My Hyperemesis Gravidarum Story

I want to share my story about Hyperemesis Gravidarum (or HG) for a few reasons. First, that it is a big part of my pregnancy and motherhood journey and so for anyone curious about that this is a peek into my story. In honor of Maternal Mental Health Awareness Month the primary motivation for sharing my experience is for the sake of anyone who stumbles upon this post while facing similar circumstances to know they are not alone.  Over the past few years, friends and friends of friends who knew about my experience would pass my number on to moms having a tough time and I was always more than happy to be the understanding ear on the other line who at the very least could commiserate but often could share resources or tricks that helped me. The HG in some ways made me feel like I was doing pregnancy wrong. I never got that second trimester burst of energy and my glow was questionable unless you count the sweat beading off my face during one of my numerous vomit sessions. It wasn’t an easy road but at the end of it was two healthy baby girls and I’d do it all over again. I mean I DID do it all over again, but as far as a third time, that chapter is closed. 

I’d grown up hearing about how sick my mom was when she was pregnant with me. My dad told tales of bringing home IV bags of fluid from the hospital where he was a resident and hanging them from the ceiling fan when she would become so dehydrated from days on end of vomiting. When she was pregnant with my little sister I remember her in bed, I remember being picked up from Pre-K by her sweet friends and having special picnics and outings. I didn’t have much other exposure to women being pregnant and when we were one of the first of our friends to have children, I thought crippling nausea and endless vomiting was just the way things were. How many TV shows or movies can you think of where the women don’t find themselves rushing to the nearest toilet as the surefire tell to the audience that they’re pregnant. Except maybe “I Didn’t Know I Was Pregnant” which is another conversation entirely!

When I was 4 weeks pregnant and didn’t know it yet, I just felt off. I was in Austin for Curtis’s graduation from the UT MBA program and was exhausted and suddenly feeling green at the thought of chardonnay, which was unusual! When we got home to Dallas and 5 days before my missed period, I took a pregnancy test – actually 6 years to the day of publishing this. Because of a medication regime I was on for migraines I had to test a lot and early each month, so after 6 cycles of trying I was starting to get used to the negatives. Even with these subtle changes I was shocked to see a positive test. We ran to Target to buy more and all the lines, YES+ and 🙂 told us what we’d been praying for. A bit of blood work later and we were feeling on our way with an estimated due date at the end of January. Week 5 came and I was excited and so far vomit-free but starting to feel more poorly. By week 6, at the end of the school year – even though we hadn’t told our friends and family – I told my principal because I could just tell she might need to be in the loop. I could almost feel a turn coming. Sure enough during the last 3 days of the year the pukefest began. Three days in a row of non-stop vomiting. Here we are, I thought with a shoulder shrug – this is what pregnancy is. At about 8 weeks I had my OBGYN visit and we talked about my symptoms, plus my weight loss, so she prescribed Diclegis and we decided on a little Phernegan just in case, since that is a nausea medication that works so well for my migraine nausea. 

The next two weeks were a roller coaster of “morning sickness”. Not a lot of getting out of bed. I wanted to tell my friends our news since obviously things were not normal. Plus we were so excited. So we had them over for dinner under the guise of a graduation celebration for Curtis. I was having a “good” night and when we told them they were so surprised and excited and of course asked how I was feeling. I said “pretty good, just nausea and vomiting but that’s normal right?” I shared that I was nervous about the upcoming trip I had scheduled to take our middle school team to Speech and Debate Nationals. It was a big deal and our school’s first time competing. We’d fundraised from generous friends and community members to send our students up to Kansas City. I was set to travel with my friend and co-coach but no other chaperones. Luckily my one pregnant friend – she was 4 months with Margaret’s future bestie – encouraged me to ask if my mom would go, and get permission from the school and parents to have her chaperone. I didn’t think I could feel much worse than I did, so was pretty sure I’d manage just fine, but I listened and thank God I did. My mom was an absolute savior on the trip considering some parts of the day I was so sick there was no way I could safely drive the children to the competition, let alone get out of bed. The students could tell something was wrong but I was still just 9 weeks so I didn’t want to tell them God-forbid something happened. I was so relieved to get home after a special, but tiring trip,  and crawled into my own bed. I don’t know if I left the house the next week. After a particularly long day and night over the toilet, I was so faint I couldn’t stand. My heart rate was out of control and the on-call OBGYN said to head to the ER. Everything was healthy and normal  with the baby and after a few hours of IV meds and fluids I was discharged. My doctor followed up the next day and suggested we switch to Zofran. Clearly the Phenergan wasn’t working for my pregnancy nausea and the Diclegis wasn’t touching it. I was on Zofran all day. I used the kind that dissolved under the tongue. For breakfast each day I’d nibble on some crackers and drink chocolate milk. I really don’t know what all I subsisted on for the first trimester but it was primarily watermelon, canned artichoke hearts and buffalo mozzarella. Everyone kept saying it would get better. Just wait until 12 weeks, maybe 14 – you’ll feel so much relief. And I believed it, and prayed that would be true. 

At 11 weeks, the Zofran was helping. I was still vomiting daily and was nauseous on some level all day. Even at night I was occasionally awakened by it and tried Reglan, but it caused extreme hallucinations so I discontinued it. Luckily the night puking was a phase. 

Curtis and I wanted to do a trip over my summer break. We figured we’d take an early babymoon and hoped that by week 12/13 I’d be a lot better. We booked a trip to fly from Dallas to Amelia Island, FL  for a few days and then drive up to Palmetto Bluff for a few days. On our way to DFW Airport I was throwing up and had to change clothes before going through security.  From JAX airport to the Ritz Amelia Island I threw up so hard I wet my pants and vividly remember heading to the check-in desk with my jean jacket tied around my waist. Our room was beautiful and that night we settled in. I remember loving a soup they had on the menu and staring at the ocean from our balcony, feeling pretty gross but still over-the-moon. The next day I felt terrible in the morning but no throwing up. I still took my Zofran per usual and it kept things at bay the whole day. My first day without getting sick in so long was spent drinking virgin margaritas and lounging by the pool. We made the announcement on Facebook and the next day was spent similarly and I was cautiously optimistic that things were indeed looking up. On day three of no puking I called my friends and shared that prayers had been answered and it looked like that magic 12 week mark everyone had been talking about had arrived. 

By now obviously you can guess it didn’t end up that way. The next day we drove up to Palmetto Bluff, and I was so excited to show Curtis this magical spot that I’d only been to with friends. I was able to have my first massage since getting pregnant and it was amazing. We cooled off at the pool, but things were going downhill. I remember being largely unable to eat and ordering a plate of sliced limes to suck on from room service. The next two days I spent almost entirely in my room and the only sights I saw were the bed and the toilet. Curtis was a sport and took great care of me, and occasionally tootled around the property on his bike. We headed back to Dallas on a low-note while the down slide continued and at around 14 weeks I landed in the ER again. 

It was after that visit that my OBGYN called me and said, “I think we may need to talk about how this isn’t going away and might not until you deliver. You might see some relief about halfway through but we need to do something and I’d like to recommend home health care.” I felt relieved and assumed that home health meant I just wouldn’t have to go to the ER every time it got so bad. But when the nurses called to schedule me they explained I’d be started on a pump. I didn’t love the sound of that and they caught me on sort of a good day. I asked if I could talk to my doctor again to ask some questions and they said of course and we hung up. I asked my OBGYN if she thought we could wait the few more weeks I had where I was still on summer vacation. After all I was spending all my days in bed nibbling on whatever I could stomach and sipping on pedialyte, so maybe I could ride it out a little bit longer. The thought of the pump scared me. She agreed and would call to check on me weekly. It was a pretty rough few weeks but I stayed out of the ER. Still on oral Zofran around the clock, the days got a little more bearable. One day my sister came to drive me to the grocery store because I started to have more of an appetite. She would stay overnight occasionally because Curtis had started to travel more and more. My friends were supportive and would drop off special treats like a bag of sonic ice and fresh sourdough bread for me to toast since I wasn’t eating much more. I remember one of my first outings. I put on real clothes and went to a backyard BBQ. I was upright and chatting, nibbling and even a non-alcholic beer sounded good. Things continued like that as I eased into school. The symptoms became more manageable and I started back teaching. The days were long but I was handling it and was so glad to be functional again. I was still throwing up every single day. Mostly in the morning. Sometimes in the late afternoon and early evening. But I was able to consistently eat and drink. I was on Zofran until I delivered Margaret. 

After the blur of labor and delivery and snuggled with my new bundle of love, I realized I wasn’t nauseous. The next day I didn’t throw up. And the next. And the euphoria I felt at the haze of nausea being lifted was otherworldly. I don’t know how it is for everyone, but for me I was nauseous for nearly 9 months and then suddenly not. 

We were pretty sure we wanted to have another child, though knowing that for sure was the first hurdle, but whenever that conversation happened it always included plans for what would most likely be a round two of HG. Well-meaning people would say “you never know” or “maybe it’ll be a boy” but my OBGYN cautioned that I was more than likely to experience it again and this time possibly worse. So we needed a plan. When would I start medicine not if. What would my care plan be for Margaret when it got really bad, not if.  

When I got pregnant again I felt nauseous almost immediately at 5 weeks, but this time I called the doctor’s office and they stuck to our plan by prescribing Diclegis and Zofran right away. The first few weeks I felt pretty good. I was taking Zofran pretty much every day, and was nauseous and vomiting, but it wasn’t a “knock me on the floor all day” kind of thing and I felt optimistic. I even wondered if maybe it was a boy? Maybe there was more truth to that supposition than not! Before I could buy much blue smocking things started to spiral. More days than not I was canceling plans, laying on the couch all day gating Margaret in the family room with me, when finally the intractable vomiting kicked in. Because Curtis traveled each week, my mom came out to stay with me, followed by my mother-in-law, but it continued getting worse. This time my OBGYN said we needed to revisit home health and a Zofran pump and I said yes. Within a few days I was greeted by a friendly nurse who had experienced HG herself. She was loving and kind while she taught me about my new IV. Then she taught me how to insert my pump and change it. She taught me all about the equipment and briefed me on my new normal. I’d insert the pump’s needle into my lower abdomen each day and manage the Zofran dosage through the brick-sized pump that was connected to it via the tubing that popped out of the fanny pack holding my equipment.

When I was hooked up to fluids I was either in bed or rolling my pole around the house, but I wasn’t always needing those. Each day I had nurses call to check in and they were angels. I tested and reported my ketones, my water intake, my daily weight gain or weight loss, number of times I vomited, and nausea level. We’d talk about my pump and make any adjustments. And perhaps most importantly they’d ask me about my plans for the day. It was so helpful to have someone on the other line who had a really good idea about the storm I was in and be a voice of encouragement. I struggled with feeling like I could go anywhere because what if I “did something to make it worse” and they were emphatic that I wasn’t going to make it worse. Resting when I felt it necessary was key but having a life was also important and the pump and my consequential improved well being allowed that. 

I was scared of the pump and it was one of the more intense experiences of my life, but in hindsight I would’ve accepted the help during my first pregnancy. It made life during this particular rough period easier to actually live which was not only important because of Margaret, but because we were about to move from Dallas to Florida and those last four weeks would have otherwise been spent making trips from my bed to the ER and back again. Instead I was able to hang out with friends, spend extra time on the playground with Margaret after pre-school, host a baby shower, have mom’s night outs, make a floral arrangement for my garden club flower show, attend birthday parties and just plain live my life. Each week with the help of the nurses I weaned down with the hope to try and go back to oral Zofran at 20 weeks and thank you God I was able to do that. It was a mix of feelings being able to unplug for the first time and sleep without a tangle of tubing. It wasn’t perfect. For weeks 20-24 the mornings until noon were incredibly rough. Sometimes I’d lay in bed and where I was at the time I could see Margaret in the shower and roll to the side toward my trusty trash bag when necessary. I’d turn it on and let her endlessly play in there and get through the worst of it. But by week 24 things were more normal. I still got sick in the mornings, sometimes the evenings, and walked around clouded by nausea- but it was doable. Most importantly baby Catherine was healthy and I was getting quality time with Margaret before she became a big sister. And for the record, I don’t think Margaret remembers the pump or even how sick I was because trust me, she would bring it up. At the time it was devastating for her normal to include a mommy with needles and tubing who sometimes laid on the bathroom floor in between fits of vomiting and with each week that things got less extreme I was able to do more with Margaret before her world was rocked. We even went to Disney for a few days, but that was a herculean effort that I don’t quite know how I managed! But I will say how special it was and how glad we are that we did it. 

The rest of my pregnancy with Catherine after I was off the pump was similar to my experience with Margaret. Still on the Zofran all day, I continued with nausea and vomiting until I delivered and then – poof, it was gone. With both girls I had complications at the end. With Margaret I had high blood pressure at 37 weeks that had me in the hospital and then on bedrest at home with an early induction. With Catherine the blood pressure spiked earlier on so I was closely monitored so that in case it escalated into Pre-Ecclampsia there would be no missing it and they could swiftly act – which is exactly what happened at 37 weeks. That’s a story for another time, but certainly an important aspect of Maternal health as well. But just as with Margaret, the haze of nausea lifted and suddenly no more vomiting.

With my season of pregnancy behind me, I realize that early intervention was the key. During my first pregnancy, I wish I would’ve reached out earlier to ask for help with the nausea and vomiting but I didn’t know or realize how bad it was.  I also would have accepted the home health care and pump too. Even though I pushed through it, I needlessly experienced weeks alone in bed completely at the mercy of the nausea and vomiting. Had it not been summer break I would have been unable to work and I am sure that would’ve made a difference in my decision making. I learned through all of the time with the home health nurses that many women simply need it for a few weeks like I did, though some need it the entire time or, God bless them, are hospitalized with feeding tubes. But for most of us in the small population of HG experiences, it is a temporary measure to help through a particularly rough patch. The other thing that would’ve been helpful is an HG community of some kind. If I’d known of social media resources to follow during either pregnancy I would’ve done so just to gain some sense of perspective and practical tips.

The HER Foundation is a wealth of resources for women and those who love them that are experiencing HG. If you or someone you know might be experiencing this, their chart is very helpful in exploring Morning Sickness vs. Hyperemesis Gravidarum. 

I had wonderful doctors who took me seriously and if anything, at least with Margaret, I wish I had been more forthcoming about my symptoms then maybe I would’ve had appropriate interventions sooner. My husband, family and friends were also so supportive. There are HG patients who are not as fortunate and face skepticism from even their own healthcare team. If you’re caring for someone with HG or just a concerned friend, this resource is helpful. There is so much more to my story. So many details that have surfaced as I sit and write this, including memories that are a bit traumatizing. If you’re reading this and struggling, my mantra was this will end. Because it does end, even if it takes a while, repeating that simple truth was helpful. But it is a wild ride and I still can’t believe it was my story – twice. For those walking a pathway of pregnancy related challenges – and I know there are so many who are – my heart is with you. From the roller coaster of symptoms, the potential stress on your relationships, the impact on your ability to perform your job, your fears for your baby’s safety or the own long-term consequences you could be facing, it is just A LOT! The sustained experience of all of that can weigh on you, and to top it off you may be more isolated than ever and as such your mental health may require a little extra care. In previous posts I’ve touched on about my time with postpartum anxiety and panic disorder, and my HG has been brought up during evaluations as a potential contributing factor. If you’re in the middle of the storm do whatever you have to do to take care of yourself which might include the care of a therapist or taking antidepressants.