Thursday 30 May 2013

HOPE - Emma's Hyperemesis Gravidarum and Pre-eclampsia Story

HOPE - Helping Others and Promoting Education - This is Emma's story -

39 weeks and 4 days being pregnant
35 weeks suffering from Hyperemesis
245 days of vomiting and suffering from nausea
Over 2,200 tablets taken
1 month in hospital
Countless medical tests
1 perfect baby

Hyperemesis completely took over my life and has changed my view on so many things. It is such a debilitating and all consuming condition that robbed me of everything. I was unable to lead any type of life, lost my independence due to needing full time care, was unable to enjoy being pregnant and became dependent on my family and medication to keep me alive. The isolation and misunderstanding of the condition made the vomiting harder to deal with. However, I have an amazing family who got me through the darkest of days and have been given the most perfect baby at the end of it all.

We found out I was pregnant on 26th August at only 4 weeks. Having suffered from morning sickness in my last pregnancy that had unfortunately resulted in a missed miscarriage, I thought I was ready for the sickness. I pre-cooked food, bought the latest expensive sickness bands from America and prepared myself for a few weeks of feeling rubbish. On 1st September the sickness started. At first it was bearable – I could cope with being sick throughout the night and then work throughout the day but gradually the sickness intensified until I wasn’t sleeping and was going off most food. Towards the end of September I visited the doctor who prescribed me my first of many different types of anti sickness medication and diagnosed me with Hyperemesis Gravidarum. However, nothing would touch the sickness.

At the end of the month I was unable to work. By now the sickness would start at 3pm and not stop until 11am the next day. I felt drained from the lack of sleep and unable to move away from the bathroom. However, things only got worse. In those weeks leading up to my first hospital admission I was sick 20-40 times a day. Nothing would stay in me. I would eat an ice cube and seconds later bring it straight up again. Even the mention of food made me vomit. The insomnia, unrelenting sickness throughout the night and my weakening state led to me sleeping downstairs. I was physically unable to climb the stairs and this also gave my husband a chance to get a little bit of sleep himself. The doctors tried other medications but I was unable to keep the tablets in my system.

When I was 11 weeks pregnant I was at breaking point. It was weeks since I had eaten anything substantial and keeping any fluid in me was a constant battle. After talking to a midwife I was introduced to the world of ‘ketones’ – a word that every HG sufferer dreads. Excessive ketones in the urine indicate that the body is not using carbohydrates from food as fuel and is subsequently trying to break down fat as fuel. Having ketones is a sign that the body is beginning to operate in starvation mode. I was severely dehydrated and admitted to hospital where I spent an entire week on a drip.

It took several days to reduce my level of ketones. The hospital was able to control the sickness with higher doses of medication and I managed to keep down small amounts of fluid. However, I only survived a day at home before the sickness was back. I managed to celebrate our first wedding anniversary at home before being admitted back to hospital due to dehydration. By now I had lost two stone. My medication was increased again and Ondansetron was introduced. Ondansetron is usually used for chemotherapy patients and due to its cost is not widely used. I was to take a minimum of 8 different tablets a day throughout my entire pregnancy.

After being discharged with a high dosage of medication the vomiting started to improve. I was still sick frequently throughout the day but I was starting to retain some fluid. However, Hyperemesis never leaves you and even when the sickness was controlled the condition still took over my life. I felt dizzy all the time, was left confined to my couch with no energy and unable to prepare food myself. The nausea was unrelenting and felt worse than the sickness. My sense of smell heightened so much that I could not stand the smell of my own husband and couldn’t go near him without vomiting. All I wanted was to hold my husband, yet hypremesis had robbed me (and him) of that too. The isolation I felt was unbearably hard. I couldn’t go into our kitchen due to the smell and I was unable to walk upstairs or wash myself due to the exhaustion. If I was a few minutes late with my medication I would vomit. I couldn’t cope with noise, light, heat or movement. The only thing I could do was lay still and wait. This state went on for weeks. Christmas came and went but other pregnancy complications started to appear.

I had been having difficulties with shortness of breath from early on in the pregnancy but was the weeks went on things began to worsen. In January I was admitted back to hospital for several tests with the fear I had DVT. I had an echo cardiogram, lung capacity test, lung x-ray, 24 hour ECG and a VQ scan where they injected radioactive material into me. It was at this time I had tests to detect for gestational diabetes, which luckily I was able to control through diet.

The weeks would go by with my family taking it turns to look after me. I had several medical appointments both with my midwife and at hospital. In March I started to have daily Fragmin injections due to my immobility. Due to the sickness (that would keep coming and going but the debilitating nausea never left) I was unable to attend antenatal classes, couldn’t get upstairs to set up the nursery and couldn’t go shopping to buy baby things. Everywhere I went I would have to carry a bag full of drugs along with my sick bowl.

At 37 weeks my blood pressure started to rise and the swelling started to worsen around my ankles. I spent a week alternating between the midwife and hospital for further tests. Finally on 27th April I was admitted for the fourth time with pre-eclampsia. The oedema spread around my entire body turning me into Elephant Mans sister!

After many weeks of myself and my midwife requesting for me to be induced to escape the Hyperemesis I was finally induced on Sunday 29th April. However, my baby decided he liked being in the womb too much and it took until Wednesday until my waters could be broken.

I knew immediately I was in labour at 12am Wednesday as I was sick straight away. Hyperemesis did not want me to have an easy labour! I was taken to the delivery suite at 3am where the sickness worsened despite all my medication. As my stomach was empty I was vomiting blood for several hours. The only pain relief I could have was gas and air which made the sickness worse. I kept losing consciousness in between the vomiting and contractions. The excessive oedema meant I was unable to move around and the pre-eclapsia meant I had to be wired up to a monitor. I also had several different drips going into me. At 11am I was finally given an epidural and for several hours it was the best I had felt all pregnancy – the sickness just stopped.

However, our baby still did not want to make a quick appearance so a syntocinon drip was added. Each time I attempted to move his heart beat would drop significantly and the syntocinon drip had to be started again which lengthened the labour. At around 6pm the pains in my back started to intensify again despite the epidural. I knew things were changing because I vomited again. We discovered the baby was actually ready to come out!

After a relatively short time of pushing our baby started to make an appearance. Due to no parenting classes our midwife had to talk me through each stage and I was learning the breathing techniques as the labour progressed! However, baby’s heart beat started to drop again and suddenly the room was filled with medical staff. I was mostly unaware of everything going on around me but was determined that my baby and I had got this far in the pregnancy I did not want intervention now!

At 19.59 on 2nd May our baby boy was born weighing 7 pounds 1 ounce. I could tell straight away that things were not right as he was not crying and was incredibly floppy. After a few second cuddle he was taken where he needed 5 puffs of oxygen before he would breathe himself. We had a few minutes cuddle before he was taken to the Neonatal Intensive Care Unit for 15 hours.

Unfortunately my epidural had stopped working for the very last stages of labour and it was soon discovered I had a third degree perineal tear that would need surgery. It took three attempts to top up my epidural but on the surgeons table I screamed due to the pain! I was I given general anaesthetic during the operation and woke up three hours later.

Baby Adam was discharged from NICU the next day and was doing extremely well. Unfortunately my oedema worsened and walking became very painful. I had to spend several extra days in hospital as they kept an eye on my kidney function. However, a day before my birthday we were both discharged (although with a catheter still attached).

As soon as Adam was born the vomiting stopped. I no longer felt nauseous and wasn’t reaching for the sick bowl. Today is my first drug free day. The recovery is going to be long but even two weeks after giving birth I feel a different person. Due to being bed ridden for so long my muscles don’t work well and the oedema has worsened the problem. It is wonderful to be able to gulp down water without bringing it straight up again! I still have several food aversions and don’t really feel hungry or have any desire to eat particular foods. I guess some things will take time.

Baby Adam is worth every second of hyperemesis. It is amazing to think he survived such a difficult pregnancy. He is thriving already and gaining weight. I just can’t take my eyes off of him and can’t believe he is here after waiting for so long. I don’t think I will ever get over hypermesis but am so thankful to have a perfectly healthy baby boy.

If you have a story you would like to share; that could help others please do get in touch. I welcome any subject and if required I am happy to post anonymous.