unfortunately). I can’t describe accurately how much the wafers helped, and I did try the tablets as well but found them to not be as effective as I would always end up vomiting them back up before they could work, the relief that I received is beyond words to express. Unfortunately I wasn’t able to get them all the time, twice a month the doctor was able to give me a prescription for 1 pack of 4 wafers, and I found that if I broke them in half I could make them last longer and for just over half the month the vomiting would be reduced to manageable levels. Fast forward to 22 weeks gestation and it had tapered off again, although it didn’t completely go away this time as there was still at least 2 days a week where I would spend the morning either with my head in the toilet bowl or hunched over in the shower dry retching. By this point I had discovered that brushing my teeth was a trigger for the vomiting, and it wasn’t just the toothpaste that caused it, both the toothpaste and toothbrush on their own (aka separately) would cause me to vomit uncontrollably, and looking back on my previous pregnancies it was a big trigger then too, it eventually reached a point where I would only brush my teeth once a week after taking a full Zofran wafer just to avoid the vomiting, and even then it didn’t always work. I had 4 weeks mostly free from vomiting until it started again at 26 weeks gestation and continued until she was born at 40 weeks and 3 days gestation. During that time I managed to avoid being hospitalised for fluids until I hit 35 weeks gestation and was so severely dehydrated that I could hardly move, could hardly stay awake, and had no saliva being produced in my mouth anymore. I was getting very close to going into a coma, very close to losing not only my unborn baby but also my own life. I was rushed to the hospital by ambulance while my husband arranged for our older 2 children to be cared for by family. What little urine I produced was a very dark brown and registered ketones as 4+ (extremely high) and protein as 4+ (extremely high and usually indicative of preeclampsia which luckily I didn’t have). My blood pressure was up and I was tacchycardic, and they had a lot of trouble finding a vein so that they could attach the drip because my veins were collapsed due to the dehydration. My baby wasn’t moving and when monitoring was started her heartbeat stayed the same, between 140 beats per minute and 147 beats per minute, it didn’t change from between those 2 numbers, it didn’t drop and it didn’t go up for the next 12ish hours and I was told if it didn’t improve I would be rushed in for my second emergency cesarean to get her out of there because otherwise she was at risk of going into distress and dying.
We were very lucky, I had arrived in the hospital right in time and 6ltrs of fluids over 12 hours rehydrated me enough to be able to go home and avoid another cesarean.
Early labour with my 3rd child and second daughter was awful as I was continuously vomiting with every contraction. I will repeat again that it was not fun at all, and I was seriously considering a cesarean (those who know me personally will know that I am deeply terrified of having surgery of any kind and was even an anxious mess who struggled to function when I needed my gallbladder taken out 4.5 months after this birth) just to make it all stop throughout the entire labour.
Hyperremesis Gravidarum is no laughing matter, it is a serious condition that can have devastating consequences if it isn’t treated properly and if the woman experiencing it isn’t taken seriously. I was very lucky in my first two pregnancies that it didn’t reach the point of severe life threatening dehydration that I went through at 35 weeks with my third child, it could have very easily gone that way all three times and I believe that my regular visits to the ER and L&D wards at least once a month for fluids with my first two children whenever I started to get dehydrated prevented that from occurring, I only wish that I had gone in sooner with my third child and avoided all the fear and anxiety that I experienced during those 12 hours.
Today my children are aged 5 years old, 3 years old and 2 years old. They are healthy and happy and while my oldest child has sensory processing disorder and may be on the high end of the Autism spectrum it wasn’t caused by the Hyperremesis Gravidarum. I am thankful that I had the chance to research Hyperremesis Gravidarum after my first child was born when no one else in the medical world would tell me anything about it or even admit that I had it. I am grateful to have had the chance to have Dr Dennis Danso at Latrobe Regional Hospital in Victoria (he has now returned to his home country unfortunately, at least the women there will now benefit from his wonderful care) as my obstetrician with my second and third children and that he took my concerns seriously and officially diagnosed me with Hyperremesis Gravidarum (although it would have helped if he had known that Zofran was a good alternative to using Maxalon with my second pregnancy, he learned from having me as a patient and was able to help other mothers with Hyperremesis Gravidarum afterwards). If more doctors were like him and willing to learn not only for themselves but learn from their patients a lot less women would have to suffer from this awful condition and would get the treatment that they need.
For more information on Hyperremesis Gravidarum visit www.helpher.org
Have you experienced something during the conception journey, pregnancy, birth and/or post partum that you would like to share on this blog? Send me an email at firstname.lastname@example.org with your story, if you would like your first name shared or would prefer to remain anonymous, and a link to your blog or website or facebook business page (if you have one).
Student Birth Doula
FOOTPRINTS & RAINBOWS