Planning for a pregnancy with hyperemesis gravidarum is essential.
I’ll be the first to admit that I am an information collector. I collect information about certain topics obsessively. I did this for breastfeeding, childbirth, pond/aquarium keeping, child-rearing, baby-wearing, urban legends, and, of course, HG. I don’t necessarily have the info memorized, although I do remember a lot of it. It’s more like I have a card catalog in the back of my head that I can flip open occasionally to find the website to access what I want to know about. I am not completely sure this is normal. I do like sharing this info, though, so I wind up fielding a lot of questions from friends and returning their well-meaning interest with a deluge of information. I’m trying to learn to give folks the drinking fountain version of things as opposed to the fire-hose version.
I’m also a serious planner. I tend to worry through a scenario until I’ve come up with all of the potential courses that something might take and work my way through each and every little aspect until I’ve thought about something so hard and so long that there’s just nothing left to think about. My husband, calls that being a worry-wart. I just think it makes me a really good project manager.
This time around, it was really important for me to have some sort of plan. Part of the despair and hopelessness I felt last time around stemmed, in large part, from not knowing what to do or when to do it. I spent so much time wondering if what I was feeling was technically bad enough to call the doctor or technically bad enough to take the medicine or technically bad enough…. You get the idea. I spent more time analyzing everything and feeling guilty about it than I did taking care of myself, and because of that, I waited too long for certain things like medication changes and fluids.
All of this means that I’ve obsessively gathered HG-related information and obsessively massaged all of that information into a plan for dealing the HG during the next pregnancy. I call it The Protocol, and it’s pretty thorough and in-depth. It’s six pages of Microsoft Excel glory. My doctor assures me that having something like this does not make me a raving lunatic thankyouverymuch.
This time around, I felt like I needed to set up project plan of sorts to help give myself direction. It took a year of writing, researching, re-writing, fiddling, re-writing some more, fiddling a bit more, tweaking here and there, and finally setting it into Excel format for readability and printing purposes.
Going over The Protocol with my doctor a few weeks ago was an incredibly nerve-wracking experience. Would she tell me I was nuts? Would she just give it a quick skim and just smile and nod? Worse yet, would she wait until after I left to roll her eyes and tell her nurses that I am one of those patients? I had never met her before. I had no idea what to expect. By the way, did I mention earlier that I am an obsessive worrier?
She ended up doing none of those things. Instead, she read through every single detail with me. We talked over each line item, and aside from a few tweaks here and there and some additional information (mostly dosages), it was able to withstand her scrutiny. I’m actually pretty proud of that. She assured me that not only am I not crazy, but that the kind of early aggressive treatment plan that I laid out can, according to studies, reduce the severity of the HG.
The biggest thing that came out of this was the change in the way I feel about this future pregnancy. My feelings of anxiety and downright terror were replaced with a sense of hope and empowerment. I know what to do and when to do it. I don’t have to sit there and wonder if my ketones are within the necessary range to get fluids or count the number of times I vomited to decide if it’s time to up the meds. The path is mapped out for me ahead of time. All I have to do is follow it.
Why is it important to have a plan put together if you’re an HG patient? Because when you’re in the thick of things with your brain foggy from the sickness, you shouldn’t have to try to find your way. Just close your eyes, grab the guide-rope, and follow it to the end.
Without further ado, here is my hyperemesis gravidarum protocol in all its six page glory. Of course, I can’t post the Excel file here, so I had to rewrite it a final time to post here as paragraphs and bulleted lists. It isn’t pretty, but it does the job.