Hyperemesis Gravidarum: Extreme Morning Sickness



When I got knocked up around Valentine’s Day several years ago, I was relieved when morning sickness hit: nausea indicated a strong “take” – and, so said the doc and veteran mommies, would last only the first trimester. Then bam: at eight weeks, I really began to hurl. So much so that I got horizontal on my puffy-cushioned family room couch, where, for the next few months, I would live – and vomit, so much I christened my hardcore morning sickness XMS, a new extreme sport.

Though my case of XMS combined action, endurance, and danger, its intensity alone qualified it for X status. To understand what I mean by intensity, take your average case of morning sickness, or, if you’ve never been pregnant, your most violent stomach bug, or else your most crippling hangover (or, of course, if you’re prone to seasickness, a tumultuous bay cruise). Then imagine it lasting all day and all night (morning sickness? – a woeful misnomer) – for months. And it’s not just eating, or thinking about eating, or thinking about thinking about eating, that gags you: light, sound, abrupt movement, water, breath (even your own) – living – makes you heave. It keeps you vomiting, often bile and blood, until you’re certain what’s coming up is your entire GI tract and possibly your nascent pregnancy, too. It’s the kind of sickness that, if left untreated, could actually kill you, and that, even when aggressively treated, feels like it may kill you anyway.

It didn’t kill me, no small thanks to a thrice-daily stunt I practiced early on, ingesting Zofran, an anti-emetic often prescribed to chemotherapy patients. This drug, like my prenatal vitamins (which incidentally smelled of Canal Street in late August), not only came in a supersized capsule version, but in a spectacular irony I actually had to dissolve the awful thing under my tongue, an arduous endeavor, considering. In the event I didn’t throw up during this task, and actually absorbed the medication, it only sometimes eradicated vomiting, and rarely quelled nausea itself. In my case, the nausea crescendoed in hourly bouts of enervating seasickness that inspired me to greet my husband, Ed, from the “Good Ship Couch” as we called it, with a weak “Ahoy” – and, on better days, with a wink. The Good Ship was a nondescript, cream-colored sofa bequeathed to us by Ed’s younger sister, which, though semi-threadbare, beat the sick-person feeling of a bed and also happened to be where we’d conceived. Back when we didn’t know there was such a thing as XMS, or that I’d have it until the moment I gave birth (for good measure, I threw up throughout labor, too) to our first son.

The arduous nature of this pregnancy should have made us take extreme birth control measures before we boarded the Good Ship for another late-night-love cruise during a midnight screening of Jaws, just before our son’s first birthday. “Just this once,” we said – after all, I was still nursing. But we knew better. We just had a dual case of PND, or permanent nerve damage, resulting from the early stages of parenting when, sleep-deprived, beholden to the love hormone oxytocin and hence, severely demented, we believed we might want to issue another yummy-cheeked progeny from my still-recovering, semi-incontinent loins, hellpit pregnancy be damned. A few weeks post “just this once,” after reading and rereading the positive result on the pregnancy dip stick, flashing through the seven stages of grief, and even briefly considering termination, I joked with Ed. “There are no accidents,” I said. We had always wanted at least two kids, and, like a war veteran who inexplicably longs to return to the trench, I actually found myself thrilled by the idea of gestating another baby. If it meant a little nausea, so be it (a determination reached by yet another parenting-related syndrome, selective amnesia). Besides – call it hubris (or stupidity) – Ed and I didn’t really believe XMS would hit twice.

A month later, of course, I threw up. “A virus,” I told Ed, though we knew: XMS was back. And impossibly, it was worse this time: I vomited away ten pounds in a weekend. My doctor, a fatherly fellow, pinched the skin on the back of my hand, declared dehydration, then promptly ordered me up some home IV therapy, the triple-X challenge missing from my first pregnancy. Back at our place, Ed helped me into my coziest jammies, patterned with blue Christmas stockings, and later that day, while I lay back for a round of afternoon XMS on – where else? – the Good Ship, a home nurse inserted a ten-centimeter-long mid-line catheter, as flexible and fine as cooked angel hair, into my right inner elbow, through which I would be continuously hydrated with a steady stream of Lactated Ringer’s, the same electrolyte solution given to soldiers wounded on the battlefield. I joked about having invented a new women-only extreme sport. It was this sympathetic nurse who, when I joked about having invented a new women-only extreme sport, told me I hadn’t, that it was an official condition with an official name, hyperemesis gravidarum, and that it worsened with each successive pregnancy. Some hyperemesis sufferers, she said, had to be repeatedly hospitalized, and dropped thirty, forty, fifty pounds. Some had to be cooped up in dark, quiet rooms and fed through tubes. Some had to administer Zofran through portable, subcutaneous pumps and augment it with steroids and a smorgasbord of other drugs. And some suffered such severe dehydration that they could no longer sustain their baby’s lives, or their own. Something about that nurse – was it that she hadn’t smiled? that, until her, no one had bothered to tell me its name, or that it could, in super extreme, unchecked cases, be fatal? – sobered me enough to ask, though I already knew, “How long will it last?” and “Is it really that serious?” I was already wishing Jaws had been a tad more gripping, that Ed and I had never inherited the Good Ship at all.

Meanwhile, the catheter running up my arm wasn’t mainlining morphine or some preggie enhancing steroid. Instead, Ed, my trusty gestation-birth coach, spiked my IV bag with three comparatively benign syringes: one full of a pee-yellow, noxious smelling (read: nausea-inspiring) prenatal vitamins, one of folic acid, and one, eventually, of liquid Zofran (“They had you choking down those horse pills?” a kind new doctor asked). The IV bag itself, hung high atop an unruly, lightweight aluminum pole-on-wheels, inspired one-year-old Zev to point and exclaim “wah wah” throughout the day. We hoped he understood: I was in training. It was the catheter’s fault I couldn’t hold, bathe or feed him. Like a gymnast wraps a moody elbow or knee, I had to wrap my own arm like a Maypole in Saran Wrap before I myself could bathe, and I was forbidden from lifting more than five pounds, the pole’s approximate weight, or, preferably, from even moving the arm, which caused catheter backups, resulting in unsightly bleeding that snaked two feet up the IV tube and which, the first time it occurred, reduced me to a weepy pile. “It’ll take more than that to kill you,” chuckled my OB/GYN sister-in-law when I called her one afternoon, freaked about the bubbles heading into my arm and obviously toward my brain. “So what if the catheter breaks? Tie a tourniquet – not too tightly! – below your armpit,” a visiting nurse casually advised. “Then call 911, lest the line bust loose and travel to your heart.”

Sometimes during peak XMS, I likened my workouts to the amateur distance running I’d since abandoned. The repeated, stealth attacks on novels I’d invariably chuck overboard when type sparked nausea? Laps, or repeats, on a track. How about all those times I hoisted myself from bathroom floor (where I lay while not manning the Good Ship) to toilet? Sprint-lunge combos. Any day with fewer than twenty incidents counted as an “easy” workout, like riding a stationary bike or gentle stretching on a mat.

Even though eating made me sick, I still got socked with a monumental desire to chow . . . on raw ramen noodles. out my catheter and torching the Good Ship in my gravel driveway. And at other times, as my quads and hamstrings atrophied, I meditated on the type of elite mommy-to-be I longed to become: one who caught normal morning sickness, then kicked it with saltines. One who exercised in fetching maternity yoga capris. One who, jacked on prenatal hormones, might actually want to bone the guy who got her in the family way to begin with. On other days, still ensconced in my Christmas jammies, I fondled Ed’s and my brand-new medi-vocab – catheter, Zofran, Lactated Ringer’s – at once savoring and loathing the way we slung it around, as if nothing were awry, as if my being in the family way actually hadn’t forced me to relinquish all family life. Now rather than hefting Zev, I was shuttling around an IV pole, which, like a guest who’d outstayed his welcome, abounded with maddening idiosyncrasies, that, taken together, comprised the rigorous cross-training component of XMS. Like the pole’s propensity to tangle its dangling tube around my arm when I was mid throw-up, or to drop one of its cheap, screw-in roller wheels whenever I was en route to the bathroom, creating a killer home obstacle course. Then there was fencing, or how, when I was in motion, the pole’s silver tip, about six feet high, made frequent overtures toward all our ceiling lights, several of which, in its ardor, it took out. All this while I was breathing recycled indoor air teeming with odors perceptible only to me, with my hormone-induced bionic sense of smell: a down throw pillow, reeking of dead goose; an egg-smeared napkin Zev stuffed behind the fridge; the fabulously dank human skin-and-hair smell of the Good Ship’s cushions, now stained and sagging – scents that warranted face plants in my favorite blue ceramic mixing bowl, which we’d placed on the floor, and which, when it had reached capacity, I swore I’d never cut pie crust in again.

Then there was performing XMS’s baddest trick: surviving pregnancy cravings. Yes, even though eating made me sick, I still got socked with a monumental desire to chow, the same way a top-notch athlete might long to gorge on French crullers or family-sized nachos. But in my case, the objects of food lust were, apropos of pregnancy, revolting: raw ramen noodles. Red miso paste spooned straight from the tub. Thyme-crusted pork chops and whitefish at six a.m. And when hunger hit, I caved – I was starving! Pregnant! – though I knew after two bites I’d be hunched back over the mixing bowl. And when there’s nothing going in, there’s nothing coming out. So what to do about those week-long traffic jams down below? Enter my visiting nurse du jour, who, after rifling through her pink satin supply duffel, handed me several pairs of latex-free gloves. “Dig in,” she winked, noting that either Astroglide or Vaseline would help “move me.” Come on, Latex gloves and a wink? This was a debilitating pregnancy, not Backdoor Babe. Then, again, there was that vomiting thing, so incessant, so exhausting, so witheringly powerful that I’d developed a set of ripped, porn-worthy abs.

But XMS’s greatest toll wasn’t physical. It was watching Zev grow up without me. For months, I watched his butter thighs melt as he perfected walking, and then as he himself learned to run. For months I watched as he – was it possible he comprehended how fragile I was? – nimbly sidestepped my pole as I waddled through his wooden-spoon-riddled play area, when he contented himself with a brief kiss, sans hug, from Mom, a gesture that scored my heart with rapture, like a grizzly marks a tree.

Every kiss reminded me how lucky I was that my case of morning sickness wasn’t the killing kind. Even on those days when it was all I could do to contemplate my slowly swelling navel and count rays as the sun swung past the hemlock grove opposite the living room window, I knew that some XMS contenders were spared all mercy and had to forfeit the game. That chilling thought that still hits me, along with a brief wave of nausea, whenever I look at the Good Ship, which could be a different couch altogether now – one where I’d never succumbed during Jaws. The extreme payoff for that night and the nine months that followed has been the Good Ship’s reinvention – as playing field, where Zev and his little brother, Leo, have perfected their own X sport: extreme couch jumping.