Friday, July 12, 2013
I am a connoisseur of commodes. I know the best places to throw up and which public restrooms tend to be crowded and dirty. When you constantly have your face in a toilet you learn a few things.
I’m not bulimic. And my knowledge of the primo toilets is no longer useful in my daily life. Like Kate Middleton, the duchess of Cambridge, I’m a survivor of the rare pregnancy condition Hyperemesis Gravidarum (HG). I spent two pregnancies vomiting so violently I bled from multiple orifices, one time so severely I thought I was having another miscarriage. The sickness was persistent. I vomited all day, every day from shortly after I found out I was pregnant to the time I delivered my babies.
On bad days I felt like I was on a boat with the worst possible seasickness after a night of heavy drinking and a touch of food poisoning for good measure. Good days, which were rare, were a combination of one or two, instead of the unrelenting torture of all three.
I was treated with IV fluids and I tried all sorts of medications to stop the vomiting: Benadryl, Regalan and Zofran. I have tooth decay, not just from vomiting but also from constantly sucking on Preggie Pops. It’s been more than 5 years since I’ve suffered from HG, and the smell of liquid Benadryl still makes me gag.
It turns out that the Benadryl and other antihistamines, which were so helpful in keeping the nausea at bay, contribute to adverse outcomes during childbirth, particularly low birth rate and premature births. That’s according to a recent UCLA study that was funded by the Hyperemesis Education and Research Foundation.
My pregnancies were desperately wanted after years of trying and one miscarriage. So it’s no wonder that I took medications with trepidation, and only succumbed after learning that the severe dehydration was worse for my unborn child than the possible side effects.
After reading the results of the study, my mom guilt kicked into high gear. My son was born “near-term” at 37 weeks, and he weighed in at just over 6 pounds.
In response to my concerns, Marlena Fejzo, the lead author for the study, reassured me: “There was no way for doctors to know of this risk.”
Fejzo, who lost a baby herself at 15 weeks gestation because of severe HG, says lack of funding limits her ability to mount the kind of campaign necessary to educate doctors on the dangers of using antihistamines as a treatment for nausea.
“Many doctors are still going to recommend it,” she says.
Because of HG, I don’t plan to have any more children. I’m sure this is a relief to my little village who helped me in so many ways, from caring for me when I was so ill to filling in for me at work while I took two extensive pregnancy/maternity leaves. It also means that the new information no longer has practical implications for me.
But it does for the .5 to 2 percent of pregnant women who are diagnosed with HG each year. And those women, who are already weak and exhausted from dehydration and the constant sickness, will need to research the effects of these remedies on their own. Under the best of circumstances, it can be months or even years before the results are considered as part of standard treatment plans for patients with HG.
I also have a daughter, and the current thinking on the causes of HG is that it has at least some roots in genetics. While she won’t be having babies of her own for many years, I am already gathering information to ease her future suffering. And Fejzo is studying the genes of HG families to understand the causes, which she hopes will lead to better treatments.