- Hyperemesis Gravidarum is not the same as morning sickness.
It’s not even just “worse” or “really bad” morning sickness. HG can cause multisystem organ damage, pregnancy loss, psychological disorders, weight loss of >5% body weight, cachexia, debility, sarcopenia, osteopenia, and financial strain. Please don’t compare the two.
2. It’s not in my head.
There are unfortunately not many quality studies available when it comes to HG, but from the handful we have available, none suggest a psychological cause. The etiology of HG appears to be complex, but here are just a few legitimate theories:
Genetics- GDF-15 and PGR
Hormones- Serum Thyroxine levels were found to be elevated during many HG pregnancies
Mutations- Mutated hCG or TSH receptors seem to be elevated in women with HG
Nutritional Deficiencies- While not a cause, reduced levels of Thiamine and Vitamin K have been shown to make HG symptoms worse, as well as contribute to cardiac and neurological damage, maternal bleeding and fetal embryopathy
3. Please do not eat or talk about food around me.
Even if you’ve never had Hyperemesis, I think we have all had the stomach flu. If you can remember how even the thought of food was enough to send you to the toilet, then you’re able to relate to HG on some level. So, while you’re with me, let’s just forget food exists all together.
4. Please do not wear perfume, strong smelling soap, or anything else with a noticeable smell around me.
While we’re on the topic of forgetting things exist, let’s not forget to forget about smells as well! Anything that has a smell, perfume, candles, and soap are the obvious culprits, but sometimes even “second hand” smells can induce vomiting. These are smells such as the scent left on your clothes after you’ve cooked a meal. The air freshener in your car lingering in your hair. Sometimes its even your sweat. We wish it wasn’t as insane as it sounds, but unfortunately, it’s our reality.
5. I am doing my best to be my own version of healthy.
While I may not be able to exercise, leave bed, or even eat properly, I can assure you, my doctor and I are doing our best to keep me as healthy as possible. The name of the game for HG is survival. Survival of the baby and myself. Please don’t ask me questions about my food choices or activity levels, as I am fully aware that I am not doing things “as recommended” and hating the fact that I can’t.
6. I am mourning the pregnancy I thought I would/should have.
Please be sensitive in regards to any pregnancy news at this time. I will always be happy for you, but please check to make sure it is a good day for me to receive your good news first. Just seeing other women on social media living out their normal pregnancy lives was enough to make me cry, I don’t want to react that way in front of you. I want to make sure we share nothing but joy for you.
7. I’m probably afraid (of everything).
I’m afraid for my baby’s life. I’m afraid of the increased risk for complications such as IUGR, low birth weight, preterm delivery, and neurodevelopmental delays. I’m afraid of throwing up even though I’ve already done it a hundred times. I’m afraid of infection if I have ports, lines, and IV’s. I’m afraid of being a burden. I’m afraid of being misunderstood. If I have a child already, I’m afraid for them to see me like this, I’m afraid of them not getting enough attention and love throughout the next nine months.
8. Please do not offer well-meaning advice/platitude.
Ginger does not work. Small and frequent meals do not work. Some fresh air will not do me good (sometimes the wind would make me throw up). Please don’t tell me to just focus on the finish line, how it’ll all be worth it in the end, and that I’ll forget how bad it was in the future, that it’ll get better in a few weeks. I understand these are all things said in love and said due to the fact that, well, what else do you say? So, here are some examples of what to say/do for someone with HG:
- In terms of what to say, it really just comes down to listening. Sometimes she will want sympathy and a shoulder to cry on. Sometimes she will be angry, sometimes fearful, sometimes okay. Just listen, make sure she knows her feelings are valid and that she is heard. Offer encouragement in ways such as letting her know how incredibly strong and brave she is.
- Ways you can lend a hand are offering to help with childcare, dishes, and any cleaning/chores/triggering tasks. Ask them what activities they are able to currently tolerate/enjoy, then help facilitate those activities (my sister-in-law got me some awesome books, crayons, and coloring books.) Talk to their primary care giver to learn their nausea/vomiting triggers (sometimes they change daily) and tolerable foods (these can change hourly).
9. I may be depressed, anxious, or suffering from PTSD
HG, for many women, causes trauma. I felt so terrible during my pregnancy that I wanted to die. Six months after giving birth, some smells are enough to send me spinning into memories I rather not relive. These feelings (physical and emotional) are sometimes enough to derail my entire day. Check up on your loved ones with HG. Help them get help if they need it.
10. I want to be included as much as I can be.
HG can be incredibly isolating. Many of us don’t venture outside unless we have to, due to the unpredictability of sights, sounds, smells, and motion sickness, and only 2% of the population is said to have HG. This leaves our pool of interaction, and people we can relate to and who can relate us, pretty small. Even if we can’t go and do activities together like we used to, we’d still like to hear about them. We could even make a future “date” for whenever we feel better, and plan out all the fun things we can do again. Its important for us to feel like the world isn’t just completely passing us by. Its important for us to have things to look forward to and restore some sort of control in our lives again.
**Bonus** Spoon Theory
This is an excellent way of learning what its like to live with a chronic illness/mental illness/trauma recovery. Written by Christine Miserando, it goes something like this.
Imagine you only have twelve spoons per day and each spoon equals a certain measure of energy. So, 12 spoons = 100% of your daily energy. However, overexerting one day, can take away some of the next day’s spoons.
Here’s an example of the chart you can look up online:
Take away one spoon per each activity accomplished- Got out of bed, got dressed, took pills, watched TV.
Take away two spoons per each activity accomplished- Bathed, styled hair, surfed the internet, read/studied.
Take away three spoons- made/ate a meal, made plans/socialized, light homework, drove somewhere.
Take away four spoons- went to work/school, went shopping, went to the doctor, exercised.
Some days, just living, took all twelve of my spoons. I stayed in bed all day. I ate my frozen blueberries and lime popsicle, watched a few shows/movies, then went back to bed. That was all I did.
So, I hope this list can help you if you ever have a loved one (and I hope you don’t) with HG. If you’re reading this and have/had HG, please feel free to direct your loved ones here and modify it however you’d like. If you feel there are things I need to add/looked over, please let me know.