The Emotional Toll of Hyperemesis Gravidarum

I think most of us in the hyperemesis gravidarum community are thankful for the attention that HG has been receiving lately.  We’re finally seeing some recognition for the terrible physical hardships we endured bringing out babies into the world.  One thing that we haven’t seen much of, though, is coverage of the emotional toll HG takes.

HG is a traumatic experience that leaves many of us changed forever.  I posted recently on my Facebook page about this and got some heartbreaking responses:

It left me feeling depressed, and hopeless. I felt cheated out of a “normal” pregnancy experience. After my second pregnancy it has also left me terrified to have another child. – KH

Torn between wanting to carry my babies to term and wanting to terminate. Fear of ever getting pregnant again. Fear of vomiting in general. Lingering food and smell aversions. Scared of sex, what it protection fails? – JF

Depression. Hopelessness. Anger. Scared I wouldn’t make it the whole way through. I felt thoroughly misunderstood. Nobody understood what I was going through. I felt so alone. – RR

Major emotional depression from being in such a dysfunctional and debilitated state with little to no empathetic support. That totally did my head in and I struggled to find my strength for life after that. – BS

For myself, the HG caused depression, which was made worse by some of the medication.  When I started contemplating suicide in my first pregnancy, an alert home healthcare nurse stepped in and had my doctor stop the prescription of Reglan.  Turns out a side effect of that medication is suicidal ideation, and I had been taking it at its maximum dose via a subcutaneous drip.  No wonder I was experiencing those horrible side effects!

I thought the depression was mostly related to the Reglan, but I was not surprised to experience it again during my second pregnancy.  The sense of isolation and despair can become almost unbearable.  Yes, many of us are on bedrest, but perusing articles on bedrest survival and an HG survivor will quickly shake her had and dismiss the advice.  Much of the bedrest advice revolves around boredom: read parenting books, start a scrapbook, order baby gear online, chat with other moms on bedrest.  Those things are impossible for many HG sufferers.  For most of us, we spend our days and nights curled up, eyes shut, trying desperately to will ourselves not to throw up.  It is an inescapable hell that is difficult to comprehend or explain.  Is it any wonder that so many HG sufferers become depressed?

The deep sense of isolation is far and away the most painful part of HG. Knowing that many people can’t relate and fearing harsh words, many HG sufferers retreat from friends and family members. Even many doctors minimize the suffering caused by HG. A few days after being admitted to the hospital for the umpteenth time during my 2nd pregnancy because my ketones were off the charts and I had begun hallucinating, the on-call doctor told me that there was nothing wrong with me.  Is it any wonder we hide?

The trauma we experience during HG can lead to life-long anxiety.  HG survivors experience post traumatic stress disorder, emetophobia (fear of nausea and vomiting), postpartum depression, and a whole host of long-lasting emotional problems.  Some of us, myself included, develop anxiety around hospitals, needles, and medical procedures.  Many of us feel angry and cheated for not having the glowing pregnancy that other women get to experience.  This anger and anxiety comes up each time we hear news organizations referring to hyperemesis as “Extreme Morning Sickness.”

Please call hyperemesis gravidarum what it is.   If it’s hard to say, you can just call it HG.  The next time you speak to an HG sufferer or survivor, validate her struggle.  Express sympathy for what she went through and may still be experiencing.  Most of all, please understand that hyperemesis is a real and terrible disease that can have a lasting impact on survivors both physically and emotionally.

Being Kind to Ourselves for our Childrens’ Sakes

A few years ago, my husband and I went through a rough patch as many husbands and wives do.  We saw a marriage counselor, and one of the things he told us really stuck out to me:  We are often kinder to strangers than we are to our spouses.

I hadn’t thought about that in a while, but a few months ago, a mom on a breastfeeding board posted that she wanted to lose weight saying, “I feel like such a fatty.”

At that moment, our counselor’s words popped into my head and I realized something that he hadn’t said:  Not only are we kinder to strangers than we are to our spouses, but we are kinder to strangers than we are to ourselves.

The more I thought about it, the sadder I felt.  You would never call someone at the grocery store such an ugly name, but women say things like that to themselves all the time.  Horrible names like fatty, cow, bitch, ugly, and so forth.  When women say those things to themselves over and over, they must believe it.  How horrible that society tells us it’s okay to treat ourselves that way.  And Magazines feed this by promising miracle diets, exercises to get your body “swimsuit ready,” and photoshopped pictures of models with body shapes that most people will never have, flawless skin, flowing locks of hair, and clothing that reveals nary a bulge or a wrinkle.  We’re bombarded with this all day every day.

Then, this week at work, I realized that I was just as guilty as other women.  As I walked to the lunch room at the office to heat my leftover pork chop, I realized that I had forgotten my fork back at my desk.  I thought to myself:

“I’m such a dummy.”

And then I stopped dead in my tracks.

It was one of those moments where images and moments flicker into your mind in rapid fire succession.  Images of me right before our recent vacation trying on my swimsuit and rubbing the stretch marks on my belly and frowning.  Images of me calling myself stupid for forgetting to pre-heat the oven before roasting the previous night’s asparagus.  Images of me climbing out of the shower, turning around to look at my butt and saying, “Ugh.”

And in the background of all of those images are my daughters.  Watching.  Listening.  Learning.

I am teaching my girls that it’s okay to hate themselves.  I am teaching them to be kinder to strangers than to themselves.

That is not okay.

And in that moment in the hall at my office, I made a promise to myself:  Any time I caught myself calling myself an ugly name or saying something rude about myself, something I wouldn’t tolerate from a stranger, I will stop myself and remind myself that it’s not true.  I’m not dumb.  I’m not stupid.  I’m a person who sometimes makes mistakes.  I won’t tolerate someone calling my family members names, and I’m ready to stop tolerating that behavior from myself.

Yes.  I have stretch marks and the skin on my belly is loose.  Every single mark on my belly is a reminder of the victory I won over hyperemesis gravidarum.  That loose skin? It may be loose, but it’s special.  That’s where I held my two precious daughters.  My body will never be the same as it was before I had kids, but really, is anyone’s?  I’m finding myself being more and more okay with that as time passes.

I hope this will not only bring a sense of peace and confidence to myself, but will teach my girls to love themselves and their bodies.

And yes.  I wore that purple bikini on my vacation.  Stretch marks and all.

Hyperemesis Gravidarum: Is it all in our heads?

How many times have you heard this:

“You’d feel a lot better if you would adjust your attitude.”  “You should be more positive.”  “That Molly. She’s so excitable isn’t she.”  “Maybe you should see a tharapist?”  “You’re not sick.  You’re pregnant.”  “You’re weak.”  “You’re hysterical.”  “You’re doing this to yourself.”

From doctors. From nurses. From the lady taking your vitals in the hospital. From a friend. From a relative. From your spouse?

It’s all in our heads.  We’re doing this to ourselves.  It’s our fault we’re so sick.

Over and over and over.

Some HGers aren’t lucky enough to have a support system.  They suffer and suffer believing to their core that what they are experiencing isn’t real.  They blame themselves when they miscarry.  They feel the agony of guilt when they have to terminate the pregnancy that they were so excited for just to save their own lives.  If they’re like the woman a few years back at one of my local hospitals, they die.  It’s their own fault.  If they hadn’t been so weak, so fragile, so excitable.

A new study has come out: Is hyperemesis gravidarum associated with mood, anxiety and personality disorders: a case-control study.

Apparently, according to the abstract, HG is a relatively common medical problem among pregnant women.  Well, gosh.  I certainly learned something today.  I wasn’t aware that it’s common for pregnant women to require PICC lines, constant IV hydration, high doses of multiple medications, and bed rest.  I wasn’t aware either that it’s relatively common for pregnant women to become so dehydrated that they begin to halucinate, to vomit until their esophagi tear and they start to vomit blood, to become so malnourished that they lose their babies, for their kidneys to fail, to die.

I didn’t realize any of that was relatively common.

After looking quite a large sample size of 142 patients and observing whether or not there were mental health issues prior to the pregnancy, these psychiatrists conclude:

The results of the present study suggest that mood and anxiety disorders, and personality disturbances are frequently observed among women with HG and that there is a potential relationship between these psychiatric disorders and HG during pregnancy.

Pardon my skepticism, but this has been done before.  It was a crock then and it’s a crock now.

Look, I get that they’re saying that HG isn’t caused by mental illness. Of course not. This is all couched in the language of statistics.  But how many of us have had doctors who told us to just suck it up before sending us on our way with admonitions to take some ginger and eat some crackers?  How many of you have nearly died because of it?  I know at least one of you personally who has had this happen.  I know it nearly happened to me when I was pregnant with Cricket.  I remember that Friday night when they suddenly went from, “Molly, you’re in really bad shape. We need to get you on TPN,” to “There’s nothing wrong with you. You need to go home.” (Of course I seemed fine at that point! I’d been on IV fluids, a potassium drip, and IV zofran and nexium for 3 days!)

Oh sure.  Plenty of us who have HG are depressed and anxious.  Who wouldn’t be after what we’ve been through?  HG causes mental illness and depression.  The researchers got it the wrong way round.