Saturday, May 12, 2012

Living With Severe Morning Sickness

Birth junkie friends - I know I've been cross-posting a lot from my hyperemesis blog. There is a reason for this! I know that many of my readers are doulas, L&D nurses, OBs, and childbirth educators. As birth professionals, you must know the basics of recognizing and treating hyperemesis gravidarum - and know how harmful it can be to give bad advice like "try crackers" or "ginger!" or "take brisk walks!" I cannot emphasize how important this is. So I hope you'll check out my hyperemesis info articles - and be prepared to help the hyperemetic mothers in the populations you serve.

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I just got finished reading through the blog "Living With Hyperemesis", which is a woman's diary of her HG journey (and beyond) starting about three years ago. This blog is truly excellent! It's easy to navigate, since it's an HG-only blog (not an HG blog mixed up with a personal blog, like mine is), and she went back and narrated through the weeks that had already happened when she started the blog. This site is an excellent resource, and highly recommended!

The point that stuck out to me most on this blog - It is absolutely critical, essential, vital - that caregivers know how to recognize and treat HG. HG may be awful, but it is usually manageable with competent care - and this mama, like so many others, had a caregiver who couldn't tell the difference between HG and run-of-the-mill morning sickness - and for that incompetence, the mother nearly paid with her life.

Pregnancy and birth care providers, you must know the basics of hyperemesis. Mothers and babies can end up dead or nearly so if you neglect this area of pregnancy care.

Natalie writes, in Week 8:
"I got a young doctor who didn't know much about "morning sickness" so he called another colleague in to discuss what to do. The more experienced doctor explained to me that medication during pregnancy was too dangerous so all I was to do was rest. He signed me off work for a week. 
"I had never heard of "hyperemesis", I knew nothing about sickness during pregnancy, I knew nothing about taking medication during pregnancy and I definately never knew anything about the effects hyperemesis can have on a person emotionally. I left the doctors that day knowing nothing more than I did when I went in."
 In Week 9, still getting sicker, she writes:
"I went back to the doctors on Wednesday. I explained my sickness to the doctor, I explained that I was being sick up to 15 times a day, I explained that I was unable to eat, I wasn't drinking very much, I was passing little urine and every day activities (like having a shower) had become too difficult. This doctor (who obviously has no clue about this illness) told me nothing could be done and refused to even write me a sick line for work!! I was nearly in tears before he gave in and wrote me another line for a week. I couldn't believe how unsympathetic somebody could be. After speaking to this doctor I started thinking this was just normal morning sickness and really believed nothing could be done."
And in Week 10:
"I saw another doctor this week who, again, didn't seem to concerned. I showed him a diary of my sickness (which showed 19-25 episodes of sickness a day over 5 days). He signed me off work for two weeks and sent me away. By now I had just accepted this was normal."
And in Week 11, when she is seriously sick:
"By the time this week came I was unable to eat at all. The smell of the house made me sick, the smell of the dogs made me sick, the smell of another person made me sick and I only had to think about food to make me throw up!!
"The sickness had increased to 30 times a day, I was keeping nothing down although I lived in denial telling myself I was fine. I was so low, I would have done anything to just have a day off being sick. I still felt that nobody understood, I felt angry that people didn't "get it". I was unable to move off the sofa and the only time I got any relief was when I was sleeping.
"I had a basin in my hands every waking second as I didn't have time to get to the toilet. I couldn't control it.
"I felt really down, I didn't care about anything or anyone. I was tired, I struggled to keep my eyes open, I just wanted it all to end - any way possible. By the time Saturday came I was extremely dehydrated (although I didn't know it), I couldn't walk, my hand, arms, and feet were numb, I could feel my eyes rolling about but didn't have the strength to stop it."
And when she was finally hospitalized:
"I struggle to remember the rest of the night, I remember vomiting uncontrolably in the van on the way to Perth, I remember begging for any injection which would stop me being sick, I remember the doctor acting very worried, I remember getting put in the back of an ambulance, I remember lots of injections and blood tests and being asked lots of questions in Ninewells.
"I closed my eyes in hospital and didn't know if I'd wake up but I didn't care as long as the sickness stopped."
Caregivers, this is when mothers die - or choose abortion. And this is totally due to caregiver ignorance. This is totally unacceptable.

In the hospital, the wrote:
"I was desperate to go home but the doctor said I would be in at least another night. She explained that I was very close to losing my life, my body had begun shutting down and my blood had began clotting. She questioned me on how I managed to get in to the state I had, she questioned why no doctor had admitted me or put me on medication before now. Finally, someone understood. She stood in amazement as I told her about my trips to the doctors, how I was told it was ok and sent away each time with a sick line." (emphasis mine)
Did you catch that? Her body had begun shutting down. She and her baby might not have made it if a competent doctor had not finally stopped in.

For pregnancy care providers - I've said it a million times, but it bears repeating. Please do your homework and know how to recognize and treat hyperemesis. Lives hang on that knowledge. Hyperemesis mothers - don't quit until you get the care you need.

Natalie, thank you so much for your blog!

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