Hyperemesis Gravidarum: A Diary

Today is black Friday, the 7th anniversary of my first child's death. I almost didn't remember it. I woke up and it seemed like any other day. The only thing amiss was feeling oddly concerned for my son's safety. I kept hoping nothing would happen that would take his life. Images of car wrecks or crazed schoolyard shooters flickered through my mind. Why? I couldn't grasp it. Was it a warning?

No. It was a memory.

Someone I loved, a child of mine, died a very gruesome, violent death seven years ago. It is in there, in my heart and mind, even when I forget to remember.

I am thinking of who that child must have been and what s/he must have looked like, sounded like, smelled like—the whole package. I wish I could remember my life without this stone. I forget who I was; I only know me without Tennessee.

I struggled to get through that pregnancy, but other than that, I never got to love my child. I gave up. I cried Uncle. I never got to love Tennessee.

For Tennessee

I'm not allowed to love you.
The "pro-life" movement says
I can only feel guilty and then set free.
The "pro-choice" movement says
I can only feel liberated and grateful.
Death says
feelings are moot.

Gears spin

as abortion snaps a belt

in the machine of adoration.

Vats of earmarked love

grease broken apparatuses,
fueling the unhappiness
of life without you,
of days that remember
your black passing,
reverberating forever
in the vacuum of time.

This is one of the crucial weeks. Week 24. Day one. This is the ever elusive "viability week.” "Viability" is a term often so creatively defined that it has virtually lost all meaning. Yet my pregnancy book says this is the viability week. If we can make it through this week, Elise will have a chance of surviving. She would most likely have severe handicaps (i.e., special needs for the politically correct set) but she's got a shot at life! 44% by some accounts.

So pray us through this week and more, people. Pray because I have been feeling "funny,” and that is never good. For the E.R. watchers who can handle graphic descriptions:

A big blob of mucus on the tissue yesterday and "loose" stool today. Let's hope it's a fluke. A big yucky fluke.

She has been sleeping pretty much all morning. Last night she squirmed so that I started getting motion sickness from her movement! Her daddy comes in and talks to her sometimes and she will stop whatever she is doing to listen. It is funny. She literally stops with his voice and starts moving again when he's quiet. This one is a daddy's girl for sure.

Lots and lots of hiccups.

I enjoy the rest when she is still, but I worry. I don't want her to be still-still! So now of course I'm thinking she's dead because it has been an hour. Ow! A nice little reminder that all is well. Ahhhh...

I have never known the luxury of a confident pregnancy. And I never will. That's a bit upsetting. Alas.

Big Punkin Butt came in here last night and crawled under the covers that the "baw head dog" (hairless cat) had been under for hours. Big PB stuck his head out and said "PU! It smells like Kitty's underpitts in here!" Now I'm thinking of marketing kitty roll-on. Just kidding. My kid makes me laugh—what can I say?

OK, boring entry. I told you it was going to get like this. That's why I don't often post.

I go to the doctor's tomorrow. I should be getting steroid injections in the near future. These will hopefully improve Elise's chances, because they stimulate lung function, and that is a biggie in preemies.

Well, I've got to go and watch back-to-back episodes of A Baby Story on TLC, so the moms can all talk about how surprisingly wonderful pregnancy is, and I can cry when they pop their little purple babies out. I always bawl when I see a baby being born. I'm a sucker. Maybe I'll see you tomorrow. Same time, same channel.

I haven't written for a few days. Not because anything is the matter but simply to avoid clone posts about bedside potties and related activities. Nothing much happens when you are in bed 24 hours a day.

For this diary the rule is:
No news is good news.

We are still hanging in there. Elise had a couple of slow days and then a day or so of nearly kicking my guts out. It's encouraging. Each movement cheers me on. "Hang in there, Mama."

Emotionally, I have caught myself wanting to cry a few times. I'm frustrated because my eating is dwindling even more. I'm not gaining enough weight and will probably start losing weight soon at this rate. It's all this tilted lying down. I want to get up and play with my son, get my life back, yadda, yadda, yadda. So I get frustrated, and my eyes start to well up with tears that I have no business spilling. I think back to those inhuman times in the midst of severe HG. I get sick to my stomach just recalling it. I sweat as my mind fogs over; it does not want to remember such a thing. Those days were songless. Suffering, like a cancer, consumed every aspect of my being. I couldn't even afford to be interested in anything other than getting through each moment. I hung on by a fingernail. I would rather die than know that suffering again.

Presently I have knocked over a gigantic glass of strawberry milk. It is soaking into the carpet as I type. I can't do anything about it except sign off and place a phone call to someone who will come and clean it up. If no one answers I'm going to have one sour mess in here. It serves me right for drinking strawberry milk in the first place.

This Just In

Just got an email from another HG mom who is pregnant and feels that she wants to either kill herself or end the pregnancy to make the vomiting stop. I can understand completely, and if you've been reading this diary from the start, perhaps you can understand a little bit too. Please pray for her. She is in agony and has a long way to go.

Hello, all. Elise has started hiccupping. I could feel it for the first time the day before yesterday. For those who wonder what that's like, it's a steady, rhythmic pulsing. It's adorable and very human. Roe v. Wade says Elise is not a human but a mass of tissue. A mass of hiccupping tissue. They know better. We all do. Even Roe herself now opposes abortion. But it’s still happening. Right now someone Elise’s age is being aborted. My God, what are we doing?

Elise was very quiet yesterday. It was one of those slow days. After not feeling any movement for three or so hours, I sort of started to worry. The moment my son came home from school and said, "Hi, Mom," Tummy Lumpkin did a somersault.

"Oh boy, my big brother's home!"

There is a five-year difference between them, but I hope they will be close. Maybe it will be easier for them because they will be homeschooled.

Again with the Potty Talk
Sorry to broach this subject again; I know you all are getting sick of it. But I have to tell you that my husband forgot to dump the bedside yesterday morning before going to work. To keep it short and relatively sweet let me just say P.U. It was cosmic justice for the asparagus episode the other day. Waves of yellow stench wafted around the room and I became desperate. The prospect of lying here in this room all day with that was pretty unthinkable. I tried to think of someone I could call for such a dastardly job. Funny thing is, I thought of at least six people I could ask. There's a saying that if you can count five true friends then you're lucky. Lucky is one thing, but you know you are blessed when you can count more than five people who would come into your smelly room and dump out a stinky bucket of all-night pee. Thank you, God, for the pee dumpers in my life!

I won't say the name of the person who came yesterday to relieve me (no pun intended), but she's a bright girl, and I told her I'd give her props in today's entry. So here you go, friend! Your efforts literally went to waste, and I thank you very much for that! You can count on me to dump your stinky pee pot if ever urine need.
Snicker.

Went to the doctor's today. Good news! There is no funneling, no dilation, and cervix has not shortened. In fact, it has lengthened! It is now 2.6 or 2.7 cm (out of 4 cm)! Good deal! Lengthen and strengthen! Keep praying!

Elise kicks her hello to you as I type this!

Three more weeks and we reach the stage of "viability" whatever that is. Babies have been born at 21 weeks and survived. "Viability" has more to do with technology than the baby's livability. Why, in 100 years they might be able to keep a 12-weeker alive. At any rate, I turned 21 weeks yesterday. I hope and pray we make it for at least three more weeks.

Doc said I can get off bed rest at eight months or so if I make it that far. I hope to! I'd get out of bed right around my birthday. That'd be a grand gift!

Potty Talk
Because I have issues with my cervix I don't really want to be sitting on the pot straining for poo to put it bluntly. I don't know if that has any effect on the cervix, but it can't be good. So one of my missions in life right now is to make my dookie endeavors as easy-breezy as possible. This involves the daily consumption of such things as bran, fruit, veggies and prune juice. So far so good. However, these foodstuffs do pose a problem for this Jumpin’ Jack Ash: it's a gas, gas, gas. (I’m such a nerd.)

The doc was a good sport and began telling me about the benefits of a good dose of simethicone when he was interrupted by my husband who had a better, drug-free solution. The doc and I yielded the floor while we listened in earnest for the alternative. All eyes on him, my husband grabbed my finger and began yanking on it saying, "This is the 'pull-my-finger' method, and it always works for me!" I made a few fart noises and we all had a good laugh.

The doc left the room and gave us a minute to gather ourselves before the sonogram tech was to come back in to help me off the table. As soon as the door closed a nice gas bubble settled right down to the bottom of things and, believing we had a few moments, I let it rip. It was silent but oh-so-deadly. My husband giggled at his newly singed eyebrows, and I remarked that the tech had better not come in for a while if she knew what was good for her. No sooner had the words left my mouth when the unfortunate tech stepped unaware into an atomic mushroom cloud.

"Do you think she smelled it?" my husband later asked in genuine wonder. I looked at him incredulously and replied, "People in New Zealand smelled it!"

So our visit was wonderful and really stank! Thank God you weren’t there! (No, really!)

Still hanging in there. I am so sore from bed rest. I need to get those "thigh calluses" again so it doesn't feel like my hip bones are coming through my skin. It wakes me up all night. My aching hips say, "Turn, for goodness’ sake, turn!" And just when it seems I've only been on the right side for five minutes I am waking up again with an urgency to turn on my left. ARGH! Later I will see a commercial with a little girl dressed in a frilly, pink dress, and nothing will matter but getting Elise to term.

By the way, I have neglected to mention that everything always smells like cigarettes and no one smokes. This pregnancy is insane! And only 19 more weeks, folks!

Yes, yes! Only 19 more weeks of my whining! If all goes well that is.

Also, I was paired up with a great support on the Sidelines Web site. She also had HG and IC and chose bed rest instead of cerclage. She had funneling and only half a centimeter left to her cervix! She also delivered her daughter on her due date! And her little one was over 11 pounds! I have talked to my support on the phone, and although I am still scared out of my mind, I feel much more hopeful and calm. It's a beautiful thing! This doesn't mean I've gone lax with my bed rest.

I have gotten a bedside potty to further express my commitment. And the best part ever is that my husband has to clean it! MUHAHAHAHAAAAAAAAA!!!
While he loudly protests the grotesque nature of his job I lie in here and snicker. He cleans the removable bucket, fills it with ice, and I pee like a highlander for the rest of the day. We do abide by Creole plumbing laws: "If it's pee let it be; If it's brown flush it down." But when I consider what I've been through and what he's been through in comparison, I think about breaking that law! And when he comes in here messin' with me about bacon, something that just sends nauseous shivers up and down my spine, I seriously want to bless him with some bedside potty Tootsie Rolls!

It's OK, though. I had a truckload of asparagus last night, and his gagged retching was music to my ears! Can you say "toxic paper mill wasteland?” Hey, I’m on bed rest 24/7; I get my kicks where I can.

P.S.
All my hair is falling out, so in addition to being fatter and more uncomfortable the next time I write, I will also be bald. If fortune cookies were real my husband would have been warned.

I would like to thank all of you who are such a support during this very trying pregnancy. Some of you have brought me food, called me on the phone, emailed me, sent cards, and most importantly, prayed for Elise. Thank you, thank you, thank you. Please continue to pray for her.

I am terrified of my cervix. I don't want it to shorten one more millimeter. I am in bed every second of every day with my feet raised above my head; I'm sort of on an incline to keep as much pressure off the cervix as possible. It is 10 steps from the bed to the loo, and I am afraid to take them. I don't go to the bathroom until it's evident that I'm either to take those 10 steps or wet the bed. And there is no terror like the strain of a bowel movement, so you can just imagine what point I allow myself to reach before taking my 10-step journey to the WC. If going to the bathroom is a life or death issue for me, then imagine getting in a car and taking a nice bumpy, hour-long trip to the doctor's office.

The Dreaded Appointment
We arrived at the medical offices and got a "Front Row Joe" (primo parking space). This was good news to someone who is afraid to take 10 steps to visit the loo. My husband opened the door and went into the lobby to let them know I was coming and would need to lie down and not wait in the waiting room. While I waited in the car I saw a healthy preggo walking up to the door where she was surprised to be met by a friend who asked her how pregnant she was. "38 weeks," came the reply. They both entered the door pleasantly gabbing away.

My husband returned and got me out of the car. The first office door opens into a small foyer with two doors. One door leads to the OB offices while the other leads to GYN. “Li'l Miss 38 Weeks” was still standing there in the cramped foyer gabbing her head off with her hand on the door handle while I was praying that Elise wouldn't fall out on the floor during the gab fest. It reminds me of those absolutely oblivious folks who stop, one in each lane, to have a nice little chat in the middle of the road as people racing to funerals and emergency rooms wait fuming behind them.

"Excuse me.” I said pointedly.

"Blah, blah, blah," said the motor mouth to her friend. "Blah, blah, blah and gab, gab, gab". Translation: "I am oblivious."

I sighed heavily and went to open the door that she still clung to. I rolled my eyes at her as my husband said, "My wife needs to enter the building."

Gabby Pants, finally realizing that other people shared the world with her and were attempting to enter the building, released her grip on the door and got out of the way. I shot all the way through to the exam room, which my doctor entered chuckling to see me lying upside down on the exam table in order to maintain my heels-over-head Trendelenburg position.

"You don't have to stand on your head this whole pregnancy," Dr. Keanu said.

"I will," I informed.

"Don't I know it," said he who knows it.

He looked at the perinatologist's diagnosis/opinion from last Friday and said, "OK, let's do the cerclage."

"Whoa, whoa, whoa!" said my husband and I, "Let's talk about this!"

Dr. Keanu indulged.

We tried to explore the subject in order to determine whether the benefit of cerclage outweighed the risks at this point. The thing with an incompetent cervix is: it's a gamble. Especially with my particular measurements. The bottom line was that we didn't know. We didn't know if we could get by without the cerclage, and we didn't know if she would live one more day after the cerclage was placed. If she makes it four more weeks she will have a chance, a chance. Fifty percent. Better odds than today's. Today she will die if born. One hundred percent probability. She will die.

Dr. Keanu really listened to our concerns. I knew it had already been a long day for him. I tried to personalize the issue.

"Pretend," I said, "that when Elise grows up she will be the one to find the cure for cancer, AIDS, Parkinson's and any other disease you can think of. Pretend that she will find the cure and develop it into one pill, one pill that costs $2. If this were really so, can you imagine how important she would be to the world? Well, that’s how important she is to us already."

Dr. Keanu knows that I get HG, and he knows how bad it is. He is aware that this is our last pregnancy, win or lose. It seems to mean something to him, and for that we are glad. But it's kind of silly when you think about it: Children are not expendable one way or the other. If it is your last pregnancy or if you intend to have 10 more, each time it's your only shot at that child and that child's only shot at his or her life. It's always the "last chance" if you think in realistic terms; it's always so very important.

They measured my cervix again: no change in two days. They pressed on the uterus as though they were trying to squish Elise out, and my cervix shortened a millimeter. Thanks loads. No funneling, just shortening. Shortening increases my risk of preterm labor as we all know and fear.

I asked Dr. Keanu a slew of questions through streaming tears. He confided that if it were he and his wife he didn't know what they would do either. He said that my history with carrying my son to term was good. He said that the contractions that I am having are not. He said that not funneling and not dilating so far is good. He said that losing six millimeters in 14 days of bed rest is not. He said the cerclage could kill her. He said not getting the cerclage could kill her. He said opting for either would be reasonable at this point and what, oh what did we want to do?

Go time. Time for the answer to a life or death question. No pressure here.

"I can't give you an answer," I said. "I'm not going to do the cerclage today, I'll tell you that much. I might not do it at all."

He was not shocked. He was not opinionated, oppositional or cruel. In fact, it seemed rather reasonable to him. Hubby felt the same way. No cerclage. He wasn't comfortable with it. We sort of decided to shift the paradigm a little. We could not get an answer as to whether bed rest or cerclage would give Elise the best chance, so we began looking at it as if she were going to die. If she were going to die, which could we live with: She died because we did something that killed her or she died because we didn't do something that might have saved her? Selfish, but we've so little to go on.

Bed rest is not "doing nothing." For anyone who has ever been on bed rest for months, you know it is SOMETHING. The moments I most look forward to in the day are the moments when I am forced to take my 10 steps to the loo. I'm terrified, but I am sitting up, and my body is so thankful then. The weight is off my back, the painful pockets of trapped air release themselves in a hail of burps and other less pleasant emissions. I can breathe, my blood flows out of my head. All of this relief lasts a glorious 45 seconds. And then the crucial moment comes: the TP exam. If there is blood I will fly to the doctor's screaming for a cerclage. If there is none I will thank God and take five steps back to the foot of my elevated bed where I will slither my body back into position.

Supine dining is no picnic. In fact my appetite has decreased significantly. The moment I swallow, gravity is not working to my benefit. I feel that everything is lodged just in my esophagus. And the toast and cracker crumbs make me feel as though I’m receiving constant, crumby "acupressure therapy." It is like having a sunburned back and sleeping in a bed full of sand and crushed sea shells. Bed rest is not nothing. This is an alternative to cerclage, and for the time being we have chosen it.

Yesterday I felt more peaceful about it than I do today. About an hour ago I had one contraction that was particularly nasty. My uterus became hard as a rock. These are not Braxton Hicks. Dr. Keanu says those don't happen until later in the pregnancy. These are abnormal and troubling contractions. But not so troubling that he did anything about them other than to warn of their unusual quality. It's just one more thing on the plate.

I'm full, thanks. May I be excused?

We hope we made the right decision. It worked with our son, although we do realize this is a different pregnancy, and things have definitely not followed suit.

Please keep praying. Specifically, pray for Elise's survival, for the cervix to stay closed with no funneling, for miraculous LENGTHENING, and also pray for the contractions to stop. Please.

I am 20 weeks and working on my second day. With each passing day we get closer to the dream of a long life with Elise. Each day is a step away from profound grief and a step toward wordless rapture. I can't help feeling though that I am twisting in the wind. I want some sort of oracle, some sort of soothsaying vane to direct my attention to the way this all will end. I feel helpless to save my vulnerable little girl. I desperately want God to intervene and prevent her death. I want the pink, happy ribbon on my hospital door 20 short weeks from now. I do not want, affixed to my door, the dark picture of the weeping leaf.

This is the valley of the shadow, and I have no option but to walk through it. It is scary, it is sad. But I am not alone.

A very dear friend sent me an email today that prompted a response that I thought I'd share for those who are wondering how I am doing with the bad news and swiftly approaching decision.

"'The Lord is my strength and my shield; my heart trusts in Him, and I am helped.’

Psalm 28:7

You couldn't know, but this was a very important scripture to me this pregnancy. When I was around six weeks pregnant I kept repeating it over and over again. It got me and Elise through some very rough times—times I thought would be impossible to get through.

The book of Job has been very guiding to me. I hope I am at the end of the story though! You know, the part where there's a happy ending and all is restored! But I read through Jesus' agony at Gethsemane and was reminded of the bitter cup. Christ did not particularly want to drink from that cup, but it was God's will, and so He did. Thus, I am reminded that this pregnancy may not end the way I want it to. I must submit and be willing even for Elise to die if that is what would bring the most honor and glory to the Lord Who knows and sees what I can't. Oh, but this is not an easy attitude!

I earnestly know that she may not live and that the Lord cannot be manipulated by good deed or attitude to save her if that is not His will. But perhaps He can be moved as He was moved by the people of Nineveh. Perhaps if He means for her to die He will take pity on my broken heart or will be moved by the prayers of others for her and will change His mind. I don't know. It's worrisome, I admit. Yet I know that even if everyone I love was lost from my life God would still be there. This has been the way of it. We are to love Him more than anyone, even our children. This is hard for me, but I think I am learning.

He is the Giver of life. How can anyone fault Him for assuming that which He Himself gave in the first place? How can one hate Him for giving the precious gift of even a moment of love? But we do it all the time! He is the Potter, and we are the clay. I have to remind myself and keep things in perspective. It is a constant battle for me. It does not come naturally or easily. God is teaching me many things. Above all, to borrow from C.S. Lewis, that He is not Who I say He is but who He knows Himself to be.

Anything inspiring or encouraging comes from the Holy Spirit and not me. I alone will only disappoint. It is a constant struggle to be less me and more of a person moved by the Holy Spirit.

I don't know what will become of Elise and me, but I know He loves us. All I can do now is beg for mercy for her life. What He does or does not do is His business, and I will always thank Him and praise Him for the miracle of my daughter no matter what."

Bad news at the doctor's today. My cervix is shortening quickly. They want to do a cerclage here at 20 weeks. The cerclage could save Elise or kill her. If we choose not to do the cerclage that decision could save her or kill her. We don't know what to do.

This is all happening because of the bad choice I made in my first pregnancy, a choice I made due to HG. Bad choices have consequences. I am praying that God will intervene, but I understand that intervention can only happen if it is God's will. Please join me in praying for Elise's life. I want her to live here with us, and I want to grow old and have her outlive me.

I praise God for giving her to me and am so sorry that my misguided choice is threatening her life.

Even if she was only promised to me for a little while, I have had her this long and have enjoyed very much her life thus far. No matter what happens I have that. I will always have a daughter named Elise, and I will always love her. I am not sorry I fought for her with everything I had to give.

Even if she dies it has all been worth it.