Annelise’s First Birthday

Have you ever forced yourself to smile even though you feel like hell on the inside? Nothing about nausea is pleasant. But what do you do when your nausea lasts for 9 months? People might be sympathetic for the first few months of the pregnancy but they expect you to feel better after a while. So, at some point, you have to suck it up and fake a smile for the world. And at some point, you have to minimize your symptoms and tell people you feel okay even though you don’t really feel all that great.

So I forced myself to smile for Annelise’s first birthday this past July.

Traditionally, Korean families hold big celebrations (called “dol janchi”) for their child’s first birthday. Apparently, this tradition came about because in the past, babies frequently died before their first birthday due to various diseases. So if a baby made it to his or her first birthday, it was a big deal. Of course, these days in Korea, most babies survive well past their first birthday but people still throw elaborate and extravagant “dol” parties.

Because of the HG, I hadn’t done a single thing to prepare for Annelise’s birthday party. Honestly, I wasn’t even sure I would feel good enough to even attend her party! We decided to do a simple, cozy family party. My mother-in-law made the reservations for the restaurant. My mom arranged catering for the fruit and dessert and she also bought a han-bok (traditional Korean dress) for Annelise. The one thing I did was order a custom-design cake for her.

It took every ounce of energy for me to get ready and go out to the restaurant for Lisi’s birthday. This would be the first time I would go out in public since my HG nightmare started. I had just discontinued my home IV treatment. Taking a shower was arduous. Getting dressed and putting on makeup for the first time in months felt strange. I was very anxious about throwing up during the car ride to the restaurant or during her party but thankfully I made it through the day without vomiting. I couldn’t eat too much because my stomach still hurt every time I ate anything.

I forced myself to smile during pictures – I really wanted a good family photo. It was pretty overwhelming to see all our relatives after being cooped up at home, but I was so thankful for everyone coming out, so I forced more smiles.

Annelise is quite a character. She became cranky and started bawling in the middle of the party because she was sleepy and tired. But as soon as we gave her a snack, she immediately calmed down. She loves food!

Looking at her gleefully chowing down on the puffs made me smile. And this one was a genuine smile…I was glad that my daughter was happy. I was thankful that the Lord blessed her for one year and that she is so healthy and chubby. My first HG miracle baby.

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Beyond Morning Sickness

I’m 31 weeks and I’m just so tired…tired of the unending nausea. It seems to have gotten worse this week. I’ve been more constipated (maybe it’s a 3rd trimester thing?) which probably makes the nausea worse. I feel so gross.

I’m tired of being stuck at home and not being able to go out regularly. I’m tired of being dependent on everyone. I’m tired of the nerve pain in my leg and major pelvic pressure. I wanted to go see the acupuncturist today for the nerve pain but I was so nauseous…I decided not to go after all! That’s when I realized the nausea is worse than the pain. I’m tired of waiting for the baby to come. I’m tired of people not understanding HG fully. I’m tired of being a halfhearted mommy to my 15 month old. I’ve been feeling down all day today due to the nausea.

By the end of the day, the fatigue was taking its toll on me. I broke down and started crying…but I couldn’t wallow in self-pity for too long because Annelise brought me a book and asked me to read to her. I wondered if she noticed that mommy had been crying. She didn’t seem to notice thankfully. I read to her…in between broken sobs. And then she wanted me to read the book again. So I did, even though I just wanted to cry.

I decided to email Beyond Morning Sickness, a nonprofit organization dedicated to supporting women suffering from HG. Ashli Foshee McCall, the founder of this organization, wrote a book about her HG experience, “Beyond Morning Sickness”; she chronicles her horrific battle with HG which ended in termination of her pregnancy. The book also contains valuable information about hyperemesis as well as a comprehensive treatment plan for HG.

Someone from BMS emailed me back immediately and offered to send me a free copy of Ashli’s book as well as a children’s book about HG. He also said that one of their volunteers (someone who has survived HG) could offer support via email. I was so touched by the generosity of this organization. I emailed him back to thank him and this is the response I received (which brought tears to my eyes):

“Mimi, you are more than welcome!  Thank you for your wishes for Ashli.  And thank you for doing so much for your baby.  YOU are an example of what true generosity is.  It’s easy for me to ship out a few books — but the sacrifice you are making is simply astonishing.  You have endured the horrendous suffering that HG brings for another human being who you have never met, and who may not even have a name.  The few minutes and few dollars I spend for you are nothing compared to what you are doing for your family and your baby.

God bless you!

Lyle”

I was so touched by this email! It is nice to know that someone truly understands what I’m going through. I’m really looking forward to reading these books. If you or anyone is suffering from HG right now, please contact Beyond Morning Sickness!

Getting “Crackered”

If you don’t have HG, you probably aren’t familiar with what getting “crackered” means. HG sufferers came up with this term to describe moments when non-HG sufferers offer (well-meaning, but insensitive) advice/suggestions regarding the pregnancy or to help reduce nausea. A common suggestion that people like to give is, “Try eating some crackers and you’ll feel better”. I guess getting “crackered” is inevitable since HG is such a rare, unknown disease. But it is frustrating nevertheless! Here is a list of times I got “crackered”:

1)      “Have you tried _________?”

If only there was an easy, magical cure for HG! Yes, I’ve tried ginger. I’ve also tried ginger ale, sea bands, Unisom, Vitamin B6, oral Zofran, oral Phenergan, oral Compazine, oral Reglan. I’ve tried everything under the sun and nothing has worked.

2)      “You’ll feel better after you eat something.”

I never feel better after I eat. I feel more nauseous after I eat. And during the worst of the HG, I threw up everything I ate.

3)      “Why don’t you try taking a walk outside? Maybe getting some fresh air and exercise will help you feel better.”

Any kind of motion/movement will make the nausea worse. Do you know anyone who wants to exercise when they’re nauseous?

4)      “You’ll forget all about it when the baby’s born.”

I still have traumatic memories from my first HG pregnancy and I know I’ll have long-term trauma with this pregnancy. HG is something that one never, ever forgets.

5)      “This is what moms have to go through…”

Many moms go through morning sickness. However, most moms do not go through hyperemesis. HG only occurs in 1-2% of pregnancies!

6)      “You look good…you don’t look sick at all!”

The reason I look good now is because of a lot of makeup and because you only see me when I feel good enough to go out in public. You don’t see me when I stay at home because the nausea’s so bad, when I’m vomiting into the toilet, when I’m in bed half the day. You didn’t see me when I was on IV treatment and when I had lost 15 pounds.

7)      “It’s easier now when you’re pregnant…Enjoy it now. Wait till the baby gets here…you won’t get any sleep!”

You think being nauseous 24/7 is easier than taking care of a baby? You clearly have not dealt with nausea on a long-term scale. I would much rather deal with sleepless nights with a newborn than the unrelenting HG nausea!

8)      “So you just suffer?” (the anatomy ultrasound doctor asked me this when I told her that anti-nausea medications don’t work for me so I haven’t been taking anything orally)

Yes, I just suffer. I choose to suffer because I’m that masochistic!

There are HG sufferers who have had friends or relatives doubt/minimize their symptoms and call them “lazy” because they are lying in bed due to the nausea/vomiting. It’s infuriating to think that people discredit HG as if it’s something fake or just “in your mind.” Fortunately, for the most part, my family and friends have been very supportive and understanding. But at times, I still feel paranoid that maybe people will think I’m exaggerating my symptoms. If you know someone suffering from HG, please refrain from “crackering” them. The best thing you can do is to simply offer a listening, non-judgmental ear. And please pray for them because HG is a spiritual battle as much as it is a physical one.

Depths of Despair

When I was in the midst of the worst state of HG during my first and second trimesters, it was a very dark and scary time not only physically but even more so emotionally/spiritually. I think when your body is going through hell and when your life is on the line, inevitably your thoughts turn very bleak. My mind was clouded with this fog of overwhelming nausea that I couldn’t escape.

I couldn’t think or concentrate. I couldn’t read anything. Any movement or motion would trigger a vomiting episode. So I slept a lot or stayed in bed. I watched a lot of TV to try to take my mind off of the nausea. I was on daily IV treatment at home. My life was dependent on this contraption attached to my arm. I had to push the IV pole everywhere I went…and the only places I went were the bathroom, my room, and the living room.

I was bed-ridden for almost three months. The isolation, loneliness, dehydration, constant vomiting and nausea, and starvation really start to eat away at your soul. HG strips away all semblance of a normal life. I couldn’t eat. I couldn’t sleep at night because of the nausea. I couldn’t go out because I was attached to the IV and was too weak. I couldn’t take a shower because the heat from the water would trigger my nausea. I didn’t feel human. I felt like a shell of a person…like an animal barely surviving.

It felt like I was on the brink of utter insanity. Every week, I would hope that I would feel better and every week, I wouldn’t feel better. With my first HG pregnancy, I felt so much better after my first trimester so I expected the same relief at the end of the first trimester with this pregnancy. So when it didn’t come and I was still throwing up and still not gaining weight, it felt absolutely hopeless. It felt like I was on this long, dark path with no end in sight and no relief from the nausea. Every meal I threw up felt like a slap on my face. Every time I weighed myself on the scale, I would get frustrated at the low number.

Depression and anger stewed in my heart. I had fleeting thoughts of death. A lot of death fantasies. I would tell Danny – “Just shoot me. Just kill me now.” Pain sounded better than nausea. Death sounded better than nausea. Anything seemed better than nausea! I wanted to die every day just to escape the never-ending nausea. So many women who experience hyperemesis battle depression on top of the physical disease.

Many women with HG contemplate terminating the pregnancy to end the battle with nausea. Some women actually follow through with the termination. Every minute of the day, I was tempted to terminate the pregnancy. But somehow I couldn’t. I had to focus on the end goal. That it would be worth it in the end when we have our little baby girl. I had to fight every instinct to die, give up, or to terminate the pregnancy.

It was a daily battle. I clung to the fact that my suffering had to have some meaning, right? I read stories of women with HG who were actually recommended by their doctor to terminate the pregnancy because their symptoms were so severe that if they didn’t terminate, their own life would be in danger. I cannot fathom the thought of being forced to make that choice. I also read stories of women with HG who miscarried even in their third trimester. I can’t imagine suffering HG for that long only to have your baby taken away from you.

So I was thankful – thankful that despite how miserable I felt, my baby was alive and well. And I was also grateful that Annelise survived an HG pregnancy and is so healthy today. I’m also reminded of what Marilla Cuthbert would say to Anne Shirley when she was going through the “depths of despair” – “To despair is to turn your back on God.” Somehow by God’s grace, I survived my first and second trimester.

Thankfully, most women with HG get through this period of darkness until the nausea subsides into a more manageable level. However, if you or someone you know is experiencing persistent suicidal ideation, please contact: 1-800-SUICIDE

If you want to vent or talk to someone about your HG experience, please take a look at the following resources:

Hyperemesis Education & Research Foundation, www.helpher.org (leading source of information for moms, family members, and medical professionals; contains medical studies and treatment options)

Baby Center’s online support group for hyperemesis suffers, http://community.babycenter.com/groups/a986645/hyperemesis_sufferers

Beyond Morning Sickness, http://beyondmorningsickness.com/ (offering books for moms and kids, forums, and phone mentoring support)

Ayden Rae Foundation, http://www.aydenraefoundation.org/ (HG advocacy and research organization)

Annelise’s Birth Story

This is the story of my first HG pregnancy. Danny and I got married in December of 2008. He left for a deployment to Africa in April of 2009. He was gone for seven months! It was such an emotionally challenging time to be away from each other as newlyweds for more than half a year. A lot of emails, phone calls, video-chatting and many prayers helped us to survive the deployment. When he came back in November of 2009, we decided to wait to have kids till we settled down as a couple.

A year later, we made the decision to forgo contraception. We weren’t preventing pregnancy but we weren’t really actively trying either. When I missed my period in November of 2010, I decided to take a pregnancy test – just in case. I really didn’t think I would actually be pregnant…but there I was holding a positive pregnancy test in early November 2010 (on Veterans Day)! Danny was pretty excited. Me…I was just shocked.

The nausea wasted no time rearing its ugly face into my life. It started out slowly…what you might call normal morning sickness. I was still able to eat and function. Then the nausea kicked into full-force and slammed me with an overwhelming sickness that I was totally unprepared for. I knew that I would have some nausea because my mom had a lot of morning sickness with her pregnancies. But I had no idea how bad it would get.

I still remember the very first meal I threw up. It’s etched into my memory because HG can be so violent and relentless in its symptoms. I had had dinner with a few friends to celebrate a birthday. We went to Tofu House and I distinctly remember the stench of mushrooms from my friend’s spicy tofu and mushroom soup. My sense of smell was extremely heightened and the mushrooms just smelled disgusting. That night, I threw up the spicy tofu soup – not a pleasant thing to throw up. That was just the beginning of my hyperemesis…

The nausea and vomiting got worse and worse day by day. Eventually, I couldn’t eat anything without throwing it back up. I remember my mom being so concerned with my eating and like any Korean mom would, she kept pushing me to eat despite the nausea. I would get frustrated and tell her – “You don’t understand, I can’t eat because I’m so nauseous and I’m going to throw it up anyway so what’s the point?” This was the daily battle I struggled with. Every part of my body was screaming nausea and telling me not to eat. At the same time, I knew I should try to eat for the baby’s sake. But inevitably, whatever I ate would come back up.

I told my OB about my excessive nausea. She told me it’s normal morning sickness in the first trimester and that it would get better soon.

It didn’t.

A week later, I called my OB nurse and complained about my nausea and vomiting. She said – as long as you’re keeping fluids down, it’s fine.

It just got worse. Not only could I not eat, I couldn’t keep liquids down either. So I decided to go to urgent care one day when I was feeling horrible. They told me I was dehydrated and gave me fluids via IV. The doctor said, “You have something called hyperemesis which means you have excessive nausea and vomiting. There isn’t much we can do. Here’s some information about HG.” I felt a bit better after receiving the IV fluids but they sent me home soon after with a prescription for Zofran (anti-nausea medication). The Zofran did not work and I was back to vomiting multiple times a day. This continued for days.

I decided to go to urgent care again since nothing was working. This time we waited three hours in the waiting room to be seen. I remember sitting in the waiting room and just wanting to die because the nausea was so strong. I silently cried because I was so frustrated and tired of waiting. I think the people in the waiting room probably thought I was crazy or something. I was seen again and given fluids via IV and again immediately sent home. Literally the moment I stepped back into the car, I threw up again – just the smell of the car caused me to retch. The around-the-clock vomiting continued again for days.

Finally, on Christmas day of all days – I knew something was seriously wrong and that short-term IV fluids and oral Zofran were not enough to help me get better. I literally felt like I was dying. I had absolutely no energy. I was either in bed or throwing up into the toilet. The nausea was so bad. I was still throwing up multiple times a day but now I was vomiting bile. At this point, I wasn’t eating or drinking anything but still throwing up! I weighed myself and was shocked to find out that I had lost 15 pounds. I should be gaining weight my first trimester not losing weight! That scared me and I called my doctor’s office and spoke to the on-call nurse

I expressed my concerns and frustrations to her over the phone – between pathetic sobs. She told me to go to the ER. I asked her – “Well, will they admit me?” She said “I don’t know.” I was so frustrated at that point and wondered if it would even be worth it to go to the ER. But in my heart, I knew something was wrong and if I continued going like this, I would just die.

So we went to the ER on Christmas day. Thankfully, there weren’t too many people there and I was seen quite quickly. The doctor gave me Phenergan (another anti-nausea med) via IV and it made me so sleepy – I loved it! Something to finally take the nausea away. They ran some blood tests and the ER doctor consulted with my OB and they concluded that I should be admitted because the numbers from the blood tests were off. I think my electrolyte level was really low due to the dehydration. I was so happy to hear that someone finally was taking my condition seriously!

I stayed in the hospital for about four days. I was on continuous IV – getting fluids as well as Zofran and Phenergan. I was still throwing up but at least the fluids were keeping me from being dehydrated. When my OB came to see me, she had a totally different attitude. She clearly didn’t think this was ‘normal’ morning sickness anymore. She wanted to do an ultrasound to make sure the baby was okay. The baby turned out to be perfectly healthy and quite active!

My OB decided to have me to get a PICC line for long term in-home IV treatment. A PICC line is a peripherally inserted central catheter. It is a long, slender, flexible tube inserted into a peripheral vein, typically in the upper arm and advanced until the catheter tip reaches into a large vein in the chest near the heart to obtain IV access. Because I would be receiving IV treatment daily 24 hours a day, it would be a hassle and also difficult on my veins to change the IV site every week. With the PICC line, you don’t have to get pricked every week for the IV treatment. I loved my PICC line! It was truly a lifesaver.

I received IV treatment for a month. A home health nurse would come every week to change the dressing and check up on me. The rest of the time, Danny changed my IV bags and administered the medications into the PICC line for me. He was a pro! His navy medical training definitely came in handy. He already knew how to administer an IV so it was a piece of cake for him.

After a month of continuous IV treatment, I finally started to feel better and could start eating again. By the end of my first trimester in January, I started to feel somewhat normal and I gained my weight back. I still had nausea 24/7 but it was at a much more manageable level and the vomiting significantly reduced. That was my traumatic introduction to HG. I was forced to take three months of sick leave from my job. I went back to work in February and thankfully, the rest of my pregnancy went more smoothly.

My labor and delivery – compared to my pregnancy – was so easy. I was actually kind of surprised at how smooth and fast my labor and delivery was. My water broke at 7 am on July 13th, 2011. I called the hospital and they told me to take a shower, eat breakfast and head over to the hospital in a couple hours. So I took my time and showered and ate some cereal. I started feeling sharp contractions and we drove to the hospital.

By 9 am, the nurse measured me and I was already 6 cm dilated! (I had been dilating even before labor started) The nurse told me I could get the epidural then since I was already 6 cm or that I could wait. I decided to just get the epidural because the contractions were quite painful. The anesthesiologist was wonderful and the epidural was wonderful! Now I was in no pain and just waited to push. By 2 pm, I was fully dilated at 10 cm. I threw up a couple times (of course!) during the pushing. I pushed for a couple hours and Annelise was born at 4 pm! She weighed 8 lbs 5 oz! The doctor was amazed at how big she was. My OB told me I was the worst case of nausea/vomiting she had seen.

The best part about delivering the baby was of course meeting Annelise finally but also the fact that my nausea was finally and completely gone! Food never tasted so good as when I ate the hospital food that day. I’m still amazed at how big and healthy Annelise is despite the HG. Annelise means “grace”. It was truly by God’s grace and many people’s prayers that I survived my first pregnancy and that Annelise was born full-term at a very healthy weight and that Annelise is such a good eater!

Here’s a picture of my little chub-chub doing her favorite thing…eating!

The HG Dilemma

Now that I’m able to eat regularly most of the time, a daily challenge I face is this peculiar dilemma that HG poses. I can get super hungry due to the pregnancy but I’m also quite nauseous at the same time. So what do you do when you feel famished but nauseous at the same time?

The two very conflicting feelings warring inside my stomach drive me insane. Sometimes I just want to scream at my body, “What do you want me to do?!” Some people say their nausea gets better when they eat…but for me, it seems like the only time I don’t feel the nausea is when I’m eating. After I’m done eating, I just feel full and even more nauseous than before! I really can’t figure out what’s worse – feeling super hungry/nauseous or full/gross/nauseous!

There’s just no escape from the nausea with HG. This perpetual mild-grade nausea lends itself to a sort of perpetual mild-grade depression. Because I feel icky/gross/queasy all the time, I tend to be irritable and sad much of the time. What keeps me going is the light at the end of this very long tunnel…my baby girl number two.

What is Hyperemesis Gravidarum?

According to website helpher.org, “HG is a debilitating and potentially life-threatening pregnancy disease marked by rapid weight loss, malnutrition, and dehydration due to unrelenting nausea and/or vomiting with potential adverse consequences for the newborn(s).”

Morning Sickness: Hyperemesis Gravidarum:
Nausea sometimes accompanied by vomiting Nausea accompanied by severe vomiting
Nausea that subsides at 12 weeks or soon after Nausea that does not subside
Vomiting that does not cause severe dehydration Vomiting that causes severe dehydration
Vomiting that allows you to keep some food down Vomiting that does not allow you to keep any food down

Signs and symptoms of hyperemesis gravidarum:

  • Severe nausea and vomiting
  • Food aversions
  • Weight loss of 5% or more of pre-pregnancy weight
  • Decrease in urination
  • Dehydration
  • Headaches
  • Confusion
  • Fainting
  • Jaundice
  • Extreme fatigue
  • Low blood pressure
  • Rapid heart rate
  • Loss of skin elasticity

It is important to distinguish normal morning sickness from hyperemesis. Many pregnant women experience normal morning sickness during their first trimester. The difference between morning sickness and HG is that women with morning sickness are still able to eat and go about daily functioning. Someone with HG has a lot of trouble eating and gaining weight and actually loses weight. An HG sufferer struggles with daily functioning – including going to work, taking care of the children, doing simple daily chores, even taking a shower.

Many women with HG end up in the ER due to dehydration and usually undergo long-term IV treatment to prevent dehydration and also to administer anti-nausea medication through the IV. The worst case scenario with HG is someone with symptoms so severe that the liver malfunctions and the pregnancy ends in a natural miscarriage or mom’s body is shutting down to the point where the doctor recommends termination of the pregnancy in order to save mom’s life.

I am so thankful that I am not one with HG symptoms so severe that it has threatened my baby’s life…I cannot imagine going through all the suffering of hyperemesis only to find out that the baby cannot make it. When I read stories of moms who have lost their babies due to HG, all I can do is cry and thank God that I have not had to go through that. The good news is that most HG pregnancies end up with healthy babies born full-term! It really is amazing how these babies are so resilient. It certainly brings a new image to mind when I think about “the miracle of life.”

Because hyperemesis is so rare (only 1-2% of pregnant women get HG), many people have never heard of it and do not understand this disorder properly. I hope this blog clears up common misconceptions about women with HG. Please share this information with the women in your lives – it can possibly save someone’s life!

Resources:

Hyperemesis Education & Research Foundation, www.helpher.org (leading source of information for moms, family members, and medical professionals; contains medical studies and treatment options)

Baby Center’s online support group for hyperemesis suffers, http://community.babycenter.com/groups/a986645/hyperemesis_sufferers

Beyond Morning Sickness, http://beyondmorningsickness.com/ (offering books for moms and kids, forums, and phone mentoring support)

Ayden Rae Foundation, http://www.aydenraefoundation.org/ (HG advocacy and research organization)