Excuse Me While I Throw Up

Trigger warning: vomiting, puking and throwing up. 

Apparently, pregnancy makes you glow. Apparently, if you drink a little ginger tea to get rid of the nausea and have a nap in the afternoon to stave off the fatigue, pregnancy is wonderful. Apparently.

Hah! 540 days of puking later, I have two lovely children. But think about that – five hundred and forty days!*

I suffer, you see, from  Hyperemesis Gravidarum, a severe form of morning sickness that doesn’t magically stop at 14 weeks. I was sick. All day, every day, until the day my child was born. Twice.

First time round, I had no idea what was going on and just hoped from day to day that it would stop. At about five months, I resigned myself to the idea that it might never stop. The second time round, I knew what I was in for, except that this time it was actually worse; I was hospitalized for dehydration, and ended up taking strong anti-emetics the whole way through my pregnancy to stop me from vomiting up everything I ate or drank. It was totally debilitating and truly horrible.

And I had it fairly easy compared to some. There are women who are so sick that they ultimately terminate their desperately wanted pregnancies. ThInk about that for a second…

But don’t get me wrong, although my experience wasn’t the worst, it was gut-renchingly, mind-blowingly horrible.

There is not much known about the causes of HG, but it is estimated that it effects approximately 10% of pregnant women. Apart from the excessive nausea and vomiting, sufferers often also experience extreme sensitivity to certain smells. For me, that meant I could not bear the smell of soap and shampoo; I cropped my lovely long hair to almost nothing in a desperate effort to avoid shampoo torture, and literally banned all soap from the house.

People who have not lived through this (the vomiting, not the haircut), simply cannot understand its impact. For someone falling pregnancy for the first time, expecting a rosy glow and relatively mild discomfort, the shock of HG is overwhelming. Not only do you feel awful all the time, but everyone seems to have advice for you. Being told to eat crackers before getting out of bed, to drink ginger ale, or use acupressure bands by every single person you meet, is enough to drive you totally batty. Those of us lucky souls in the HG in-crowd refer to this as having been “crackered”. Helpful hint: Whatever you do, do NOT offer an HG sufferer crackers, she may actually kill you, or worse, intentionally puke on you!

Even obstetricians fail to appreciate the impact HG has on pregnant women. Until fairly recently, doctors were taught that HG is psychological  (you know, part of the “all women are hysterical” school of thought). My doctor’s approach was one of shut up and buck up. Her marvelous advice included: “Go to the gym” – so I can puke in the gym pool? “See a dietitian” (when I lost 10 kg in 12 weeks) – because clearly I’m eating the wrong stuff! “Drink four glasses of this stuff” (to deal with side effects from the medication) – when I can barely get down one glass of water a day? No surprise, I  changed doctors (though it took me long enough), and was immediately admitted to hospital for dehydration treatment.

Feeling permanently sick and out of synch with those around you is very isolating. Between not wanting to go out for fear of throwing up in public (I have puked in car parks, on the side of the road, in shopping malls, at airports, at doctor’s offices… ), and  an increasing desire to avoid people in order simply to avoid being “crackered”, you can end up getting very depressed.

The emotional strain was most noticeable for me in my first pregnancy when I had no idea what to expect going forward and was trying to keep working. I cracked. Literally. Mid-way through my pregnancy I was so depressed that I had to start taking medication (despite being preggers and very reluctant, but that is a story for another time). It helped me get through, but I was genuinely traumatized by the HG experience; something which happens to a fair number of sufferers. After the birth of my child, I continued to suffer nightmares about being pregnant. I can kind of laugh at it now, but I really do have mental strategies for the quickest route to every bathroom in every shopping centre I frequent.

It took almost five years for me to get up the courage to get pregnant a second time. This time, I did some Internet research early on in my pregnancy. What I found was the Hyperemesis Education and Research website (helpher.org), a wealth of evidence-based insight into HG and masses of support from fellow sufferers. I wept during my first visit to the site; finally here were some people who understood what it felt like to throw up from the smell of water! Their advice for coping with the condition was not far off from what I had already worked out for myself, but what a relief to feel that I was not alone.

Their advice, and my own conclusion, was this: before taking the plunge a second time, if you know there is a likelihood of suffering from HG again, quit your job and settle for unemployment. Since there was absolutely no way I would have been able to continue my full-time, high stress, high responsibility job, I did exactly that. Go career! Literally. Go into the bin. I’ll catch up with you in a year or two. In the event, I couldn’t even manage a small amount of work from home, so it was a pretty good call. And I’ve actually been rather happy as a stay-at-home mom.Nevertheless, my feminist self is pissed off!

Although we had kind of planned for me to be unemployed (and thus totally totally broke), what we hadn’t fully realized was the cost of being ill, all the time.

For one thing, the medication prescribed to control the vomiting (Zofran) is very expensive and the medical insurance will not pay for it – this seems to be true around the world. Go figure, the medical aid would rather pay for repeated hospitalisations than the meds. And without the drugs I was totally dysfunctional, so there was no question about not taking the meds, or taking a limited dose. So there I was once again taking prescription meds while pregnant.

It’s not just mum who suffers though. Although only four at the time, my daughter developed a number of strategies for dealing with my illness. Things which bring tears to my eyes when I think back on them: “Mummy, please will you play with me? You can be the bus driver, she sits down all the time.” or, “Mummy, you can be the patient, I’ll be the doctor. Then you can lie down all the time.” Despite her clever strategies, the amount of quality time I spent with my little one during my second pregnancy was nothing like what I would have wanted. She watched a lot of TV, played a lot of iPad games and nearly exploded with excitement and relief when her dad got home from work.

Luckily, with pregnancy, there is always an end in sight, and a massive pay off. Within hours of having each of my kids, the nausea was gone. And the elation I felt at feeling normal again just added to the euphoria that has typified my experience of the first months of my children’s lives. Everything seems rosy when you’re no longer feeling ill all the time, even sleep deprivation!

Am I glad I had children? Absolutely. Would I ever do it again? Not a chance. And yes, I did say that after my first pregnancy. But seriously now, Never. Again.

Photo credit: M Nota

*ok, so that’s an estimate based on the number of days I was pregnant, but it’s pretty damn close