Wednesday, August 12, 2015

the hyperemesis gravidarum saga, part 1

You've probably heard that Kate Middleton, during both of her pregnancies, suffered from hyperemesis gravidarum.  Poor lady.  About a year ago, I had come up with a plan I was pretty certain would go viral: people could dump buckets of vomit on their head to raise awareness from this condition I had for both of my pregnancies.  {Remember the ice bucket challenge that was going viral at the time?}  But now it looks like the public awareness has been somewhat raised thanks to the Duchess, and no vomit buckets needed after all.  Thank you, Kate!  {Now if only the commoners like myself had people to wait on us hand and foot during our illnesses!}

I've mentioned on my blog before that I had HG, and I've long meant to write about it.  The thing is, it's kind of hard to write about, because it's all a bit of a blur, and not a very pleasant one.

It bears writing, though, because it is a part of my story.  A part of my kids' stories.  A part of our family's story.  And more importantly, it is a part of the stories of an estimated 1%-3% of women, and those women need understanding, empathy, and help when we have opportunity to give it.

* * *

In my first pregnancy, with Nell, I remember the early signs of nausea before the vomiting began.  I tried ginger, peppermints, saltines, sour candies, protein, exercise, lemon drops, sea bands on my wrists -- everything I could think to try, I tried.  Nothing touched that awful pit in my stomach that grew worse with each passing day.  That unrelenting queasiness.  We hadn't told friends about the pregnancy yet, so I would grit my teeth through grad school classes in musty lecture halls and quartet rehearsals in smelly basement practice rooms all while feeling like I might vomit at any moment.

That was the early nausea part, when I wasn't yet vomiting much.   Then when the vomiting hit, it hit hard.  I remember a Sunday morning when Nathan was at church and I was vomiting in the bathroom.  The next thing I knew, I woke up on the floor, my glasses bent, my face pressed against the tile.  I had passed out.  It was the first of many times to come, but I learned to anticipate it, to feel that sudden change of blood pressure coming on alongside the need to vomit, and to make sure I was someplace soft.  Safer to stay in bed and keep a bowl beside me than to try to run for the bathroom.

I remember keeping a pad of paper beside the bed one day and jotting down a tick mark each time I threw up that day.  By evening, there were seventeen tick marks.

* * *

I was in grad school at the time, and freelancing and teaching violin lessons, and somehow I managed to continue with all of these things.  I got an appointment at a birth center, told the midwife how sick I was, and got a prescription for Zofran.  I was anxious about taking the medication -- although it is approved for use during pregnancy, you can always find some terrifying things online -- and if I had a day where I could stay home, I wouldn't take it.  I'd just stay in bed and be sick all day.  When I had school or work, I'd take the Zofran and push through the nausea.  The Zofran mostly stopped the vomiting, although it barely touched the nausea.

Looking back on my day planner from that fall, it looks like there were eight days when I was flat out unable to go to school or work and had to cancel everything.  Only eight!  The rest of those days, days filled with lessons I taught and classes I attended and rehearsals and concerts and presentations... somehow I did most of those things.  Thank God for Zofran.

a photo Nathan took at the end of October when I was 12 weeks along.
I had just come back from playing a concert!

I could manage to eat cheddar goldfish crackers and drink cranberry juice mixed with seltzer during that first pregnancy.  Onion rings and coke icees from Burger King took the edge off, too.  I'm sure there were other things as well, but those are the main things I remember being able to eat.  For someone usually committed to healthy eating, it was pretty ridiculous!

I remember my brother-in-law brought me some spaghetti one day, carried it into the bedroom where I lay in bed, and it actually sounded quite good to me and I was able to eat some.  Shortly thereafter, it came back up again -- some of it somehow, horrifyingly, coming out my nose.  Did you know that, Nell?  I barfed noodles out my nose for you, kid!

I remember driving to Boston for school with waves of nausea, then stopping at a cafe near school for a poppyseed bagel.  Thanks to Zofran, I could eat and almost enjoy that poppyseed bagel.

I remember telling an orchestra conductor about my pregnancy and my condition because I was so terrified I was going to vomit during rehearsal.

I remember being grateful my academic courses weren't too intense that semester.

I remember one administrator at school being a real asshat to me about the pregnancy because I had missed two orchestra rehearsals, even though I had medical excused absence notes from my midwives.

I remember walking through a grocery store, feeling like I could be sick at any moment, searching the shelves desperately for anything that I felt like I could eat and keep down.

I remember pulling over to the side of the road while driving home from that grocery shopping trip to vomit out my car door.

I remember Nathan driving from his school in Boston over to mine to take me to lunch once on a day when I was feeling well enough to eat but was so exhausted and miserable that I was nearing tears.  I just needed to see him, and I was so relieved and glad to see his car swing by to pick me up.  We got eggs Benedict at a diner and it was a wonderful hour together.  A calm amidst the busy flurry of our lives that autumn.

* * *

I watched a lot of Grey's Anatomy during that time, and it's the strangest thing: the brain surgeries and heart surgeries and blood and guts didn't make me the least bit queasy, but if a character was eating a sandwich, well, I'd be reaching for my bowl, puking, and maybe passing out briefly.  Coming to, and passing another hour or so watching Grey's until the next time I was sick.

I don't remember a lot about the hours and the days, except that when I hadn't taken Zofran I couldn't even roll over in bed without the motion making me sick.  I couldn't see or smell food or think about food.  I could barely talk, quite literally, and so Nathan and I had a little code system that went like so: a small, miserable moan meant, "hold my hand;" a medium, miserable moan meant, "bring me some juice;" and a big, miserable moan meant, "take me out to the back pasture and shoot me dead."

Of course, not seriously, but that's what I told him it meant, and he knew it meant that I felt the absolute worst and needed some serious sympathy.  Somehow my sense of humor remained intact through it all, and we'd laugh together about that joke, that I should be taken to the back pasture.

I also remember those months as being a very lonely time, the hours and days sick in bed, Nathan busy with his own graduate school and work, friends unaware of what I was going through.  I'd check my computer, hoping someone had made a move in a Words With Friends game so I could make my next move.  One can only watch so much Grey's Anatomy.  Pinterest would have been an option for passing the time, but I didn't dare log on to see the inevitable pictures of food.  Despite how busy many of my days were, I have vivid memories of longing for more human connection, for someone to know and understand what I was experiencing, maybe for someone to come take care of me.

a selfie ("bumpie?") from late November.
lying in bed in my pajamas; a very common scenario

Perhaps the strangest thing of all is that, through it all, I managed to feel mostly overwhelmingly happy.  This is not a fact I take for granted, because I'm well aware that many women with HG are so miserable they consider terminating their {very much wanted} pregnancies, the sickness is that bad.  I'm grateful that mine wasn't as bad as some, and that somehow, I would puke and puke and then manage to smile at Nathan, still happy about our secret growing family.   We were so excited.  I have such happy memories of that excitement.

* * *

It was really hard, for almost three months.  Things got bad in early September, when I was five weeks along, and then it started to get better in early November.  I was weaning off of Zofran by around 14 weeks pregnant, and then definitely feeling almost 100% better by Thanksgiving.  I remember just feeling so very grateful to be able to eat all that good food!  We visited my in-laws that Thanksgiving, and I have sweet memories of the much-needed rest at their house after such a difficult couple of months for me.

Over the course of the ten or so weeks that I was sick, I lost ten or twelve pounds.  Now, a lot of women would like to lose ten or twelve pounds, and truth be told, I could probably have been counted among that number.  But not like that.  No one wants to lose weight like that.  It will always boggle my mind a bit that some people, upon learning of my pregnancy and the near-debilitating sickness I had, would say, "Well, you look terrific!" or something similar.  I half wanted to say, "My health care providers are concerned about my falling weight, but I'll be sure to let them know you think it's an improvement, thanks."

Or, on the flip side, other pregnant women would bemoan their own rising weight and wish aloud to have had first trimester weight loss like I had.  No, you don't wish for that.  I promise, you don't.

Possibly the strangest thing about that time period was that, aside from telling our immediate families, we actually kept that pregnancy a secret up until the first trimester had passed.  I have no idea how we did this, and truthfully, I imagine that most of my close friends had guessed that I was pregnant but just chose to respectfully wait until I was ready to tell them.  I have pretty great friends.

a photo from early December.
so happy to be feeling 100% better!
In retrospect, keeping up with my graduate school studies and my work during that first pregnancy was quite possibly easier than keeping up with my toddler and my work during my subsequent pregnancy, but I suppose that's a story for another time.

{the hyperemesis gravidarum saga, part 2 coming next}