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.