Tuesday, 4 December 2012

Duchess of Cambridge has Hyperemesis Gravidarum

Yesterday, it was announced to the world that the Duchess of Cambridge had been admitted to hospital for hyperemesis gravidarum.  Whilst I am pleased that this is bringing publcity for the condition and may help sufferers of it, I am not glad that she is suffering.  This is actually my first HG free December/Christmas in three years so I know first hand just how horrible it is to suffer from it at this time of year.  It is a pretty horrendous illness to suffer from especially since it is so misunderstood but to have to live through it whilst under the scrutiny of the world's media must make it far worse.

Already people are criticising both the fact that the pregnancy has been announced "too early" (whatever that means) and the fact that she has been admitted to hospital for "just morning sickness" whilst "us commoners just get on with it".

Hyperemesis gravidarum does not discriminate by social class.  Whilst some claim that her position means she has it easy and gets the best possible treatment straight away, I do not believe this to be so.  Given that admission to hospital meant announcing the pregnancy not just to friends and family at an early stage (which is something that many of us are forced by HG to do) but to the entire world, it is not likely that she would have rushed to hospital unless it was pretty bad.  Many of us have had hospital admission delayed due to prejudice and lack of knowledge but she and William must have had to think of the media attention involved when deciding whether/when to seek hospital treatment.  Hyperemesis gravidarum is not morning sickness - it is incomparable and requires medical treatment.

Just last week she was performing royal duties (i.e. doing her job) and while some critics use this to argue that she cannot be that ill, I disagree.  Firstly, once the vomiting strikes a person can go downhill to the point of needing hospital admission very rapidly.  And secondly, given she didn't know how serious her condition would become and given her position I imagine she forced herself to carry on at a time when many people would have had the option to call in sick for a day or two.

As far as announcing "too early" is concerned, why is it too early?  Yes the pregnancy might go wrong and I imagine that is why they did not want to announce it yet and only did so because they were forced to.  If they had chosen to then that would be their perogative.  Since they did not choose it but had it thrust on them by the nightmare that is hyperemsis gravidarum they deserve our sympathy and not out judgement.  I hope and pray that this pregnancy will not go wrong but I also hope that in the event that it did that people would be sympathetic and not judgemental.  Announcing a pregnancy does not cause it to go wrong and thirteen weeks is not a magic point beyond which it is safe and never goes wrong.

As far as media coverage of hyperemesis gravidarum goes, it has been a mixed bag.  I know that many people have been contacted through the Pregnancy Sickness Support Trust and have had good interviews but there have also been many medical professionals perpetuating the typical misinformation and old wives tales.

Hyperemesis gravidarum cannot be treated with ginger or pear drops.  In fact ginger is a bad idea if you are going to vomit as it burns on the way back up.  I believe research has shown it to have some effect on nausea but not on vomiting which presumably is why it helps with regular morning sickness.  Suggesting it to a hyperemesis gravidarum sufferer is like suggesting a sticky plaster to someone with a broken leg.  It just doesn't work.

Hyperemesis is not benign with no long lasting effects.  When I mentioned this particular claim (apparently made by a GP on national television), he said to me, "Don't some people lose teeth?"  He is correct.  Some people suffer organ failure, damaged oesophagus and other physical effects which can be long lasting.  Sometimes the illness is so severe or access to treatment is so limited due to lack of knowledge in the medical profession that women have to resort to termination of much wanted pregnancies.  Hardly benign with no long lasting effects.  It limits people's family size, destroys marriages and causes people to lose their jobs.  And then there are the psychological effects.  Reminders of the pregnancy and the illness such as the time of year, clothing or food you ate or didn't eat, places you went to etc can trigger flashbacks, nausea and sometimes even vomiting.  Seems long lasting to me.

And what about William?  Spare a thought for him.  Yes he is not the one lying in a hospital bed on a drip.  But he has to support his wife.  He has to see her this ill whilst not being able to do anything about it.  Last time I was admitted to hospital for hyperemesis gravidarum my husband thought I might die.  Money and status does not protect you from that or make it any easier.  I hope that Kate is one of the more fortunate ones whose hyperemesis goes by around twenty weeks but if it does not then he almost has to live with no wife for eight months.  I'm sure privilege and private hospitals do not stop it from being a horrendous experience for anyone and I hope that those around them are well informed and supportive.

Tuesday, 24 January 2012

14 Weeks Pregnant - A Day In My Life

0200: Wake to alarm, reach out for middle of the night milk and drink it. Go back to sleep. (I can't get through the night with nothing or at least having nothing overnight makes the sickness/ nausea worse and I figure having something in the middle of the night helps me get more calories.)
0530: Wake up feeling very thirsty. Drink three mouthfuls of water, feel sick due to drinking so much water and stay awake for the rest of the night.
0700: J's alarm goes off, take medicines.
0715: Take supplements with a glass of milk (brought to me in bed by J).
0725: Eat first half of breakfast in bed. (Half a weetabix with raisins and milk.) Browse Facebook in bed on iPod.
0745: Eat second half of breakfast then lie down hoping not to be sick.
Pray for a few friends, cuddle A who has just woken up and come through then send her to get dressed. Pray a bit more. Turn down offer of more breakfast.
0840: Wake up with a half dead arm. Open and close fist a few times to regain feeling.
0850: Clean teeth in bed, drink a mouthful of water and lie down again. Regret drinking water due to now feeling uncomfortably full and more nauseous.
0910: Consider running to the bathroom to be sick and narrowly escape needing to. Contemplate whether eating would improve nausea or trigger vomiting and conclude it would be the latter.
0930: Call A (who has just cleaned her teeth) through for a cuddle and a chat. Get A to "write" letters on my back for five minutes (inspired by the "40 ways to entertain your kids while lying down" link I found through Island of Grief, Mountain of Joy) while J is busy then give J some suggestions for today's educational activities.
0945: Listen to J and A discuss birds whilst still feeling too close to vomiting to move. Ponder whether eating more and vomiting might be more pleasant than continuing nausea on the brink of vomiting but conclude even the thought of eating is too unpleasant. Wonder whether getting up yesterday and sitting in an armchair was a mistake.
1000: Read Facebook for five minutes and take homeopathic remedies. Ponder whether I can walk to the toilet without triggering vomiting. Decide I can. Almost vomit in nappy bucket. Grab hair bobble off cistern and tie hair back to avoid vomiting on hair. Almost vomit in toilet. Ponder whether I should have eaten more as a fuller stomach makes for easier and less unpleasant vomiting. On vomiting discover stomach was almost empty. Rinse mouth and gargle with water. Decide not to use mouthwash in case it triggers further vomiting. Worry about teeth being wrecked. Return to bed and ponder whether a snack would be a good/bad idea.
1030: Have mouthful of water and ask J for a cheese scone. Realise there was no blood in the vomit and feel relieved. Listen to 2 Peter on iPod. Feel thankful for iPod. Resolve to be more patient. Drink two mouthfuls of water. Pray.
1100: Hear J cooking and feel sick at the remembrance of Sunday's pea risotto. Daydream about being able to select food without consideration of taste on the way back up and being able to eat an entire meal. Try to remember what that feels like. Decide to go on Facebook/other forums as a distraction from the nausea.
1130: A comes upstairs and gives me a present "to help me feel better".
1145: Eat first stage of dinner in bed (rainbow trout, mushrooms, tomato, broccoli & mashed potato) then chat on Facebook.
1220: Take some supplements and eat part two of dinner.
1240: Ponder how much water I can safely drink and have two mouthfuls in a vain attempt to improve dehydration headache. Chat briefly on Facebook before resting in preparation for trip to library.
1345: Ask J to get my clothes out. Get dressed, take medicine and drink additional two mouthfuls of water. Feel thankful for the ability to dress myself. Look at self in mirror on way out in the hope that I might look pregnant but find I still look thin. Hope thinness is due to my lack of fat and not a sign of SGA baby (Isabella was SGA). Go to car to be driven the 300 metres to the library with A.
1400: Sit in armchair in library for one hour of singing and story time. This week I managed most of the actions although it made my arms ache. (Singing is out of the question - I just don't have the energy/breath.)
1500: Picked up and taken home in car by John. Have small snack and lie down to recover as the activeness of the last hour has put me on the brink of vomiting. (Thankfully I did not need the tubs I took with me to the library.)
1600: Feel almost normal. Chat on Facebook and read the odd online news article.
1700: Eat half a ham sandwich.
1725: Take some supplements and eat other half of sandwich. Feel uncomfortably full and slightly nauseous but not at risk of vomiting.
1800: Eat rhubarb yoghurt.
1820: Sit up to play a couple of rounds of "Guess Who?" with A and have goodnight chat/cuddle. Notice A feels warm so ask J to get the thermometer to check. She announces she will have to sit with me and watch the Mr Benn DVD all day tomorrow due to her temperature.
1840: Feel worse from sitting up so lie down to recover. Reflect on the probability of being sick later.
1900: Pray.
1915: Feel thirsty - risk drinking three mouthfuls of water at once.
1930: Start watching a DVD with J. Feel glad that the planning/preparation I did for being ill means we actually get to spend time together. Regret drinking so much water.
2000: Eat 1/4 serving of M&S apple cake given to us by friends. (J must think he should share it equally as he has been eating equally tiny portions of it.)
2030: Feel too worn out to sit up any longer so ask J to stop DVD. Lie down and catch up with messages and Facebook. Feel very thankful for Facebook and friends on Facebook - that and internet access through the iPod really help me to feel less isolated/bored/lonely when ill and limited in what I can do. I am blessed with some wonderful friends.
2045: J gets fresh pyjamas out and I realise with dismay that thanks to going out I am dressed and need to change for bed. Get changed. Clean teeth in bed. Take homeopathic remedies. Realise I forgot to take them this afternoon. Take final antiemetic of the day with three mouthfuls of ice cold water. Appreciate the ability to drink water and think about how useful it is.
2105: Reflect upon how my character could be improved and resolve to make more effort to be quick to listen, slow to speak and slow to anger.
2115: Listen to J read a chapter of The Horse and His Boy.
2130: Turn light off, pray, note nausea has increased and hope tiredness will outweigh it. Eventually sleep.

Food intake ~1500Cal (about average). Fluid intake ~1.2l (below average).
Overall day in-between average and good relative to the last week.

Saturday, 7 January 2012

Hyperemesis Gravidarum Pregnancy Three - Twelve Weeks

Today while J and A were out I went downstairs and cut, buttered and ate a slice of (homemade!) bread. Okay the bread was out on the worktop unbagged because it was fresh and I left the dirty knife on the worktop so it wasn't as much work as it should have been but still, I did it myself

This is exciting for two reasons: 1. In previous pregnancies I couldn't eat HM bread and 2. I would never have gone to such extreme lengths to get food for myself.

Although still limited relative to normal, there are a number of significant things I can eat this pregnancy but couldn't in the others. In addition to the HM bread (I only had a short phase of being unable to eat it) I can drink water and I can eat sweet things. In previous pregnancies just the mention of many sweet things made me feel like I might throw up so it is very nice not to have that. Also it is rather useful to be able to drink water (in my first pregnancy I was worried I'd never be able to drink it again) and I'm sure the ability to drink water has been a big factor in my staying out of hospital this time.

I actually feel well enough to possibly start "getting up" routinely now (ie spending my days in an armchair downstairs instead of in bed upstairs) but as I have my "booking" appointment with the MW on Tuesday I think I should save my energy for that and start getting up once I have recovered from it.

Wednesday, 4 January 2012


Engulfed by fog again
The fog I know so well
It sucks away my life
As I try to find my way
I cannot see ahead
To where this path will lead
Yet what I fear the most
Is that this fog might leave

Tuesday, 3 January 2012

Hyperemesis Gravidarum Pregnancy 3 - The First Trimester

Not long after my last post my nausea disappeared completely. I stopped everything I was doing to minimise/avoid/control nausea/vomiting and the nausea did not return even though I was continuing with my normal everyday life so I assumed the worst.

About a week later (5 1/2 weeks) I came down with the flu and ended up in bed and throwing up right about when I had in my previous HG pregnancies. After a week all my flu symptoms had gone except the vomiting. Initially I thought it was just in my head because of associating pregnancy with being sick but when it started to get worse after almost another week I realised it had to be pregnancy sickness and resumed taking all the medicines/supplements.

Once I started taking everything again I improved a bit and settled into a pattern where maybe once a week I kept all meals down and the rest of the time it was 50/50 whether I kept down one or two. In the first 2 1/2 weeks of sickness I lost 5lbs followed by 1lb in the following week after which my weight stabilised. After Christmas I had a few better days without being sick before getting worse again (nausea almost as bad as the worst bit but actual vomiting less). Now at 11 weeks it seems to have settled down to an average of once a day but ranging from zero to three.

Summarised like that it doesn't really sound that bad. Indeed it's been my best pregnancy so far and having not ended up in hospital due to out of control vomiting I did wonder whether it was legitimate to call it an HG pregnancy. But thinking about it, I'd say it is an HG pregnancy - it is just controlled this time. Although I don't have the out of control vomiting or excessive weight loss, it's not really normal morning sickness when you have had to stay in bed pretty much doing nothing (in addition to all the medicine) in order to achieve that.

I'm convinced that the early disappearance of nausea and how much better this pregnancy is (eg I can drink water, dress and bath myself and stayed out of hospital) are down to the different medication. I am also hopeful that this means I will improve enough to be able to resume some of my normal life during my pregnancy. Which not only would be quite nice as sitting/lying about while your life passes by isn't much fun but would make life easier for J as he wouldn't be having to do everything I usually do AND look after me AND do his normal job.