Surviving Severe Morning Sickness: A Life and Death Issue

          Welcome back, or welcome! Grab a cup of coffee or tea to join me today. This post will be longer than usual, but I promise it’ll be entertaining and educational! And read all the way to the end. I have some hard-learned advice for any of you suffering unnecessarily during your pregnancy, or those of you who have suffered and are willing, able and ready to try again.  

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“When Jesus heard that, He said, “This sickness is not unto death…”

John 11:4a NKJV

(Oh, but it certainly felt like it to me!)

           

           

            My euphoria evaporated when my morning sickness rapidly developed into a severe, twenty-four-hour-a-day blight. (Can any of you relate to this?) Often, I lay curled on my bathroom floor, crying out to God to end the affliction, or take me home. Either scenario was totally okay with me!

           

            Yet the nausea worsened. One day, in a fit of frustration and tears, I called Chris at work, asking him to first pick up our son Parker from preschool and then to meet me at the urgent care clinic. When Chris arrived there, I lay outstretched on a table. The doctor was just beginning a glucose IV to rehydrate me. The official diagnosis was severe dehydration. Medical term: hyperemesis. Within minutes, the cool fluid rapidly coursed through my circulatory system, making me feel plumped up and relatively recovered. Oh, the relief and joy!

           

            Momentary joy.

           

            Unfortunately, the medical staff was overzealous in the amount and rapidity of fluid administration, and I ended up relieving myself of their efforts in the restroom immediately following my treatment. One of the nurses terrified me when she jovially reminisced about her pregnancy experience: she had suffered bouts of nausea all the way into the delivery room! I blinked and gaped at her, wondering why anyone would ever have any children under those circumstances. She quickly added that she’d never again subject her body to that insult. Was I destined to be sick-to-the-bitter-end too? The thought made me shudder.

           

            The next afternoon I was back in the doctor’s office waiting to be seen by someone about the persistent nausea. The effects of the previous night’s IV were only temporary, and I was in serious need of additional medical intervention. The anti-nausea medications weren’t helping, and I was becoming increasingly dehydrated and severely weakened. I wondered just how long my body would sustain itself under this unforgiving assault.

           

            After waiting half-sprawled in a chair for three hours, I insisted that I be allowed to lie down in a room, away from the oppressive, glaring lights of the waiting room.  Chris was uncharacteristically outraged. He kept saying he didn’t know how much longer he could take this. As much as he suffered physically (fatigue) and emotionally, he could never understand my agony. Too weak and shocked to respond, I simply stared at him, and fought to pound my flickering feelings of guilt and defensiveness into submission.

           

            The medical director – the one I argued with on the phone for my ultrasound – finally arrived and decided that I needed prolonged IV rehydration at home. However, she emphasized, it would be difficult to receive authorization for treatment so late in the evening – six o’clock – on a Friday night. My insurance company only used one facility for that kind of treatment, and their office was in another county. I silently wondered why the hospital wasn’t an option; the obstetrician had told me about a patient he kept admitting to the hospital for just such treatment.

           

            Didn’t my insurance company pay for that, or was the director trying to save money again? And what would happen if something went wrong during the day while I was home alone?

           

            Why did this sound like a bad dream turning into an inescapable nightmare?

           

            She promised to remain in her office until authorization arrived. Until then, she’d give me a shot of anti-nausea medication and send me home to await the arrival of a home health nurse. The medication made me drowsy, but not so drowsy that I didn’t need to once again lock myself in the bathroom. (Now that I think about it, I might have made my point better if I had just gotten sick right there in the middle of the waiting room. That might have gotten everyone’s attention, and I might have received the in-patient treatment I needed!)

           

            A nurse and my husband repeatedly knocked on the door to check my status. At that moment I would have been content to lie on the cool bathroom floor indefinitely, but my years of competitive athlete discipline and “work through the pain” attitude kicked in. With steely resignation, I leaned on the icy porcelain sink, slopped cold water on my face and vacated the cubicle. Sympathetic comments, murmurs and looks shot my direction upon my dramatic exit. I walked stoically from the medical office.

           

            “I’m fine!” I flippantly tossed my hand at the onlookers and managed to eek out a convincing smile. (My theater and performance training had also kicked in.) “I’ll be just fine.”  

           

            Three hours later, the doctor called to confirm the authorization, and soon after a home health nurse contacted me for directions to my house. She lived an hour away in San Diego and was unfamiliar with our rural area. Since the fog was thick and our road dark, her arrival took much longer than any of us expected. 

           

            She finally arrived just before midnight and unloaded her arsenal of IV bags, shots, machines and always-insurmountable insurance paperwork.

           

            The only redeeming factor in this midnight affair was that this woman was one of the kindest, gentlest people I’ve ever met. She spoke lovingly, soothingly, and carefully explained the procedures. While she worked with me upstairs, her husband fell comfortably asleep downstairs on our living room couch.

           

            Chris received a crash course in hanging IV bags and machine adjustment, and administering intramuscular shots. In record time, he perfected the necessary wrist flick for pain-free insertion. He’d get to practice his new skills every eight hours, and the IV machine would awaken us when IV bags needed changing.

           

            Then the moment arrived for introduction of the IV into my hand.

           

            The nurse spread her sterile paper towels, gloves and equipment on the bed next to me. While turning our king size bed into a medical-surgical table, she cautioned us that there would appear to be a lot of blood lost onto the towels, so I might not want to watch. She handed Chris several items to hold for her, then checked my veins. Another problem. Due to my severe dehydration, my veins kept collapsing, making it impossible for her to keep the needle inserted.

           

            Again she tried, with more blood spurting onto the towels. It hurt, and the word pincushion flashed across my mind. The vein collapsed again, and the needle sprang from its location. Simultaneously, the color rapidly drained from my husband’s face as he quickly dropped the items he held for the nurse onto the bed, hastily excused himself to retreat through the bedroom door and quickly assumed a prostate position on the floor outside our bedroom. So much for moral support, I thought.

           

            Throughout this futile exercise, this wonderful woman repeatedly apologized and patted my arm tenderly. I could hardly blame her for my body’s lack of responsiveness to her efforts. She said she’d try a third time, and if she couldn’t get the line started, another nurse would have to come in the morning. If that attempt proved unsuccessful, an eight-inch flexible catheter-like tube would be threaded through a vein in the elbow area.

           

            The third attempt wasn’t the proverbial charm. With profound disappointment, we had to settle for another nurse later that morning. At 2:30 AM, Chris managed to gather enough strength to stand, wobble downstairs and awaken the nurse’s husband for the long ride home. More apologies and expressions of regret passed between us. Chris helped them pack and stood waving goodbye in a swirl of fog.

           

            My teeth were being eroded from stomach acid. My throat and mouth burned from vomiting. I was 10-12 pounds below my pre-pregnancy weight. My skin was ash gray; my eyes were sunken. My skin looked and felt like tissue paper.

           

            Another twenty-four hours had passed without water, fluid or food, for my unborn baby or me. Wasn’t this getting more than a little ridiculous – and dangerous. For both of us?

                                                                        ~  ~  ~

            I have some additional thoughts on this horror.

           

            Severe morning sickness, or hyperemesis gravidarum, is a serious, potentially life-threatening condition that is often dismissed or downplayed by doctors. Pregnant women have died of it. It is thought that Charlotte Bronte may have died of it in 1855. One woman in the United Kingdom elected to have an abortion because of it. (Google “The all-day hell of extreme morning sickness” in The Guardian newspaper.)

           

            For my situation – and no, I was not able to keep ANY food or water down for days – Chris and I believe the care I received was irresponsible, reckless, and bordered on malpractice. After one hour of waiting for the medical director to arrive, Chris should have driven me to the hospital emergency room. They would have contacted my obstetrician directly, and he probably would have ordered admission and in-hospital treatment. I should not have tolerated the treatment I received from the medical director.

           

            Now that I’m older, wiser, and can evaluate these events with a critical, more realistic eye, I want to leave you with some tips.

           

            1. KNOW your insurance policy, especially what it has to say about pregnancy care. Some policies don’t pay for it. Some offer extra benefits for it. If you are even thinking about getting pregnant, make sure you have a good policy that will provide all of the care you MIGHT need. Please DON”T assume you won’t have problems.

           

            2. Have a strong advocate with you when you visit your doctor. I think you should take them with you EVERY visit. Pregnant women are in a vulnerable position, with hormones all over the map. You don’t need the added stress of having to combat condescending medical staff. Find a strong family member or friend who’s willing and able to ask questions.

           

            3. Bury your fear and ask questions – LOTS of them. Be firm. Do your homework. (Some doctors won’t like informed patients; they want to have total control. Find another doctor if yours is like that.) Demand and expect the best treatment you can get. You and your baby deserve it!

           

            4. If necessary, get a second opinion! I can’t stress this enough. If you have even the tiniest shred of doubt about how you are being treated, find another doctor or midwife and get their opinion.

           

            5. Call your insurance company to complain. I actually learned from my insurance company – way after the “final” devastating event – that my medical group and the director had a habit of repeatedly denying treatment and payment. That was their typical operating procedure with patients. I learned that information from someone at my insurance company. If I had known this ahead of time, my demands and insistence upon proper care would have been much different. I assumed too much and deferred too often.

           

            6. Much later I learned from a doctor that the best way to locate a good obstetrician is by asking the OB nurses in the hospital. Find someone who knows these nurses and ask them who they recommend. It could mean the difference between life and death – for you and your baby!

            Until next week!

Blessings,

Andrea

           

             

             

Pregnancy: When Sadness Turns to Joy

Weeping may endure for the night, but joy comes in the morning. –

                                                                        Psalm 30:5b NKJV

            That afternoon, saturated to the point of bursting with the required amounts of water for a uterine ultrasound, I sat squirming in a chair in my new doctor’s waiting room. Pregnant women filed in and out of the office – happy, expectant women with whom I was reluctant to make eye contact. I wasn’t sure if I should be sad or elated and wanted to avoid any reminders that the outlook for my baby wasn’t good.

           

            Finally, they called my name, and I walked diffidently into the examining room. The medical assistant asked me the standard, perfunctory questions then slapped a blood pressure cuff around my arm. “Good blood pressure. Any problems with the pregnancy?” she wanted to know. Without waiting for my answer, she continued, “How far along are you?”

           

            “Yes, if you check the chart you’ll find the problems; and, no, I don’t know how far along I am. That’s one of the reasons I’m here.”

           

            “We don’t have your chart,” she snipped. “It’s at the other office.”

           

            My eyebrows shot up. So much for medical efficiency, I thought. More disturbing patterns of disorganization and unprofessional conduct.

           

            A small, Asian man in a lab coat – who I surmised was my doctor – suddenly burst into the room pushing an ultrasound machine. Without introduction he initiated his preparations for the test then visually assessed my swollen abdomen. With a smile that squashed his cheeks up so high his eyes squinted, he pronounced, as though he’d made an impressive discovery, “There’s baby in there!”

           

            “That’s my bladder,” I quipped cynically as he continued to slide the ultrasound head across my abdomen before switching on the picture screen.

           

            All six eyes were glued to the screen. To my shock, then utter glee, the doctor was right. The three of us watched – mesmerized – as a beautiful fetus with a strong heartbeat wiggled around amidst the ultrasound vibrations. The rough calculations told us I was probably eight weeks along, and that everything looked fine. My cervix, however, was still open, so he insisted that I take it easy. I pressed him about continuing work, and he relented to that, as long as I could sit down while teaching. No problem. Since we weren’t presently performing any lab work, there wouldn’t be anything to carry around the room and assemble. He wanted to draw blood, but due to my severe dehydration resulting from my constant nausea, the nurse found it impossible to keep a needle in my vein. That specimen gathering would be left for another visit.

            

             My fear and sadness evaporated, and I exited the office elated and light-headed. My first stop was a pay phone in the lobby; I couldn’t wait another minute to call Chris. I wanted to wrap my arms around him and erupt with the good news. The previous evening we had mourned our abrupt loss. Now I was telling him to prepare a nursery! I couldn’t discern whether he was happy, shocked, bewildered – or all three – but I couldn’t contain my euphoria. The phone call was too brief since I was running late for work. Oh, why do I have to work on a night like this?

           

            With tears streaming and praises of thanks on my lips, I treaded into a rain-soaked parking lot. The deluge was both physical and spiritual refreshment, and I was happily drenched when I slid into my car. 

           

            God had answered my desperate and defective prayers. He had “come through” for me. We were really going to have another baby after all!

~  ~  ~

Within days my joy would be overshadowed. Life was going to get rough. Really rough.

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Below is an email I received from a friend and writing mentor of mine: writer, editor and speaker Donna Clark Goodrich, about the event her daughter experienced during her second pregnancy. She has graciously allowed me to share it with you.  

Andrea, I can so identify with your blogs as my daughter had two miscarriages. The sad thing about the second one is that the doctor didn't tell her the day of the ultrasound when she went in for some spotting, only ordered some blood tests. I was with her and when we left the doctor's office, Janet said, "Those were the same blood tests they ordered when I lost the last baby." I told her to go back and ask her, but she didn't want to.

A couple weeks later when she went back for her regular appt., she met not with her doctor or her doctor's nurse, not even the other doctor, but the other doctor's nurse who opened the folder and said, "Are you Mrs. ____?" My daughter said yes, and the nurse said, "According to this, your baby's dead." That was it!

My daughter, knowing she wouldn't go back to that doctor, asked for her records, and when she checked back on the day of the ultrasound, the doctor had written "spontaneous abortion; patient notified," which, of course, was a lie.

The worse part was, that the doctor had sold her name and due date to manufacturers, and the next May when the baby was due, Janet got all kind of congratulatory letters, coupons, and samples. It was living it all over again!

Donna

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This horrific, inexcusable event happened some years ago. I would like to think – hope – that doctors, nurses and medical staff have become more competent and compassionate since then. A baby is a living human being from the moment of conception, and the loss of one is traumatic no matter what week, month or trimester you’re in.

Does anyone else have any more stories to share, good or bad? Good ones will certainly raise our hopes and confidences!

Blessings,

Andrea  

The Journey of Death - and Life - Begins

            This is a story about severe physical pain and deep emotional hurt. It’s a story about grievous loss and deep grieving. Fighting. Losing. Depression. Agony. Death.

           

            Yet it’s also– probably even more so – a story of spiritual awakening and renewed hope. Healing. Redemption. Love. Life.

           

            It’s a story of miracles – given and taken.

           

            Your story might sound very much like it.

           

            I hope you like stories, even if they’re the kind that hurt. I hope you share yours and we can recover – and learn to live again. Together.

~   ~   ~

           

            I should have known from the beginning that things weren’t going to end up in my favor. And I should have known that not all pregnancies are the same. I should have known that I wasn’t different, that bad things happen to “good” people.  

           

            There are many things I should have known. But, for whatever reason, I didn’t, just because I didn’t, or I chose to willfully ignore them. Or I insisted on hanging onto a double-minded hope.

           

            Eight weeks into my second pregnancy, I started having problems. Having a medical group that seemed more concerned about practicing medicine on a shoestring budget was one of them.

           

            Chris and I had been forced to change insurance companies, and I selected a medical group recommended by a co-worker in the medical field. The clinic was near our home, which seemed like an added convenience.

           

            From the onset I had reservations about the care, and the skepticism intensified as my pregnancy progressed. More than once I discussed switching facilities with Chris. At the time we lived in Fallbrook, a small avocado and citrus farming community in North San Diego County, California. Instead of continuing to drive to Temecula, just ten minutes north, I thought it might be best to find a doctor in Escondido, thirty minutes south of us. The hospital there was bigger and more comprehensive in its care. Our small village hospital offered limited services.

           

            Selecting and staying with my current medical group because of the driving distance turned out to be the worst reason I used for selecting a medical facility. Working in the medical field, I knew better. You don’t select a doctor because of convenience.

           

            Eight weeks into the pregnancy, I started bleeding and immediately drove myself to the urgent care facility of my new doctor’s office. Upon arrival I signed in, listing my ailment as a possible miscarriage. Somehow the receptionist missed this information, so I sat patiently in a chair – praying fervently – and preparing myself for what I thought would be a heartbreaking diagnosis. If I were miscarrying, there’d be nothing the urgent care doctor could do for me. I resigned my heart to a loss even while I prayed for a miracle. After ninety long minutes the admitting nurse read my questionnaire, gushed with apologies for making me wait and rushed me into a treatment room.

           

            Thankfully the ER physician was a compassionate, gentle woman. During the examination she found what she thought was embryonic tissue and softly announced that if I had not miscarried, then I was probably in the process of doing so. A glimmer of hope ignited when she promised to send the tissue to the pathologist’s office for immediate evaluation. Furthermore, she insisted that I have an ultrasound performed the following day to determine if there was indeed an “intact” pregnancy. Reluctant to perform other procedures, she decided to “just let nature take its course.” I was sent home to relax then resume my normal schedule in the morning.

           

            I returned home acutely depressed, my heart drenched in failure and loss. I attempted to encourage myself with self-talk about it not having been a strong pregnancy. Perhaps there was something wrong with the baby; that it was just “not meant to be.” It was easier to package my true feelings in a box, seal it shut and discard it than to confront the pain.

           

            We’d just have to “try again.”

           

            The following day I felt renewed hope and determination – a hope that I’d be able to “hang onto” this pregnancy, especially if I fought this fight mentally – concentrated on good thoughts and hanging on. In the morning I drove to San Diego – almost an hour drive – to substitute teach and then spent more than an hour on the phone arguing with the medical director of my primary care facility about having the ultrasound that the urgent care physician said I needed.

           

            Then good news elated me. The pathology report returned with questions as to the identity of the tissue extracted the previous night at the urgent care facility. It was definitely not embryonic! Hope blossomed anew since the cramping had ceased and bleeding had stopped. With all of these factors working in my favor, I remained determined to have a diagnosis that afternoon.

           

            Yet the medical director insisted that I’d have to schedule an ultrasound for three days later because there were other tests they could perform first to identify bloodstream hormone levels. She also wanted an ultrasound technician to perform the test – cheaper than a physician doing it. Although she didn’t say as much, I knew it would save her medical group money to do it her way.

           

            Yet I didn’t back down. After I insisted that she tell me what she’d do if she were bleeding with a baby she was carrying, she gave in – after a prolonged silence – and I obtained my appointment with my delivering obstetrician for that afternoon. My delivering obstetrician I hadn’t yet met.

           

            That meeting couldn’t come soon enough for my anxious heart.

You will show me the path of life… Psalm 16:11a NKJV

              

             

Surviving the Premature Death of Your Child

           When I think back to that day – when I allow my mind to return there – I am drenched again in the confusion, the heartache, the what ifs, the what-might-have-beens, the agony, the horribly empty arms. The abruptly still and empty womb.

           

            The physical pain isn’t replayed, but the emotional agony dances around the edges of my heart. It’s easier if I don’t allow myself to “go there” at all, so when I talk about it I often sound hollow, detached, like it all happened to someone else instead of me, and I’m just a fact-repeater to the listener; because being attached guts my heart all over again.

           

            April 13, 1993. Nineteen-and-a-half years ago, and it still hurts. I walk through Target and can barely eyeball the poofy organza, satin and lace dresses hanging in the baby section without wondering what she would have looked like in one of them. Easter is particularly hard, when the white patent leather shoes, spring hats, white gloves and purses show up alongside the dresses. Red and green velvet and satin Christmas dresses get to me too.

           

            I see girl babies, in their pink-trimmed, flowery jammies and my heart bleeds a little. Every year, I wonder what she’d be doing now. In 2011 she would have graduated from high school; she’d (probably) be embarking on her second year of college. Where would she be attending? What would she be studying? What would she look like? How many eager young men would her father be running off the porch?

           

            Would there be joint shopping trips, manicures and pedicures together, enjoyed mother-daughter teas?  

           

            But I do allow myself to go there, especially when I am alone and holding the tiny, square, sterile white box that contains her remains, because doing so validates her as a living, breathing human being. It reminds me that while I have two living children, I really do have more than two. I know so, because I held her, caressed her, wept over her. But before that, I carried her in my body and felt her move and wiggle…and hiccup.

           

            In this blog, I will take you through the journey of the death of our precious daughter, Victoria Lee Owan, in premature delivery. In the process, we’ll explore how mothers grieve, fathers grieve, siblings grieve, grandparents grieve, and your closest friends grieve…or retreat.

           

            Losing a child prematurely, either in pregnancy, at birth, or soon after, isn’t called “A Silent Sorrow” for nothing. Most people don’t have a clue what you’re experiencing, and they don’t know what to say, and you end up walking this path and facing this agony alone. Well, not really. God walks this path with you, even though it often seems like He’s not even in the vicinity. We’ll talk about that too.

           

            And we’ll talk about what to say and what not to say to a friend or family member who’s suffered this kind of loss. I want it to be a forum where you pour out your heart, inquire, maybe even rail at life and all of its injustices. I want it to be a place where you can come to weep and to heal; to encourage and to edify. My husband will even jump in occasionally to give advice to husbands – those grieving, often-forgotten-about and neglected fathers.

           

            We’ll talk about how to keep your marriage intact and grow in your faith. We’ll even help you come to faith, if you’re struggling with that.   

             

            Even though life will never be the same again – this type of event seems to snatch away whatever vestiges of innocence you still possessed – you can recover and heal. There is life to be lived – a lot of it. That fact, and hope for it, may be so very hard to see if your pain is fresh, but it’s there. Give yourself time to find it; don’t let anyone rush you.

           

            Don’t care right now about finding it? You will. There are a lot of people in your life who need you to find it – eventually.

             

            Everyone experiences their loss in a unique, personal way, but there are particular emotions that everyone goes through. We’ll explore all of those.

           

            No medical or psychological advice will be dispensed; we simply want you to consider this your personal support group – for as long as you need it, or us.

           

            May the God of all comfort guide and be with us as we journey together.

Blessed are they that mourn, for they shall be comforted. - Matthew 5:4 NKJV

WOUNDED HEARTS

O Love eternal, Love divine,

In wounded hearts pour oil and wine.

Where darkness broods like moonless night,

O Light of Life, let there be light.

And Thine the praise, the glory be,

When Thy beloved come home to Thee.

~ Amy Carmichael

           

New posts will be added to this blog every Monday. Comments are welcome at any time.

Thanks for joining me!

Andrea