Hyperemesis gravidarum: not your garden variety morning sickness

So the tabloids have finally broken the real news that yes, Will and Kate, everyone's favorite Royals, are really, truly, pregnant. This time it's for real! And wouldn't you know it, Kate is making headlines for yet another reason: because of her recent hospitalization with hyperemesis gravidarum.

HG is probably one of the most poorly
understood conditions of pregnancy,
and its sufferers sometimes find
themselves marginalized, ignored,
and made fun of or told to
"just suck it up." If you wouldn't
say this to a recovering cancer
patient, then don't say it to a
pregnant woman - who likely is
experiencing daily debilitating
and excessive vomiting and nausea,
weight loss and severe dehydration.
For more information, visit the
Hyperemesis Education Research
website at helpher.org.

Many pregnant women have suffered through it and can relate. Many of us, like myself, have not, and find just regular old run-of-the-mill morning sickness utterly a royal pain, if you'll excuse the pun. When I wanted a second child, two things worried me: the recovery (as I planned at the time to have another cesarean), and the morning sickness. I don't know what it is, but even while not pregnant, I cannot stand being nauseated. I crocheted a lot while pregnant and now, can't even think of crocheting because the thought of doing so makes me queasy. So Kate is probably pretty miserable right about now.

HG, as it's called, can be a nightmare for sufferers. Many women I've talked to or know suffered for months, sometimes the entire duration of the pregnancy. One friend was finally, to her great relief, hooked up to a Zofran pump (like an insulin pump) that helped her manage through the feelings of constant nausea, complete loss of appetite and many, many trips to the toilet. If you've ever suffered through a day or two of stomach bug, you know how easy it can be to get dehydrated. Now think how that would feel day after day, for months. 

When it gets bad enough, a hospitalization for IV fluids can sometimes be in order. In order to differentiate between it and just normal morning sickness, severity is a consideration: if your nausea and vomiting are especially bad, to the point of being able to keep nothing in your stomach, then you're probably the lucky winner. The author of this Washington Post article humorously noted (although probably not funny at the time, I'm sure):

"I have often told people that I knew my condition was bad when a helicopter flew over my home and instead of listening to its rumble to make sure it passed safely overhead, I thought to myself, 'Well, at least if it crashes into my apartment I won't have any more morning sickness.' Death would have been an improvement...I mostly slept, and carried a trash can wherever I went. All my husband wanted was an omelet, but the thought of eggs made me want to kill him."  

One of the women who commented on The Washington Post article said that her daughter had it - and was hospitalized for the better part of her first pregnancy. Unlike Kate, however, the traditional remedies (and we're talking the big guns here that you get only at the hospital) did not work. To top it off, she became pregnant again, only to have it worse than the first time, which resulted in TPN (total parenteral nutrition, a form of IV that basically gives you all of your nutritional needs in IV form. *insert completely horrified face here*.) That would basically make you never want to have any other children, ever again. (As a side note: I used to make that stuff for patients when I worked in a pharmacy, and it basically meant you were pretty sick.)

I was glad to see that it made news, though, because of one thing: this horrible, not-your-average-pregnancy symptom is often delegitimized by people who think it's just regular old puking and feeling yucky. They often say terrible things like, "Suck it up!" or "You're just doing it for attention!" Sadly, I've even heard things like that from labor and delivery nurses, one of whom basically said, "You were the one who wanted to have a baby, so deal with it." She didn't seem to believe that it could be debilitating. I asked on my fan page if anyone had dealt with it and if they could share their comments:

"It was debilitating. I had little to no support. I was told to eat crackers, sip ginger ale, and it would just stop. I vomited around the clock for close to 7 months. When it did ease and I could eat, I had lost a lot of weight and began to develop very severe pre-eclampsia...The comments which hurt the most were when I was told I was doing this 'for attention' and that morning sickness is "all in your head." I could have died, my son could have died. I *wanted* to have a baby. I *wanted* to enjoy being pregnant. Why in the HELL would I then bring such suffering upon us both for 'attention?' It caused a lot of heartache and created a rift in my family relations for a long time afterwards." - Rebekah

"I was unable to hold down water, let alone food. Even with meds I'd have to crawl into an E.R. once a week for IV meds and fluids....The worst is when the doctors don't want to believe you...not sure I could ever put myself through being pregnant again. Which sucks because I long for another child." - Noel

"Meds didn't work. I spent my whole day either throwing up or trying not to. I lost my job - had to be hospitalized for dehydration. I lost my baby as a result of being so sick...The comment that hurt the most especially at the end where I was still but knew the baby was gone was when everyone would say the baby would be worth it." - Robynn 

"I threw up daily around the clock for 88 weeks out of my three pregnancies...it was worse with each child. The puking and never-ceasing nausea is hard, but the time you lose being completely debilitated is the hardest part. Your children don't understand. Your mother-in-law doesn't understand or people think you are exaggerating. When people ask "How are you feeling?" you learn to simply say, "Hanging in there." Reading or looking at a computer screen might exacerbate it. Grocery shopping becomes a challenge - beat the clock before you hurl. Your ribs ache from dry heaving. You eat and eat because you are worried your baby isn't getting enough. Your partner stops being empathetic. It becomes "normal." You clean your own puke off the wall behind the toilet. There is no one to take care of you. You will have days where you will cry clinging to the toilet as you dry heave bile and over and over again say "I'm so glad my baby is healthy!" to keep your affirmations as positive as possible." - Green Births

"Green Births is totally spot on. Eventually no one around you cares or will even help. Honestly it's so emotionally, physically, mentally crippling. I feel so awful for my daughter who has no idea why mommy can't do fun things with her very often, the strain and stress it has put on all my relationships, I just feel miserable and helpless." - Aimee

"I was losing a pound a day. I had to leave university because I was constantly running out of class to throw up...most of my day was spent with my head in the toilet or laying on the sofa." - Catherine

"Favorite moments were pulling over to puke in front of a bunch of teens in town. Puking in my work car park and simultaneously weeing. Puking on my steering wheel because I couldn't get out in time. HG destroyed my life for 9 months." - Sian

What's really sad, is that for some women, hospitalizations are really the tip of the iceberg. For some, the meds do not work, and it's speculated that as many as 6,000 abortions a year are performed on women who are at their wit's end dealing with HG and just can't take it anymore. Honestly, if you are experiencing misery day in and day out for months on end and then someone comes along and tells you "just deal with it," wouldn't you be reaching the end of your rope, too?

Those who think it's "all made up" might need a little education as to what it actually is: that big-sounding Latin word might trip them up. Maybe they need to be shown? Who knows. If you were a cancer patient going through the rigors of chemo, would they dismiss you as creating drama and trying to attract attention to yourself and just "suck it up?" I highly doubt it.

My best to Kate - I hope she responds well to treatments and gets better soon.

More reading:
Our lady of hyperemesis gravid arum - The Washington Post