HG - HYPEREMESIS GRAVIDARUM - A GUIDE TO COPING, MANAGING & SURVIVING
I can’t put my finger on why but for some reason I’ve written this blog, deleted and started again so many times. Something about trying to give my advice on this makes me feel anxious. Maybe it’s because the feelings are still raw or maybe it’s because I know deep down when you are in the depths, the trenches of HG nothing really helps and all you can do is survive each day and hold on to hope knowing that pregnancy is only 9 months long, for many HG isfo 16-20 weeks and that you’re carrying your precious baby who will make what is hell on earth worthwhile.
But even though it makes me anxious I am passionate about helping women far and wide to understand HG, to find help, treatment and to look for ways to manage and cope a little better both physically but also mentally too.
I want this article to be read by husbands, partners, family, friends and for them to help the person they know who is struggling through this to to manage because they have a better understanding of what is so commonly swept under the rug as “morning sickness”.
On that note I want everyone reading this to understand that Hyperemesis IS NOT MORNING SICKNESS, its not even all day nausea or pregnancy sickness, it is a serious life controlling illness that completely controls your life and consumes you. HG is a very serious illness.
SO WHAT IS HYPEREMESIS GRAVIDARUM?
HG is a condition during pregnancy characterised by severe and excessive nausea, vomiting, dehydration and weight loss.
According to studies I have read during pregnancy 85% of women will experience nausea/morning sickness but only 3% will have HG.
Hyperemesis is not morning sickness. It is a debilitating condition that consumes your life while suffering with it.
It is a rare but serious condition.
SIGNS AND SYMPTOMS
As previously said morning sickness (nausea and vomiting) in pregnancy is very common but its when it becomes more than that.
Signs and Symptoms include:
Extreme and constant nausea for a prolonged period of time.
Dehydration - dark urine or not urintating for a long period of is a very simple sign of dehyrdation
Extreme fatigue, dizziness & fainting
Ketosis - a serious condition where there are an elevated number ketones in your blood and urine which a poisonous acidic chemicals.
Hypotension (low blood pressure)
These symptoms are mainly caused by the excessive fluid loss and lack of nutrition because of the excessive vomiting and nausea.
TREATMENTS & COPING
There are a range of medications that your doctor can prescribe and even ones you can get over the counter that can take the edge off particularly once the first trimester of hell is over.
I was medicated my entire pregnancy with both girls.
The second time around I knew the protocol I wanted and what worked for me and being very firm with the emergency department staff in various hospitals certainly helped because a lot of the time they just brush you off and give you a zofran wafer and some fluids and wave you goodbye.
If you can find a OB or medical team who is understanding and wants to help work with you to find the best treatment plan for you you will be so much better off.
Also remember not all drugs work equally or for everyone for example both ondansetron and maxalon trigger anxiety and panic for me and actually make my nausea worse but they work for others.
These are some of the medications available to treat nausea and vomiting:
(This is just generalised info - not to be used as medical information but to inform you and help raise awareness around options available. Your doctor MUST prescribe what is best for you and your baby.)
Antihistamines - (Restavit, Phenergan etc.)
All medication comes with some factor of risk but these risks are small and all medications you’re prescribed in pregnancy by a doctor will be considered safe for pregnancy. For HG mamas taking medications must be weighed up against the realities of what your body is going through during HG with malnutrition and severe dehydration and usually medication is the only option to keep both mother and baby safe and well.
The HG Australia website has a great article on medication options and protocols READ HERE.
None of these will cure you but they can help take the edge off:
Essential oils I got mine HERE. Speak to someone knowledgeable about how they can help and how you can implement them.
Avoiding strong smells
Avoiding strong flavours
Eating Ice cubes
Plain foods no spice or no high fat
Asking friends and family not to cook around you or wear strong perfumes
Eating cold foods that don’t have a strong smell
motion sickness bands
Stay as hydrated as possible
Small portions of food at a time
Bland foods - no spices or not too fatty.
REST, so much rest is needed
The first time around I left it too long each time before presenting at ED. I would keep pushing my body so far and become so dehydrated I was barely able to comprehend was what going on. The second time I made a promise to myself and my husband that I would be more vigilant and stay on top of my hydration and if I needed to I would take myself to the ED. The hospital is not the funnest place to be but it where you need to be when things get really bad and you cannot stop vomitting.
If you feel like you have nothing left to vomit, there is blood in your vomit, you feel like you are dehydrated or you are concerned about yours or the health of your baby take yourself to see your doctor if you can get straight in or otherwise to the Emergency Department at the hospital . Your GP will often advise you go to the ED when they see you are suffering.
In hospital they will usually give you IV fluids to hydrate you and IV medications which work so much better than oral meds with HG as orally you often throw them back up before they have the chance to work. They will also check you and your baby to make sure everything is ok and check for ketones in your urine.
In serious cases you may need to be admitted put of a nutrition line to get nutrients and stay for a period of time to have a longer course of medication and so they watch your vitals.
Many people swear by acupuncture to help their nausea during pregnancy. I tried it a few times but could never make it through the session with out vomiting so decided to give up trying but I have heard wonderful things and would certainly try again next time especially of the end of my pregnancy.
As hard as it is eating is essential and can help you to feel slightly better and keep you out of the danger zone and hospital. The first time around I refused to eat and it made the situation so much worse. This time I forced myself and it definitely helped. I found in the first 16 weeks i could barely stomach anything other than white foods - hot chips, bread, crackers etc., icy poles, frozen drinks and some fruit. I listened to my body and ate what it was telling me. As much as it would be lovely to eat all the greens and lean meats its just not possible for most HG sufferers so don’t feel guilty and just listen to your body. There will be a time where you can eat healthy again. Small frequent meals are what are usually advised by your docs but just listen your body and take it as it comes.
The days living with never ending sickness are long and lonely. I found a lot of peace in writing down my thoughts (and sharing some on instagram). It also helps to see how far you have come. I also used my journal as a tracking tool for symptoms that I could then see how I was going each day and week and speak to my OB about.
Every morning as soon as I opened my eyes I felt an incredible sense of dread for the day ahead knowing it would be another day living in hell. I promised myself early on that I would do something for myself each day other than laying on the lounge feeling absolutely miserable. Usually exercise would be my outlet but being unable to train I needed to find another way. Meditation was my answer as it was something I could physically manage. Some days I would just do 10 minutes, other days when I was extremely sick I would go longer as I found it was a great escape.
There are lots of apps you can purchase to teach you how to meditate but you can also just find guided meditations on YouTube.
Pregnancy should be a happy time and unfortunately for us HG mamas its the complete opposite. Its long, exhausting and almost unbearable so its no wonder its easy fall into a very negative headspace.
Practicing mindfulness allows us to become more present and more grateful and have a more positive outlook.
Some ways to practice mindfulness during pregnancy:
Reading & journaling
Listening to motivational podcasts ( podcasts are a great way to pass the days in bed)
Spending time outside and really focusing on what you see and feel in that moment - the sun on your face, the trees in the wind, the fresh air.
Dancing and listening to music you love
Practicing breathing exercises
Paying more attention to things that make you smile through out the long days ( write them in your journal).
Getting up before your other children (if you can manage to get out of bed) and do something for you - have a cup of tea or read a few pages of a book
Finding mantras to repeat to yourself. Write them down - on your phone, in your journal, on your bathroom mirror, above the toilet where you spend most your days.
Plan a holiday or trip to celebrate your baby
Practice gratitude with yourself , in your journal or with your other kids
Acceptance and surrendering. This sounds so strange but once you surrender to the journey it can feel easier.
ASK FOR HELP & UTILISE ANY HELP YOU CAN GET
As women and mums in particular we tend to think we need to do it all and do it all ourselves.
But when suffering with HG you literally can barely look after yourself and many days you won’t even be able to do that. Don’t be afraid to ask for help, seek help and outsource help. This is going to be particularly important and totally necessary if you have other kids to care for.
When I was pregnant with Remi Millie spent so many more days in daycare, with her grandparents or having sleep overs with friends or family. I felt so much guilt but it was also so necessary for her as well as me. If I was to ever have HG again I would hire a nanny or au pair as I would not be able to physically care for two kids and be in that state.
If you can afford to outsource some cleaning to keep the house in order it will help you a lot.
If your friends or family as if they can help SAY YES!! Get them to look after the kids, walk the dog, clean, cook for the other members of the family, run errands - whatever you need. I know it can be hard saying yes but people generally don’t offer unless they mean it.
Speaking to a psychologist is a massive help when trying to navigate through the feelings and emotions. Its so helpful to have a safe place to vent and to help you rationalise your thoughts. A high percentage of women who suffer HG will develop antenatal depression so even seeking help before it gets to that point is a great idea. If you think you could or should see someone speak to your GP about a mental health plan (if in Aus) which will give you a number of sessions at a discounted rate.
FEEL THE FEELINGS AND DITCH THE GUILT
One of the hardest things that no one speaks about with HG is the emotional toll it takes and how many mixed feelings you will experience.
Pregnancy is meant to be a joyous time but when living through the hell of HG its pretty hard to stay positive or see the joy in everyday.
You may feel sadness, resentment, anger, fear, anxiety, overwhelm, depressed and even jealousy towards others who don't feel the way you feel. You may sometimes wish you weren’t pregnant at all. It’s okay. You’re not a bad person.
These feelings can be hard to accept because you know that you are also so grateful to be able to carrying a baby but what I learnt is that all these feelings can and will be felt and that gratitude can also sit along with these feelings. Just because you feel these feelings it doesn’t make you a bad person or mother; it just makes you human. HG is extremely hard, being sick for any extended period of time is.
Its so hard to not feel guilty about the feelings you may be feeing but the guilt doesn’t serve any one, it doesn’t help you and you don’t need to feel that way. Ditch the guilt and instead just feel your feelings.
SUPPORT GROUPS & WEBSITES
HG affects only 2-3% of pregnant women so it can feel like you’re completely alone. There are support groups and resources that can help you and make you feel more connected.
Some of these include:
HER FOUNDATION - THE WORLDS BIGGEST AND MOST EXTENSIVE HG SUPPORT NETWORK.
HYPEREMESIS GRAVIDARIUM AUSTRALIA - SUPPORT, INFO AND GUIDANCE WEBSITE FOR AUSTRALIANS