Friday, November 16, 2007

Hyperemesis in the news!

The founders of The Hyperemesis Education and Research Foundation ( are being interviewed for two national news stories on HG this weekend. Jeremy and Ann Marie King will be on NBC's Nightly News with Brian Williams Friday evening. The Today Show will have a follow up story on Saturday morning. Kimber MacGibbon will be interviewed at that time.

Please tune in to one or both segments so you can learn more about HG, and please also let your own friends and family know about these news stories so they can also tune in. Doing so may allow you to save a life.

Thursday, November 15, 2007


Emma and Ben today at one of Emma's favorite places in the whole world...the dentist. Really. No kidding. Emma absolutely loves going to the dentist and it's not like going to the dentist is all sunshine and roses for her, she has had significant work done (cursed with bad enamel unfortunately). She just loves the dentist and her staff. She talks, they listen, they get a real big kick out of her and she loves having an audience.

Wednesday, November 14, 2007

Just in case someone doesn't know what the above image is, it's Bob. At approximately 12w5d gestation. Laying on his back, head on the left, legs sticking up on the right. This was from the nuchal translucency scan. NT is a simple screening tool for chromosomal defects. The area on the back of the baby's neck is measured. You can see it a little in this image, it's a dark line running down the back. Less than 2mm is normal, greater than that there is an increased risk of a chromosomal abnormality or heart defect. Bob's was about 1.5mm. Just fine. In no way guarantees that there is no chromosomal abnormality, just a piece of information. I am not willing to risk losing my baby to complications from an amnio so the screening tools are all we have to rely on, we've chose a very new maternal blood screen that is very sensitive in screening for Trisomy 21,18 and 13 and neural tube defects-there are only one maybe two labs in the whole country that do it. All that would change is where I give birth. The hospital my OB usually uses has no NICU, if my baby is suspected of having a problem I'll birth at the hospital with the Level III NICU.

Saturday, November 10, 2007


I've had quite a few people ask me why I do this. I could give the short and sweet answer, that Christopher and I are Catholics and follow the Churches teaching regarding marriage and children and accept children as God chooses to send them and that would be quite truthful and I could simply end it there.
I think a deeper look into my take on it might be useful (I speak for myself and no one else, every woman with HG copes or doesn't, in her own way).
Children are a blessing, a gift, something to be cherished. Anything worthwhile is worth sacrificing for. This period of illness is difficult but only lasts a short time. To bring another life into the world, another soul..can I not endure for a few months? Especially with all the treatment and help I receive. My grandmother had hyperemesis (although no one really called it anything back then). She could only eat oranges. She had no IV's, she had no zofran. All she had were the crates of oranges, which were the only food she could tolerate, that my grandfather brought her.
I know you are asking but what about the other children, what about your husband? It is difficult for them, I can't do much for them or with them and everyone has to buck and help. Is that a bad thing? To help someone else in their time of need, to witness someone willing to suffer for something bigger and better than themselves? To understand that one has to work and work hard for things that are worthwhile?
I am NO saint. I spend plenty of time crying that I can't do this anymore, that I'm tired, wishing I could just fall asleep and not wake up for three months. Remember to offer it up? I try....and fail. Then I have a good day, or hear the heartbeat or see Bob the Bean on an u/s, hold someone elses newborn, talk with Katie (bad HG without any treatment) or any of my children, think of all the mothers who have gone before and suffered so much more, especially the Blessed Mother, then, at least for a few moments, I can remember why I do this.
The night Lucy was born, after we were all cleaned up and moved to our postpartum room, she was sleeping on my chest. I had the lights off and the only sounds were the street sounds drifting up to the 22nd floor and Lucy's fast newborn breathing. It was then as I held her to my chest, just my baby and I, I offered a prayer of thanksgiving. "Thank you Lord for giving me this baby. She was worth every moment of suffering." With God, and faith and lots of pharmaceuticals I fully expect to be saying the same prayer again in May 2008. And if something happens, and I don't get a baby in May, then I will have to surrender to that too. I can choose to let my crosses crush me, or I can have the courage to pick them up and carry them.


It has been a good couple of days. ::fingers crossed:::: after a rough first part of the week we may have finally gotten the drug regimen down pat (max dose Zofran through pump, 25mg phenergan 3-4x/day and 25mg doxylamine 3x/day). I'm eating and occasionally drinking and haven't vomited in a couple days. \o/ Yay me!
I'm still running 1L of IV fluids every night, on bad days I'll run more. Bob the Bean is doing just fine. I see the maternal fetal medicine (MFM) doc on Monday. Routine visit because I am of advanced maternal age (AMA). We'll do a nuchal translucency, I'll refuse amnio, he'll probably try and talk me into an elective C-section which I will also refuse. Typical Karen meets highly interventionist doctor scenario. Only reason I am doing any testing is because if the baby is need of extra care it will change where I deliver. Hospital without a NICU vs hospital with a NICU.

An educational moment

Lifted directly from the Hyperemsis Education and Resources Foundation (

****Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting in pregnancy. It is generally described as unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids. If severe and/or inadequately treated, it is typically associated with:

loss of greater than 5% of pre-pregnancy body weight (usually over 10%)
dehydration and production of ketones
nutritional deficiencies
metabolic imbalances
difficulty with daily activities
HG usually extends beyond the first trimester and may resolve by 21 weeks; however, it can last the entire pregnancy in less than half of these women. Complications of vomiting (e.g. gastric ulcers, esophageal bleeding, malnutrition, etc.) may also contribute to and worsen ongoing nausea.

There are numerous theories regarding the etiology of hyperemesis gravidarum. Unfortunately, HG is not fully understood and conclusive research on its potential cause is rare. New theories and findings emerge every year, substantiating that it is a complex physiological disease likely caused by multiple factors.

Diagnosis is usually made by measuring weight loss, checking for ketones, and assessing the overall condition of the mother. If she meets the standard criteria and is having difficulty performing her daily activities, medications and/or other treatments are typically offered.

Treating HG is very challenging and early intervention is critical. HG is a multifaceted disease that should be approached with a broad view of possible etiologies and complications. When treating mothers with HG, preventing and correcting nutritional deficiencies is a high priority to promote a healthy outcome for mother and child.

Most studies examining the risks and outcomes for a pregnant woman with nausea and vomiting in pregnancy find no detrimental effects long-term for milder cases. Those with more severe symptoms that lead to complications, severe weight loss, and/or prolonged nausea and vomiting are at greatest risk of adverse outcomes for both mother and child. The risk increases if medical intervention is inadequate or delayed.

The list of potential complications due to repeated vomiting or severe nausea is extensive, all of which may worsen symptoms. Common complications from nausea and vomiting include debilitating fatigue, gastric irritation, ketosis, and malnutrition. Aggressive care early in pregnancy is very important to prevent these and more life-threatening complications such as central pontine myolinolysis or Wernicke's encephalopathy. After pregnancy and in preparation of future ones, it is important to address any resulting physical and psychological complications.

Hyperemesis Gravidarum impacts societies, families and individuals. Recent, conservative estimations suggest HG costs nearly $200 million annually just for inpatient hospitalization. Considering many women are treated outside the hospital to save costs, the actual cost is likely many times greater. Beyond financial impact, many family relationships dissolve and future family plans are almost always limited. Women often lose their employment because of HG, and women are frequently undertreated and left feeling stigmatized by a disease erroneously presumed to be psychological.****

HEG is very real. It is NOT all in a woman's head, eating crackers and drinking ginger ale do nothing for HEG and usually make things worse. NO ONE chooses to feel this way. NO mother WANTS to fill her body with drugs while she is pregnant and be hooked to IV's and pumps all the time. Please be considerate when you happen to meet a mom that is suffering or has suffered with hyperemesis, it will be a pleasant surprise to her to hear genuine sympathy.