I’d like to start by congratulating you on a fantastic site- you have done a great job. I have only just discovered HUGS, even though our son Liam recently turned one. When I started reading the stories, I was dumbfounded – it was like reliving my own pregnancy!
I became pregnant in August 1998 after trying for only a short time, and we were both over the moon. Because it was planned, I knew that I was pregnant quite early on and started to do all the ‘right things’- that is, until hyperemesis struck. Within three weeks I had used up all my sick leave, had lost almost 5kg(12 lbs.) and had started on a nightmare treadmill of presenting to outpatients for rehydration (and waiting anywhere between 4 and 8 hours just to be assessed!). By this stage I had certainly given up any thoughts of healthy eating!
The other complicating factor in this whole mess was that prior to becoming pregnant I had made the decision (after discussing it with my doctor) to remain on antidepressant medication throughout my pregnancy. This was something I had thought long and hard about, but in the end it was a decision I was comfortable with. Unfortunately, the hyperemesis meant that I was unable to keep the medication down at all and it seemed to aggravate the vomiting, so I had no choice but to go off it. The weird thing was that when the hyperemesis was at its worst, it seemed to have an antidepressant effect in itself (due, my doctor thinks, to hormonal factors). So even though I was sicker than I had ever been in my life, I was not at all depressed.
The hyperemesis started to ease off a bit at around 23 weeks (by this stage I had lost around 18lbs), where I actually had periods in the day when I wasn’t nauseous. Despite this, I seemed to be less functional and was having difficulty coping with work (at this stage I was working halftime). When I became unable to sleep, having spent the previous 18 weeks sleeping about 15 hours per day, the penny dropped. I spoke to my doctor and started back on a small dose of Zoloft- and disaster struck again! The Zoloft reacted with Maxalon, which I had been on to try to control the nausea, and I became agitated, needing to go to hospital to get some Valium. By this stage the hospital staff definitely thought I was off my tree, and probably thought that psychological factors caused the hyperemesis in the first place. I wasn’t functional enough to argue or to figure out myself what had happened, but luckily my own doctor worked it out and I went back off Zoloft.
So when I was finally at a stage where I was not as nauseous, I found that it had been replaced by a deep depression and I was unable to sleep, had no appetite whatsoever and no motivation to do anything. It was at this stage that I formally gave up work for the remainder of the pregnancy, which was a heartbreaking decision (I work as a physiotherapist at a Children’s hospital, and apart from loving my job, I really felt I was letting people down). My doctor referred me to a psychiatrist who specialized in the area of ante-natal and post-natal psychiatric management, and she in turn organized for my ante-natal care to be transferred from my local hospital to the Royal Women’s Hospital (Melbourne’s specialist obstetric hospital) Although it was daunting changing hospitals at such a late stage - I had my first appointment at 30 weeks - it was the best move I could have made. It was a relief to finally deal with people who were prepared to discuss early induction in a non-judgmental way, and who allowed me to play a large part in the decision making process.
The weeks continued to drag by (I have never known time to move so slowly), and now it was a case of each week I got through being a bonus for the baby.
Reaching the 32-week mark actually seemed to take some of the pressure off and I found some new resolve to stick it out as long as possible. Not that I told the doctors that – I was terrified they might then push me to go full term, and even though I was feeling somewhat better I was nevertheless still counting off every half day, and trying to sleep as much as possible to help time pass faster. I was absolutely bored out of my brain but was incapable of doing anything to occupy my time, and spent most of my time in bed (my ‘safe’ area in those days) watching TV. Even now I don’t really enjoy watching TV, and can’t watch those programs I watched regularly when I was pregnant.
At about the time that I transferred to the Women’s, my stepfather was diagnosed with advanced throat cancer and underwent immediate surgery followed by radiotherapy. Following surgery, he was hospitalized for over four weeks and required a high level of care once he went home. Being so sick myself really limited the amount of time and support I was able to give, and since he died when Liam was only three months old, I feel that this was another thing HG robbed me of.
I ended up being induced at just over 36 weeks (and that took a bit of wheeling and dealing!) and Liam was born on 28/4/99 weighing 5lb 11oz. The labor was nothing compared to the pregnancy, and I was just SO happy not to be pregnant any more. I felt better instantly - within a day I was more active than I had been for a long time, and I had an appetite (for normal food instead of my staple diet of McDonalds thickshakes and filets of fish!). Liam required oxygen for the first 12 hours and needed to go under lights for jaundice, but really has thrived since he was born (better out than in I think).
By 3 months he had reached the 50th percentile for height and weight, so I felt happy with my decision to go for early induction even though at the time I felt very guilty. Liam is now 14months old and over four times his birthweight. He is developing normally and is a very happy and sociable baby (must be all that Zoloft in the breast milk!). I have enjoyed every minute and it was definitely worth it in the end - but I still haven’t been able to even THINK about another one, and the thought of going through HG again gives me the cold shivers.
Just to finish, I thought I’d list some of my observations/comments about the experience of going through HG:
*I spent a lot of time feeling guilty because all I wanted was to not be pregnant, and no one told me this was OK. In fact, until I switched to the Women’s any mention of early induction would be met with a shocked response and comments like ‘but if he is born early he may need extra care’, which made me feel even more guilty. It wasn’t until I found HUGS that I realized other women had felt the same way, and it didn’t mean they weren’t going to love their babies.
*From what I can gather, there doesn’t seem to be a consistent treatment protocol for hyperemesis – it appears to differ widely and be quite haphazard. I had a couple of overnight admissions for re-hydration, but on the whole it was done in the emergency department, and I was sent home with no follow-up. There was a general lack of knowledge on the part of the medical profession and I think that they were often frustrated because of this. Unfortunately this often came out in the way I was managed, and the attitude towards the cause of my illness (I don’t know how many times I was asked if the pregnancy was planned). Does anyone know of any studies that have been done to investigate which treatment works best?? – I think if there was a more definite protocol it would help address that feeling of being completely out of control and alone that so many of us seem to have experienced.
*As an extension of the previous observation, it would have been great to have some written information about HG and sources of support (I’m sure knowing about HUGS would have made things just that bit easier and I would have felt less convinced that I was going mad). A pamphlet, which could be distributed to relevant agencies, may make a difference to those going through the ordeal, and if it could prevent just one woman from those extreme feelings of isolation (on top of the HG!) then it would be worthwhile. This may also address another facet of this isolation by increasing general awareness of the condition (and stop the “yeah, I had shocking morning sickness too – you should try having crackers first thing in the morning” comments).
*There seems to be little or no follow-up for women who have suffered HG, either in terms of return to fitness (I reckon it took at least 6 months to start regaining fitness, not to mention trust in my body doing what I wanted it to do) or in terms of counseling about subsequent pregnancies (have there been any studies done on the probability of suffering HG in these, because I’m a bit dubious about the “every pregnancy is different theory”).
Thankyou for reading my story –I’m sorry it’s so long, but you don’t get many opportunities to talk about the experience (when I told my husband about the HUGS site, he said “aren’t you over that yet”). I’m looking forward to chatting more!