Tuesday, September 30, 2008

Research Results: Motherisk Hotline

Last week I finally got around to calling the Motherisk NVP hotline, so I thought I'd just go ahead and post my notes from that phone call rather than trying to summarize it in paragraph form.

Motherisk is a free hotline based in Canada at the Hopsital for Sick Children. They give free information on several pregnancy-related topics, one of which is morning sickness. Unfortunately all of their advice is mainstream-pharmaceutical based (no herbs or naturopathic remedies), but they are a super resource for drug information. Give them a call!

And here are my notes from my call:

Motherisk NVP Hotline: 1-800-436-8477

Called and spoke to counselor on September 26, 2008

- They have no data on herbal remedies

- They also have no data on preventing HG (although they are doing a study currently to see if Diclectin is more effective if taken at conception rather than at first nausea)

- Thus, I just asked them how to replicate Diclectin

o Diclectin (Bendectin) is a combination of 10 mg B6 and 10 mg doxylamine succinate (Unisom)
- Must break a 25 mg tablet of unisom in half to get ~10 mg
- Can take more B6 – up to 200 mg/day (make sure to include multivitamin in total)

o Take one dose four times daily – one in the morning, one midday, and two at night

o Some women take more
- Six doses/day is common
- Eight doses/day also is done, but should be done under care of OB
- Max dose of unisom is ~ 75 mg/day

o Drowsiness from unisom generally wears off after 2 weeks (sometimes less, sometimes more)

o Try to take doses at the same time each day

o Try to time them before your worst times of the day

o Can mix with other anti-emetics such as Zofran

o When you think you are ready to drop dosage, don’t go cold turkey – taper off gradually
- Eliminate one dose per day at a time, and wait several days to make sure you are still
100% okay before dropping another dose

Monday, September 29, 2008

Residual Nausea?

I wanted to do a quick post on this to see if any other HG mums can relate to the experience of postpartum residual nausea.

Here is my "nausea history":

Pregnancy test at 4 weeks - felt fine
5 weeks - Nausea began
First trimester - Nausea builds
20 weeks - Nausea finally breaks a wee bit
20-40 weeks - Nausea gradually abates but still stays around with occasional stronger surges
1st week postpartum - Nausea drastically decreases
Birth - Baby's 18-month birthday - residual nausea lingers

It's the last part that I want to ask other HG mums about: Did you deal with residual postpartum nausea? My postpartum nausea was just brief moments or minutes of nausea. It never got to the point of throwing up (almost did once), but could be pretty strong. This would happen several times a day. This residual nausea was still pretty strong at one year postpartum, had mostly gone by 18 months and was almost entirely gone by 24 months.

Also, I've noticed changes in my system overall. For example, I now get nauseated when I get up in the morning if I don't eat right away (like right now!) - and that's something that never happened to me pre-conception.

I'd love to hear from other HG-mothers about this. Have you dealt with anything similar? Let me know!

A Postscript

I wanted to add a brief postscript to the entry below...

For those of you who don't know fertility signs, your "luteal phase" is the second half of your cycle - the post-ovulatory half - and it is generally constant for any given woman. For example, even if your cycle varies all over the place (28 days, then 32 days, then 34 days), your luteal phase will stay the same (for example, 11 days plus or minus one day).

Doctors vary on what they consider to be "normal" for a luteal phase. Some consider anything under 12 to be dysfunctional; some consider anything under 10 to be dysfunctional. (When estimating a due date, they will use a default value of 14 days. This is one reason why it is SO important to chart your fertility signs - otherwise your "estimated due date" may be horrendously off. With my cycles, which are long with short luteal phases, my due date will usually be one week later than that estimated by a pregnancy wheel. Thus, if I didn't know my fertility signs, I could conceivably have had an OB pressuring me to induce when my baby was still premature.)

Anyhow, regarding my last post, when I wrote that I thought that I was pregnant because I had a long luteal phase (12 days as opposed to 10): I had started taking vitamin B6 supplements a month or so ago to deal preemptively with morning sickness. BUT, vitamin B6 also happens to be one of the over-the-counter remedies for short luteal phases, LOL!!! I had known that but forgotten about it, as I was not at that time wanting to increase my fertility. But I can now testify that it works!!! I'll post next month to see if my luteal phase continues to lengthen with additional B6 supplementation. Kind of cool to see that such a simple supplement can do such amazing things!

Friday, September 26, 2008

Phew. Phew. Phew.

What a week. What a WEEK!!

My goodness.


So anyhow, this past week was "that time of the month" when I'm wondering if we've conceived or not and if this is "time to pay the hyperemesis piper." Well, I was absolutely convinced that I really was pregnant this time! (Not that I'm not convinced every month, but this was an especially intense one.) My luteal phase, which is 9-10 days, has never, ever gone longer than eleven days on occasion - this month it went to twelve days. I was FREAKING OUT!! Luteal phases are just NOT supposed to do that!!!

Of course, that raises the possibility of an early miscarriage. It's definitely possible. It'll probably take about another six months of charting to know. If my luteal phase is finally lengthening out, then 12-day luteal phases will become more normal over the next stretch of time. If it was an early miscarriage, then it will be the one-and-only 12-day luteal phase. It will be interesting to see. But I didn't feel particularly pregnant, so I'm guessing that it's my luteal phase lengthening.

So anyhow, yesterday I decided to go ahead and get an appointment with my consulting OB for early next week, so this morning I emailed and cancelled (I was too embarrassed to call!).

I have been an utter stress case the past, oh, week or so. I have been basically living on a steady overdose of adrenaline!!! As usual, it's a combination of pure, exhilerating joy and pure, debilitating terror - alternating between the two. Last night I was so incredibly stressed out thinking about HG recurring that I was actually up till 1:00 a.m., unable to sleep (which is totally unusual for me - I like to be asleep by 9:30 p.m.!) and basically just freaking out. I just lay there with my heart racing, thinking, "Oh, my God, I can't do this. I just can't. I can't do this again."

I have also spent this week making massive plans for what I would need to do if I was pregnant, and it was a HUGE list - another reason for my stress this week! Packing our house up, writing our Christmas letter, planning for our choral ensemble to be able to get along without me, getting substitutes for work, backing out of church and volunteer activities, dealing with our home purchase, dealing with my mother (who would be mad as a hornet if I got pregnant during our home purchase), and much, much more. I've also been making grocery lists for supplements, etc. etc. etc. So I've been busy! Physically and mentally. Mentally and spiritually, it's been exhausting.

Of course, it's been very productive as well. I finished my "post-conception HG-prevention protocol" which I have posted on this blog, and I have submitted it to various sources for review, including:

- My consulting-OB staff
- My midwife
- www.hypermesis.org
- Shonda Parker's website (she gives advice for a fee)
- Motherisk NVP hotline

The cool thing (now that I'm NOT pregnant) is that each of these sources is taking longer than expected to respond (I haven't gotten final answers from any of them yet), so I have at least another month to receive and review each answer and then complete my protocol. Considering that I was planning on doing my supplement shopping this morning, I would have been extremely frustrated to have to shop without having the return data to go from.

So, the lesson for post-HG mothers who are considering conceiving again: Do your research now! Have your plan and protocol in place before you conceive so that you're ready to go as soon as you suspect you're pregnant. If one waits until one is pregnant to begin research, it's going to take longer than anticipated!

Oddly enough, I was terribly disappointed to find out that I was not pregnant (yes, I do seem to be certifiably insane). Well, the human race wouldn't last very long if the Lord hadn't given women this undeniable batty-ness over having children! :)

And now I think that I shall go collapse in a heap. And stay there for the next two weeks.


* P.S. A spiritual note: I have realized that I need to get serious about memorizing Bible verses more systematically. I have never been big on Bible memorization - I'm good on reading, but not memorizing. But last night when I just so filled with fear, the only thing that helped was repeating Bible verses focusing on the love and care of God - and I realized how very few I knew by heart. I realized then how incredibly important it is to have those verses actually in my head and heart rather than just on paper for those inevitable tough times of life. I'm going to try to focus on that in the future.

Thursday, September 25, 2008

A Note for Rachel

Hi, Rachel! Thanks for the sweet note! I can't answer it directly due to the "Anonymous" setting, but I wanted to say a quick hi. I hope that you have a wonderful second pregnancy (whenever it happens!). Thanks for saying hi!


Wednesday, September 24, 2008

Book Review: "A Grief Observed" by C.S. Lewis

"A Grief Observed"
C. S. Lewis
89 pages, 1961

Anyone new to this blog may wonder why I am including a book review having absolutely nothing to do with hyperemesis! I will note, therefore, for the benefit of said newcomers, that this blog is also an examination of the spiritual meaning behind human suffering, from a Christian perspective.

I loved this little book. Actually, it's not a "book" per se, but a journal of notes jotted by Lewis after the death of his beloved wife, Joy. It is a precious volume that I have now read about three times and loved more each time.

This book is completely different from "The Problem of Pain," also by Lewis. "PoP" was written from an intellectual standpoint - a logical and theological examination of the purposes behind human suffering. While PoP was a truly great book which greatly advanced my knowledge, it did not really touch my heart. AGO (A Grief Observed), while much less scholarly and much more personal, helped me greatly along my journey of understanding.

The term that comes to mind for this book is "raw." Lewis wrote it while deeply hurt and grieving. He expresses doubt, anger, despair - all of the emotions experienced by anyone in the throes of great physical or mental suffering. But just as a hug means more to a suffering person than does a lecture, so does this type of book speak more deeply to someone trying to understand suffering than does a scholarly essay.

Here are a few great quotes from this book:

"Meanwhile, where is God? This is one of the most disquieting symptoms. When you are happy, so happy that you have no sense of needing Him, so happy that you are tempted to feel His claims upon you as an interruption, if you remember yourself and turn to Him with gratitude and praise, you will be - or so it feels - welcomed with open arms. But go to Him when your need is desperate, when all other help is vain, and what do you find? A door sleammed in your face, and a sound of bolting and double bolting on the inside. After that, silence. You may as well turn away. The longer you wait, the more emphatic the silence will become. There are no lights in the windows. It might be an empty house. Was it ever inhabited? It seemed so once. And that seeming was as strong as this. What can this mean? Why is He so present a commander in our time of prosperity and so very absent a help in time of trouble?" (pp. 17-18)

I think we have all felt like this in moments of despair.

"Not that I am (I think) in much danger of ceasing to believe in God. The real danger is of coming to believe such dreadful things about Him. The conclusion I dread is not 'So there's no God after all,' but 'So this is what God's really like. Deceive yourself no longer.'" (pp. 18-19)

I have definitely felt the danger of this temptation - not to cease to believe in God, but to believe Him to be other than Good - what a horrible thought.

"It is hard to have patience with people who say, 'There is no death' or 'Death doesn't matter.' There is death. And whatever is matters. And whatever happens has consequences, and it and they are irrevocable and irreversible. You might as well say that birth doesn't matter." (pp. 28-29)

Very true! And I'm sure I've murmured the same platitudes unthinkingly.

"Talk to me about the truth of religion and I'll listen gladly. Talk to me about the duty of religion and I'll listen submissively. But don't come talking to me about the consolations of religion or I shall suspect that you don't understand." (p. 37)

Oh, how true this sometimes feels in moments of depression and hopelessness.

"Your bid - for God or no God, for a good God or the Cosmic Sadist, for eternal life or nonentity - will not be serious if nothing much is staked on it. And you will never discover how serious it was until the stakes are raised horribly high; until you find that you are playing not for counters or for sixpences but for every penny you have in the world. Nothing less will shake a man - or at any rate a man like me - out of his merely verbal thinking and his merely notional beliefs. He has to be knocked silly before he comes to his senses. Only torture will bring out the truth. Only under torture does he discover it himself. And I must admit... that, if my house was a hosue of cards, the sooner it was knocked down the better. And only suffering could do it." (pp. 49-50)

Suffering is truly the great truth-teller - it reveals our faith for what it truly is, not what we thought it was because we were happy and well. We all have to go through this stripping away at some point.

"What is grief compared with physical pain? .... The body can suffer twenty times more than the mind. The mind has always some power of evasion. At worst, the unbearable thought only comes back and back, but the physical pain can be absolutely continuous. Grief is like a bomber circling round and dropping its bombs each time the circle brings it overhead; physical pain is like the steady barrage on a trench in World War One, hours of it with no let-up for a moment. Thought is never static; pain often is." (pp. 52-53)

The one advantage of mental pain over physical - that there is occasional relief from it (with sleep, with social interaction, with moments of forgetfulness). But each type of pain carries its own suffering, regardless of the pattern of recurrence. Right now, as I am dealing with the subject of physical suffering, mental suffering seems preferable. But I know that when I'm experiencing mental suffering, I long to exchange it for physical! A no-win situation.


I loved this book and highly recommend it. I'll definitely be picking up a copy whenever I find one somewhere. It's great to know that people (even the great C. S. Lewis!) go through spiritual struggles and times of lowness as well as oneself - kind of a brotherhood of human spiritual experience. Very comforting, and very reassuring.

Highly recommended!

Saturday, September 20, 2008

Website: Hyperemesis.org

There's really no need to promote this website, because it is unarguably the most famous and well-used website having to do with hyperemesis ever! Check it out here.

This is the website of the Hyperemesis Research Foundation, an organization dedicated to researching HG and providing information to healthcare providers and HG-mums and families. There is a wealth of information on this site: Commonly asked questions, drug and treatment information, forums for every HG subject under the sun, and every kind of information available.

Oddly enough, I hadn't really been around this site till lately. I used the site when I was sick to determine that I did have HG (rather than garden variety morning sickness), but I was too sick to do more than that and I just hadn't been back. This past week I've registered on the forums and taken some time to explore the site. It rocks!!

While surfing the forums I found a great little piece of HG-lore - it's a phrase called "being crackered," in reference to when someone (with great motives, of course!) tells an HG-mother to "try eating dry crackers"! In that case, you've "been crackered"! I loved it. I think we've all been crackered. Probably most conditions have their own form of being crackered!

If you haven't been to this website yet, check it out! It is an invaluable resource.

Thursday, September 18, 2008

HG Plan #1

Note to Readers: I am currently in the process of getting the below plan revised and reviewed by various medical practitioners. I will publish an updated and approved version when that process is over. Please do NOT use this version, if you are tempted to use my plan, as I have already discovered some big errors in it (specifically in my formulation of Diclectin). Wait until I publish the updated version. As always, use at your own risk.

And here it is, ladies! My first official "hyperemesis prevention" plan. This is based off of much, much, MUCH research, although it is by no means exhaustive. I have posted it on My Morning Sickness for comments, and I will probably post it on hyperemesis.org as well. After that I'll probably run it by the Motherisk hotline and possibly email Shonda Parker (she does online question answering for a small fee). So you can expect this to change! I'll post a revised copy as I go along. It will probably take a while to get all the revisions done (unless I find out that I'm pregnant this cycle, and then I'll be working like the wind and contacting all resources at once, LOL!!!). I'd like to take off anything that is redundant, because, as you can see, there is a LOT of stuff on this list.

The hardest part (for me) was dealing with the non-major herbs. There are SO MANY of them for nausea!! So I've just lumped them all together rather than trying to deal with them exhaustively in this document.

If anyone has any comments, please let me know!

As always, YOU are responsible for doing your own research. ALWAYS do your own research and take responsibility for your own health.

And without further ado, my HG-prevention plan:


: Cleansing

: Liver cleanser
Dosage: At least once a day – as often as possible
Notes: Recommended by Shonda Parker

: General nutrition, folic acid
Dosage: One daily

: GI health and general health
Dosage: Acidophilus (1 cap daily) and yogurt

: General health
Dosage: 1-2 capsules of fish oil daily

: Morning sickness prevention
Dosage: 1 B-100 daily or 2 B-50 daily (each contains 100 mg or 50 mg each, respectively, of all the B-vitamins, including B6)

: Liver Cleansing
Dosage: 2 capsules daily
Brand: Thislyn is a good brand. Anything with 70-80% silmaryn
Notes: Recommended by Shonda Parker

As Soon as Pregnancy is Confirmed

: Cleansing, health

: Liver cleanser
Dosage: Lots and lots and lots and lots!!
Notes: Recommended by Shonda Parker

: General nutrition, folic acid
Dosage: One daily
Brand: Possibly something without iron

: GI health and general health
Dosage: Acidophilus (2 tablets with every meal) and yogurt

: General health
Dosage: 2-4 capsules of fish oil daily
Brand: Possibly NOW?


: Morning sickness prevention
Dosage: 3 B-50 daily (each contains 50 mg each, respectively, of all the B-vitamins, including B6)

: Morning sickness prevention
Dosage: 3-50 mg tablets, taken with the b-complex

: Absorption
Dosage: Take a little bit with the B-complex and unisom

: Liver Cleansing
Dosage: Increase to 3 capsules daily
Brand: Thislyn is a good brand. Anything with 70-80% silmaryn
Notes: Recommended by Shonda Parker

: NVP prevention
Dosage: (1) 3 capsules per day – try PLUS by Mannatech, (2) 1-2 tsp. dried extract three times daily, (3) 2-4 mL tincture three times daily)

: Cleansing, health, NVP Prevention
Dosage: As directed on bottle

: NVP prevention
Dosage: As directed on bottle
Notes: http://www.mountainmeadowherbs.com/morning-sickness-balm-p-32.html?osCsid=8792a1b5dfaa82954bd35f5bd4534f0b

: NVP prevention
Dosage: 1,000 mg every 2-3 hours as needed, no more than 20,000 mg per day
Notes: Shonda Parker

: NVP prevention
Dosage: 3 caps per day with meals
Notes: Shonda Parker

: NVP prevention
Dosage: 2 caps three times daily with meals
Notes: Shonda Parker


: Supposedly helps deal with nausea
Notes: http://www.karenhurd.com/morningsickness.html

: NVP prevention
Dosage: 1,000 mg every 2-3 hours as needed, no more than 20,000 mg per day – or till you can taste it!

: Supposedly helps deal with nausea

: For NVP

: For NVP

: For NVP


: For NVP
Dosage:Under an OB’s care

: For NVP
Dosage: ½ - 1 tsp. tincture or ½-1/4 tsp. (1-2 g) extract three times daily

: For NVP
Brand: alfalfa, basil, black horehound, chamomile, ginger, lavender, peppermint, peach leaf, wild yam root, red raspberry leaf, yellow dock

Wednesday, September 17, 2008

My first birth publication!

I am so excited!! My birth story was included in a book of Arizona birth stories/art, and I just received the book in the mail! So fun!! It's called "Our Stories, Our Births: A compilation of birth art, poetry, letters and intimate birth narratives told by mothers in Arizona."

Of course, it's nothing to be super-proud of, because there was no "selection" - everyone who submitted material was included!

But it's my first time any of my "childbirth writing" has been put in actual print, and I am just excited about that!! Hopefully it's not the only time I'll be able to write on the subject.

In other news....

We have a gigantic spider hanging out in our storage closet. Actually, he/she has been there for months, but I was reminded of it yesterday when my vacuum struck her web and she rushed out and attacked the vacuum cleaner! I did a pretty good version of Patrick McManus's "Modified Stationary Panic," but I forgot the Russian dance steps - I had to settle for leaping upwards, dropping the vacuum and shouting something like, "Eergghhh!"

I am not a fan of spiders. I wouldn't let DH kill the spider, because it's obviously not a black widow or a brown recluse, and I don't like any unnecessary killing. But I'm giving the storage shed a wide berth! Maybe I'll get my dad to relocate it when he's out next. I'm thinking it's a female Southern House Spider - that's the closest I could come to identification. Ergh.

Our house purchase still eludes us! Bid #11 seems also to be slipping away from us, but we still hope.

Monday, September 15, 2008


Well, DH finally cracked.

Actually, he didn't really crack.... It was forced upon him.

Explanation: DH has been doing this new low-carb-type diet for the past four weeks. I sort of did it with him for a week (I was cheating at the 3-day mark), but then quit. I'm just not cut out for low-carb living (I went to baking & pastry school, for goodness' sake!). But anyway, it's been really successful for DH - he lost something like 25 pounds in those 4 weeks.

Anyhow, on Thursday he started feeling yucky. He ended up taking half the day off on Friday and was out of sorts and feeling badly all day. He couldn't figure out what was wrong. Eventually, when he got on the phone with his sister, who is the guru of all things low-carb, she was able to instantly diagnose his issue - being that he had done too much low-carb too quickly, and was having a fairly common bad reaction. The solution? Eat carbs and go about the whole thing more moderately. And he obeyed! He's feeling much better. He's decided to ditch Diet Evolution for now (thank heavens!) and try to switch over to The Maker's Diet instead (which is a much more balanced diet, though not as good for quick weight loss). Hallelujah!!!

Here's a funny (though somewhat gross) story about Diet Evolution (skip if you're squeamish):

This diet completely ditches all ground grains - including pasta. Well, one "replacement pasta" is shirataki noodles, which are made from tofu. One disadvantage of the noodles is that, although they taste okay once cooked (just a bit rubbery), they smell fishy while you're preparing them. With my post-HG stomach (much more easily nauseated than it used to be), that was not a good thing! But the worst part... I guess these things aren't too digestible!! So I fed them to my toddler, and later, when changing his diaper (pause while I go throw up!!) there they were, in all their glory, looking for everything like the worst infestation of intestinal parasites you've seen north of South America. Aaackkk!!! The other packages have sat in our fridge, uneaten, ever since. I'm going to try to get up the guts to cook them and get them GONE this week so that I can forget about them.

Other than that, the response to our eleventh house bid is still silent and unavailing! We live in hope.

And I think that FOUR blog entries is enough for one day!!

The reason I'm blogging so much: I'm in "that time of the month" when I have to wait 2 weeks or so to find out if "this is the month" or not. I am always over-zealous in my HG research during those two weeks, because I feel like time is running out!! So I'm trying to get more bases covered just in case. I've learned a lot just today!!

Website: Diclectin Product Page

Check out the website for diclectin.

What is diclectin?

Long story.

Long story made short... Diclectin is the same thing as Bendectin, which was produced in the United States until 1983 when it was voluntarily removed from the market following lawsuits alleging birth defects. You can find out more about the history of this drug here.

What is it? It's very simple - from the website, it's:

"a combination of 10 mg of doxylamine succinate and 10 mg of pyridoxine hydrochloride (vitamin B6) in a delayed-released formulation"

The FDA's subsequent testing revealed no teratogenic effects, and the overall conclusion is that Bendectin is probably perfectly safe. However, it still is not produced in the United States - only in Canada under the name Diclectin (Canada = Diclectin, US = Bendectin, UK = Debendox).

Thankfully, it's easy to remedy - mothers can simply combine 10 mg of vitamin B6 and 10 mg of Unisom to get the same thing (although it's not time-released). Many women do, and I would have no problem doing so.

This works for some women and doesn't work for some. It's basically a line of first defense - something to try before heading for the big guns.

Check out the website. It's extremely biased toward Diclectin (I wonder why!), but you can get some basic information off of it.

* The usual disclaimer: I am not a doctor, and the above is not medical advice. You are fully responsible for any medical decisions you take regarding supplements, and all decisions should be discussed with your midwife, OB, or physician.

Website: MyMorningSickness.com

Just found a new website for morning sickness, and it looks pretty neat! Here it is:


The authoress, Wendy, offers an e-book, morning sickness forums, her personal story, free nausea-tracking charts, and a free instructional video clip showing how to make one morning sickness remedy. I haven't been all around the site yet, but it looks awesome!! And she has the most adorable family!! Definitely check this website out and look around.

I was especially interested in this site once I discovered that the authoress has a very similar life philosophy to mine. I love connecting with like-minded mothers, and with HG, life-philosophy is especially important. Many HG forums are wrapped up in the "should I abort, should I not abort" question, and thankfully that is blessedly absent from her forums. This is a great life-affirming site that will encourage and help HG mothers without encouraging them toward abortion.

Research: Legumes????

Check out this article! The authoress, who is a nutritionist, has an interesting and unique solution for morning sickness - eating legumes!! Does it work? Does it work for hyperemesis? Well, we can only try! Here's the article:


Saturday, September 13, 2008

Eating Crow, Part I

Well, I knew I'd come down to it sooner or later! This is probably the first of many.

In my last post I wrote the following about Miriam Erick's book "Managing Morning Sickness":

"However, there was one section in here which was so funny (unintentionally, I'm afraid) that I have to mention it. It is called "boredom and morning sickness" - a list of things to do when one is kept at home by morning sickness - things such as "make beaded barrettes or belts with a kit," "writing a child's storybook for the baby's third or fourth birthday, complete with pictures," "Knitting or embroidering," "Organizing a photo album," etc. What on earth??? If, like I was, you are in bed with morning sickness, you are in NO condition to even think about activities! That is just about as practical as giving a list of "things to do when you're home with severe food poisoning." When I was at home in bed, I was either throwing up or sleeping. Period. Origami never crossed my mind. If you're feeling well enough to do these things, I don't think you need to be in bed!! Of course, every case could be different. Who knows? I only have my experience from which to judge."

I now stand corrected by one of my severe-HG friends, who wrote to tell me that when she had her less-severe days, finding something mindless to do (such as the things on Erick's list) was very helpful in taking her mind off of her morning sickness. And so, I admit it! I was wrong!

Or at least in generalizing.... What I wrote was definitely true for my case - just not all.

I have heard from several HG mothers, however, agreeing with my statements questioning Erick's nutritional advice - they have all said the same thing: "How does nutritional advice help someone who can't tolerate solid food?" So at least I was right on that one!

I'm looking forward to hearing from other HG mothers about this book, if anyone out there has read it. Let me know how it worked for you!

And since I'm supposed to be working right now, I'd better get back to it!

Thursday, September 11, 2008

Book Review: "Managing Morning Sickness" by Miriam Erick

"Managing Morning Sickness"
Miriam Erick
2004, 412 pages

After reading this book, I felt.... confused. Yes, definitely confused. And also irritated.

I liked the book better upon rereading it. It definitely has good information. So I guess that my review is mixed!

I want to start off with three big complaints.

First - This is not a book about hyperemesis. This is a book about morning sickness - ALL morning sickness - from the slightest queasiness to the severest case of HG. I am not sure that the choice to lump all forms of MS/HG together was a wise choice. What works for one will not work for the other, and what applies to one will not apply to the other. I found it confusing to wade through oodles of advice, only some of which applied to me.

Of course, I realize the quandary. Hyperemesis is not a well-defined condition, just because morning sickness is a spectrum/continuum condition. It progresses from mild to life-threatening, and the exact dividing point between garden-variety MS and HG is not well-defined - or rather, it is an artificial division that doesn't really exist! So it would be hard to separate the conditions for separate books! Still, it was confusing.

Which brings me to my second complaint - Miriam's definition of HG. First of all, she gives several different definitions of HG:

"The technical name for moderate-to-severe nausea and vomiting during pregnancy is hyperemesis gravidarum (HG)." p. 5

Although she admits that "Currently, there is no set of criteria that can delinate this spectrum," (p. 5) she later states that "On occasion a hospital stay to correct dehydration is necessary. If this happens, morning sickness becomes known as hyperemesis gravidarum." (p. 245)

She seems to stick with this definition, for the most part - she repeats it several times throughout the book. So, if you end up in the hospital, you had hyperemesis; if you don't, you didn't.

Speaking from a somewhat scientifically-trained background, this is the WORST possible way to define a condition - to define it based on the clinical action taken. Frankly, I don't know how she could even contemplate this methodology! Let's take some analogous situations to see how ludicrous this appears:

- "You only have pneumonia if you go to see a doctor. Otherwise it's just a bad cold."
- "You only have cancer once the doctors decide to do chemotherapy. Otherwise it's just your imagination."
- "You only have a broken bone if the doctor gives you a cast. Otherwise it's a strain."
- "You only have a bad cut if you get stitches. Otherwise it's just a scratch."

Conditions need to be defined symptomatically; not by end-results.

My own case is a good example. I know, by personal experience and symptom-matching, that I had a (mild) case of HG. If I had known then what I knew now, I would have gone to the hospital (and thus I would have "had HG"). However, we did not have insurance and I believed (falsely) that there was no medication to give to pregnant mamas for fear of harming the baby. Thus, we stayed home even though I was dehydrated and wanting to die. But if we had gone in, like we should have, then I would (by Miriam's estimate) have had HG! Since I didn't, I obviously didn't!!

A couple more examples....

- What about the woman in a third world country who doesn't have access to medical care? Well, obviously she doesn't have HG because she wasn't hospitalized!
- What about women who check themselves into a hospital unnecessarily? I once heard a doula describe an unbalanced, hysterical-type client of hers who constantly checked herself into the hospital for imaginary or minor complaints (including nausea and vomiting, which didn't exist). Well, obviously she had HG - because she was hospitalized!
- What about the woman who isn't hospitalized because her doctor is ignorant or insensitive and refuses to hospitalize her even though she needs it? Well, obviously she didn't have HG!

Forgive the sarcasm - but her definition did make me angry. You simply cannot classify a disease condition by what the medical community decides to do about it. It must be symptom-based.

My third complaint:

I realized about two-thirds of the way through the book that this book didn't have the same "feel" as other HG books I have read. It took me a minute to realize what it was, and then I realized that this book (as far as I could tell) was not written from personal experience. Miriam has not been through HG herself. How do I conclude that? #1 - She has no "my story" part of the book, something that will never be missing from an HG-mama's writings. #2 - She has a statement in the beginning of the book that pretty much clinches it (more on that later).

Hyperemesis is what I can only describe as a "path of darkness." It is an experience with the deepest physical agony and mental suffering - an encounter with deep, deep darkness. A friend of mine described it as "sliding into the Pit," and I highly concur. Writings of HG women (such as McCall and Schmitt) deeply reflect this experience with darkness. This book had no such reflection - it was mostly bright and cheerful. I found myself thinking, "Gosh, I was making a fuss over nothing! This is just a normal condition that can be treated sensibly like anything else."

This statement made me laugh, and it made me a bit mad at the same time. Here it is:

"Believe me I know exactly what you are going through - because I take care of women just like you every day of the year." (p. xxiv, italics in original)

Oh, my goodness! Miriam, don't write things like that! If you have not been through HG, you do NOT know what HG-mothers are going through. You may know about the condition, how to treat it, have empathy with HG-mamas - but until you've been there you will not know anything about "what you are going through" - and it is presumptuous to say that you do. If you have had HG, you need to state it. If you have not had HG, then I suggest the following rewording: "Believe me, I have a lot of experience working with severe morning sickness - because I take care of women just like you every day of the year."

Let's take an example: Imagine a male obstetrician leaning over a woman in transition (the hardest part of labor) and saying, "Believe me I know exactly what you are going through - because I take care of women just like you every day of the year." What would we do? We'd laugh him out to the parking lot!!!

For major life changes, disease conditions, suffering and crises, not one of us can say that "I know just what you're going through" until he/she has been there. I cannot truly know the hurt of infertility, the hurt of deepest grief, the hurt of losing a child (much as I may sympathize) because I have not been down those paths in my own life.

There's no reason why people shouldn't study or write about conditions that they haven't experienced. Counselors and pastors counsel people all the time who are going through disasters that the counselors themselves haven't experienced. Men can make great obstetricians. And I'm sure Miriam is a great dietition helping out HG mothers. But she should not say that she "knows exactly what we're going through."

Enough complaints (for the moment).... Let's move on to a survey of this book.

The first chapter deals with the question "what is morning sickness?" There are so many facets to this condition that it is actually a pretty hard question! Miriam lists some of the different facets of morning sickness:

- Nausea, vomiting, retching
- Aversion to odors
- Aversion to bright lights
- Aversion to noises
- Aversion to tight-fitting clothes
- Low-level claustrophobia
- Sensitivity to visual motion from computer screens/televisions

I personally experienced the first two, and I have no idea about the rest - I was too sick to notice!!

She then goes on to give some of the differences between MS and HG (which, again, is hard to do). She mentions some of the other facets of morning sickness - that it's not generally "morning" sickness, that it doesn't always (or even usually) dissipate by the end of the first trimester, and that it is a condition unfortunately prone to relapse.

Miriam then writes a chapter about how morning sickness affects women's careers and families/relationships. Very important! I know that with my experience, social relationships suffered greatly (from neglect). If I had had a career, it would have been over, and if I had had a less than perfectly-patient DH, my marital relationship would have suffered as well. I got off easy - but many women don't, especially when they have careers or small children.

Chapter three is really interesting - it presents the different theories as to WHY women get morning sickness. Oddly enough, no one really knows for sure!! Here are some of the theories:

- Lowered blood sodium
- Adjustment of the brain's chemical sensors
- Metabolism of pregnancy hormones
- Slower emptying of the stomach
- Rising hormone levels
- Left vs. right ovary theory (women, for some reason, have more MS when the egg is released from the right ovary)
- Protection from sexual activity (which might conceivably harm the baby)
- Placental enzymes and low blood sugar
- Protection from food toxins
- Heightened stress
- Your diet 1 year before pregnancy (diets higher in saturated fats result in more morning sickness)
- Baby girls (has been pretty much disproven)
- Altered ratio of t-helper cells
- Lowered levels of B vitamins

When it all comes down to it, no one really knows! But it's a great education to read about it.

Chapter 4 is a study of "morning sickness through history" - it describes, in some detail, the remedies for morning sickness used throughout history and in other cultures. When I first read this chapter, I was really annoyed - because this is a chapter that is utterly useless to me as an HG mother. However, upon rereading I realized that this book is a book about morning sickness - and thus, any information known about morning sickness should be included in order to form an exhaustive text. Anyone doing research on morning sickness from an academic perspective will find this chapter very interesting - it's just not useful to here-and-now morning sickness sufferers.

After a chapter on odors (where they are, how to avoid them, etc.), Miriam writes about the technique of dealing with morning sickness "triggers." In other words, for MS/HG women, various things (noises, sights, odors, tastes) set off vomiting. Miriam writes that one should practice extreme vigilance to notice what triggers nausea and strictly avoid that. She also writes that one should think deeply about what one wants at a given moment (ice cream? soup?) and pursue that. She gives a chart which women can use daily to chart their nausea level, food preferences, climate (which can cause shifts in nausea levels) and various environmental stimuli so that they are able to track patterns and make shifts accordingly.

This all sounds great in theory. In practice? Well, she claims it works. But when I think back to my own experience, it doesn't sound very practical. I was too sick to be charting anything, all food sounded repulsive, and the least bit of solid food would cause uncontrollable vomiting. There is no way on earth I would have been able to sit there and say, "Okay, it's ten o'clock and I'm craving pickles. I see by the weather that the storm front caused an increase in nausea, so I'll wait to take my prenatal." No way!!

But I'm willing to give it a try. Hey, I'd stand on my head for an hour a day if it would work! So I'm definitely willing to give this a try.

And I should say that this book got great reviews on Amazon, with five HG mothers saying that Erick's techniques helped them greatly. So despite my skepticism, I'm not writing off this advice - it just sounds impossible from the outside.

Miriam's next chapter is on morning sickness and emotions. This covers a myriad of topics, most of which are helpful. However, there was one section in here which was so funny (unintentionally, I'm afraid) that I have to mention it. It is called "boredom and morning sickness" - a list of things to do when one is kept at home by morning sickness - things such as "make beaded barrettes or belts with a kit," "writing a child's storybook for the baby's third or fourth birthday, complete with pictures," "Knitting or embroidering," "Organizing a photo album," etc. What on earth??? If, like I was, you are in bed with morning sickness, you are in NO condition to even think about activities! That is just about as practical as giving a list of "things to do when you're home with severe food poisoning." When I was at home in bed, I was either throwing up or sleeping. Period. Origami never crossed my mind. If you're feeling well enough to do these things, I don't think you need to be in bed!! Of course, every case could be different. Who knows? I only have my experience from which to judge.

The next part is the part I find the most puzzling. As a nutritionist (registered dietitian), Erick's main focus is on "helping morning sickness with food." She (as mentioned above) asks mothers to think, for example, "Would something salty reduce or aggravate the queasy feelings at this very minute? What food or drink comes to mind at this very moment?" (p. 171) and "What food or beverage would ease your nausea? Something salty, sour, bitter, tart, sweet, crunchy/lumpy, soft/smooth, mushy, hard, fruity, wet, dry, bland, spicy, aromatic, earthy, hot, cold, thin or thick?" She then gives lists of foods for each category and asks mothers to focus on finding what they really want to eat or drink and to pursue that thing.

I can't but be puzzled by this. Erick claims to have helped cure hundreds of women with hyperemesis with this method... But even with my own mild HG, I can't imagine this helping! When all food sounds horrible beyond belief and you're retching at the first bite of solid food (and some of my severe-HG friends have been unable to even tolerate liquids), I can't really think that satisfying cravings (which I didn't have) would be the least bit helpful.

She then gives "sick day meal plans" according to the various flavors mentioned above (crunchy, salty, etc.). Again, I am puzzled. Let's look at this one, from p. 204

Sick-day meal plan (bland)
7 am - 4 unsalted oyster crackers
8 am - 1/2 egg matzo cracker
9 am - 1/2 cup instant cream of wheat
10 am - 1/2 ripe banana blended with 1/2 cup milk to make a milkshake

How does that help when you're throwing up so hard you can't even leave the bathroom? How does that help when you're so sick you can't even handle food? I remember being annoyed with my poor mother when she suggested making milkshakes, because getting out to the kitchen and getting out food and equipment to make a milkshake was simply impossible due to exhaustion and food aversions. In a later chapter, Erick gives recipes as well. They look great, but again, how is a woman with HG (whose hubbie is generally at work) going to get out to the kitchen to start cooking? I couldn't even manage to make the cheesecake for my friend's baby shower, let alone get out into the kitchen to cook for myself!!! The average hubbie is not going to be spending his entire evening cooking up various from-scratch recipes (not to mention that even if he did, that wouldn't help day-time cravings). Especially since HG-hubbies generally have a TON to do in the evenings with childcare, basic meal prep, shopping and housework - they don't have time to be whipping up various recipes.

Erick then gives a very helpful chapter on hospitalization, with all the procedures and policies to expect. This is not as indepth as McCall's treatment, but still very good.

She writes sections also on pharmaceuticals for HG, and also a bit about alternative treatments - her main focus is on acupuncture, with a wee bit on herbs and homeopathy. Her sections on herbs/homeopathy need a bit of formatting help for clarity, as she just incorporates the remedies into the text rather than putting them in bold or bullet-format - they're very hard to locate.

She closes with a chapter on the rarer complications of HG, and then gives a list of resources for HG women. Very, very helpful.

Side note: I do not like Erick's treatment of the subject of abortion. She is remarkably complacent and blase about the fact that many HG pregnancies end in abortion. It was kind of like, "So-and-so couldn't handle the nausea, so she aborted. Okay! Moving on to our next subject..." There is sympathy, but that's it.

Abortion is an inextricable part of HG. It's kind of inevitable in a country where abortion is available on demand. When you're in the midst of unbearable suffering and relief is either nine months away (basically an eternity) or one short doctor's appointment away, many women choose abortion. While I don't condemn these women, as I know what they went through, I am still 100% pro-life and believe that any abortion is a tragedy and a deep violation of human rights on the part of the unborn baby who was denied life. Any book on HG needs to contain in-depth material on abortion - at the very least, encouragement for abortion-minded women, telling them strongly that HG WILL PASS and that their beautiful baby will be in their arms. When HG is over, it is over. But when an abortion is over - the HG is gone, but the baby is dead. And most post-abortive HG women feel compelled to try again for a baby - meaning that their journey through HG will be considerably longer than if they didn't abort in the first place.

Ashli McCall's book "Beyond Morning Sickness" covers this in depth. McCall suffered severe HG four times, the first time ending in a second-trimester abortion which left her deeply scarred and grieving for life. She devotes a large part of her book to dealing with abortion and encouraging HG mothers to stick it out. There is no such encouragement in this book, and it is a big hole that needs to be filled.

On the whole? Well, I recommend this book for the information. There's a lot of information here. Even if the nutritional stuff doesn't help, there's a lot of helpful information. For myself, as a post-HG mother contemplating another pregnancy, I want to know everything about morning sickness and HG before going into another pregnancy. In the middle of HG is NOT the time to be flipping through reference books! I want to know all facets of morning sickness, drugs, alternative therapies, hospital procedures, coping strategies, nutrition, complications - knowledge is power, and I want as much of it as possible before facing another pregnancy.

In terms of the nutritional coping strategies Erick outlines, I do not possibly see how they could be helpful (although for any morning sickness short of HG, I am sure they would be GREAT - don't get me wrong). However, this woman has years and years of experience with treating HG mothers, so I'm not going to write her off. I'll give her methods a try. And I'll let you know if any of it works!

So.... Buy this book. Read it, and let me know what you think of it. If you use or have used any of her techniques in the past, let me know about it and I'll post it here. I'm quite willing to eat crow if they work!

Signing off,

Tuesday, September 9, 2008

Motherisk Morning Sickness

I just discovered a great website for morning sickness and HG:


Check it out! There is a free telephone hotline that you can call to get counseling for your morning sickness. There is also information, forms, and links to informative articles. I'm going to go through it more thoroughly later.

Check this out!

A busy week!

Our week of houseguests is over! It was a fun week - exhausting, but fun. We finally had the experience of finding our absolute dream house - a new experience, despite the fact that we have put in ten (yes, TEN!) bids on other houses over the past year. We've had a distinct fondness for three of the ten houses, but on the whole they've all been "right-place-right-price-so-let's-buy-it-quick!" houses. With this one we really lost our hearts to it. That's bad, because we have only about a 5% chance of getting this house! It will truly be a God-thing if we do get it. But I'm focusing on praying for God's will rather than the house, because I do not want to get ourselves in over our heads (this house would require a TON of yardwork and upkeep) or be outside of God's will for our lives. If you're reading this, we would appreciate your prayers for the Lord's guidance and peace in our lives right now!

Other than that, my house is currently filthier and more cluttered than it almost ever gets (happens with houseguests every time), so getting it in order is priority #1! All of my Bible studies start this week, so we're off to a busy fall season.

Over this past week I finished reading "A Grief Observed" for the second time and will be posting a review soon. I also finished "From Here to Maternity" (for my other blog) as well as "Morning Sickness Management." The latter will be getting a very mixed review, and a very long review. I'm rereading it right now, and will be starting my review soon afterwards.

Well, off to housekeeping! Love to all!

Saturday, September 6, 2008

Recommended Readiny List

This will be an extremely small reading list, but here goes. It will be constantly updated as I continue to read. If anyone has any suggestions for reading material, please let me know!

On Morning Sickness and Hyperemesis Gravidarum:

.....Highly recommended:
- "Beyond Morning Sickness: Battling Hyperemesis Gravidarum" (Ashli McCall) - Great source of information and personal stories

- "Body Mutiny: Surviving Nine Months of Extreme Morning Sickness" (Jenna Schmitt) - Great book of free verse dealing with the experience of severe HG

......Also recommended:
- "Managing Morning Sickness" (Miriam Ereck) - Practical guide for MS and HG focusing on nutrition

On the Meaning of Human Suffering (from a Christian Perspective)

- "The Problem of Pain" (C.S. Lewis) - An academic explanation of the purpose behind human pain from a Christian theological perspective

- "A Grief Observed" (C.S. Lewis) - A deeply personal diary written after the death of Lewis's wife. This book focuses on grief but is applicable to any experience with suffering.

Tuesday, September 2, 2008

Blogging Break

I'll probably be taking a break from blogging for the next week or so, due to hosting some family who will be in town. Thus, don't be surprised if this blog stays stagnant for the next bit of time! I'll be preparing my book reviews mentally and will hop back in after the break.

I have not gotten around to telling my family about my blog. Frankly, I guess I need the privacy. And one doesn't necessarily want one's closest family reading blog entries about one's reproductive life, LOL!! (Or at least I don't - perhaps some people might. For me: Friends and strangers, yes; family, no.) So that will necessitate a break from blogging.

Until later!

Love to all,

Monday, September 1, 2008

Upcoming Book Reviews

I have almost finished my third time through "A Grief Observed," and so should hopefully be posting a book review of that book very, very soon. It has turned into my favorite so far on the subject of human suffering. I highly recommend it!

I have also ordered a new book, "Managing Morning Sickness: A Survival Guide for Pregnant Women"by Miriam Erick. It has really good reviews on Amazon. Frankly, I want to be as prepared as possible for any possibly-future pregnancies, and this looked like a good bet! I do NOT want to repeat the innocent naivete of pregnancy #1 and #2. Knowledge is power!! So I'll be starting this book as soon as I get it, and I'll post a review soon afterward.

I realized that I have pretty much dropped the original intent of this blog. My original intent was to post information to help pregnant mums with HG, such as information on herbs, homeopathy, pharmaceuticals, etc. Well, I have done that (mostly in the early days of the blog), but this blog quickly morphed into more of a spiritual healing exercise (that I didn't even realize I needed!) helping me to deal with the spiritual hurt resulting from hyperemesis (common to all experiences with great suffering). Frankly, I think that this purpose is way more important, and I'm so grateful to the Lord for giving me this outlet and this means of healing. I really needed it, and I'm still in-process.

And, of course, another purpose of this blog is to get some much-needed air-time for hyperemesis. As I've noted before, it is almost impossible for HG to be a headlines-type disease, simply because the women who have it are in no shape to organize marches and hold signs and run marathons with cute ribbons pinned to their shirts, and the women who have just recovered from it are exhausted from newborn-care!! The only women who can publicize HG are those who have it in their pasts - I being one of them.

However, I don't want to neglect the original intent of this blog! So hopefully I'll be able to continue posting research as well as other items.

Have a wonderful holiday, all!