Recovery (Baby Steps!)

One of the absolute best things I’ve learned from the Nerd Fitness Academy is the importance (and effectiveness!) of baby steps. Incremental changes over long periods of time will stick 100% better than quick, monumental changes. I used to be the kind of person who wanted to change everything at once. It’s a funny kind of perfectionism, where you say “Today is the day that I do EVERYTHING right!” And maybe on the first day, you do. Maybe even the second. But somewhere down the road you miss something, and all of a sudden your change, your effort, is no longer “perfect.” You’ve already failed, so why keep trying? So you give it up, and slide into your old ways, and then weeks or months down the road you map out another quick, monumental change that won’t stick. All the while getting down on yourself because you can’t seem to get better at life even though you want to.

Nerd Fitness has taught me to take it slow, and to love myself. You can’t hate yourself into a better person. You just can’t. But you sure can love yourself into a better one. That starts with letting yourself make mistakes. Letting yourself miss stuff, and not giving up just because you broke a streak or things won’t look “perfect” when you track them in your planner. Putting self-care and self-love before everything else has actually improved my productivity and my health. If I’m deep in the feels and really need some Netflix binging, I allow myself to do that. Depression isn’t something you deny your way out of, after all. But with a little TLC, I can come out of it faster and better prepared to get on with my life.

With all that in mind, I knew that I would need to be forgiving in my recovery process after the pregnancy. C-sections are no joke, caring for a newborn is tough in ways that you don’t quite expect, and since I spent the entire pregnancy laid up with HG I was starting from a literal ground zero, with no muscle strength, no stamina. Here’s my recovery process, broken down by weeks.

Week One: Hubby took this week off work to stay home with us and help out, and that was super important and wonderful. Baby girl was eating every couple hours, and on some days even every hour or half hour (they call it a growth spurt…I was just exhausted). I just did not have the energy to constantly feed her AND change diapers, soothe her back to sleep, etc. I couldn’t even get up from a sitting position while holding her, because of the extra weight, my weak muscles, and the pressure it put on my incision. Likewise, if I’d had to cook for myself that whole week, I wouldn’t have eaten anything. Having hubby there to cook and refill my water (breastfeeding makes you SO thirsty) was a lifesaver. I didn’t give myself any goals this week, because I was expecting to still be in need of some major rest.

Week Two: My sister came to help out for the week, ferrying us to doctor appointments and cooking for us and spending lots of time hanging out with her niece. I was feeling way better after the surgery—what’s a little incision compared to the nine months of HG? I was also still taking ibuprofen and tylenol pretty much around the clock, which I can see now tricked me into thinking I was doing better than I was. I set a goal of 1,000 steps every day, and met that goal because in a single week I had a lactation consultation, a follow-up with my OB, an eye exam (because I desperately needed new glasses, and had run out of contacts), and a weigh-in at the pediatrician for the little one. Definitely too much to take on in week two of recovery! I also set a goal of writing 200 words/day, and brushing my teeth every morning. The teeth brushing went well (with someone else here to hold on to the baby while I did so, it was pretty easy), but the writing I only managed on one day. (Belly Progress: Still a super big uterus in there. I’ll need my maternity clothes for a while.)

Week Three: My mother-in-law came up for this week. No doctor appointments, so we took it easy at home every day. I upped my daily step count goal to 2,000 a day, and met it 6 out of the 7 days. It was tough to meet on some days, though, because my incision was still hurting when I did too much (and sometimes just taking a shower was enough to lay me out for the next hour). I tried to brush my teeth every morning and evening, and only really managed to hit the mornings consistently. My word count goal of 200/day was completely neglected. I began to think that I was taking on a bit too much, expecting more than just tiny little goals. Even through the frustration, I kept telling myself it was okay if I didn’t get to write on a given day. Newborns need a lot of attention, and I still wasn’t fully mobile/functional. But it might get better/easier as time goes on. Certainly once she doesn’t need to be held constantly to be happy, once toys are interesting and she’s got full neck control and can go a little longer between feedings, there will be more snippets of time for me to snatch for writing. (Belly Progress: When looking from the side, my belly finally drew even with my breasts)

Week Four: My first week alone with the little one. Hubby works down in LA, so it really is just me and her at home all week. The fridge was pretty abysmally empty. The first day was super tough, and we didn’t reach our step goal of 3,000 steps/day. The surgery recovery seemed to be going great, as my incision didn’t give me so many of those warning pangs that I was pushing myself too hard. I did have to schedule another emergency doctor appointment, though, to deal with some shoulder/breast pain that kept growing in intensity. I shouldn’t have to take ibuprofen around the clock four weeks post c-section, so I figured it had to be thrush or mastitis developing. Not fun. Thankfully, the meds worked pretty quickly. Baby girl did a good job of staying pretty easy the latter half of the week, and then we had another fairly easy weekend with her. (Belly Progress: Finally sticks out less than my boobs!)

Week Five: In which I learn that having visitors is great for my mental health but bad for my sleep. Seriously. If I can’t sleep when the little one is sleeping, I end up staying up way too many hours in a row because then she’s awake when I want to be sleeping later. No bueno. I decided to throw out my step counts this week, mostly because it still hurts enough to shower or to bathe her that I can’t do both of those in the same day. I’m obviously still recovering and still needing not to push it too hard, so I just need to trust that it will get better with time, and that higher step count goals will be attainable in the future. Honestly, it’s hard enough just brushing my teeth morning and night, since there’s no real semblance of routine with this little one yet. I read a good book, though, and managed to do all the dishes before hubby got home for the weekend. I’ll consider that a win for this week. (Belly Progress: Seems to have stalled a bit, but more of the dermabond is coming off my incision and it’s a nice healing pink underneath, so that’s good.)

Week Six: My mother can be pretty abysmal at “taking it slow” after surgery, so when she decided she had to travel with my dad for his work a mere 1.5 weeks after knee surgery, my sister and I decided she’d be better off spending the time at my apartment than alone in a hotel room. It was a rough week for me—loading and unloading stuff from the car with no one to help, cooking for two when sometimes all I wanted to do was snack on something unhealthy instead. It was nice to have someone here to watch the baby while I got out of the house briefly—I even bought some new shorts, in my pre-pregnancy size, that fit perfectly (a little loose, even). (Belly Progress: Still stalled.)

Week Seven: My mother-in-law is visiting again this week, and she’s great about staying up late with the baby and giving me ample time for naps. I’ve had to check my blood sugars this week for a follow-up appointment to make sure the gestational diabetes went away. I was kind of freaking out, getting a lot of high numbers, until I realized that the test strips I was using were reading a whole 45 points higher than they should have been due to leaving them out of their special container! A fasting number of 130 is not great. A fasting number of 85 is spot-on. The gestational diabetes is well and truly gone. Unfortunately, at the end of this week I had to head to the ER three times in one weekend. You’d think I would have had enough of hospitals after that hell of a pregnancy. What is it this time? Gallstones. Stones that I know weren’t present before, because the last abdominal ultrasound showed a “sludgy” gallbladder, thanks to the weeks spent on TPN, but no stones. But pregnancy hormones have a way of completely screwing with your body’s normal processes—so now I’ve got symptomatic stones and am scared to eat any fat or chocolate. I have to do little experiments of eating something to see if it triggers a gallbladder attack. And I now have to convince a surgeon that we shouldn’t be hasty about getting my gallbladder out, because if I can get these stones to resolve no new ones will form (not being pregnant or having HG or diabetes anymore).

Week Eight: The little one still has night and day mixed up, but a kind friend is going to sleep over on Thursday night so that I can get some uninterrupted rest before I have to go in for my first full day back at work. I’ve cleaned the house and done the laundry in preparation for the nanny’s first day, since I figure everything should be in its place at least once, so she knows what things are supposed to look like and where they all go. I’m apprehensive about going back to work, mostly because I haven’t gone in for a full day since week 7 of the pregnancy. And here I am with a two-month old daughter. What if I’m rusty? What if there’s too much to catch up on, and everyone is annoyed with me for being so far behind? I love my coworkers, and none of us could have foreseen all these health issues, and they aren’t resentful because it’d be pretty silly to resent me for getting sick, since I obviously would have done anything to avoid it if I could have. Still, it feels strange. I’m nervous. And hoping that I can prove myself a valuable asset again. And that it doesn’t take too long to pump. And that my milk supply doesn’t start dwindling from the pumping. *Sigh*

Week Nine: Back at work! I can’t say I’m 100% recovered yet, of course. It takes a body a very long time to recover from being sliced open. But, I am strong enough to go back to my mostly-desk-work job, and slightly eager to get out of the house and have some time free of my responsibilities to the little one. As much as I miss her when I’m not with her, I do feel slightly more like normal when I’m at work and just dealing with work stuff. More posts will follow later, probably about the new challenges of being a working, nursing mother.

Overall, I don’t think I’ll know what full recovery feels like until I’m done breastfeeding. My body still isn’t completely my own, and my incision still hurts sometimes a full three months after the surgery. Mentally, though, I’ve made a full comeback from the horrible illness of the pregnancy. And a year from now, I’m sure I’ll be stronger and healthier than ever.

Side Effects

Hubby and I were talking about medication side effects, because of how strange some of my reactions have been to certain things. He majored in Psychology, so he knows a little about the biophysical effects of various medications on the brain and all that. He talked some about the blood-brain barrier—not something I’ll claim to understand, but it seems kind of cool and would explain why I’ve got some of the reactions I’ve had to particular medications.

I realized that even though internet searches can sometimes yield confirmation that what we’re experiencing isn’t completely, totally unheard of, that only works when people share their experiences somewhere on the internet. So here are some of my weird side effects, in the hopes that someone will feel less alone if they also suffer from the same ones.

-Synthroid vs. Levothyroxine. This one is weird, but people theorize that it has to do with the way that the drug is formed (binding agents used and stuff) differing between companies. All I know is that when I take brand-name Synthroid for my hypothyroidism, everything is great. When I take any of the generics, I end up with symptoms of hyperthyroidism, even though my TSH numbers don’t reflect hyperthyroidism after being on them for a while. Heart palpitations are not fun to deal with on a regular basis. Or ever at all. So I always ask my doctor to have them dispense only Synthroid for my prescription, instead of giving me the generic.

-Reglan. This is supposed to move things through your digestive system faster, theoretically so that you don’t have as much opportunity to feel nauseous and toss your cookies. What it did for me was create a vague and very uncomfortable feeling of constant achy pain in my abdominal region. It didn’t touch the nausea for me at all. But the pain was irritating enough that I couldn’t keep taking the drug.

-Phenergen. Made me EXTREMELY tired but simultaneously gave me such bad restless legs that there was zero percent chance of me being able to sleep at all. Ugh.

-Zofran. One of the best-known side effects, so I hardly need to include it, but just to be thorough: constipation. There are gads of women on pregnancy and HG forums who have already talked about the awful-ness of this, so I won’t go into details. Oh, the pain.

-Vicodin/Norco. Usually around the time it’s supposed to be wearing off in my system (4-6ish hours after I’ve taken it) I get the sudden and overwhelming urge to vomit. And I always do. No bueno.

-Percocet. The worst nightmares in the history of anything. My husband physically abusing me, my baby dying right in front of me, the ones where I can’t move, can’t wake up, and there’s an intruder in the house, horrible brushes with death like drowning… I wake up from all these in a complete traumatized terror. I got so scared to sleep that I went more than 24 hours without any sleep once in the week post c-section, just through willpower and the sweet, sweet services of Netflix. Interestingly enough, oxycodone by itself in the hospital didn’t give me nightmares, but did make it hard for me to sleep deeply (or for more than an hour or two at a time (no, not because my newborn kept waking me up—she often sleeps more than two hours already, though I’m not crossing my fingers that it will last)).

The End of HG: Our Birth Story

I suppose the beginning of our birth story starts with an OB appointment. I had my week 37 growth scan with the perinatologist, and the results weren’t heartening. An abdominal circumference higher than the 99th percentile, and a head size in the 97th percentile. My OB drew me a bell curve and charted out our chances of getting the baby out of me naturally—he said we were probably running a 40% chance of either oxygen deprivation during labor and/or broken baby bones while trying to get baby out of my pelvis. And, a slight chance that baby’s head would fit but shoulders wouldn’t, in which case you’re looking at a 1% survival rate if they try to push baby’s head back through my pelvis to do an emergency c-section.

Looking at those odds, it’s vastly preferable to just do a scheduled c-section. It took a few days of calling my OB office to remind them, but then the labor and delivery nurses at the hospital finally stepped in and bugged my OB until we had a date and time nailed down. Then it was just six more days of waiting, and a 7:30 AM c-section (arriving at the hospital at 5:30 AM that morning).

I’ve got some control issues, a holdover from my childhood/relationship with my parents. They manifest most often in other family relationships, in people who have certain expectations and are vastly disappointed in me if those expectations aren’t met. So, I can get a little controlling when I feel like people are expecting something of me that I don’t necessarily want to grant. In this case, it was extremely important to me to preserve my dignity during the invasive procedure of cutting a baby out of me. I told all the (grand)parents that they should just hang back until we let them know that the surgery was over and we were settled. My mom ended up going in for a semi-emergency surgery of her own that morning, so it was just the in-laws who came into town. Respectful of my wishes but also trying to fulfill expectations of her own, my mother-in-law was waiting in the hospital lobby at 5:30 that morning to wish us well. She did go back to their hotel after that, for which I’m grateful. The last thing I want while I’m on the operating table is to worry about all the people who are impatiently waiting for me to make an appearance afterward. Having no idea how I would feel, or whether there would be any complications with me or the baby…it just made sense to tell people to chill out, relax, and not expect anything from us until it was all well and truly done.

My husband did an excellent job of being my sole support person (being the only person I felt comfortable having around while I was naked under hospital gowns, organs exposed during surgery, etc.). He described his feeling that morning as a “first day of school” sort of anxiety. We made sure he ate something (I had to fast for eight hours prior to the surgery), and made jokes and took pictures of him in his surgical scrubs. I got an IV and some instructions and a really fabulous Labor & Delivery nurse who walked me through everything with clear explanations, eye contact, and reassuring touches. The operating room was very bright, and slightly warm (to accommodate for baby). The table was much more narrow than I was expecting, but there was no risk of me falling off with that epidural.

The fabulous nurse held my shoulders while the anesthesiologist administered a numbing shot and then the epidural. I think that was the scariest part, just because you’re conceptualizing a shot going into your spine, and if things go wrong with your spine they’re not little things. I was just able to swing my legs up onto the table and lay down, and then they set up the curtain and surgical area while the tingling spread and my anesthesiologist tested my sensation with a pin. At one point, before my husband was even seen into the room, my OB asked, “Did you feel that?” My response was, “Feel what? Cause I didn’t feel anything, if you did something.” “I made an incision. I already started cutting.”

With hubby there with me, holding my hand, the rest went pretty quickly. There were a lot of tugging, pulling, pushing sensations that I could feel somewhere around my rib/breast area, but it was more the suggestion of things being done than actual feelings of touch or anything like that. And at one miraculous point, with a lot of tugging and moving of my numbed body, I was all of a sudden able to expand my lungs to their full size for the first time in months. It was—well. People talk about childbirth like it’s a miracle because they think children are blessings and reproducing a sentient individual is so damn cool and all. I think childbirth is like a miracle because of how in one split second it can restore you completely to yourself. Just you. No longer two cramped people sharing the same space. You get to live alone in your own body again. And if that isn’t the coolest feeling in the world, I don’t know what is.

The OB held the baby above the curtain for us to see the sex (though we were so shell-shocked we had to double-check with the nurse in charge of her!). They weighed her (7 lbs 15 oz), clamped her cord, wiped her down, all within sight of us. They brought her over to my shoulder so we could get some skin-to-skin right away, though pretty soon after her arrival there I had to turn away to be sick with a slight bit of projectile vomit that came on rather suddenly. I really only had time to say to the anesthesiologist “I’m feeling nauseous” before it was coming out. I’ve heard it’s pretty common for HG moms to vomit one last time during labor, and I’m not sure about c-section moms but it makes sense to me that my body would be freaking out a bit with all the cutting and such going on.

The rest of it was just a matter of cutting my tubes (thank the gods!) and sewing me up. Dissolvable sutures and dermabond. Super easy. The incision itself is about ten inches long, but then, she was still a pretty big baby for my 5’3” frame (and short torso).

Afterward was when I was so grateful for asking everyone to just hang out elsewhere instead of waiting impatiently at the hospital for us to finish. It isn’t like the movies, where dad comes running out yelling “It’s a girl!” and the baby is wheeled to some room full of baby bins and you coo at the one with the right name tag. Since she wasn’t exhibiting any ill health indicators, and her sugar checks were coming back in a good range, she never left our side. They wheeled us to a recovery room where my L&D nurse and the baby’s nurse stayed with us for two hours, taking vital signs and checking the things they check every 15 minutes without fail. It wasn’t an appropriate time for visitors—not with my bleeding constantly being checked, with her heel being pricked, with Matt being so steamrolled with the enormity of a baby AND a wife who had just been through major surgery. He was fantastic. Our phones had to be on airplane mode in the operating room, and we just left them like that, much too busy and preoccupied with “Is everything okay, is everyone healthy” to worry about the outside world just yet.

Eventually they transferred us to a room on the mother-baby floor, and we finally started calling and texting and sending pictures, trying to get the order in which we told people right (all the (grand)parents deserved to know first, then the siblings, then the extended family and friends, and on down the list all the way to our old therapist and the nurse practitioner who helped with my gestational diabetes…). My in-laws came to visit once I was decently gowned (still stuck in bed with no feeling in my legs and catheter inserted…but at least draped enough for slight modesty’s sake).

For a while the epidural and the morphine they’d given me during surgery kept the pain completely under wraps, and I was just feeling over the moon. Better than I’d felt in months. Physically, I’d say every ill effect of the pregnancy and its complications went away almost instantly. Slight heartburn stuck around for a few days, but considering all the hormones still circulating through my system, that just made sense. The headache, nausea, general malaise and lack of energy, muscle fatigue, food aversions, bad taste in the back of my mouth…it all disappeared faster than a bad dream. It was a friggin lightswitch, and all of a sudden the HG beast faded like it had never existed.

Emotionally, I think I can easily say that the day I gave birth was the best day of my life. It tops the wedding, it tops the day we found out we were pregnant, it tops graduations and friendships and just…all of it. Because in just one surgery, in just one moment of that sweet full expansion of lungs, I got myself back.

As far as the kid goes, Senga is fabulous. I’m very much in love with her. I don’t feel super different now that I’m a “mom.” Nor did I really expect to. I’m still me. And she’s her own person, and I have no idea who that is yet. I expect we’ll love each other, and we’ll fight, and we’ll have an interesting adventure getting to know each other and navigating some of the messier parent/child battles. All of that comes later, though. Mostly, I’m just so in love with every bit of her. I described it to a friend like this: “I’m super grateful to her for giving me the chance to house her body and soul for a little while, and I’m in awe of her existence because it’s so freakishly weird and cool that I helped make her.” Our pregnancy journey was not easy. If we’d known what to expect, we would have chosen a different path, and found a fulfilling life in other ways. We chose to have her, though, and we chose to survive the nine month battle to buy her the time she needed to come into this world. And now that she’s here, I feel like every smidge of discomfort, every experience that could now be an emotional trigger, every bit of physical deterioration, was ultimately worth it. It was a high price to pay, but I’m glad I did. And now I get to go along for the ride of watching her grow up and become who she’s going to be. How cool is that?

Your Hospital Stay with HG

I’m part of a Facebook group for moms with Hyperemesis Gravidarum, created by the HelpHER foundation. One mom currently in the middle of her worst weeks just got admitted to the hospital for the first time, and asked for advice. I hadn’t known what hospitals stays were like, either, before my lovely friend HG showed up. So here are some of the things I learned during my times in the hospital with HG.

A good nurse is your advocate, friend, holder-of-hair-while-you-puke. If you’re lucky, your hospital will put you up in labor & delivery instead of leaving you in a ward that may or may not have infectious people (your immune system has basically given up, so you might get every single cough and cold and flu you encounter while pregnant with HG). Labor & delivery nurses are not used to taking care of such “needy” patients, but they are used to frequently checking on their mothers & babies, pushing for breastfeeding every few hours and the like. This will help you stay on schedule for your meds (because when you were supposed to get your Zofran two hours ago, but the nurse still hasn’t made time to come give it to you…). Depending on your hospital, they may even be much less busy than nurses on other floors. During one of my hospital stays a super kind, lovely nurse brushed out my hair for me, complimented me on my Beauty & the Beast socks, and spent time talking to me about her husband. Busy nurses can’t always give you their time and attention like that, even if they want to.

Which brings me to: your nurses might be very busy. They have a lot going on, and while the great majority of them really care and took up this profession because they want to help people–sometimes they are distracted. Sometimes that distraction can lead to mistakes. If you can, watch them when they are pushing your meds. Ask questions. Do NOT be afraid to ask them to push a medication slowly, and/or to dilute it in saline if possible.

Zofran, when pushed too quickly, hits your system in a very overwhelming way (that strangely enough makes you want to puke, which is exactly what the Zofran is supposed to be preventing!). Ask your nurse to push it slowly.

Benedryl can feel very nice when it is first administered (but don’t get up to go to the bathroom or anything for about ten minutes, because you might be woozy and likely to fall). Benedryl is also super caustic to your veins. Ask that it be diluted in saline and pushed slowly.

You might be on several IV-push meds, a couple bags of continuous meds (like antibiotics for a PICC-line infection), and TPN. Make sure your nurses are doing a saline push between each med, and/or pausing your TPN/antibiotics/vitamin bags when they push your meds. Some of these meds, while fine together in your system, can react to each other in the IV line. That will likely cause pain and complications, and worst of all you might miss your dose, because they will be scared to give you more after pulling out the reactive part of the line. This happened to me once and the hours until my next doses were not pleasant.

Potassium is commonly given to HG moms, because all the vomiting depletes our levels so much. IF IT HURTS when they start running the potassium, ask them to set it at a slower infusion rate. One L&D nurse set me up with a potassium drip that was much too fast, and it hurt SO MUCH. I don’t blame her–she wasn’t used to having to give potassium to her patients. But don’t be afraid to hit that call button if there is pain.

DO NOT HESITATE to hit that call button. Be as kind and polite and virtuous as you can when talking directly to your nurse (if you can manage any of that while you’re so sick, of course), but don’t hesitate to hit that call button if you need something. That is what they are there for. You will need to call them to empty your urine catch after every time you pee, because they are tracking how much is going through your system. You will need to call them after (or during) every time you vomit, because they need to be aware of the times and durations of this to put in their notes. It will help your doctor treat you more effectively. Trust me. Do not be ashamed to call often. Do not clean up your own vomit–they also need to see the consistency/color and whether there is blood in it.

If you are sharing a room with someone, that patient might be getting regular meals. Meal-time at the hospital absolutely sucks when you have HG. Your nose is hypersensitive, and the smell of the food will make you vomit. You can apologize to your roommate if you like, but DON’T feel bad for throwing up while they are eating. It is not your fault, and frankly every hospital should let HG women have their own room. When light, sound, and smells can keep triggering intense and prolonged vomiting sessions–we deserve our own space with total control over the level of light, sound, and smells. This is another time it is nice to be in labor & delivery, because most labor rooms are singles. Your hospital might have a policy about not putting anyone less than 20 weeks in labor & delivery. One of mine did, and it sucked. The first twenty weeks of HG are usually the hardest, and the most likely to have you dealing with hospital stays.

Feeding tubes suck, and insertion is a real pain when you are vomiting all the time. If you trust your doctor, though, try not to fight it too much. The feeding tube liquid they fed me did not make me vomit like eating real food would. Swallow repeatedly during insertion to help the tube go down. Get a nice nurse to help you tape the end of the tube to your cheek, and tuck it behind your ear. It will dangle/move less and that will tickle your nose a lot less. Ask for the smallest french tube. You do not need anything bigger than that, and they are much less irritating to your throat than the big tubes they use to empty people’s stomachs.

If you need a midline or PICC line, don’t be scared. They use local anesthetic during insertion, and it didn’t hurt for me at all. It was a quick procedure with a competent doctor, and I was pleasantly surprised. The beauty of being able to get IV fluids and meds (and then TPN) 24/7, even at home, was amazing. Listen carefully when your home health nurses explain and show you how everything works. Have a spouse and/or buddy or two there for the explanation, so that everyone is getting the same education. When you are too weak to push your own meds or prep your own new TPN line or run your own fluids, you will need someone else to know what proper sanitation procedures to follow. Once a week, when they change the dressing on your PICC line site, make sure that you are both wearing face masks. Breathing bacteria onto that exposed site is not a good idea. IF YOUR LINE GETS INFECTED, don’t blame yourself. The sugars and nutrients in TPN are a magnet for bacteria, and often there is nothing you could have done to prevent it. But please go back in to the hospital as soon as you notice any sign of fever, chills, pus, redness at the site, etc.

You ARE allowed to tell the phlebotomists drawing your blood what works best for you. I have small veins that like to roll out of the way, so butterfly needles are best for me. You might have sore veins in some places, and you are allowed to ask them to search elsewhere for a good place to stick you. The best phlebotomists will do all this automatically, but they are also busy and distracted, so don’t be afraid to comment if you have preferences. It is so very unfair to be as sick as you are and then get a phlebotomist who can’t find a vein and likes to move the needle around while it is inserted (bad practice!). I had a fabulous phlebotomist once, though, who took his time drawing the blood for my infection cultures (they need to take blood from multiple sites for these–don’t be alarmed). He talked to me the whole time about graphic novels and superhero movies, and was so gentle I hardly felt anything.

IF YOU CAN EAT OR DRINK ANYTHING, maybe because you’re having a good day, or because the steroids are finally kicking in, do not be afraid to request exactly what you want. Cravings during HG are your body’s way of telling you what nutrients it needs. You want a breakfast that is composed of bacon, sausage patties, and yogurt (but not eggs, because the smell sets you off)? Request it. You can often call the kitchen directly to change your food order or request food items outside of normal meal hours (but usually not during the night, as the kitchen does close). Your nurse’s station will probably be equipped with ice cream and popsicles, though, so don’t hesitate to ask your nurses for it if you feel like a midnight snack. Any food at all is good when you have HG.

Brag to the dietician who comes to see you, if you have one helping with your case. If you can, write down the types and amounts of food you are able to keep down each day. This helped me prove that I did not need the feeding tube anymore (after several days of the IV steroids) and it convinced my doctor to have them order it taken out. Being free of that feeding tube was one of the best feelings ever. I earned it with every spoonful of yogurt.

Don’t be scared if they can’t find the heartbeat right away when they do a daily doppler (IF they are doing these…sometimes you are not far enough along for doppler readings). Your little one is a survivor, often absolutely thriving even as your own body is wasting away. Some days it’s just in a strange position and the nurse might not have much experience finding the heartbeat of such a young little one (because finding the heartbeat when your uterus is the size of a beachball is very different from finding it during your first or second trimester!). Let them call in a colleague to help look, but don’t stress yourself out until your DOCTOR tells you that something is wrong. If they need to order an ultrasound to check that everything is okay, they will do so. The best thing you can do for your little one is to just focus on your own health. You are the one in danger during the bad times with HG. You are the one who needs treatment and attention and help. Staying alive is your goal, and I promise it will be directly benefiting your baby, since it will likely be too young during the bad weeks of HG to survive outside of your womb yet.

Don’t be offended if they send a social worker/psychologist to come see you. Be honest with them, but also try to get a feel for whether they believe that HG is caused by psychological imbalances. There are sadly some very backwards practitioners out there who still believe that women with HG are MAKING THEMSELVES SICK because they don’t want the pregnancy/baby or whatever other nonsense. In your worst weeks, you likely will not want to be pregnant. You might wish for a spontaneous miscarriage. You might consider terminating the pregnancy. I won’t ever judge you for that. HG is horrible, and you have every right to consider your own health, mental and physical. But be clear with that psychologist: regardless of any past history of depression or anything else, HG is the CAUSE of depression and PTSD during pregnancy. Not CAUSED BY them. This is a very important distinction that I wish was universally known. My talk with a psychologist during one of my hospital stays was, quite frankly, useless and a waste of my small reserves of energy. I had a fabulously supportive husband, we had planned and wanted this pregnancy more than anything. I have a history of depression, sure, but I know myself well enough to know that when I was depressed with HG it was because of the debilitating, restricting illness, not because of my normal thyroid issues that cause depression. Trust yourself. Do not let them tell you that you are crazy. Do not let them admit you to a mental hospital–you will not get the care you and your baby need at a place like that. If ANYONE suggests to you that you have made yourself sick and the HG is all in your head…use up every ounce of your available energy to disabuse them of this notion. And then switch doctors or hospitals or whatever you have to do to find a medical professional who takes their job seriously and won’t write you off.

Finally, my most important piece of advice. You will be tired. You will be vomiting. You will be weak and sad and feeling hopeless and abandoned and neglected. You will not think that you have the energy to do ANYTHING. But there is one thing you need to do, above all others. BE YOUR OWN ADVOCATE. I’m serious. Too many health professionals know nothing about HG, and will often deny you access to treatments that can help keep you alive. FIGHT IT. FIGHT THEM. I promise this is the most effective use of any bit of energy you are able to muster. Get the nurses on your side, if you can. Have your spouse or parents or friends sit in your appointments or your hospital room to second your complaints and put more pressure on your medical team. Do whatever you have to do to educate yourself about correct dosages, medications that can be mixed, treatments that have worked with HG moms in the past. If you are not doing this research yourself, do you honestly expect your doctor to be doing it? Direct them to the resources on the HelpHER website. Go on internet forums when you can look at your phone or laptop without vomiting. Listen to other people’s stories to get ideas for treatments/medications to try. Do not give up. Do not become complacent, or trust that your doctor must know best because they have all the medical training. They only see 1% of pregnant women with HG, if that. An OB in practice for 30 years can go the entire 30 years without seeing anyone with HG so bad that they need a PICC line. My first OB was like that. I would have died if I’d stayed under his care. Seriously. If nothing else sticks, please please please, BE YOUR OWN ADVOCATE.

Best of luck, to any of you right in the middle of all this. I can promise that it won’t last forever. And usually, survivors of HG have their lives completely changed by the experience, in a lot of ways. Many of those ways are good. We tend to have a fierce bond with our babies, because we survived something so traumatic together. We know that we earned each kid a thousand times over, which can be comforting when you have fears of being a good parent. We become strong in mental and emotional ways that probably wouldn’t have been possible without experiencing such a debilitating illness. We are warriors, fighting for survival against odds that totally suck. Hang in there, strong mom. You can do this.


You can find the other posts in my series on hyperemesis gravidarum here.

Small Wins: 34 Weeks Pregnant

I brushed my teeth with real toothpaste today.

If you know anything about HG, or have been following my other posts about it, you’ll know what a big deal it is for me to brush my teeth. I’ve mostly been brushing with just water, which is a huge step up from not brushing at all (which was the case for many weeks during the worst times). Every once in a while I could use the special strawberry toothpaste that my husband got me–very mild taste, not as likely to trigger my gag/vomit reflex as the minty stuff. But today I used real mint toothpaste! And only got close to vomiting once, which I think I’ll blame on this lingering cough/throat tickle, not on the toothpaste.

I’m feeling relatively good today, though I wonder if that’s because it’s overcast and supposed to rain tonight. Last week I was dealing with depression, which could have been due to my thyroid levels, but could also have been because of the hot weather (really, it’s not supposed to be hot out in February!!). So it’s nice to see how the light is different in the apartment with cloud cover outside, and to look out the window with my cat at the beautiful grey blanket protecting everything from the sun.

We’re very much playing the waiting game with this baby now. I had contractions a few days ago that happened every few minutes for about three hours, and were worsening in intensity as we went. But then I ate some food and took a bath and they went away. 😦 My OB says from here on out we will just deliver instead of stopping the contractions with meds, which is a huge relief. Of course, as soon as he says that I stop having as many contractions as I was before. *sigh* They will definitely induce me at week 39, if we make it that far, because of the gestational diabetes. But baby and I are also taking longer and longer to pass the non-stress tests each time, and I keep hoping that means my OB will want me to deliver sooner rather than later. There’s also a chance that at the 37 week growth scan they will say the baby is already getting too big, and we should induce then. Fingers crossed, I guess. (I know how much other moms worry about delivering early, and I don’t mean to make light of it. But the month of steroids I was on for the HG probably helped with the baby’s lungs, and a good number of babies born at or after week 34 don’t even need to spend time in the NICU. It’s tough balancing my desperate desire to be done with this pregnancy (which has been the hardest challenge I’ve ever faced in my life, let me tell you) and concern for my kid. But mostly the desire to not be pregnant anymore wins out, because I’m confident about my little one’s health and fortitude.)

I have another non-stress test tomorrow, again at the hospital I need to deliver at (no NICU at the hospital ten minutes away, of course, so I have to deliver at the one 40 minutes away…). So I went to the grocery store today after my gestational diabetes appointment, and got some prepared foods to bring with me. The plan is to go early and spend a few hours at work (which is five minutes from the hospital). The trick, of course, is that maybe by going to the store today I have exhausted my energy reserves, and tomorrow I’ll be feeling worse. That happens super often. So I’ll just take it a day at a time, like I’ve had to do this entire pregnancy.

At this point, I’m almost tempted to push my limits as far as I possibly can every day, to possibly go into labor sooner rather than later. I just have one more week to wait until the full 30 days will have passed since I signed my consent form for the tubal. So really, any time after that, I’m ready to meet this baby. It would also be super nice to get just one normal paycheck under my belt before delivery–we would’ve been lost a long time ago without short-term disability, but I still miss my full income and worry about the six to eight weeks I’ll have to take off after having the baby.

Every day feels like a confusing mix of progress and mounting frustration. I don’t know if I’ll really know what to do with myself once I don’t have nausea and headaches and potential vomiting hanging over my head. Or when I can eat whatever I want again, because the diabetes will be gone. It seems so foreign. Too good to be true. I really think I’ll be one of the only moms out there who says that a newborn is so much easier than pregnancy. And while I hate the HG and wish I had never had to go through it…it’s like a small consolation prize knowing that life will actually be easier once this kid is born, instead of more difficult.


You can find the other posts in my series on hyperemesis gravidarum here.

That HG Beast

Are you familiar with that feeling you get the day after a good workout? Your muscles are sore, and every time they hurt or restrict your movement you just have to laugh, because that kind of pain feels like progress?

I miss that feeling.

I’ve described HG before as a sort of wall that you keep running into. You might recover just this much and no more, and when you try to push it because you feel like you should be making incremental progress, and getting better, you just run into that wall again. Or you can think of it like a predator playing with its prey. The cat that will only let the mouse get so far before snatching it back into the playing field. That mouse isn’t getting away, it’s just getting more and more run down.

When we were kids (well, let’s be honest, as an adult she does this too) my sister used to take in every injured or abandoned little animal she could. We nursed a little finch back to health who had fallen out of her nest into a pond at our church. We got her crickets and mealworms and somehow taught her how to fly. She had this one mealworm for a while that was clearly dead. It was a toy to her, something she could throw around without actually eating. By the time we removed it from her cage, it was entirely black with bruising.

I feel kind of like that mealworm, some days. HG is the predator who lets me run around in circles feeling tiny shards of hope, like maybe now that the vomiting has stopped I can go back to work! NOPE. Maybe now that we’re trying to aggressively stay on top of the gestational diabetes I’ll feel a lot better! NOPE. I keep getting dragged back into that playing field, entirely at the mercy of this horrible, debilitating predator that is HG. And I feel sore and bruised and abused.

I went to a breastfeeding basics class at the hospital last night. It was tough for me, sitting in those uncomfortable chairs and listening to people talk about the miracle and majesty of pregnancy and birth and breastfeeding. I haven’t felt like much of a magical creature, these past months. Chances are, every single other woman there, including the two instructors who had five children between them, had fairly normal pregnancies. They probably don’t have to go in for non-stress tests on the baby until they’re past their due dates. They probably have continued going to work this entire time, shoring up funds for their maternity leave, where depending on their employer they could actually choose to take more time than the standard offered, because they aren’t broke from medical expenses and being on disability. They probably don’t make jokes about almost dying, and how little we “care” about the baby’s health because we’re just so glad that I’M not at death’s door anymore (to be fair, we’re getting more excited, and would obviously be devastated if anything was wrong with the baby. It’s as much a survivor as I am, though, and we tend not to worry about it because it’s proven its strength).

Driving home, I complained into the speakerphone the entire way. My husband is super patient, and supportive, and wonderful. And he understands how difficult all this is, and it pains him to watch me go through it all and not have much he can do to actually alleviate the difficulties. We’re both damn excited for when I’m not pregnant anymore because, wow, I’ll be a real person again.

And today, feeling sorry for myself because I need a full day of recovery after the simple exertions of yesterday’s class, I complained about how other women with HG handle the whole thing with more grace. Some of them let faith get them through it. It comforts them to think that this is God’s plan, and they are earning the wonderful blessing that will be their child. But others? Like the woman posting in an HG group last night who lost her baby at 20 weeks, is completely devastated, but still managed to close her post by saying good luck to the rest of us who are still in the middle of it? That level of grace just leaves me in awe.

I am bitter, and resentful, and so very tired and bruised. My husband says I am a warrior surviving a battle pregnancy. He says I have “warrior’s grace.” I like the thought of it, especially considering that my patron goddess is such a warrior herself. And some days, I believe him. Some days, I think that I’ll be a totally awesome mom, because I had my priorities all sorted out by this stupid illness, and I’ll actually appreciate my kid without using them as some vicarious life-surrogate (because fuck that, I’m going to go out and live my own damn life after the HG is done with me). But other days, like today, I stay in bed all day. I think about how much the HG has robbed from me, and how much it will continue to rob from me when I am forced to go back to work after having my kid, because we just can’t afford for me not to. I think about how tiny my fitness goals will be, and how long it will take me to work back up to being able to walk a simple mile, or even deadlift five pound dumbbells. I think about the novel in my head, for once not being written because of illness and health restrictions instead of writerly procrastination.

Some days, like I said, are better than others. Today is a defeated kind of day, though. Today is a day when I give in to the HG and feel sorry for myself. Tomorrow I have to get back up again, take myself to the endocrinologist appointment and the non-stress test at the hospital. This weekend, I have to rally my strength and help my husband set up the baby furniture, so that we aren’t caught unawares if this little one makes an early appearance. I have to keep trying to work, because I’ve reached my personal limit on being on disability, and I just can’t accept the hand-out anymore.

Maybe when all this is said and done, years from now, I’ll be able to think on it with grace. For today, though? Today I’m letting the HG win. It isn’t a strategic defeat that I’m taking to shore up my strength for another battle. I’m just tired. Tired and bruised and defeated.


You can find the other posts in my series on hyperemesis gravidarum here.

Hypothyroidism: A Tricky Beast

Disclaimer: I’m not a doctor/medical professional. Don’t take health advice from me, and do your own research.

I had a recognizable pattern of “bad summers.” It started when I was 16, or at least that’s the first time we noticed it. I was sleeping all the time, preferring it to being awake. The summer in between tenth and eleventh grade was hell. I had just spent the previous few months helping my best friend with her campaign to be elected on the student body council—we had tons of fun making posters and she ended up winning. Then through the natural rhythms of life, she had a super busy summer. A lot of it was outings with the rest of the student body council. The first sign that something was wrong (though I didn’t realize it at the time) came when I hadn’t heard from her in a while, but heard through a mutual friend that she had visited Stanford. It was a routine sort of field trip, nothing crazy. We were all thinking about colleges then, and she just happened to go with the student body council. I got so mad. Not really jealousy that she had gotten to go visit the campus, but anger that she hadn’t told me about it. Irrational anger, obviously. I justified it in my head by saying that Stanford was one of the most prestigious schools for writing, and she should have known I would care about it as a writer, and so she should have told me.

I gave her a hard time about it, left angry voicemails, and generally acted like a crazy person. She stopped talking to me entirely (can’t really blame her, when we were only sixteen and I was obviously off my rocker).

My mom was worried about me, thought that all the sleeping meant that I was depressed. She took me in for blood tests, and we got my thyroid levels checked. I don’t remember much about it—just the probing questions from the doctor about whether I felt sad all the time, and the rebellious sullen answers a typical teenager would give to those sorts of questions.

Fast forward to years later. I’m 24, and realizing the pattern of horrible, depressed, sometimes suicidal summers. I’m mystified—seasonal affective disorder is certainly a thing, but reverse seasonal affective disorder was still new enough to maybe not be real. So I start researching. And asking about family history. And finding obscure internet articles about how depression can be linked to thyroid issues. And even more obscure references to the seasonal fluctuations in thyroid levels. I think I was determined to find something that meant I could treat my depression with something other than antidepressants. I’d already been on the suicide crisis lines for a while, and I hated that so many of the callers were dealing with suicidality as a side effect of their mood stabilizers. And so many of them weren’t monitored as closely as they should have been, with follow-up psychiatrist appointments months in the future, when they were obviously having adverse side effects to the dosage NOW.

I dug through old paperwork and managed to find the results from that thyroid test when I was 16. My TSH was at 4.5. Most labs say the cutoff for a normal thyroid is 5.0, but some big group of certified Endocrinologists said those numbers should be revised, that anything above a 3.0 was worrisome… So I started the hunt. I saw a doctor who said that if I was depressed I should listen to happy music. She was also the one who asked about my religion and tried to imply that I was depressed because I wasn’t Christian. That was a fun visit. I saw an endocrinologist who said that she wouldn’t even think of treating me unless I had a TSH above 9.0 and an obviously enlarged thyroid (goiter).

Finally, the third doctor agreed to treat me based on my symptoms rather than the lab numbers. My TSH was coming back as 4.3, near the tail end of another difficult summer. What doctors now call “subclinical hypothyroidism” but what for me means a terrifying stretch of time when depression and suicidal thoughts rule my life.

Long story short? I got on thyroid meds and haven’t had a bad summer since.

Just to prove how delightfully tricky it is to recognize thyroid issues, though, here were my symptoms back when I was trying to get treatment:

-Hair loss (which, due to my genetics, meant that my very thick, vibrant, copious amounts of hair clogged my hairbrush more than it should. I wasn’t going bald, my hair was not noticeably thinning out, strands would just fall out more than what was “normal”)

-Temperature sensitivity (Cold was super cold, hot was unbearably awful. It’s most obvious when I go to work at our company’s beautiful warehouse-style location that takes a while to warm up in the mornings. The guys are down to shirt sleeves within an hour. I’m still in two sweaters after lunchtime.)

-Depression/Suicidality in the summertime (Confusing, because some people who are hypothyroid are hypothyroid enough for the depression to last all the time, whereas my numbers are low enough that seasonal fluctuations mean some of my symptoms go away during the colder months…)

-Fatigue (Difficult to distinguish from the depression, since they’re usually wrapped up in each other. Mine was most recognizable after spending time in hot environments—any time in the sun and I would have to nap for hours to get anywhere close to a normal energy level again.)

-Weight gain (This was very gradual. Just over ~5 pounds a year, over the course of several years. But that certainly adds up.)

Then, along came pregnancy and my lovely hyperemesis gravidarum. Sleepless nights spent scouring the internet for any little distraction that might help me put off the next vomit session by a half a minute uncovered the weird link between thyroid hormones and hCg. HCg is the growth hormone that is detected via pregnancy tests. Your numbers multiply for a while, peaking somewhere near the end of your first trimester, and then remain elevated somewhere into your second trimester, until the placenta can start taking over some of the hormone production. High levels of hCg are thought to be linked to hyperemesis, a nifty explanation for why women pregnant with twins often end up with HG or just higher levels of nausea and vomiting during pregnancy. Turns out the alpha subunit of thyroid stimulating hormones is nearly identical to hCg. What does that mean for me? It shouldn’t have meant anything. Unless my hypothyroidism is caused by Hashimoto’s autoimmune disorder, in which case it could mean very bad things.

I don’t really want to go into all the intricacies—everyone should do their own research on this stuff, and since I haven’t been formally trained in it there are probably bits that I’m getting wrong. But basically when you have Hashimoto’s your immune system is trained to attack your thyroid, slowly breaking it down until it loses more and more of its mass and ability to produce the T4 hormones that are converted to T3 and then used throughout your body to regulate everything from your metabolic system to your temperature. Homeostasis in the face of Hashimoto’s? Pretty tough on the body to maintain.

So, basically beyond a certain threshold of hCg, my immune system started going into overdrive. I’m guessing (though it isn’t proven) that this is why my body was rejecting everything useful during the worst times of my hyperemesis (ex: food, liquid, any nutrient whatsoever). The hyperemesis, again for unknown/unproven reasons, sometimes causes what they call “transient hyperthyroidism.” Which meant that for a while my TSH numbers went the opposite direction. I had to stop taking my Synthroid (synthetic T4 replacement hormone used to treat hypothyroidism), because I was getting all these symptoms of hyperthyroidism. I had heart palpitations, increased heart rate, I was losing weight at an alarming rate (also due to the hyperemesis though, of course).

So I’ve been off my thyroid meds for a few months, ever since the last hospital admission. Unfortunately, in most normal pregnant women, doctors don’t have a standard protocol of checking all areas of thyroid production/health throughout pregnancy. In one routine blood test (I think for the second trimester screening) they only tested my free T4 numbers, which came back normal. They advised me to not re-start my thyroid meds, because everything looked good.

Along comes a visit to my primary care physician, who is following up on my overall health now that my body has been going through so much (and to think, before the pregnancy all I was dealing with was a vitamin D deficiency!). He runs some tests, and low and behold, my TSH is all the way up to 7.0!

Have I been dealing with depression? Just the normal amounts for any woman with hyperemesis, which thankfully died back down after the steroids started allowing me to eat and drink again. Am I sensitive to cold? Hell no, I’m pregnant, I run way hotter than usual and end up soaking my sheets in sweat every night.

The depression is usually my big indicator that something isn’t right. If the depression isn’t present, I don’t really notice that anything’s wrong. So the recent levels of insane fatigue I’ve been feeling, I just attributed to third trimester symptoms, plus a possible correlation with my gestational diabetes diagnosis, because high blood sugar numbers can cause extreme fatigue.

It’s only after my doctor comes to me saying myTSH is at a record 7.0 that I realize I’ve been having to clean off the hair from my hairbrush about five times more often than I normally would have to.

Interestingly enough, women with hypothyroidism are something like 17% more likely to develop gestational diabetes. Probably something to do with how the thyroid hormones are hooked into your metabolism, and therefore the way and rate your body metabolizes glucose…

The lesson in all this is pretty simple, for me. Stay more on top of my thyroid condition. I’m a little hopeful now that with some thyroid meds we might see some improvement in my fatigue levels, which would mean I can go back to trying to work again. Who knows, maybe it will even make the gestational diabetes easier to keep in check. I’m a little miffed that my body is so complicated right now…my PCP says that it’s probably due to the lasting effects of the steroids on my system that things are so complex and confusing now. I thought that hyperemesis gravidarum was enough to have to deal with—I wouldn’t wish it on my worst enemy. Then add the gestational diabetes, and now thyroid issues…

The one definite good thing in all of this is that we’ve finally tested for, and confirmed, Hashimoto’s. Right now with my weird dietary restrictions/needs, I can’t do much about it. I’m still eating whole wheat carbs and just trying to manage my blood sugar numbers in any way I can. But after delivery, when I can get rid of this placenta and my body will return to functioning the way I’m used to it doing…I can go gluten-free to help limit the negative affect of the Hashimoto’s. It feels good, knowing that I will finally be able to manage a health problem myself, with just some lifestyle tweaks. I don’t have to feel like such a victim, buffeted by the endless storms of uncontrollable pregnancy complications. Just ten weeks to go. Longest ten weeks of my life…but the end is in sight.

Finding Peace in Additional Pregnancy Complications

My battle with hyperemesis gravidarum isn’t over yet. It won’t be, until I give birth, and even then I know I will struggle with post-traumatic stress disorder brought on by this debilitating illness.

This week we’ve had a new pregnancy complication to deal with, on top of everything else. I just barely failed the one-hour glucose test set by my doctor. They had me go in for the three-hour test next—a rather hopeless undertaking considering my state. Fasting for twelve hours and then putting 100 grams of glucose straight into my empty system almost guaranteed a poor outcome. I made it past the one-hour blood draw, but then the exertion of walking back to the waiting room to wait for another hour sent me over the edge. The bathroom had nice thick walls, so no one could hear the retching as I lost all of the sugary lemon-lime awfulness that hadn’t yet been absorbed by my system.

It was scary, walking into that handicap bathroom stall with no one else around. The world was spinning and my vision was going dark. I couldn’t help thinking about my obstetrician’s warning, that a fall at this stage could seriously hurt, even kill, the baby.

Nausea and I are old friends by now, so I lay down on the cold floor. Sometimes if I can cool my temperature enough by contact with the tile floor, I could stop myself from vomiting or passing out. Unfortunately, it works a lot better when I’m in my own home, not wearing any clothes (any pressure or constriction from fabric can exacerbate nausea, and even seems to make my skin crawl more violently when I’m dealing with an episode of restless legs). There wasn’t enough of my skin exposed to the cold laminate, so lying down didn’t lower my body temperature enough. I barely hoisted myself to the trash can in the corner of the stall fast enough.

Luckily for me, I didn’t pass out. Emptying my system of that horrible glucose concoction stopped my vision from greying, and made me feel more steady. My system was still reeling from far too much sugar entering it at once, and the baby was definitely doing the flips and tumbles that I now associate with a transferred sugar high. The phlebotomist I informed seemed scornful and disappointed, like it was my fault that I couldn’t keep the drink down. I’ve gained more compassion for people who seem to judge me for my illness, though. Early the very next week she was the one to draw my blood for other tests, and she was kind and efficient, going straight for a butterfly needle the way all exceptional phlebotomists do when faced with my difficult veins.

One of the midwives in my doctor’s practice told me to track my fasting and post-prandial blood sugar levels for a week, and report back to her. Something I wish I could have just done right away, without enduring the trial of attempting that brutal three-hour test.

My numbers came back on the verge of being bad the first day, but we weren’t worried yet. There was a special cleaning and purging session at work, and for the first time in months I had my husband take me in so that I could cover the phones while my colleagues worked on the special project. It felt so good to be useful in such an obvious way.

The exertion of those hours sitting at the phone though, seemed to act the way light exercise does—by the next day, when I was completely wiped out and unable to do anything physically exerting, my numbers were already higher. They keep climbing up. I’ve noticed a terrible feeling of dis-ease that seems to correlate exactly with the height of the numbers. A friend took me to the grocery store, an undertaking that completely wiped me out yet again. Even eating a “diabetic diet,” I can’t get those numbers under control.

For the past six days I have been sleeping close to 20 hours a day. I’m more nauseous all the time, a nausea that the Benedryl doesn’t seem to touch anymore, I suspect because it’s brought on by the high blood sugar. My fasting numbers are always high, and even limiting carbs and making sure to have a good protein source with every meal and snack isn’t helping much.

I suspect that my body is just too worn down to deal with this new complication. Gestational diabetes is similar to Type II, where your body is still producing insulin but your cells are more and more insulin-resistant. It is likely to get worse as long as I have this placenta in me, producing greater and greater amounts of hormones that are helping baby put on the fat stores it will need for protection in its first weeks out in the wider world. I have to wait to see an endocrinologist—I don’t know how long it will take them to call me to set up my first appointment, but I’m hoping it’s soon. I haven’t gotten a single bit of work done this week, because of how awful I feel on a constant basis. I don’t think my blood sugar ever drops below 90, and even two and three hours after a meal I still see numbers that are very high for a non-diabetic. I can’t go for a half hour walk after meals to help use up the sugars entering my system—I hardly have the energy to make myself eggs in the morning, though their protein is one of the only things that doesn’t make my blood sugar shoot higher.

With all of this going on, I’ve been feeling very defeated. The hyperemesis is in NO WAY my fault. Likewise, the gestational diabetes is NOT MY FAULT. Likely the GD is actually caused by the HG wearing down my system—nothing is working as it should, and if I was able to keep up a normal diet and routine of exercise I might not have ever gotten into the range of GD. Even knowing that there’s nothing I could have done to prevent either of these illnesses/complications, I still feel targeted by the universe. It feels like everything that can go wrong at this point will likely go wrong, because my body is so worn down and incapable of handling this strain. That’s a mixed bag in a lot of ways. The more complications arise, the more likely my doctor is to decide on an early cesarean, which means pregnancy is over that much faster, and recovery is right around the corner. But at only 30 weeks pregnant, I still need another six or seven weeks before we wouldn’t have to worry too much about baby’s health at being delivered early. And even at 36 or 37 weeks, baby’s lungs might not be as developed as we’d like, and we could be looking at dealing with baby being in the NICU post-delivery.

The title of this post might be a little misleading. I haven’t actually found peace yet in these additional pregnancy complications. But I’m trying. I’m struggling, I’m battling, I’m trying to cultivate acceptance and a calm mind. I write late-night rants to a friend who is a good listener. I reach out to my cousin who was the man of honor at our wedding, the brother I never had. He has a way of reminding me that life is worth it, that I’m worth it, no matter what I’m facing in the current moment. I kiss my husband and long for a return to normalcy for us, when I can shop and cook and clean for him again, when our sex life is normal because my body is no longer frail. I fear, every day, that I might never get better. That the instant relief other HG moms feel as soon as they deliver the afterbirth won’t come, and I’ll be looking at a life of nausea and complications, at failed organs and feeble health. I read books on Buddhist acceptance and release from suffering. I dutifully record my blood sugars and count the kicks of my squirming tenant.

I am trying, and that is all anyone can ask of me.


You can find the other posts in my series on hyperemesis gravidarum here.

Restless Legs and Alien Parasites

Arguably, the chances that I’m carrying an alien parasite a la face-eater are pretty slim. We’ve had two ultrasounds, and it looked pretty human at the second one (this doesn’t, however, rule out werewolf, because it wasn’t a full moon on the date of that ultrasound…). Still, when something at the crown of your enlarged belly seizes up and feels like you think it would feel if someone were to punch you and then just hold that force in place… Followed a few seconds later with a swift jab to the inside of your ribs that reminds you to start breathing again… It’s a little unsettling.

We already know that I’m not one of those women espousing the “joy” and “wonder” of pregnancy. Sure, I think it’s cool in a sort of weird way, that we can create life and all that. And since I believe in souls, I spend some of my time wondering how the hell the soul gets in there, and at what point in the procedure it enters, and whether I would be able to feel another soul inside my soul, or if they could even occupy the same space at the same time, though they probably wouldn’t have anything to do with the physical plane as I understand it… So yeah, mystical process of creation and all that. Women’s bodies are miraculous and whatever.

But dark humor is really how we’ve survived this pregnancy. You kind of have to, when your body is basically allergic to being pregnant, and you and your poor parasitic fetus almost die a couple times. If you’re not laughing about it you’re neck-deep in despair, and that’s not very productive or helpful. Heap on top of that the scorn from the rest of the world who sees you “making light” of this whole miracle of creation, because they’ve never gone through HG and probably never will, and therefore don’t understand an iota of your emotions or experience at this point…

The truth is, I’m probably going to be a great mom. I don’t say this out of arrogance (well okay, I can be pretty self-assured, but still). Being so sick, and so close to death, it gives you an interesting perspective. You realize what matters and what doesn’t. All the WEIGHT of society’s expectations, imaginary concepts like “career success,” it just starts to slough away. I don’t shower much when I’m this ill, but every time it feels like more and more layers are being scraped away. The surface stuff that doesn’t matter. The walls we’ve built up or had placed on us that are supposed to help us fit in with everyone else, protect ourselves and make “progress” in this strange world.

The fact is, everyone is always telling us what to think, how to behave, what to feel. Very rarely are we left to our own devices to discover what is unique and intrinsic to our own cores. I realized today that the first time I told the world I wanted to be a writer, the message I immediately got back was, “You’ll never be able to support yourself with that.” There are two implications there. 1) I’ll never be a good enough writer to make a living at it, like some writers are able to do. That’s an interesting one, and probably due more to the psychological baggage of the person saying the comment than an actual reflection of my talent (it was seventh grade, no one expected me to be a Hemingway or King or Rowling yet). And, 2) The way to measure “success” as a writer was connected to monetary reward.

Have you caught on yet? How silly that second implication is? It took me a while to see it. How much money we make tends to be all wrapped up in our feelings of self-worth, because, hey, America. Couple that with a generation like mine who’s fighting tooth and nail with the baby boomers for their jobs, and more often than not failing due to lack of experience because hey, we’re still young, and you’ve got a dangerous cocktail that plunges you into mad despair. Except, look at the writers I most admire. No, I take that back. Look at the people I most admire. They tend to also be writers. But they are people first. I think of my middle school English teacher. She saw the passion in our fumbling attempts at poetry and prose. She encouraged us, praised us, pushed us to open up that well of creativity and let it pour out through the pen. My 11th grade English teacher, who had us write essays on what we thought was important to the human experience. Who let us pick feminist books to read, and told us that our opinions mattered and that we were people, valid and important, regardless of the teenage hormones raging inside. My undergraduate creative writing professor, who realized how fragile a college student’s ego could be, who would couch criticism in encouragement just to see a student keep writing, because as soon as we stop, there’s where despair lies. My graduate professors, who realized how necessary and timely it was to deliver swift kicks to the ass when your dialogue was boring or nothing was working dammit.

What’s interesting about all of these people? They have day jobs. Teacher salaries, sure, which are woefully inadequate in America. But a lot of them are writers. Published writers. Hell, my graduate thesis professor has written so many books and short stories that his Wikipedia page lists only “Selected Works.” I’d say he’s pretty impossible to keep up with, the pace he writes at. So why teach? Along with a healthy appreciation for the profession, I imagine there’s some desire in there for many of these people to have a slightly more stable, reliable income. Maybe health insurance, if we even offer that to teachers (we do, right? Please tell me they get health insurance…).

So, is it true that the measure of a writer’s success is in how much money they make? I’d say no.

Is it true that the measure of a writer’s success is in whether or not they’re published? Again, I’d say no. There’s a part of us that wants to be heard, to connect with someone out there in the faceless multitude. It’s why we write. But does it have to be through traditional publishing, or does it have to happen within a certain time frame? No, and no.

I’m 25. I’ve got a graduate degree, but no completed manuscripts I’d be ready to send to agents. I’m about to have a baby, which people tell me will take up a lot of my time and energy for the next 18+ years. Should I be down on myself for not being published yet? Or should I use this time to reclaim my natural love of writing, the mysticism and passion that I felt back in the seventh grade?

Because, to me, that’s so much more important than money. Writing used to be so much fun. It had a sense of wonder, of discovery and adventure and exploration. I want to feel that again. And that means, for right now, separating “being published” from my definition of success as a writer.

So on these long nights, when the infuriating, mysterious cases of Restless Leg Syndrome descend and keep me from sleep (not for any proven reason, but just because I’m PREGNANT, like that’s a specific medical, chemical, hormonal, genetic reason for something…), maybe I’ll be here, trying to reclaim that sense of wonder.


You can find the other posts in my series on hyperemesis gravidarum here.

A Day in the Life of HG Recovery

I just hit the 20 week mark of this pregnancy. Officially half over. The first 20 weeks were the longest and hardest of my life, due to hyperemesis gravidarum. When I think about the things that helped me through the darkest times, I think about endless internet searches for forum posts and blog entries. Desperately grasping for some reassurance that I’m not alone. That other women have been through this, and that they survived.

An astonishingly small number of those women talk about the really dark parts. You see it hinted at, here and there. Just last week I stumbled on one that was a real stream of consciousness account of the worst times. I think it might come from the fact that when we’re in those dark times, we don’t often have the energy or capability to write down what we’re feeling. It’s too much work, just trying to lie completely immobile in a dark and hopefully scent-free room, fighting with every ounce of your will to not throw up for the twentieth time today. And then when you get past it, when you’re starting to feel like a person again, you don’t WANT to dwell on those bad times. You don’t want to remember how flimsy your resolve was, how much this illness stripped away every recognizable part of you and showed you what you really are, underneath it all.

Not being able to find enough of those accounts is why I wrote this blog entry. In some ways I want to be able to remember how low HG brought me. I want to look at how broken and defeated I was. I want to mourn the loss of the person I was before HG swept into (and took over) my life. And I want to be able to compare that to the person I am now. Slowly picking up the sad, small pieces that are left. Trying to build them up into a stronger person.

Today, though, I want to address another part of HG that I had trouble finding accounts of: Recovery.

The tricky part with this is that some women don’t experience any lessening of HG until after they give birth (and sometimes not even then, because the nausea will linger). And for many HG women, it seems to be the norm for the symptoms to shut off like a light switch. All of a sudden the nausea is gone, the appetite is back, and the only lingering effects are atrophied muscles and teeth corroded from all the stomach acid. Not to mention the more subtle psychological impacts that give many HG women PTSD. So, a gradual recovery isn’t very common, and once these women have their baby in their arms I think many of them want to just put HG behind them, rather than record how they come back from it while dealing with a newborn. Not to mention that a mother with a newborn is a very busy woman, and might not have the time or energy to keep talking about HG and its longterm effects.

But here I am, at week 20 of the pregnancy. It looks like I might be one of the lucky women who experience some relief from the HG during the second trimester *knocks on wood*. It might only be due to the steroids, it might be linked to the placenta taking on more of the task of regulating hormones for the baby, it might be due to the lessening of the huge amounts of hcg coursing through my symptom. We really have no idea, because no one has yet found the cause of HG.

I haven’t vomited in a month. It has been a full month since I have had to be in the hospital. I took a shower yesterday. Life is considerably better now than it was in the dark times.

So here is what a day looks like for me, trying to recover from HG.

Wake up around 8:30, praising the Unisom I took last night because it let me sleep for a full ten hours, only waking up a couple times because of vivid nightmares (this time including velociraptors, which is what I get when I read Michael Crichton before bed).

Open the bedroom window a bit to catch some of the sound of the light rain, so rare in our California desert areas. Pull the covers up some more, because the air outside is finally, officially cold.

The cat notices I’m awake, and decides it would be excellent if I got up right away and fed him a can of wet food. I spend the next half hour pushing him off the bed, trying to protect my stomach so that he doesn’t step all over the baby as he tries to bug me into getting up. I browse Facebook, check up on what my pregnancy app says is going on with the baby during week 20.

Eventually my bladder is just too full to let me stay in bed longer. I pull bottle after bottle out of my nightstand drawer, which won’t even close anymore because it’s overflowing with about twenty different medications. I dutifully take my steroid dose, trying not to worry that tomorrow is the last day of the steroids, and we don’t know whether I’ll be doing well when I have to cut them out completely. I take my Pepcid, thankful that switching from the Prilosec worked, because I was worried about what it was training my body to do, being on such a strong acid blocker for so long. I hesitate for the merest second before also taking my Benedryl, reasoning that even if I’m not super nauseous right now, it’s better to be safe than sorry. Already having Benedryl in your system is much better than getting super nauseous and then having to swallow one.

I remember the conversation I had with friends yesterday, that before I got pregnant I thought I would eat entirely paleo and never take any medications or even have caffeine while I was pregnant. I’ve done great on the caffeine side of things, but I’m lucky if I eat anything at all, so it doesn’t make sense to restrict my diet. And the “no-medications” I had to give up on in week six of the pregnancy, or risk both myself and the baby dying. So it goes.

I intend to brush my teeth right after emptying my bladder, but find myself already back in the bedroom. Women talk about “pregnancy brain,” the sort of absent-mindedness that causes them to forget what they were doing or where they were going. I think it’s training, for when the baby comes. Like your brain wants to show you that you really aren’t capable of multitasking, when you have fifty million things running through your brain at any given time. You think of everything, but have follow-through on nothing. I sit on the bed again, wondering if I really have it in me to go back to the bathroom and brush my teeth. I think about the awful taste in my mouth, and trying to eat food with it present. I decide to brush my teeth.

The minty toothpaste helps for a minute or two with that nasty taste that lives in the back of my throat. I described it to my friends like this: picture a hearty kale smoothie. That you leave out on the counter for a few days, until it’s growing a nice patch of mold. Imagine that you drank just the chunky bits, and they coated the back of your throat. That’s the kind of taste I live with every day.

I’m not hungry, in fact the idea of food makes me feel like crawling under the covers and trying to sleep until doomsday instead. I force myself to walk to the kitchen. I microwave some frozen, fully-cooked sausage links. Gone are the days of cooking fresh food for myself. I fill a small disposable bowl with Cheerios and milk (the less dishes that need to be cleaned, the less my husband has to do when he comes home for the weekend). The milk coats the taste at the back of my throat, making it even worse for a while, but I think about the calcium that my baby probably needs right now, and I force myself to finish it all. I chase everything with a banana, which helps with the taste for a little while.

Five weeks ago, I was in the hospital with a feeding tube, IV nutrition, and IV meds every six hours around the clock. I owe my ability to eat entirely to the steroids, which after four days of IV dosing finally started kicking in to stop the vomiting. The 40 mg of prednisone I took the week after the hospital gave me a voracious appetite, trying constantly to soothe that empty feeling I had in my stomach all the time. Now, on 10 mg, I’m lucky to force things down and not have them come back up. I don’t eat enough most days, because when you have no appetite and no energy even getting up to get yourself a snack is a monumental task. But I’m eating every day, and my body must be absorbing some of the nutrients for the baby. I don’t feel stronger at all, but the baby still feels alive and well.

I seriously consider spending the entire day catching up on Once Upon a Time episodes. I know that when I push myself too hard, I don’t just sleep more and have achy muscles. The HG symptoms get worse, threatening a relapse. Last week I drove myself to my doctor appointment, for the first time in three months. I even went to Target afterward to get myself some milk and shampoo. I paid for that the rest of the week with increased nausea, less stamina, and poor sleep. I get a little better on the weekends, when my husband is here getting me food and water. I don’t have to get up as much, then, and I end up eating and sleeping more.

I decide that today should be a productive day, as much as I can make it one. I feel guilty, doing anything “productive” that doesn’t involve working from home. I feel like they might have forgotten about me for the most part. They must all be used to me not being around, by now. I know I’m lucky to have a job who won’t fire me for being so sick. I’m lucky to have a doctor who will sign off on my short-term disability, so that I won’t lose my job. I worry, though, about when my doctor says I’m “well” enough to start working again. I think about how much it taxes my strength for the rest of the week when I take myself to a doctor appointment. I think about the half-hour drive to go to work, and the rewarding but relentless minor stress of “getting things done” while I’m there. Even working from home, I know that added responsibilities at this point will stretch my limits. It could all bring about a relapse, and then I’m back to bed all day every day.

Every tiny bit of “progress” is like that, for someone who isn’t sure whether the HG is going to come back with a vengeance. Third trimester relapses are unsettlingly common, unfortunately. I could manage to go back to work week 21, build up to actually going into the office and working a full 40-hour week. Only for it all to come to a grinding halt around the mid-30s weeks, as I descend back into something as bad as the dark times at weeks 8-11.

Or I could try to work from home next week, just a few hours a day, and then have an even sooner relapse because my body is just waiting for an excuse to succumb to the lingering HG. It feels like being stalked by a deadly predator every moment of every day. You hope that you’re hiding well enough, you hope that you can stay ahead of it. But it’s smarter than you, and stronger than you, and ultimately you won’t even see it coming.

I will likely spend the rest of the day trying to write blog posts, book reviews, and working on my novel. The going will be slow, and I will have to force myself to get up every couple hours to grab another snack. Once I’ve started eating for the day, it’s better to keep something in my stomach at all times to fend off the stronger nausea that accompanies an empty stomach. I will be looking forward to five hours from now, when I can take another Benadryl. They’re supposed to work on the nausea in a consistent sort of way, and maybe they do. But the real relief comes a half hour after taking it, when it’s hitting your system and for two or three blissful moments, you feel woozy and lightheaded but also amazingly free of nausea. It only lasts a few minutes, and then you’re back to a constant state of low-level nausea, but those minutes are damn worth it.

I won’t have the energy to do any cleaning today, though I could make a list a mile long of the things I’d like to be doing around the house. I won’t attempt a shower, because I just took one yesterday and I have to conserve my energy for when I really need it. Surprising, how much a single shower can take out of your energy reserves. I will likely say no, when my friends ask if I want them to keep me company later in the day, because I know that even as lovely as it is to have contact with real people, it also taxes my strength. I will try to get through the day without napping, because every time I let myself nap during the day it throws my whole sleeping schedule off, until I’m in a strange cycle of 5-6 hours awake, 5 hours asleep, 5-6 hours awake, 5 hours asleep, ad infinitum. Sadly, five hours of sleep doesn’t leave me feeling rested or rejuvenated, and it takes some careful Unisom dosing to get me back to sleeping through the night.

I will spend the day fighting myself, which is all I do lately. Mentally, I’m sound enough to know what needs to be done, what should be done, what I’d like to be doing… Physically, I have restrictions that don’t ever seem to want to let up. The constant state of frustration at not being capable of doing the things that I want to do wears me down. Give me three months off work and my normal strength and I could have had three novels completed by now. Instead, I’m lucky if I can write a little bit at a time, and not get nauseous looking at a computer screen. Gone are the hours of relentless pounding at the keyboard, writing or working and not noticing when the whole day has passed me by. Now I’m lucky to get through twenty minutes without having to pause everything, take a mental inventory of my symptoms, consider climbing back into bed to lose myself in fitful sleep.

Every day is colored by the fear that I will descend back into the dark times, without any warning. I may have reached the halfway point of this pregnancy, but that just means I know how damnably long twenty weeks can feel like. Twenty more weeks of this cautious testing of boundaries, the constant small relapses when I push myself too much without realizing it—it’s enough to drive anyone crazy. Doctors and family members and friends are always so overjoyed to hear that I’m not vomiting, that I’m eating a little and keeping it down. As if that means I’m finally better, and it’s all easy as pie from here. Except nothing is easy, when HG is stalking you. It knows where I live, it knows where I sleep, and there’s no level of cunning or strategy that can help me lose it entirely. It’s probably exactly what it feels like after the pregnancy, too. A constant knowledge of how low illness can really bring you. Anxiety or panic attacks every time you feel the least bit nauseous. A forever altered relationship with food, because you won’t ever be able to eat it without being aware in some small part of you that it could disagree with you. A fear that if you start vomiting, you’ll never be able to stop again.

Recovering from HG is as much a psychological battle as it is a physical one. I could be years out from needing another gym membership, because my body is so weak that I can’t even imagine being able to lift a 10 lb dumbbell. I don’t even know, at this point, how much I will hold myself back from even trying to push things, because of the fear of relapse. It isn’t one of those situations where you just throw up your hands and do it anyway, to see what happens. There’s enough fear in me to fill a fucking reservoir and keep a small city hydrated for ten years. And I’m not allowed to talk about the fear, with most people. They get slightly uncomfortable, talking about pregnancy in anything less than a happy, optimistic, joyful way. And eventually they all say something along the lines of, “at least the baby is healthy! Isn’t that great?” But I don’t define myself through my kid, the way some other parents do. It isn’t the be-all-end-all of my existence to have a child, and be a mom. I’m still my own person, and I still matter in plenty of ways that don’t factor a kid into the mix. Sure, I can be happy that we haven’t lost the baby. But I can also be damn sad about how sick I am, about how weak my body is, about how long it will take me to work back up to being a normal fucking human being, able to take care of myself and my house and my normal responsibilities.

You can tell there’s anger there, when I have enough energy to let it boil up to the surface a bit. Anger is my natural response to things—a defense mechanism so that I don’t have to feel defeated and weak. The truth, though, is that I am defeated. I am weak, and sad, and my life can now easily be broken into two halves. Everything before HG, vs. Everything after. I will never again be a person who has not known the terrible reality of such a debilitating illness. I will never again be able to look at myself and think that I’m strong enough to handle anything. I wasn’t strong enough for the HG. I couldn’t hold onto myself through it. I lost so much of who I was, and now I’m left to figure out who I could possibly be on the other side of it. All while worrying that it will emerge from the shadows to drag me down to the depths again.

I’m tired, and every day is difficult. I wish I could say I’m proud of myself for surviving, for still living. I’m still just doing what’s expected of me, though. Being a good little girl, forcing myself to eat and drink when I’d rather never risk that again. I’m tired, and I want to remember what it feels like to not have to TRY to stay alive.

For me, right now, this is what it’s like to try to “recover” from HG. This is the mental and physical battle that I fight every single day. There are plenty of women out there who know exactly what I mean, who have faced this day in and day out. My heart goes out to them, and I pray every day that someone somewhere will find the cause of this terrible illness, so that we can start working on a cure. Preferably before my kid has to go through it, since it might have a strong genetic link.


You can find the other posts in my series on hyperemesis gravidarum here.