Understanding Hyperemesis Gravidarum

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Bettina Whitmore was as pale as a sheet and listless. Worse: She could no longer care for her toddler. It wasn't just morning sickness anymore and Bettina knew she needed help.

Bettina Whitmore was on the floor. Two months pregnant and with morning sickness so severe it lasted all day long, she could no longer keep up with her toddler or her job, and she was wiped out — literally. Her worried husband was out of town on business, but she’d promised him she’d get to her doctor … except that here she was on the floor, too weak to drive. Thankfully, help was on the way.

“I couldn’t believe it,” says Lori Simpkins, Whitmore’s best friend since high school. “Little Amanda (Whitmore’s toddler) was zoned out from this steady diet of videos and snacking and Bettina was as pale as a sheet and listless. I wanted to go right to the emergency room but she wanted to see her OB.”

Brentwood OB/GYN, Roy Burch, M.D., took one look at the debilitated Whitmore, tested her urine for electrolytes, pinched her forearm skin checking for elasticity and told her she was going to the hospital.

“He told me I was dehydrated and that without intervention I was jeopardizing my health and the baby’s health,” says Whitmore. “I was no longer capable of doing anything for myself, I was just so weak, I just nodded and went along.”

When a woman’s morning sickness becomes so severe she can’t keep anything down — not even water — and she begins losing weight, it’s hyperemesis gravidarum (HG). The rare pregnancy condition can rear its head in about week nine of pregnancy and stay through week 20 or longer. Some say HG can be avoided by keeping something in your stomach at all times, but it’s not really as simple as that. Hyperemesis Gravidarum begins where morning sickness left off, making you feel like you shouldn’t eat (the kicker is, when you DO eat you feel better). With HG, if you don’t eat, your sickness gets worse. By the time Whitmore forced herself to eat she no longer could — even sucking on ice chips made her vomit.

“Looking back, it’s a blur,” Whitmore says. “It’s hard to take care of yourself when you have a little one running around, so forgetting to eat and getting run down can happen. It’s a weird catch-22. Unlike an unpregnant person, if you have a stomach virus you can’t eat until the virus has run its course. But morning sickness isn’t a virus — you have to eat through your nausea — it’s a nasty little situation!”

Whitmore spent two days in the hospital getting rehydrated, nourished and rested.

“I felt better almost immediately,” she says. “Partly because I knew I was being taken care of, but mostly because of the IV,” she says.

“Once I was out of the hospital, I got in the groove of always having my lunch tote with me so I could nibble in the car, at my desk or anywhere. I just started grazing all day long and that seemed to be the answer. I didn’t get sick at all in my first pregnancy, so this caught me off guard,” she says.

Morning sickness in pregnancy is related to the pregnancy hormone human chorionic gonadotropin, but that doesn’t explain why some women don’t get morning sickness in pregnancy at all or why others may get HG. The only answer is that we’re all different. If there’s any good news it’s that HG can be easily and quickly treated once detected.

“I just felt like I was dying,” says Whitmore. “I couldn’t control it and it was scary. Everything made me sick.”

Some doctors will prescribe Phenergen or other anti-nausea medications (Compazine or Unisom), but many women are leery of taking medications during pregnancy.

“I tried Phenergen,” Whitmore says, “but it made me sleep all day,” she says. Whitmore’s solution became eating constantly. If she started to feel any tinge of nausea she’d grab a handful of something and eat it fast.

“Once I got to 21 weeks I felt so much better, I could smile again,” Whitmore says. “But I’ll never forget how awful that was. I don’t wish it on anyone and only want to encourage all pregnant women everywhere to eat, eat, eat before getting that awful feeling in your stomach. Once that wins, it’s all downhill from there.”

Susan Swindell Day is the editor in chief of Nashville Parent and the mom of four amazing kids.

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