My Pregnancy Journey with Hyperemesis Gravidarum (Part 4)

I had been talking on the phone to the nurse at the new practice about how the medication simply was not helping, telling her how severe the nausea was, that I was eating next to nothing and what I did eat would come back up. That even fluids were a no-go as far as staying down most of the time. I remember one day I did a "test" and decided that I would intake nothing for the entire day except a little bit of water (and I do mean a little bit). I still threw up multiple times that day. My body was unquestionably putting out more than it was taking in.

The nurse called in a prescription for Reglan. "Reglan (metoclopramide) [is a medication that] increases muscle contractions in the upper digestive tract. This speeds up the rate at which the stomach empties into the intestines." (source) It tries to speed up the digestion process, so that anything you do intake doesn't just sit there (extremely slowed digestion is a symptom of HG) undigested for you to vomit back up later. Upon taking the first dose I knew something was very, very wrong. Within a few minutes my muscles felt very stiff and I was literally unable to stop moving my body. I was lying in the bed and I could not stop moving my legs in particular. It was like a compulsion I could not control.  I simply had to shake them and jerk them about. I was turning back and forth in bed because I simply had to. I don't know how else to describe it. I couldn't stand it anymore, so I got out of the bed and even though I felt horrible I began to pace the room while shaking. My heart was racing and I was hyperventilating. I started reading the package insert that had come with the medication and the side effects section was listing many of my symptoms. I called the nurse from the new practice and told her what was happening. She told me to stop taking the mediation. It was a double edged sword, because I am almost certain the Reglan had helped a great deal with the nausea (or maybe I was distracted by the side effects, I'll never know). But the side effects were far, far to great to ever take it again.

A portion of a list of possible side effects of Reglan

On August 16th, 6 days after my first appointment with the new practice, I went in for an unscheduled appointment after one of my phone updates with the nurse prompted her to ask me to come in. A friend drove me because I was truly too scared to drive at this point from fear of having to vomit while driving as it would hit very suddenly. It would usually be 60 seconds or less from knowing I was about to vomit to starting to do so. Whichever doctor I saw that day decided to send me over to the hospital to get some IV fluids, and not in the ER but on the maternity floor. I think he made this decision based on the condition of my urine. I have no doubt I was spilling ketones like it was my job (as I know I had been for many, many weeks now). I will borrow from this site in order to explain ketones: "Excessive ketones in the urine (ketonuria) indicate that the body is not using carbohydrates from food as fuel and is inadequately trying to break down fat as fuel. Ketonuria is a sign that the body is beginning to operate in starvation mode." Translation: your body is eating itself. And it doesn't feel good. At all. 

When I was admitted to the hospital that day, I was scared but I was also relieved that something was being done, someone was taking me seriously. I remember at least two very kind nurses who I am so grateful for. There was a younger one who was pregnant and just a few weeks behind me so I felt some comradery, and a middle-aged one who started my IV. I told her how terrible I was with needles and she said she was going to try to use a newborn needle just so the stick wouldn't hurt me so badly and was hoping it would work . She even treated me with respect as I resorted to a combination of singing and yelling out an ongoing description of the painting on the wall and the contents of the room as she was getting the IV in place. Hey, we all have our coping mechanisms. 

The fluids were started and I was given either Phenergan or Zofran by mouth as well, I can't remember which. There may have been some anti-nausea medication put in the IV during one of the bags as well but I am unsure of that part. Later in the day when my husband got off work and was able to come to the hospital, a doctor I'd never met before came in and told us he wanted me to stay overnight to keep the fluids going. I wasn't expecting this when I had been admitted, so I was initially upset (not angry upset, just emotional upset) and asked him if it was really necessary and he said he really thought it would be best. I realize now I was an idiot for even questioning it, I should have been singing his praises at the top of my lungs for actually helping me and seeing at least some of how bad off I was. But I was scared because I had never stayed in a hospital overnight before. My husband and I decided that he would go home to sleep after bringing me some things I would need because he had to work the next day and we both knew he would get little sleep if he stayed with me particularly because there was no couch, only a chair for guests as I was in a triage room.

They continued a steady drip of fluids in me throughout the night, and I had to use the restroom probably 10 times. I was used to hardly urinating at all so this was a huge change. I was supposed to be calling the nurses to help me walk the few steps to the toilet and navigate my IV pole. After a few times of that it got really old and I literally could not hold it until someone would get there so at first they would meet me in the bathroom because I already had to walk myself and eventually I stopped calling them altogether. I slept like crap due to the frequent bathroom trips and of course the interruptions of the staff. At some point a very mean nurse came in the dark room with a tiny flashlight and actually shined it in my face. Of course I stared at her like she was crazy and she asked me how I was sleeping. Awesome. At 5AM someone from the lab came in and turned on all the bright lights telling me she needed blood now. Again, I am horrible with needles and this woman was anything but gentle or understanding. She woke me from a dead sleep with bright lights and had a huge needle sticking out of my arm in under 90 seconds, collecting her much-needed vials of my blood. This truly traumatized me, and when she left with a very un-heartfelt "sorry, hun" or something of that nature I was on the verge of tears and I was literally shaking. I called the only person I thought might be awake at that hour, my dad, and gave him an update just because I simply couldn't be "alone" anymore at that moment. 

They decided to release me from the hospital later on the next day, and another friend drove me home. The amazing part about my hospital stay was that I did not throw up one single time during my entire stay. This was pretty much unbelievable for me as I was accustomed to vomiting many times a day. I truly believe it was the help of the IV fluids. When I got home, I vomited almost as soon as I walked in the door, and things went back to "normal" (meaning, really bad) from there. While I was in the hospital I was almost upset with myself that I wasn't throwing up while I was there. Of course I didn't want to throw up but I wanted them to see how sick I was, to believe me and to see a need for some kind of further treatment. But they released me, I guess because the blood sample must have looked OK and my urine was surely looking better after many bags of fluids. They had been pumping them into me so fast that I remember asking a couple of times if the infusion rate could be turned down because it was really bothering my arm. 

There was another ER visit, solely for IV fluids, on another occasion and I can't remember exactly when it was. I know it was after I switched to the new practice, so after August 10th, and very likely still during the month of August. I think I was sent over during a routine appointment. Other than that visit, the hospital stay, and the ER visit where I was given fluids while staying with my parents, I received no other IV fluids. 

August 24th is was a bad day for me in my journey with HG- it was the day I reached my lowest recorded weight in the pregnancy. I weighed 104.8 pounds. Right before getting pregnant, I was 128 pounds. I had lost over 18% of my body weight in two months.

My Pregnancy Journey with Hyperemesis Gravidarum (Part 3)

For the next week I spent my days in the recliner in front of the television in a feeble attempt to distract myself from the ever present nausea. I would continue taking the Phenergan most of the time, but sometimes I would skip doses because I was very frustrated that it seemed to do nothing at all for my sickness. I wondered what the point was and felt guilty for taking medication while I was pregnant, particularly medicine that seemed to be useless anyway.

I tried my best to intake at least something into my body every day even though I did not feel like doing so at all, I forced myself out of concern for my baby. I remember calling up my dad one of those days and asking him to bring home the one and only thing that sounded even remotely palatable- a cherry creamslush from Sonic. Oh yes, that's right. The only thing that my brain was telling me I might be able to handle was total junk food loaded with red food coloring. Awesome. But I hardly cared at this point because I knew that surely getting even junk food down and having it stay down would be better than getting nothing in me at all. It was a bad call- it came up anyway.

I remember the same thing happening with a bowl of cereal on another day, and my dad having to clean it out of the bathroom sink. I didn't make it to the toilet, and honestly, I had gotten pretty tired of hanging my head in a toilet bowl by now so sometimes I just went for the sink because it felt a little less horrible. Since I was eating almost nothing, the majority of the time I would throw up it was pure yellow bile that burned terribly, so usually there was no mess to clean up even if I did throw up in the sink instead. On another occasion, I felt the need to vomit so suddenly that I couldn't even get myself out of the recliner in time and my parents handed me a bowl to throw up in. I had never been this sick in my life.

On July 26th, while still with my parents, I made a visit to an OB that I had used for my yearly exams while I was a teenager. I couldn't take the nausea and vomiting anymore and I was becoming more concerned for myself by the day. My scariest symptom at this point and one of the primary reasons I went to the doctor that day was the condition of my urine. It had not only become darker and more pungent than I even thought was possible, but I truly think it had actually become thicker as well and I knew that something was very wrong with me for it to be like that. They took some blood as well as a urine sample (which I could barely produce) and then I sat with my mom in one of the exam rooms.

When the doctor came in, she told me that she wanted me to go to the ER next door right away to get some IV fluids and she went out of her way to track down an ultrasound machine so she could do a quick scan to check on the baby. Baby looked fine, and even though I was extremely scared at this point, it was so wonderful to be able to see my baby. This was actually the first time I had ever seen the baby because I wasn't able to view the previous ultrasound I'd had for the bleeding until I went back home from my parents' house. The baby was facing forward, not sideways like you usually see in ultrasounds, and I thought it looked like the cutest gummy bear I'd ever seen in my life. I wished I could have had pictures to take with me but the printer on the machine she was using wasn't working that day. This is when I had an emotional breakdown, right in that exam room. I remember the doctor handing me a tissue. I was on the phone with my husband at one point telling him what was going on, and doing a lot of crying both on and off the phone. It made me feel a little better to finally get it some of the fear and worry I had inside of me out with those tears.

I went straight to the ER where I was given two bags of fluids, and they checked my urine again once or twice. I remember being really disappointed that they were only giving me two bags of the IV fluids. I just felt like I needed so much more help than that. At the very least, more than two bags. Having that thought was pretty major for me because I absolutely hate needles having anything to do with my body. I hated the sensation of the catheter that had been run through my vein and the cold fluid running through me making my left arm feel like it was freezing and causing me to cover myself, and particularly my arm, in blankets.

But two bags it was, and after that I was sent home. I think this the day when I was prescribed Zofran (some of the details on things are fuzzy if it's something I didn't write down), I assume because someone finally saw that the Phenergan was doing absolutely nothing for me and I was sicker than ever. Zofran is an anti-nausea medication normally reserved for cancer patients and post-surgery use. I started taking it immediately and I didn't notice a huge difference in the nausea and vomiting at all. I kept taking it as prescribed though because I felt like I had to try do something to help myself and this was all I had.

At the end of my husband's two weeks away, my parent's drove me the 8 hours back home. I made an appointment for August 2nd, the first available date, to see the OB that had prescribed me the Phenergan so that I could update him on all that had happened while I had been staying with my parents. I also wanted to talk about any other potential treatment options because I was basically panicking now. I saw what this was doing to my own body and I was having terrible thoughts about what it could do to the baby.

The day of the appointment, I had driven myself there because I felt like I didn't have much of a choice since my husband was at work. Even the simple act of getting ready to go and driving there (around 10 minutes) really pushed my body too far. I remember being very sick in the waiting room and sucking on some candy, trying not to throw up in public. When I got to talk to the OB and caught him up on all that had been going on, he listened to my concerns and seemed to feel badly for me, but he acted as if I wasn't sick enough to require any further treatment. When I inquired about what further treatment options were even available, he didn't really offer any suggestions. I liked this OB on a personal level, and I had originally chosen him because of the recommendation of many friends, but now I was doubting that decision. I knew that he leaned more on the "natural" side and that was something I was originally looking for in an OB, but now that I was so sick and needed serious medical intervention, he was just not the doctor I needed during this pregnancy and I knew it then. He very kindly personally called me three days after that appointment, just to check on me and see how things were going. I have no hard feelings for him at all, it just turned out that he wasn't a good match for the type of care I needed during this difficult pregnancy and that is fine. If I ever had a "regular" pregnancy, he would be my go-to OB.

I ended up switching providers right after that appointment, and started going to a practice with four OBs. I was 11 and a half weeks along on August 10th when I went to my first appointment with the new practice and they performed an ultrasound. It was my third of the pregnancy. When I first found out I was pregnant, I knew I wanted minimal ultrasounds, possibly even only one. That as well as so many of my other desires for my pregnancy had been thrown out the window along with my health.

My Pregnancy Journey with Hyperemesis Gravidarum (Part 2)

Two days after my first appointment with the OB, my husband was to begin a two week trip out of state with his Army Reserve unit. This was the only time in our marriage that he has ever had to be apart from me for that long, and all I could think was, "what crappy timing, with me being so sick." Fortunately, two very kind friends of ours volunteered to drive me the entire 8 hour trip to my parents' house where I would stay while my husband was away. At this point, I was unquestionably sick enough that driving myself anywhere would have been risky and felt almost impossible, much less driving myself on an 8 hour trip.

So on Saturday, July 16th, I arrived at my parents' house and finally got to tell them that I was pregnant. I walked in the door and immediately presented each of them with a gift bag that contained a white bib with green writing saying "I love Grandma" and "I love Grandpa." They were clearly surprised, but also seemed excited, and my dad gave me a hug immediately. Even though I had become so sick, I knew I had wanted to tell my parents the news in person somehow and I was determined to wait to tell them until I could make that happen. I remember times that I would be on the phone with my dad, curled up in the fetal position with my eyes closed, trying to block out the world to keep the nausea at bay and distract myself with his words, and all the while he had absolutely no idea what was really going on.

The car ride there had actually been unusually tame as far as my nausea and vomiting went, and for that I was very grateful. As soon as I had broken the news, I followed it with the words "but I've been very sick." I didn't really know what else to say. That was a huge part of why I had come to stay with them these two weeks and they had no idea until then. I am forever grateful that the Lord allowed us to make the very wise decision for me to stay with them, because it turned out that it was during this time that my health began to deteriorate even further.

On July the 18th, 2 days after I had arrived, I was up during the night for a bathroom trip and I noticed a very small amount of blood. I was quite alarmed but because it was such a small amount, I tried to keep myself from getting too carried away with unnecessary worry and just went back to bed. When I got up for the day and finally had to go to the bathroom again (I was urinating very little because most, if not all, of what I drank was coming back up so I wasn't drinking much at all), there was more blood, a good amount more and it was bright red. This is when I completely freaked out. My mom had left the house for an appointment that morning and my dad had already left for work so I was by myself. I remember calling both my mom and my dad, basically flipping out and pretty much crying, saying that I needed one of them to drive me to the emergency room NOW. All I could think of was my baby. I was terrified that I was having a miscarriage. 

When I got to the ER, they did an ultrasound, my first one of the pregnancy, to try to find out what was going on. The tech scanned me for about 20 minutes, and I kept asking her questions, all the while knowing she wouldn't be allowed to tell me anything. She was very kind and tried to distract me from what she was doing by talking to me a little bit about other things. I kept trying to look at the screen to no avail, not that it really would have told me anything anyway. I just wanted to see my baby so badly. It was a terrible, terrible wait until the doctor told me what was happening. 

I was told that I had something called a subchorionic hemorrhage. I still have a hard time understanding exactly what it is, so I will quote from this page: "Subchorionic bleeding is the accumulation of blood within the folds of the chorion (the outer fetal membrane, next to the placenta) or within the layers of the placenta itself. These bleeds, or clots, can cause the placenta to separate from the uterine wall if they get too large, if they develop in a bad spot, or if they aren't eventually reabsorbed." I was told that it may or may not heal on its own, there was no way to tell. I asked what the chances were that I would remain pregnant, and I remember the doctor saying that it was 50-50. Not reassuring. To make matters worse, I had no internet access while staying with my parents, so I had no way to research this condition until I went back home. If I would have been able to do so, I would have learned that the majority of subchorionic hemorrhages heal on their own, and the doctor seemed to be misinformed. Just my luck, because of course I spent those two weeks even more worried than I really needed to be. I remember trying to lie as flat as possible as opposed to sitting more upright, and trying to move very slowly when I would shift positions in what became my "nest" of my parents' recliner. As if any of that wold have helped if I was going to miscarry, but I was so desperate and that's all I really had in my power to do. I prayed a lot, "Lord, please keep this baby safe!" Each time I would wipe in the bathroom I was so fearful of what I might see. But God choose to keep my baby safe through this, and I am so thankful. One of my later ultrasounds revealed that the hemorrhage had completely healed. 

On my way out of the ER that day, I asked a nurse if I could have some kind of picture from the ultrasound they had taken, because I still had never seen it. I wanted something to keep in case I lost the baby. So along with the the paperwork I was sent home with and after a little bit of extra wait time, I was given a disk with what seems to be a video of a very small portion of the ultrasound. I am forever grateful to that nurse for taking the extra time to make that disk for me.

From the video on the disk, my baby at 8 weeks and 1 day.

While I was in the ER for the bleeding, nothing was done as far as any additional treatment for my still severe nausea and frequent vomiting. I informed them that I was taking the Phenergan that had been prescribed by my OB and told them it wasn't really helping. I remember they took a urine sample, and little else was said or done regarding my sickness during this visit. 

My Pregnancy Journey with Hyperemesis Gravidarum (Part 1)

On the afternoon of June 17th, 2011, my life forever changed. I saw 2 pink lines appear on the pregnancy test I had just taken. I was a huge mix of emotions, because this pregnancy had not at all been planned, but mostly I was excited for the journey ahead. Little did I know at the time just what that journey would involve and how incredibly sick I would become. 

                                       First positive pregnancy test. You can barely see the line, but it's there. :)

I had been feeling a little sick to my stomach since 2 weeks prior when I discovered that there was a good chance I may be pregnant. That feeling in my stomach was simply due to the extreme anxiety I was feeling about the situation. After all, the pregnancy was completely unplanned and, due to the nature of the "mistake" that caused it, was in fact, my "fault." I put these things in quotations because we believe that God does not make mistakes and that this was part of His plan for our family. However, this is something that was initially very hard for us to work through as a couple, and particularly so for my husband.

Because I had been feeling so anxious and therefore a little sick to my stomach for so long while waiting to find out, and then again after I had confirmed that I was in fact pregnant, it's very hard for me to pinpoint an exact day on which I began feeling nauseous due to being pregnant. It was like my "anxiety nausea" just led into the pregnancy nausea somehow. It got increasingly worse as the days went on and by the time I was 5 weeks pregnant I remember feeling unquestionably nauseous in a way that I knew was not just from anxiety. At 6 and a half weeks, I began to vomit. By this time, I had become so sick that I was staying in bed for the entire day. I didn't want to move or stand up to do anything because I would instantly have to vomit again. I was trying very hard to eat and to take my prenatal vitamins because I knew I needed to be able to keep the baby healthy and growing. But everything I was eating was coming up. EVERYTHING. And then some.

I tried all of the standard remedies for morning sickness, which is what I thought it was at the time- eating saltines, making sure I had at least a little bit of food in my stomach before getting out of bed in the morning, sea bands, ginger ale, the works. You name it, believe me, I tried it. I remember using every ounce of energy in me to drag myself out of the house and having my husband, Nathan, drive me to the pharmacy so we could talk with the pharmacist about any over the counter medications I could try to help with the unending nausea and vomiting that would also be safe for the baby. He was very kind and recommended Dramamine which is actually a medication for motion sickness. We bought it and I took it immediately. It may as well have been a sugar pill because it didn't do jack squat for me. I was so disappointed. By now I was also getting really scared. I was very concerned that if I was this sick myself, what in the world was going to happen to my baby? I called to make my first appointment with an OB because I knew I needed help. Surely they would have something for me that would make the endless nausea and vomiting stop. 

July 14th was my first visit with an OB since I had become pregnant. I was 7 and a half weeks along. This OB prescribed Phenergan, which is a standard anti-nausea medication. It did nothing. I went from scared to terrified. I was thinking that if even this prescription medication wasn't doing anything for me, what was I going to do?