Thursday, August 8, 2013

Life with Hyperemesis Gravidarum

I’ve debated a long time about writing this post. I don’t want this post to be considered a platform for me to complain because I’m not writing this post to complain. I don’t want a pity party, and despite the struggles I’ve had with hyperemesis, the struggles are absolutely worth it when I consider my precious children. I’m writing this post because I want there to be more awareness about hyperemesis.  It wasn’t something that I was ever expecting (and even knew existed) when I became pregnant the first time. And even now, dealing with it for a third pregnancy, it isn’t something that is easily handled, physically, mentally, or emotionally.

What is hyperemesis gravidarum?

Hyperemesis gravidarum, or hyperemesis or HG for short, is a rare, extreme form of morning sickness. Depending on the statistics you read, hyperemesis occurs in anywhere from 0.2%-2.0% of all pregnancies. At times when I’m trying to explain my sickness I really dislike describing it as an extreme form of “morning sickness” because I think people just think, “Most pregnant women suffer with morning sickness, what’s the big deal? Can’t you just get handle morning sickness like everyone else does?” But hyperemesis is a big deal, and it isn’t something that can just be shrugged off or ignored. Hyperemesis really is extreme compared to typical morning sickness. It is often characterized by severe nausea and vomiting that does not subside, weight loss, inability to keep any food down, and sickness that extends past the first trimester (and may occur for the entire pregnancy). It is not uncommon for hyperemesis sufferers to be hospitalized due to dehydration. You can read more about the differences between typical morning sickness and hyperemesis here.

My pregnancies

(I apologize in advance for the length of these sections. Part of the reason I’m taking the time to write about my experiences here is so that I can remember for the future as well).

1st pregnancy

My first few weeks of pregnancy with Ella were pretty much symptom-free. I wasn’t sick, and I thought I’d be one of those women who didn’t suffer with morning sickness. I had reached the point when most women start to complain of problems, and I hadn’t had any. Then it hit. I got sick, really sick. At first I thought I was just having a few bad spells and they’d pass. I was trying every morning sickness remedy or “reducer” I could read about, but soon I got to a point where I just didn’t feel like I could handle it. Though I didn’t think there was anything my doctor could do for me, I finally called her because I was so sick all the time, unable to keep much down at all (I think I lost around 10 lbs within the first couple of weeks of the sickness starting). My doctor prescribed Zofran for me, and I went to the pharmacy hopeful for some relief. However, I was shocked when I got to the pharmacy and my insurance denied coverage for the medication. On top of that, the medication was extremely expensive (at the time around $1000 for a month’s supply of generic), and I couldn’t justify buying it. I called my doctor and my insurance, and had to go through what seemed like a lengthy pre-approval process to get the medication covered. In the approximately week/week and a half it took to get the approval I had gotten to a point where I couldn’t even keep water down anymore. I was absolutely miserable, unable to do much of anything but lay on the couch and throw up.  Finally, thankfully, my insurance gave approval for the medication, and after starting it I was finally able to start keeping water and food down.

I anxiously awaited the end of the first trimester, knowing it would mean the end of my morning sickness misery. But my first trimester ended and the sickness didn’t. I continued to suffer (although the suffering was decreasing some as I progressed in my pregnancy), and after the sickness continued through the midpoint of my pregnancy my doctor suggested that I have my gall bladder checked out. I did, and although I didn’t have any gall stones, the doctor said that there was “some evidence” in my gall bladder that could be causing my sickness problems and suggested I have my gall bladder removed three weeks after I had Ella. I had it removed, and with its removal I hoped and generally assumed I wouldn’t have that kind of terrible sickness with another pregnancy.

2nd pregnancy

Once again, my first few weeks of pregnancy with Troy were pretty much symptom-free. I wasn’t sick, and became very optimistic that my gall bladder had been the true cause of my terrible sickness after all. I was wrong. It hit again, although I think it came on a little more slowly, but eventually it was worse than it was with Ella. I was convinced that I must be having a girl because of the old wives’ tale that if you are sick you are having a girl, and if I was even sicker than the first time, this baby must be a girl (I was shocked when I found out I was having a boy). Once again, I got a prescription for Zofran, and tried to quickly get the process going on getting the pre-approval for the medication. Unfortunately, things were slow again, and I was miserable. My doctor prescribed a couple of other medications to try in the meantime (one of which was Phenergan), but they did pretty much nothing for me except make me sleepy (didn’t reduce nausea or keep me from throwing up). I was semi-optimistic that my problems would cease once I passed the first trimester, but once again, I ended up being sick and requiring Zofran my entire pregnancy (though things did get better towards the end).

3rd pregnancy

Once again, I started this pregnancy out without sickness, although I told my husband that I kind of felt like a ticking time bomb (just waiting for the sickness to hit). By the time I had my first doctor’s appointment, I still wasn’t sick, but I asked for a prescription for Zofran anyways because 1) I knew the sickness was probably coming and 2) we were vacationing in a couple of weeks and I didn’t want to be stuck on vacation without my medication. I am on a different insurance this time around, and they don’t require pre-approval (thankfully), but I do have to pay for the medication out-of-pocket first and then be reimbursed. It was so nice to have the medication from the moment that my sickness started because I never got to the severe throwing up that I had experienced with my first pregnancies because I was able to preempt the severe throwing up. The sickness has once again progressed throughout this pregnancy, and I’m still on Zofran at this point (34 weeks along) though I am actually able to function well now. Although I never had the severe throwing up because I had my medication to start out, this has been my “sickest” pregnancy yet. I attribute a lot of the extra sickness to the fact that I have to chase around two other kids, but I don’t really know if that is the case or not.

Everyday Life with Hyperemesis

Hyperemesis is not only physically exhausting and draining, but also mentally and emotionally exhausting and draining. Even after getting medication that keeps me from throwing up, I still struggle with almost constant nausea for a large portion of my pregnancy. I cannot even begin to describe how being nauseated all-day, day after day, for months on end affects someone. It is hard to complete everyday tasks at times. I look back at the first 5 months of this pregnancy, and I see a life of undone things (from the mundane to the important). My children and my husband were neglected. My house was neglected. Many other things were neglected.  I think about when I have a good day and hope that the good day means I’m moving in the right direction, only to be miserable again the next day. I think about the fear and panic that I have felt when I think I might run out of my medicine before I can get more. I think about how thankful I am to have a doctor who is considered “HG friendly” and is willing to prescribe the medication I need.

I want to end this post on a positive note. Children are a great blessing from God, and no matter how sick I’ve been or the struggles I’ve faced, their precious souls are worth it.

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