Why was my Hyperemesis Gravidarum So Short?

Well, today is it.  I made it halfway through the pregnancy.  140 days down, 140 days to go.  More or less anyway.  That due date really is just a guess date after all.

But darn it!  I made it to the halfway point!

I suppose, at a monumental time such as this, it seems appropriate to do some speculating about why my hyperemesis gravidarum was so atypically short.  This is a post I’ve been putting off for a number of reasons.

Honestly, I feel a little guilty about it.  It sounds crazy, but I do.  Hyperemesis gravidarum is supposed to be a whole pregnancy thing.  Or at lease to 20 or so weeks!  Here I am, an HG sister, who had her HG start to let up around 12 weeks.  That is just really, really abnormal.  I’m not saying I would go back and suffer a little longer.  No, no, no, nononononono.  No way.  But it does sort of take away my HGer cred a little bit.  Here I am going to my daughter’s baseball games while other moms are farther along than I am, bedridden, and on TPN.

Why did I get so lucky?

The fact is, I don’t know.  I’m certain that, yes, I had HG.  Women with morning sickness do not require IVs or PICC lines.  They do not require home health.  They do not require their mothers to come live with them for an entire month to help then with even the most basic tasks like going to the bathroom and taking a shower.  What I had certainly went well beyond morning sickness.  It was frightening and intense and awful.

But it was so short.

Can the short duration of the hyperemesis gravidarum be attributed to my very aggressive treatment protocol?  I suspect that was a part of it.  I started taking the Zofran orally from the moment I started feeling not quite right.  Once I started feeling nauseated and having trouble eating and drinking, we started rehydrating very aggressively at 3 liters of fluids per day right off the bat.  While, ultimately, the IVs and PICC didn’t work out, I think having that kind of very aggressive treatment allowed me to reach the point where my mom could push enough fluids orally.  In the midst of all that, I was receiving the Zofran via the pump in very high doses, with my maximum dosage at around 39 mg per day (most doctors are only willing to go up to 32 mg per day).  We did not rely on Zofran alone, but attacked the nausea from all angles: Meclazine for the motion sick aspect of it, Nexium to prevent any potential reflux from contributing, and Benadryl to deal with any potential allergy aspects or side effects.

I do think that taking this kind of aggressive approach from the beginning helped in a pretty significant way.

A lot of it, though, I think needs to be chalked up to sheer luck.  I was lucky that I responded to the treatment.  I was lucky that my mom was able to come out and care for me.  I was lucky that it eased up early.  And I was damn lucky to have a doctor willing to deal with the HG quickly and decisively.  So many doctors like to wax poetic about keeping the baby safe.  She recognized that a dehydrated, malnourished, and desperate mother is a far greater risk to a baby than medicines that research has shown to be safe.  She was willing to drop a nuclear bomb on the HG, and that, I think, makes me a very, very lucky patient.

Here is the bottom line:  If you know someone who has hyperemesis gravidarum and you are in a position to help advocate for them, please do.  Early, aggressive intervention seems to have made a remarkable difference for me.  Will every woman respond to treatment the way I did?  No.  But every woman deserves a doctor who is willing to treat her the way mine did for me because that level of treatment gives women the very best chance at relief.

Should I feel guilty about how short my HG was?  No.  I know I shouldn’t.  I know that despite the excellent treatment I got, most of it was just dumb luck.  But I do.  It’s a monkey I am working on putting aside.  No one makes me feel guilty in the HG community.  That’s not the way the HG community operates.  It’s a supportive community.  There’s no one-upmanship that goes on, no games of Top My Tragedy.

Mostly, I just don’t want anyone to feel like I in any way suggest that there is a magic bullet to “fix” HG.  There just isn’t.  We all have to deal with the cards we are dealt.  Sometimes we get lucky and draw a hand with a fantastic doctor, stellar insurance, and a responsive illness.  Other times not so much.  Who can say why this happens?  Not I.

I’m so grateful for what I have at this point.  I feel so… not sick!  I catch myself wondering if this is now normal pregnant women feel.  Mostly, though, I give thanks for the blessing of health that I have been given and pray for similar relief for my HG sisters.  I swear that I will never, ever take these feelings of normal health for granted.

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7 thoughts on “Why was my Hyperemesis Gravidarum So Short?

  1. You have no idea how happy I am for you that your HG was so short-lived (I guess only another HGer would feel such relief for someone else even though they’ve only just “met” online recently!) I’m happy and relieved for you because you didn’t have to suffer for too long, but I’m also happy because it gives hope to the rest of us that doctors do exist out there who take this seriously!

    My doctors (and I have seen every single one at my surgery) have never once wanted to use the term HG and despite putting me on oral tablets at 7 weeks, they were very, very insistent I should not be on them and that I should come off them as soon as possible. As such, I forced myself off them at 14 weeks and now at 20 weeks I am still utterly miserable. I know I have a “mild” case of HG in that although I was bedridden until week 12 and completely unable to move without retching, I have since been able to work a couple of hours per day during the second trimester. But even so, taking 4 hours in a morning to be able to get out of bed without dry heaving (I never did vomit as I never seemed to get enough down to bring back up) and feeling hungry yet too sick to force anything down without setting off my gag reflex and still being like this at 20 weeks is so awful and the worst part is that nobody other than other HGers seem to get that.

    I have been backwards and forwards to doctors and every time I am told “we can’t give you anything because of the baby” and last week a nurse even said to me “it’s normal to feel a bit ill, you’ll just have to put up and shut up”. I go back tomorrow and I hope I am strong enough to sit in the doctor’s room until he prescribes something. I am so sick I can’t eat, I still only manage about 1litre of liquid per day, I haven’t once seen friends during the pregnancy due to being so sick, which has isolated me totally, and my sinuses are constantly blocked or I have post-nasal drip which only makes the gag reflex worse. And yet still the doctors think the best thing for me and my baby is to let me suffer it alone.

    Sorry for writing all that, but I wanted to make it clear just what I meant by how it makes me happy to know that there are some doctors out there who take HG seriously and are willing to help make it as easy on the mother as possible, because that gives hope that one day HG will be treated effectively in every case, rather than just the odd few!

    Also, I just wanted to say that you should NEVER feel guilty for feeling so good so early on in your pregnancy. No HGer would ever hold that against you (which you seem to know deep down, but it doesn’t hurt to remind you of it!!)

    Thanks for being so open about your experiences… it helps the rest of us to know what others have been through and what has helped them! Here’s hoping the rest of your pregnancy goes well xx

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  2. Amanda, thank you so much for sharing your experience. Frankly, I’m appalled at the shoddy treatment you are receiving from your doctors. I’m not surprised, because I know how rare doctors like mine are, but I am shocked and disgusted.

    I’d like to attach a link here for you:
    http://www.helpher.org/health-professionals/

    This is the section of the HelpHer website geared toward health professionals. It’s a list of links into pages detailing how patients should be treated for HG. Print these out and bring them with you when you go in to your doctor. Of particular interest to you will be the suggested protocol, patient comfort measures, common treatments, complications, and risks and outcomes.

    From the sounds of it, you are in the UK. There is a forum section dedicated to HGers outside the US in the helpher forums. They may be able to suggest some ideas for you. I know there is a specific doctor in the UK who has done studies on steroid treatment and HG, but I don’t know his name. I know some HGers have called him or had their doctors call him to consult on risks/benefits of steroid therapy. He might be another resource for you. They could probably tell you his name in the international forum.

    Best of luck. The idea that there is an HGer out there suffering with no medical support just boils my blood.

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  3. It is wonderful you fought your HG so well!! I’m sure the aggressive treatment, both you and your doctor took helped put you were you are today. I wish doctors would more openly tell women they have HG instead of making them feel like ‘babies’ for not being able to handle a little morning sickness.
    In my second pregnancy, the worst out of the 3, my midwives were unbelievably uncompassionate. Finally, at 10 weeks along they told me that if I thought I needed IV fluids I could head to the ER. I was severely dehydrated with high levels of ketones and down 7/8 pounds. It was the trauma nurse, bless his heart, who was the first one to show me compassion. He was also the first one who ever mentioned hyperemesis to me. Turns out his wife suffered from it. I was in the ER twice that week and my midwife never came in to see me. Even when I went to my next appt with them, they were still very unkind and not wanting to give me meds. I had to BEG for the phenagran. I wanted to see if it would work better than the Zofran that was only constipating me.

    How can we make people more aware of HG? I find that when I tell people my story, their response is “yeah, I had some m/s, too” They don’t understand this is not the same as m/s:(

    ENJOY your pregnancy. You earned it!!

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  4. I just wanted to say a massive thank you to you for your words of support and the links you gave me. I read so much last night and thus went to my doctor with much more idea of what I needed to say to my doctor (yes, I am in the UK!)

    The doctor I saw was actually very sympathetic and spent some time looking through his books to decide what was best to give me. In the end he prescribed an antihistamine for my sinus issues and cyclizine for the nausea, saying that if they work well he sees no problem with me using them for the rest of the pregnancy if necessary and if they don’t that I am to go back to see him and we’ll look at other options.

    So thank you for helping to boost my confidence with your words to go in and make it clear to the doctor just how badly I needed help and what options I had read about for dealing with the HG, because that made a huge difference.

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    1. Amanda, I’m so glad you were able to find some strength here to go in confidently to your doctors. Hearing this absolutely made my day. Depending on which antihistimine they gave you, that could also help with the HG as well. Many antihistimines seem to have that kind of crossover effect. Keep us posted on how you do. A lot of women have really good luck with a combo of meds which is what you’re walking out with.

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  5. Dear pallasathena2007, it’s really great to hear that the treatment did work so well. I’m going to print your blog and hand it out to my doctor, if things are getting worse again… I’m at the beginning of week 5, and I still feel good (just a little bit sick and i already smell EVERYthing, i know now how a dog must feel…), but in my first pregnancy it startet in week 6 very intensly. But when I mentioned the word “ZOFRAN” towards my gyn he nearly collapsed, here in germany there will be almost nobody, who will give you that. But I’m absolutely going to ask vor IV fluids at home in an earlier state than last time, because I think the lack of fluids definitly did make things getting so bad during my first pregnancy, where I had to be hospitalised for a few days. But after week 12 it was getting better – from a 9 on the nausea scale down to a 4 and the last three months I felt quite good. But seven weeks of hard suffering were enough for me, I couldn’t have imagined of done more and I hope and pray that it won’t be longer this time …
    Thank you for sharing your experiences! Do you even think of child Nr. three? with warm regards anja

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