Wednesday 8 June 2016

My pregnancy experience: Hyperemesis Gravidarum

I would hedge my bets that you haven't heard of Hyperemesis Gravidarum, unless you've actually suffered from it yourself. Let's call it HG for typing sake. I had very briefly heard of it before my diagnosis, because Princess Kate had it during her first pregnancy (and subsequently, her second), so I remember sitting in a coffee shop and it was all over the news that she was in hospital with 'morning sickness'. "Wimp" was my exact thought to be honest with you, "can't even get through early pregnancy without extra help". Future me would have slapped that version of me round the face, if I'd had the strength.

6 weeks and 6 days; that's how long I was pregnant before the hormones kicked in and knocked me off my feet. I couldn't work, I had to take almost 2 months off sick, and I couldn't eat or drink, or taste, or smell...or breathe. I can't even put into words how horrific it was. I was hospitalised 3 times (with dehydration and my body had entered ketosis), until I was eventually given the godsend that is Ondansetron (Zofran). I would have sold everything I had to get that drug if I'd have had to pay for it. I was constantly reminded that it costs £30 a pill, and "have you tried ginger biscuits?" Insert your chosen expletive here.

Now, there is a difference between morning sickness and HG. I don't have first hand experience of both, only the latter, but I do know that morning sickness goes around the end of the first trimester (though I am aware it is not set to a clock and we are all different). Every time I saw a nurse/midwife/doctor I had to go through all my symptoms again - as if they weren't glaringly obvious, I was vomiting dusk til dawn - and I had to sit through all the remedies that "would work" for me. I gave them my best shot but I can no longer stand mints or anything minty, ginger biscuits, dry foods etc. I wasted money on anti-sickness wristbands, considered acupuncture and was even counselled on considering a termination. There were hours, days, weeks that I thought I couldn't do it, I wanted to give up and feel normal again, to live my life without having to be 5ft from a bathroom.

Luckily at 7, 10, 20 and 22 weeks I had something to hold onto - seeing my baby. She is how I got through the darkest moments, knowing at the end I would be given my reward for staying as strong as I could.

Now, the serious stuff. If you think you have any of the symptoms of HG you need to get to your doctor or midwife ASAP. It is a fairly rare pregnancy illness and sadly the knowledge of it is so varied. In Essex, I was diagnosed immediately, but when I got home to Lancaster it took 2 more hospital trips, countless doctors appointments and, unfortunately, 31 weeks of vomiting, for everyone to believe something was wrong. Although I got the best medication (for me) early on, there were many things I was not informed about that changed the end of the pregnancy for me;

  • HG babies are likely to be premature with a low birth weight - Harrie was born at 37+1 weighing 6lbs; 
  • HG labours tend to need medical intervention as the mother is weak from being ill - I needed a forceps delivery; 
  • it is important for the mother to see a consultant from fairly early on to help manage HG and discuss any problems that can occur - when my midwife eventually agreed to referring to me to a consultant it was too late because I went into labour a few days later.
  • it wasn't known whether I could breastfeed or not - I didn't in the end as I didn't know how long the medication I had taken for 7 months was going to stay in my system and no one I spoke to could tell me whether it would pass through my milk to Harrie. I decided not to as she had already been 'taking' the medication with me for almost the whole pregnancy and at that time there was very little information on Zofran's impact on babies. If you are interested in reading into that a bit more a study has recently been carried out regarding this.

I'm going to put a bit of information about HG now that I have taken from the website. The most fantastic resource I had through my pregnancy was HelpHER - I cannot thank the community enough. I lurked on that site as much as I could and found some solace in that I was not the only one to experience HG, as well as the terrible and conflicting emotions that also reared their heads.

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.

I haven't gone into too much detail regarding my illness as a) it's an emotional thing to write about for me, still, and b) it's quite gross and frankly, TMI. If anyone wants to have a chat about it and/or their experience then I'm contactable via my email here, and I do really look forward to hearing from you.

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