Three Boys and a MOMMY: February 2010

Its been a long road, and its comforting to find people's blogs or stories about women who have had this condition and learning about how people cope, and how I can better cope with the emotional stress along with all the physical stress. Like most medical conditions, you never really learn about it until it effects you or someone you know. I thought I would share some of what I have learned...

What Is Hyperemesis Gravidarum?

HG is a debilitating and potentially life-threatening pregnancy disease marked by rapid weight loss, malnutrition, and dehydration due to unrelenting nausea and/or vomiting with potential adverse consequences for the newborn(s).

Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy. It is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. If severe and/or inadequately treated, it is typically associated with:

loss of greater than 5% of pre-pregnancy body weight (usually over 10%)
dehydration and production of ketones
nutritional deficiencies
metabolic imbalances
difficulty with daily activities

HG usually extends beyond the first trimester and may resolve by 21 weeks; however, it can last the entire pregnancy in less than half of these women. Complications of vomiting (e.g. gastric ulcers, esophageal bleeding, malnutrition, etc.) may also contribute to and worsen ongoing nausea.

There are numerous theories regarding the etiology of hyperemesis gravidarum. Unfortunately, HG is not fully understood and conclusive research on its potential cause is rare. New theories and findings emerge every year, substantiating that it is a complex physiological disease likely caused by multiple factors.

Diagnosis is usually made by measuring weight loss, checking for ketones, and assessing the overall condition of the mother. If she meets the standard criteria and is having difficulty performing her daily activities, medications and/or other treatments are typically offered.

Treating HG is very challenging and early intervention is critical. HG is a multifaceted disease that should be approached with a broad view of possible etiologies and complications. When treating mothers with HG, preventing and correcting nutritional deficiencies is a high priority to promote a healthy outcome for mother and child.

The list of potential complications due to repeated vomiting or severe nausea is extensive, all of which may worsen symptoms. Common complications from nausea and vomiting include debilitating fatigue, gastric irritation, ketosis, and malnutrition. Aggressive care early in pregnancy is very important to prevent these and more life-threatening complications such as central pontine myolinolysis or Wernicke's encephalopathy.

Where do I begin??? Let me start in October when I found out I was expecting, I didn't tell anyone but my brother and sister in law, we made cookies that spelled "Get ready 4 baby #2" and cupcakes with baby booties that my brother thought of, he is so talented ! And a cute sign that was so much fun! Erin was a trooper and made me even more excited because she was so enthusiastic.. it was contagious so we spent a good portion of the day. I WAS SO EXCITED to tell Tom, we were not trying to get pregnant, so it was a shock to me, and I knew he would be really shocked. I set up the cookies on the counter and had Kaden holding the sign, we heard him coming and we stood by the door, he opened the door and his first words were "Are you serious??" and "are you sure?" then he saw the cookies and smiled and kissed and hugged me! He was shocked, but very excited and it was perfect! Thanks Buddy and Erin couldn't have done it with out you... THEN the wave of "morning sickness" came.. but more severe then when I was pregnant with Kaden, I began going to the doctors office and getting on medication but it did not ease anything and soon by week 5 I couldn't hold any food down for a 72 hour period and noticed that I had been spotting bright red blood. I quickly run to the doctors and they hook me up to an IV and they hydrate me with bags of fluid and IV medication, I soon learned that the force of throwing up has torn my cervix, too much info I know... but hey... this is my journal and I might as well remember all this by writing it down right?? Anyways, after 2 weeks of going to the doctor severely dehydrated I was put on home health. I was getting a new IV every 4 days and giving myself medication and fluids twice a day. Then by week 12 I still could not keep anything down, and very dehydrated, I was poked 15 times by 4 nurses and told they could not continue to poke me and dig for veins so they called and had an emergency picc line placed. They feed a tube from your arm to about 2 inches above your heart. This was to be a permanent line until I was to get better and then it would be pulled, I wont lie it hurt SOOO bad the first few weeks because they stitch it in your arm and they have to make a small incision to place the tube, so the skin is so tender under your arm which made it very painful for a little while. Erin and my brother have made us meals, and Erin cleaned my house, she is a sweetheart! My mother and father came down to help me and take care of me, my dad made great food, and my mom stayed for a week to help me get better and it worked, I did better and enjoyed her company and help with the house work (laundry with Erin). After the pain passed I enjoyed the picc line and not getting poked anymore, it was very nice. The home health nurses came once a week now and cleaned and changed the dressing with rubbing alcohol, I hated getting the dressing changed because they would scrub the opening.. ouch! Unfortunately the picc line made it a little longer the a month, and got severely infected and a big blood clot. I was visiting my sister and she took me to the ER and they pulled the line, and my arm got HUGE and had a horrible rash. The blood clot was around the major vein restricting blood flow to my arm but was not an immediate threat. I was put on an antibiotic and sent home. Connie took great care of me, I soon returned home and slowly slipped back into throwing up everything... I went to the doctor and they were not sure what was causing more symptoms that were more severe, I couldn't keep down the antibiotic so they gave me a series of shots in my hips into my joints that were serum of antibiotic to kill the infection, by this point this was the most pain I have been in at one time! I cried... alot! I had to go back to IV's and on home health. The rash spread and continued to get worse, and continued to throw up so much I pulled on the muscles in my chest around my sternum. I started having contractions and was seen in the ER where I work, very embarrassing when you know everyone. I was so dehydrated that it caused my uterus to contract and they quickly hydrated me and did an MRI of my lower back because of the pain, and the possibility of having an infection wrapped around my spine. No infection on my spine, but they found that I have 2 herniated discs in my lower back that will get worse as the baby grows, and the cause of these herniated discs.... throwing up! Yes throwing up violently for a period of time will make you injured in places you never imagined! I was sent home on some pain pills and unanswered concerns that they cannot find the infection, a normal persons white blood count is 10, and pregnant ladt goes up but only no more then 12 or 13 count... mine is 18. And not a clue to why! Scary, but the baby measures a little small, but is doing awesome and has been a trooper through everything. Strong heartbeat and moving all over! I then continued to loose a lot of weight and ended up with no relief. I now am put on a feeding tube to get some nutrient and hydrated. A feeding tube is by far helping more then any other medical intervention so far, it is the most uncomfortable and causes horrible cramping then any other device, but I am doing better and that is already worth it. My condition is called hyperemesis, and it is rare and only effects 1% of pregnant women, and will get worse with every pregnancy no matter the sex of the baby. I took it very hard when the doctors told me that I will not have many more children, if any after this one. We found out we are having a BOY and just feel so blessed to have so much help and support, and that this little boy is still hanging in there and healthy to everyone's knowledge. Tom has been great support, and my ward has been bringing meals for my family (I cannot eat) and my father in law and mother in law have been helping so much with Kaden, taking him whenever I need, and bringing food, and medical supplies for me! I love you all.. Even though I cry and I complain sometimes about why it has to be so hard, it has been a very humbling and VERY selfless experience, my family has grown together, and my love has grown for my family. I have to say this unborn baby and I have bonded going through this together and I cant wait to hold him and kiss him for being so strong, he has held me together more then he will ever know. My family and their prayers have kept me going, and have performed miracles! I am due June 20th, and 20 weeks, it been along 20 weeks but we are hanging in there! I love you all.. and thank you so much!