December 2011. Conception.
It’s my 31st birthday. I’ve returned home from a pub lunch with the girls and bubs from my Mother’s Group. Bronte (one year old) is hyperactive today. All afternoon she has been across the floor, crawling from one end of the dining room to the other and I’ve spent most of the afternoon chasing after her and battling her strong, chubby limbs. After changing her nappy on the floor of the disabled persons toilet (there was absolutely nowhere else even slightly suitable), I emerged to discover a lovely smear of her poo on my shorts. Quickly looking myself over, I can’t spot it anywhere else. But in my disheveled state, I forget – shock horror - to wash my hands. I never forget to wash my hands.
The afternoon was one of the rare times when I’ve been able to enjoy a couple of beers in a row as I’ve exclusively breastfeed Bronte since birth and have just dropped a midday feed. Given my now low tolerance for alcohol, it’s fair to say I was too tired (and too tipsy) to do the return bushwalk home with Bronte in the hiking pack. Thankfully, my husband finishes work early and picks me up in our car.
With Bronte asleep that afternoon we, cough, ‘celebrate’ my birthday. I know it’s prime time for me to conceive. Particularly as we’ve been ‘celebrating’ a fair bit over the last few days. And we are trying to conceive.
Later that evening, I don’t feel so good. I head to bed early. But within seconds of lying down, I am up and charging for the loo where I make it just in time to paint our retro 1970s avocado green toilet with extra technicolour shades. And I mean really paint it – walls, floor, door, everywhere. Between 8pm and 6am, I’m vomiting from both ends. My only relief throughout the night is that Bronte stays asleep, despite the violent retching going on down the hall.
Over the next 48 hours, the rest of my little family go down like dominos with this nasty bug too. It takes me a good week to feel like eating properly again. While my head was launched down the toilet bowl that night, I had a horrible realisation – I’m not ready to get pregnant again! Why? Because my first pregnancy was a traumatic experience, with eight months of suffering severe hyperemesis gravidarum (HG).
HG. Two nasty letters.
HG is a debilitating form of extreme morning sickness. Rather than dealing with a first trimester of on and off nausea and maybe a bit of odd vomiting, HG sufferers experience 24 hour nausea and often, plenty of vomiting as early as five weeks after conception. It is a relentless, overwhelming, intense nausea and in many, many cases it last the entire pregnancy. Women have terminated their pregnancies because of the extreme suffering. There is no cure for it, only a handful of drugs to dull the vomiting and worse still, the cause is largely unknown. Of the minimal research conducted into hyperemesis gravidarum, hormones are the main suspect.
A hike and a vomit, please.
For me, HG struck like lighting the first time. With Bronte conceived on our first wedding anniversary in April 2010, I was blissfully unaware of our developing fetus as one month into it I had a) a huge night out on the turps after a rugby union match in Sydney, and b) we set off on a long-awaited six-day hike through the Victorian Alps.
The night prior to leaving for the hike, I felt a bit ‘wrong’. Dinner wasn’t sitting in my stomach well and my alcohol limit was two measly beers. Shaking it off, we set off in snow for Mount Feathertop the next day, feeling well again. It was only the following morning that I had a sudden need to eat – immediately. I felt I was going to throw up if I didn’t get food into my stomach right there and then. Grabbing a museli bar, I chowed it down and gave the experience little more thought as a brilliant day of walking followed. At night, I felt a little more queasy again. I put it down to the unfortunate timing of probably having picked up a flu-like bug that my boss had the previous week. I was in bed early and feeling unusually cold. The following morning, I failed to enjoy a usually scrumptious breakfast of damper and maple syrup. Still, it didn’t click. I guess when you’re not trying to get pregnant, you don’t look out for the signs! We enjoyed another beautiful day of hiking.
Then, night. Only a sip of port was tolerated – blasphemy for a hiker! – and the dehydrated meal was revolting (more so than usual after several days of eating it). Freezing, shivering and in bed at 6pm in an old hut, I was extremely nauseous. The morning was no better. When I tried to brush my teeth, it made me gag. Little did I know that this was the beginning of a nine month love/hate relationship with dental care.
As we slowly set off that morning, I battled with the horrible idea that we may have to pull out of the hike early. We have never had to do that before. Trudging along a single track, I suddenly couldn’t walk straight. I was dizzy. I wasn’t sure it if was my mind caving in to negative thoughts, or if there really was something going on with me. After about an hour walking, we reached an intersection on the track and sat down to contemplate our options. Continue and hope for an improvement, or walk out to the snow village of Falls Creek and get some sort of transport back down the mountain to Bright where we’d left our clean clothes? I felt terrible, but I also felt so sick and shuddered at the thought of spending another night in the bush feeling the way I did. Sadly, we pulled the pin. But it was still one very long and very boring walk along a hard, sealed road to Falls Creek.
To make matters worse, once we got there everything - bar a small supermarket and cafe are closed. No accommodation. No public transport. Off-season in the snow fields of Australia… Again we sit and contemplate our options. Possibly call my parents, over an hours drive away to pick us up? Hitchhike? Fork out a huge sum for a taxi? We want to spend a night or two in Bright before heading to my parents – so we try a hitchhike. After a few non-events (really, who would want to pick up two muddy, smelly hikers?), a middle-aged man who turns out to be the CEO or some similar title of the Western Australian ultralight association finally picks us up. With a slightly weird stopover at a hydroelectricity operation halfway down the mountain as part of the hitchhiking bargain, we continue on to Mount Beauty, where our driver decides he’s happy we’re not going to kill him (apart from with the stench of our hiking gear) to continue driving us the extra 30 minutes on to Bright, back to our clean gear.
I feel revolting on the winding roads. I’m certain our driver thinks it’s a common case of the wife feigning illness to get out of a hike! That night, a gourmet pizza dinner goes equally bad and all I want to do is have a really hot bath and sleep in our luxurious Bed & Breakfast. Still, it hasnt’ clicked.
But, the next day as we wandered past a chemist, I’m suddenly struck with the thought, ‘Uh oh… I wonder…?’. I sneak off while hubby is in the local bookstore and purchase a pregnancy test so as not to alarm him too soon. Of course, I mentioned to him a bit later about what I’d gone of to do, and as suspected watch the blood drain from his face. ‘I don’t think it’s what it is,’ I say reassuringly, ‘but I just want to check.’
Strangely, I had the patience to wait until the following day when we’d reached my parents place to do the test. Denial, or certainty that it wasn’t the reason? I think I was probably still wanting to believe that we weren’t about to embark on a life-changing event.
The following night at my parents (who also believed that I had just picked up some nasty bug), I peed on the stick. Two pink lines immediately appeared. There was absolutely no delay whatsoever in those two little intimidating lines appearing. There was no room for error with an instant result at night – when the human Chorionic gonadotropin (hCG) is meant to be at its lowest.
I have a bath with a mixture of excitement and shock. Then I go and tell hubby who is equally shocked. We were about to become parents! At that stage, I could still stomach most foods and so just believed I was just going down the usual morning sickness path. On our last day in Wangaratta, we went to a local GP to confirm the pregnancy.
On the drive home, I began craving the kind of disgusting food I never eat - KFC, McDonalds, etc. Over the next few days I would, but then I began throwing it up. My taste buds went to bland things, or at least what was suggested to settle morning sickness. A few more days and nothing – not even sips of water were staying down. I was throwing up constantly, mostly when I tried to eat or drink, but also in between. The sight of anything to do with hiking; our packs, our boots; the clothes we wore; the smell of the deodorant we used – it all made me hurl. I grew weaker and all I wanted to do was sleep. Sleep was the only thing that gave me respite from the continual vomiting and nausea.
I saw a GP in Bowral - one with the first available spot at our clinic. An unsympathetic, old-school, grey-haired Doctor, he quickly sent me on my way with an admonishment that I was just experiencing ‘a bit of morning sickness most pregnant women get’ and to suck it up and eat dry crackers. I persisted with his advice for a day, but my husband and I knew something wasn’t right. I shouldn’t be vomiting this much. So we booked in to see another Doctor. This one, a young Indian Doctor, went one step further and used an online medical encyclopaedia – doesn’t exactly instill confidence in a patient - to diagnose and prescribe Maxalon. Maxalon is used for HG, but like many of the things that can be prescribed, it didn’t work for me. It didn’t even touch the sides. It did, however, make me sleepy which meant I could avoid chunks of the day by not being awake and therefore, not feeling sick.
At the time this was happening, we were living on my husband’s parent’s property. We were saving money for a couple of years to put down a large deposit on our house by living in a demountable type shed that had once been used as an office. But, being the onset of Winter and given how freezing I was feeling we moved into the main house. We were forced to tell some family members early on in the pregnancy what was going on. They’d began to worry that I had some terminal illness. Now, I felt like a lazy, sick, unhappy invalid imposing on my in-laws. I was throwing up at a minimum a dozen times a day. I was starving and dehydrated – not to mention miserable and wondering whether the hell this having a baby business was all worth it.
Not satisfied with Maxalon, or having been prescribed something that was found online, we bit the bullet and booked in to see a private Obstetrician. I’d rung Dr. Leong’s rooms about a week prior to enquire about booking in. But when her receptionist rattled of the thousands of dollars worth of fees, ‘$2000 at delivery not covered by private health insurance, $1200 for a caesarean (Bronte was breech for the entire pregnancy), extra for the anaesthetist, plus the cost of the hospital bed, etc.’ I freaked out thinking how much more it was going to cost than by going public. Could we afford it?
In the end, affordability had nothing to do with it (though after investigating the costs a little more thoroughly, we found that even with our minimal private health insurance coverage, we were able to afford it comfortably). I was quickly wasting away and growing increasingly stressed over the health and safety of my little jelly bean. When I rang again to request and appointment, I was told it would be weeks before I could be fitted in for an appointment. My heart sunk. I had reached my limit and sobbed down the line, ‘I am really, really sick. I can’t keep anything down – is there anything I can do?’ Once I’d explained that and the receptionist heard the desperation in my voice, I was in. She seemed to have come across what I was going through before, and even said, ‘The Doctor will be able to give you something to help with that.’ Phew.
Within the next day or so, I saw Dr. Leong who was to become my saviour (well, as much as you can be when helping someone with HG). I felt I was no longer seeing quacks or trainees, but someone who had dealt with my condition before. She prescribed Zofran, my new disgustingly tasting, dissolvable table friend. From what I have heard, Zofran is apparently prescribed to chemotherapy patients to stop them vomiting after treatment. I feel so much more for cancer patients than ever before. Because, while Zofran can stop a percentage of vomiting, it doesn’t take the edge off the 24-hour intense nausea. But, while I still continued to vomit, I could now keep some things down.
Living with my nasty friend.
For months I couldn’t eat anything more than boiled potato and occasionally boiled chicken. Sometimes I could stomach dry cereal for breakfast. I hated brushing my teeth because it inevitably made me vomit. I was going to kill the next person who told me to eat dry crackers or ginger products. Never tell a HG sufferer that. The usual remedies for morning sickness don’t work! HG is beyond ‘normal’ morning sickness and believe me, a HG sufferer has tried every possible alternative already. I was off work for four months, gradually returning with a few hours work from home, then increasing it to a day or two and then gradually managing to drive to and from the office.
During the first three months of my first pregnancy, I lost 9kgs from my already lean 63kg, 172cm frame (I’d been training for the Canberra Marathon just prior to falling pregnant), down to 56kgs. I was gaunt and not the least bit pregnant looking. This was the worst time. There was nothing ‘to show for it’. I wondered how on earth I was managing to sustain another life. It was certainly not an enjoyable way to lose weight.
When my bump arrived at about 4 to 5 months it began to feel like something worthwhile was happening. As my condition improved, and it did, maybe at the six months mark – my deprived appetite wanted anything and everything it could get its hungry stomach juices on. By then end of my pregnancy I stacked on a whopping 16kgs. While I didn’t enjoy being ‘porky’, I reminded myself regularly that I was pregnant and no one else I knew had suffered like this, so there was no comparison in pregnancies. In my final month, while extremely uncomfortable with being heavily pregnant with indigestion and during summer, it was absolute bliss to eat anything and everything!
The support from my husband was unwavering. He never flinched at emptying my sick buckets and always came home from work with a smile for me, when I was utterly miserable.
I remember I was still taking Zofran at around 8 months, but somewhere around 7 months I’d finally began to be able to wean myself off it slowly. I went from 8mg a day (two halves), to 4mg a day (one half), to a quarter tablet every day, then every few days.
Post-birth I quickly got back into shape to achieve my goal of running in my second half marathon, when Bronte was 9 months old. I returned to 69kg when I fell pregnant this second time – a few off my goal, but I was fitter and stronger than I’d ever been because I’d used my year of maternity leave to intensely focus on raising my first child and repairing my body.
Brave or stupid?
I avoided having to go to hospital for an IV drip as many sufferers do, I believe only by persisting with trying to sip, bit by bit, mouthfuls of water. It was nearly 9 months of torture. Yet, here I am again. Why? Because despite how regretful and horrible I feel now about being pregnant with HG, I know it does get better and it is worth it. We want just two children. It is the second and last time I will ever go through with it. I give endless credit to women I come across who have suffered through four or more HG pregnancies. They really want to have kids!
My obstetrician politely warned me at my six-week checkup post-birth that given the severity of my HG, I should expect to experience it during subsequent pregnancies. It is for this reason that we were determined to have our second and last child as soon as possible to get the trauma over and done with in one swift block.
Looking back, because of the way our brains work to ‘forget’ pain and suffering, it is hard to remember exactly when things improved. Which is why, this time around, I’m keeping a diary. It’s for myself and my husband, to remind us to stick to our resolution of having two kids, and two kids only. And it’s for other HG sufferers. Because, let’s face it – the ensuing blogs are going to be far too depressing for any non-pregnant, non-vomiting, readers out there!