Saturday, December 8, 2012

In Which I Do Some Seriously Random Musing

I am currently at home while my husband gets to go do something really fun without me, due to the fact that this week's cold has left me almost completely voiceless (not to mention stuffy and partially deaf). With that in mind, I figured I'd waste a few minutes musing, in a very uneducated and uninformed manner, on a subject which has fascinated and puzzled me for several years.

So.... let's talk hyperemesis gravidarum (I know, new subject, huh?). When I look around, it seems that this condition is fairly common. I know I'm biased, since I'm an HG blogger, but it seems like most people at least know someone who has experienced it. I think I once counted up people or friends/relatives-of-people at our church who had experienced HG, and I came up with something like ten. That's a lot for a tiny church of maybe 100 people! And those were just the ones I knew of off-hand - I did not interview anyone for further information.

Nowadays, medicine is available to control all but the worst cases of hyperemesis. That is, although it still happens, most hyperemetic women are not going to die.

But here's the thing - if we didn't have the drugs treating hyperemetic women, many HG mamas would die. I'm not one of them, but I know several women personally who probably would not be here today if they had not had modern pharmaceutical help and/or hospitalization to get them through hyperemesis.

True, no?

But here's the big question. The really big question.

Where is hyperemesis in the annals of history?

In other words, where are all the recorded deaths in history showing the thousands of women who died of hyperemesis before there was treatment for it?

That's the thing. There aren't any. There simply are no (or not many) gravestones or genealogical studies showing all the hundreds of grandmothers and great-grandmothers who died of hyperemesis. But today, there would be (if we did not have the drugs available to treat it). 

So.... what's the story here?

There is one person whose death I have heard associated with hyperemesis, and that is Charlotte Bronte. Bronte is said to have died from tuberculosis, but some believe that her death was occasioned by hyperemesis. Here's what Wikipedia has to say:
"Charlotte became pregnant soon after the marriage but her health declined rapidly and according to Gaskell, she was attacked by "sensations of perpetual nausea and ever-recurring faintness." Charlotte died with her unborn child on 31 March 1855, aged 38. Her death certificate gives the cause of death as phthisis (tuberculosis), but many biographers suggest she may have died from dehydration and malnourishment, caused by excessive vomiting from severe morning sickness or hyperemesis gravidarum. There is evidence to suggest that Charlotte died from typhus which she may have caught from Tabitha Ackroyd, the Brontë household's oldest servant, who died shortly before her."
I have always thought it rather odd that no one could tell the difference between tuberculosis and hyperemesis, because they seem as different symptomatically as night and day. ("Madame, we cannot tell if your husband died from chicken pox or a gunshot to the head. The symptoms are so hard to tell apart!" etc.) However, it's hard to tell only reading the historical accounts.

But here's the thing - even if Charlotte Bronte did die of hyperemesis, that is one possible case in all of recorded history (unless anyone else knows of more - and even then, they're still rare). That still doesn't solve the mystery of why hyperemesis is so prevalent today.

Misdiagnosis and underreporting are always possibilities, though they would only be a partial explanation even if this is the case.

Does anyone have any ideas?

I have always believed that hyperemesis, like almost all other diseases, has both a genetic component (the genetic susceptibility) and an environmental component. For example, if you do some research on the history of cancer, you will find that primitive cultures almost always had a nearly nonexistent cancer rate. When Western foods (preserved foods, white flour, sugar, etc.) were introduced, cancer rates began to skyrocket (ditto for industrial chemicals). Today, cancer rates are extremely high - almost everyone I know who has died of recent years has succumbed to some kind of cancer. For us in America, high cancer rates are "the new normal." But that doesn't mean that it has always been that way - it just means that we're used to it. (Ditto for numerous other diseases - see this article for more info.)

Could it be the same with hyperemesis?

I am not, repeat not, saying that hyperemesis (or cancer, or any other condition) is anyone's fault. Far from it. We are all exposed to disease-causing toxins and conditions (electromagnetic waves, poor sleep patterns, stress, you name it), and those things take their toll on our bodies. Every known chronic and degenerative condition (and other countries, of course) - from metabolic conditions, to lupus, to gut disorders (Crohn's, ulcerative colitis, IBS, etc.), to cancer, etc. -  is on the rise in America due to toxin exposure and other modern factors. Is it possible that the high number of women experiencing debilitating or life-threatening nausea and vomiting of pregnancy could in some way fall under the same category?

I ask this for two reasons: (1) the lack of evidence I see for widespread hyperemesis gravidarum in history, and (2) the fact that it is not normal for pregnancy to be lethal (or debilitating) to a healthy woman. For a hyperemetic woman, an unmedicated pregnancy can be a death sentence. That is a pathological state, not a variation of normal.

Could it be gut health? Could it be the crazy number of hormone-simulating or stimulating chemicals (birth control, makeup, toiletries, cosmetics, factory-meat) that are screwing with our hormones? Could it be.... any number of things that I don't even know of?

This is just food for thought - or really, the invitation to tell me what you think, or what questions you have. This is an enigma, a mystery, that I have not been able to comprehend fully, but I thought I'd at least write out my questions and my thoughts so that you ladies could comment. If you feel like telling me that I'm an idiot who doesn't know what I'm talking about, please refrain - I know that I am writing with very partial knowledge.

But I'd love to hear your thoughts!

So much of the research today seems to focus on "finding the cure." I know that finding cures for various illnesses is important - but equally important is investigating the causative environmental triggers and factors that are causing the disease. I would like to see research of that kind for hyperemesis!

Anyone wondering why I'm blogging so much today - well, that's what happens when one can't talk! It comes out through the fingers - I'm oozing the words that I can't say in speech right now.

Cheers, all! Bring on the comments!


  1. Could it be that a good number of women whose deaths were attributed to TB actually died from HG?

  2. Hi, Becky!

    Hey, while I'm (not) on the subject, I just wanted to let you know I used your shower cleaner recipe yesterday! It worked beautifully! Didn't take the stains off the floor, but I think that would take an act of God. :) I'm definitely going to use it again.

    Okay, so HG v. TB. The thing is just that the symptoms seem so completely different!! In all the literature I've read depicting fictional accounts of tuberculosis/consumption, it seems like it's a long, slow death of coughing and lung weakness - not nausea and vomiting at all. HG would be a much quicker death (weeks as opposed to years) and is made up entirely of the nausea/vomiting combo. I just can't see how they could be confused, at all! But there could indeed be other diseases that could be confused with HG (the typhus mentioned seems much more probable), especially since untreated HG could conceivably kill before a woman knew she was pregnant.

    One other factor that I didn't mention would simply be the fact that the disease might proliferate nowadays because HG women do NOT die and thus live to pass on their HG genes to their offspring.

    I'm guessing that the true answer is some combination of all the above:

    - Under-reporting
    - Misdiagnosis
    - HG women living to pass on their genes
    - Higher manifestation of a condition with genetic susceptibility due to environmental factors (discussed in the post)

    This would be a fascinating research project for someone to undertake! However, it would take someone who could really, really, really work without pre-conceived ideas and bias, because someone on the naturopathic end (like me) would tend to blame the environmental factors, and someone with a bias for Western medicine would most likely credit the under-reporting/misdiagnosis theory. Finding the true answer would require some seriously honest research - but it would be fascinating!

    :) Diana

  3. Adding to my last paragraph, Becky, it seems like this question that I am posing ("If HG is on the rise, why is that so?") is remarkably like the autism question, which I have watched for many years. Naturopathically minded researchers tend to say, "Autism is not normal, and rates are skyrocketing, so what environmental factors are making this happen?" Western-type researchers (that I have seen) seem to focus on the "There is no such thing as an increasing autism rate; it was just underdiagnosed in the past." True progress can only occur when ALL possibilities are honestly examined.

  4. And yet another note! This just came to mind.... What if Charlotte Bronte was dying of tuberculosis, and then had normal morning sickness thrown in? That would make sense - she would feel rotten from the morning sickness on top of the tuberculosis, and that would cause the confusion of symptoms that has led to so much confusion in trying to diagnosis her cause of death. What do you think?


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