I wanted to break from the topics I typically share on this blog to share something much more personal today. When I first became a mama, I remember all those moments where I'd meet another mom (typically at Caribou Baby, where I spent all my time) and hear some tip or story that would make me feel like I'm not alone in the struggles of being a new mom. That's why I wanted to write this post about my experience with hyperemesis gravidarum. I thought if it helps someone else feel less alone in her struggle with this debilitating condition, that definitely makes it worth sharing. So for most of you, this may be a post to skip. But for anyone out who's felt crippled by morning sickness, here's what my experience was and what helped me.
How it began:
For me, the morning sickness began seemingly overnight — poof — it was there one morning right at the start of my 6th week of pregnancy. There was a distinct change in how my body felt. The nausea came on strong right away, as well as the loss of appetite, but I also developed a very strong sense of smell that was present throughout my morning sickness. I called it "the smells", and it was my main trigger for throwing up. From week 6 till about week 22 of both pregnancies, I had an extraordinary acute sense of smell that crippled my ability to do everyday things. There were obvious smell triggers that probably affect most pregnant women here in the city — the Halal food trucks would set me off from a block away. The smell of any Asian foods were a strong trigger. Being morning sick through the hot summer this time around was really tough, since New York smells the worst in the summer with the heat. But it was also things you wouldn't expect — the smell of summer produce at your market (typically a delicious smell) would set me off. I couldn't walk in grocery stores without risking throwing up. My refrigerator was also off limits. If you microwaved something in our kitchen, I could smell it all the way in the bedroom and it would likely set me off. I couldn't even open our dishwasher, more or less deal with washing dishes.
It's not just in the morning:
I don't think it's just women with hyperemesis gravidarum who experience morning sickness at times other than the morning. It's really a silly name for this condition. Sure, for some women, it's worse in the morning. But that's not the case for everyone. With my experience, it was constant — all day, all night. There were no moments of relief, just times where the nausea got kicked up and then I vomited. For four months, I felt in this fog of nausea, trapped like groundhog day in this overwhelming feeling similar to the first day of a stomach flu mixed with the fatigue of being jet-lagged. In fact, the evenings were the worst for me. I often experienced fever-like chills in the evening, which would last a while. Eating something sugary sometimes helped — hot cocoa helped my chills in my first pregnancy. In doing some more reading this time around, I think the evenings were worse for me because my body was extra tired and fatigue is definitely your enemy with this condition. It only makes the nausea more pronounced and you more likely to throw up. First thing in the morning was another rough time for me. I had trouble sleeping through the night, because the nausea often woke me up. And fast movements made it worse — the act of getting up out of bed and walking to the bathroom was always tough. If your experience with morning sickness is a constant sense of nausea, that's a good sign that you may have hyperemesis gravidarum. If you can avoid having to rush around in the morning — have your partner take care of the to-dos first thing in the morning — that will help.
The obvious remedies:
With my first pregnancy, I tried all the typical remedies recommended for morning sickness — keeping something in your stomach, Saltines, ginger of all kinds (which made me more nauseas, in fact), anti-nausea teas, acupuncture, herbal remedies, beads in my ear, motion sickness bands, sugary lozenges, taking extra B6 vitamins with Unisom, you name it. Honestly nothing helped. I did do a fair amount of acupuncture in my first pregnancy through the really rough weeks — I went in for treatments twice a week. I felt great during the treatments — it was the only time I felt good during that time. But about an hour or two after treatment, the nausea came back. The herbal formulas likewise didn't produce a noticeable change for me. So this time around I skipped acupuncture.
Small things that did help:
When you have hyperemesis gravidarum, you're so sick that you're just trying to make it through each day, hoping to throw up less than you did the day before. There was nothing that made the nausea go away for me, so my goal was simply to find ways to avoid throwing up so often, since vomiting put my body closer to serious dehydration. After two experiences with this condition, here are some small things that did help save me from throwing up at times, especially in public (though I can't even count how many times I threw up in public — that was one of the more difficult things for me to emotionally handle.)
+ Lemons: The smell of lemons was a positive smell for me. Dan actually figured it out in my first pregnancy. Sticking my nose in a bowl of lemons helped save me from the brink of throwing up many times. In my second pregnancy, I walked around with lemon-scented towelettes I found at my pharmacy. Sure, I looked silly walked around with a towelette held up to my nose, but it was the only way I could walk around without throwing up instanteously from the city smells. With my first pregnancy, I was morning sick through the fall and early winter, which made it easier in that I shielded my face with a scarf to block out smells. If I'd known about the lemons then, I would have gotten an herbal lemon spray to mist on my scarf. Because some places, like the subway, have smells that are so strong I needed a good smell to counteract it.
+ Gummy pre-natal vitamins: I'm not a great pill taker to begin with, and when I got morning sick, the gag reflex came on strong. It was next to impossible to swallow (and not throw back up) my prenatals during Juniper's pregnancy. And of course, you want to take your vitamins. You're already feeling guilty that you can't eat anything, more or less eat the healthy foods you'd expected to be eating during pregnancy to help your baby. I didn't know back then that there are gummy pre-natal vitamins. They taste like candy and were easy for me to take even during the worst weeks of this pregnancy.
+ Sleep: It's obvious, and it's not something that's often possible (much harder for me with a toddler at home this time around.) But the more I could lie down and rest, the better my chances of not throwing up as often that day. Getting to bed early was also really helpful. In my first pregnancy, I was in bed by 8 whenever possible. That was much harder to do this time with taking care of Juniper. But the earlier the better.
+ Sugar: For both pregnancies, sugar helped cut the edge of the nausea at times. The cracker trick at night never did anything for me. But in my first pregnancy, I literally ate through boxes of popsicles one week as my only food. I've heard the reason sugar works is that your body has low blood sugar while growing the placenta. Unfortunately, I didn't find that the sugar was enough to bring me out of the nausea — but it did save me from throwing up at times.
Taking in fluids with hyperemesis gravidarum:
You're pregnant. Woohoo! So commence drinking tons of water, right? Wrong. That was my experience with both pregnancies while I had hyperemesis gravidarum. In my first pregnancy, I could only drink sugary drinks while I was sick — Gatorade, sometimes lemonade, sometimes ginger ale, and eventually blueberry-infused water and other combos of juice and water. And I found that it's best to sip only. I found that gulping down any drink would aggravate my gag reflex. With this second pregnancy, I really couldn't keep down any kind of water for the first few months (which was especially tricky since it was during the summer, when you crave water in the heat.) Honestly, I drank only ginger ale for more than three months. I'm not a soda drinker, and I can't even express how much I hated ginger ale by the end. But it was the only drink I could keep down for some reason. Water made me instantly throw up. I was so tired of drinking sugary drinks —I just wanted water! I learned the value of ice and watering things down in this second pregnancy — ginger ale is much more palatable on ice and with a little water in it. I would try diluting the drink that works for you, so you're sure you're drinking enough. It was so hard to consumer ginger ale in large quantities, so I drank less and had a hard time staying hydrated. My midwife recommended coconut water, which unfortunately didn't work for me. But that's another option to try if you're struggling to get any liquids down. I didn't push myself enough to drink what I could drink, since the ginger ale was so not appetizing in the middle of July. But I wish I had, as the more dehydrated I got, the more likely I was to throw up, which in turn made me more dehydrated. It was a vicious cycle that landed me in the hospital a few times for IVs. It felt amazing to drink plain water once my morning sickness passed.
Sweet versus salty foods and proteins:
With both experiences with morning sickness, plain carbs and sweet carbs (plain bagel, piece of banana bread, cookies) were the few foods I could keep down. I also was able to eat some fruit — grapefruit always worked for me. So a good food day would include a grapefruit and a bagel, with not much else. Sometimes ice cream would go down, so I'd eat that. Obviously not the healthiest of choices, but I had to let that go. The goal was to get something in my stomach so that I would not get sick.
No one likes to throw up, and the seemingly neverending experience of throwing up in my first pregnancy made me terrified to try any foods. I assumed anything would make me throw up. The second time around, I was more brave to try and test it out. Ultimately, I found the sugary foods worked less well than something salty, if I could find something salty to stomach. Shockingly, I could eat Greek olives while I was morning sick this time around. We'd take Juniper to our local cafe for breakfast, and I couldn't eat anything but a bowl of olives. But that made the sensation of needing to throw up go away better than a cookie or piece of bread would. I also experimented with protein bars. Some made me instantly throw up. And I was not able to try many brands, since we're nut-free in our house with Juniper's nut allergy. But I did find a couple protein bars that worked for me at times. And those definitely helped sustain me better. Two protein bars a day in the summer was a good food day. I had some success with cheese, too.
Traveling while morning sick:
I read in a couple of books that women who are prone to bad motion sickness are more likely to experience hyperemesis gravidarum when pregnant. That was me, for sure. I've always had awful car sickness — like I can't even look at a map nor sit in the backseat. When I had morning sickness the first time, and we roadtripped up to Maine, I literally thought I was going to die. I even asked Dan to leave me in Connecticut at some random hotel we passed at a rest stop! (He did not leave me.) If you can avoid long trips in the car, they definitely don't help the nausea. But sometimes you need to get somewhere. We went back to Maine this summer, in part to get me away from the smelly, hot city. I drove most of the way, which was easier for me than being a passenger. Make sure to have bags handy. It's worse to not be prepared.
The emotional side of hyperemesis gravidarum:
I think the most crippling part of hyperemesis gravidarum is the emotional side of the condition. I felt so helpless, so miserable, and so scared that it would never end. The first time around, I read online forums constantly to get a sense of what others experienced (bad idea). Was I going to be one of the women whose morning sickness lasted through her 7th or 8th month? How would I survive this? Those months in my first pregnancy were filled with me literally moaning in misery, which was also really tough for Dan to be around. Neither of us knew what to do and there was so much fear surrounding the sickness. It was also just unpleasant. In both instances, I had to have buckets in every room. Not a pleasant thing to see or hear, of course. With my first pregnancy, I felt super depressed. I barely worked and stayed in most of the time, because I didn't want to risk throwing up in public (which happened often.) But my head was in such a fog that I couldn't even enjoy the "down time". I couldn't focus on anything — a good movie on Netflix, reading a book, doing some simple craft project. My mind felt like mush and the fear of throwing up and the battle with my nausea was the only thought present to me.
This time around, the morning sickness came on as I found out I was pregnant. I had no time to prepare. I went from finding out I was pregnant (and being a freelancer who was full-time taking care of my daughter) to needing full-time care to watch Juni two days after my pregnancy test. I literally couldn't feed my daughter — couldn't prepare her foods or sit with her while she ate. That was one of the toughest parts of this mess. I felt incredibly helpless. I hated losing that time with her. She was a year old and we were working to expand her palate and see food as a fun, social activity. I couldn't experience any meals with her through that time. The few times that I did often ended with me getting sick. She was such a trooper and continued to eat one time after I threw up right in front of her. I hated having to run off to the bathroom to throw up — constantly worried that I was scaring her or scarring her emotionally with seeing me so sick. I went to a really dark place of fear with my first bout of morning sickness, but this time around, my fears were mostly centered on how I couldn't care for my child in the same way. It was a painfully, helpless feeling. But I do think I got lucky. For one, I had help around me. And I let more friends in to what I was experiencing, which helped greatly (see below). And Juniper is such a sweet soul. I learned that letting go of my own fears made her not get scared about seeing me sick. And I just let some amazing sitters show her the summer that I'd wanted to show her. It was hard to let go after spending my days full-time with her. But I had to take care of myself, and I was happy that she was getting out to the playground and experiencing summer outside, especially when it was so hard for me to be outside in the heat. We also got out of the city (went to Maine for two weeks) which helped a lot. I didn't battle the smells as much in the outdoors at the lake camp of Dan's family. Juniper loved the water and hanging out in the grass (novelty for a city girl.) Getting moments of reprieve from the daily grind of being so sick in the city helped a lot emotionally.
I also struggled with negative feelings about being cheated out of the summer with Juniper, and losing so much time. But now that I'm past the morning sickness, I feel less negative about everything. It's important to remind yourself that it will end.
Letting people in:
With my first pregnancy, the morning sickness hit me like a truck and then I got trapped inside of it. A few of my closest friends live on the West coast, and with the time difference, I could never find an evening where I felt well enough to call them post-work. And then there were friends with whom I wanted to share the news in person, but I couldn't find the energy to meet up. Most of all, I had a hard time figuring out how to let people in to my amazing news (we're pregnant!!) while feeling like I couldn't function at all. I was better at letting more people in with this pregnancy, but I still fell into that trap of feeling too physically sick to reach out, but not wanting to announce my news in an impersonal way, like email. And I think it's really hard to reveal you feel like you're falling apart. I don't think it helps to shut people out when you're going through something like this. I wish I had done things differently with a lot of friends. It's definitely hard to reach out and even harder to ask for help. But I know I wouldn't have gotten through this summer without the support of some friends who knew about my sickness. One amazing friend even came to the hospital with me and spent many hours with me while I waited for an IV. I had friends do without asking — send care packages, call to check in, and help in many ways with Juniper. It only helps to have support around you, so I definitely learned that letting people in — even if it's not in the way you imagined — is the best way to go. You'll then have the support you need and your friends won't wonder why you suddenly disappeared.
Going to the hospital for treatment:
I wound up going to the hospital a couple times with this pregnancy (once up in Maine). Of all the remedies I tried, I will say that getting two bags of IV fluids was the one and only thing that did work to quell my nausea and make me feel like a normal person. Unfortunately, that good feeling only lasted part of a day and then the nausea came back. But the IVs helped get me out of the danger zone of dehydration. I waited until I couldn't keep anything down before going to the hospital both times. I wish I had gone earlier — with the second trip, it was a painful process to get the IV started, since I was so dehydrated. It's certainly not a pleasant experience to go to the hospital, but I will say it's worth it if you're experiencing this extreme nausea and keep throwing up what you eat and drink. Don't forget to bring layers as I didn't realize how freezing ER rooms can be. I also felt hungry (for the first time) instantly after my IV was finished during my first hospital trip. I wish I'd had a snack handy.
There are two medications that are often prescribed for hyperemesis gravidarum. While I'd hoped to have a more natural pregnancy free of chemicals and bad stuff, I hit a wall after being in the hospital. I just couldn't take the nausea anymore. i did try both meds, and unfortunately (or fortunately because I didn't like the idea of taking the meds), they didn't work for me. As with everything I'm saying or suggesting here, I'd talk with your doctor or midwife first to see what's best for you. For me, the IVs were the only solution that got me to a better place for a little while.
Be kind to yourself:
Pregnancy is no walk in the park for most women, but it's certainly more challenging if you experience hyperemesis gravidarum. I made the mistake of laying a ton of guilt on myself. In the first pregnancy, I was convinced I was harming the baby because I wasn't eating much and couldn't eat healthy for so long. Juniper was born healthy at 8lbs 11oz — my body took care of her just fine. In this pregnancy, I felt so guilty for not being able to take care of Juniper, doing anything from feeding her to changing her diaper. Even holding her was tough when I was in a bad place with the nausea. I feared she'd have bad associations with food from watching me and from me being absent from mealtimes. I felt guilty for not sending thank you notes from her first birthday party. I felt awful for all the times we were trapped indoors, because I couldn't handle the heat outside without being sick. But Juniper, like all kids, is resilient and her sweet spirit seemed to understand and empathize with my condition. She's actually doing great with eating, and all my silly worries were wasted energy. I sent her birthday thank yous in tandem with our holiday cards ;) All is well. Try not to pile on the guilt, as the emotional stress certainly doesn't help your physical state.
There was no book I found that I really loved, and I had a hard time finding great information online, outside of the endless online forum threads. But I would recommend checking out this post by Stephanie. I found it very insightful, honest, and it helped me to read another woman's experience with hyperemesis gravidarum.
And lastly, for those of you brave women who have also dealt with hyperemesis gravidarum, I would love to give you a hug. I never met anyone during my first pregnancy who'd experienced it. Though I did grow tired of people telling me to try crackers and ginger to cure my nausea. The main thing I learned the first time around is that you need to advocate for yourself if you are someone who's dealing with this extreme morning sickness that's constant and affects your whole life. So many women get morning sickness, which is why I think some caregivers don't take this condition seriously enough. I would have greatly benefitted from getting IV fluids during my first pregnancy. But instead, I had my initial doctor offer useless advice like "stay away from greasy foods" when I was unable to keep a piece of toast down. Let your caregiver know the details of how bad it is for you, because hopefully something — whether it's a trip to the hospital for IV fluids (not fun, but certainly a great boost to your body) or medication or some other treatment may be able to help you.
Obviously, I'm not a doctor, so read this post as my personal account and definitely consult with your caregivers about how you treat your condition.