Pregnancy Nausea and Vomiting - Results for Pregnancy #6

Hello, dear friends!

This post will be of interest primarily to those of you who stop by for information on nausea and vomiting of pregnancy. Feel free to shoot me any questions.


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This is our sixth pregnancy (the first five comprising one first-trimester loss and four live births).

This pregnancy was unplanned. I should say, in the interests of clarification, that it was intentionally unplanned. (We have had two planned pregnancies, two surprise pregnancies, and two intentionally unplanned pregnancies.)

This is our earliest postpartum conception - we conceived at 19 months postpartum. (Previous conceptions were at 29, 20, and 24 months postpartum.)

I have a history of severe nausea and vomiting of pregnancy, something that would be characterized as mild hyperemesis gravidarum (manageable at home with a combination of OTC and prescription medications).

For the past ten years, I have researched prevention of hyperemesis gravidarum. At first, I followed the more traditional model of looking for the "magic bullet" solution - something that I could take when pregnant that would stop the illness. This was a complete bust. Herbs were useless. Prescription drugs managed the condition, but it was still miserable.

My search next turned to healing the body so that my body would no longer present with hyperemesis gravidarum - that it would handle pregnancy in a healthy manner without developing this debilitating condition. Our last pregnancy was what I call our Big Success Pregnancy. Not only did I not develop HG, but I was able to manage on a minimum of medication and did not throw up once. Yes, I was nauseated for the entire pregnancy, and somewhat minimally functional during the first half of the pregnancy, but with a history of HG, this was an overwhelming success. (Deo Gratias.)

This success was achieved primarily through two channels: the probiotic approach and the very-low-carb (VLC) diet. I also used a minimum of supplements.

With this current pregnancy, as I have before mentioned, I had had a much tougher time staying on the VLC diet pre-conception with any regularity. The VLC diet may have achieved miracles health-wise, but it is neither easy nor the least bit enjoyable. When we conceived, I was kinda-sorta-VLC and kinda-sorta-Trim-Healthy-Mama. I was being regular with the probiotic approach and was taking a much more active approach with supplements and super-foods.

The results lined up with my expectations: This pregnancy was much rougher. While definitely non-HG, I put in some definite time throwing up and was on a much higher medication dose to achieve those lesser results. (I will note the comparisons below.)

My conclusion is that each of the legs of my three-legged approach is vitally important to my pregnancy health - supplements, the probiotic approach, and the VLC diet. If we are blessed with another baby after this one, I will plan to be more vigilant with all three components.

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And now to review this pregnancy (#6). I will be comparing some statistics with our previous pregnancy, #5 (the Big Success Pregnancy).

At 2w6d, I experienced an entire night of strong nausea. This scared my to death, as I knew how early we had to be in my cycle. Incidentally, this is the earliest I have ever been nauseated in a pregnancy. (My previous earliest-nausea record was 3w3d or 3w4d.) Of course, the pregnancy test that I took was negative.

In the Big Success Pregnancy, I did not experience first nausea until 3w6d, the day after I got a positive pregnancy test.

Needless to say, this caused me to jump back on the VLC bandwagon, big-time. This was a good thing, as it helped me to be less panic-stricken when I got a positive test the following week.

Over the following week, I had several episodes of strong night-time nausea. All pregnancy tests (and believe me, I took a lot of them) were negative.

At 3w4d, I finally got an extremely light (as in, holding up to within two inches of my eyes to detect the line) positive pregnancy test. Much rejoicing, much shock, much fear. I immediately went into survival mode - rushing to Sprouts for supplements, getting on the internet to order even more.

Only post-HG mamas can understand the panic that a post-HG pregnancy causes. It hasn't been as bad since I have experienced a non-HG pregnancy, but it's still there. I spend the first four to eight weeks of pregnancy in a state of suppressed panic, wondering how bad it's going to get and if I can hold on. Y'all know where I'm coming from on this one.

At 3w6d, I had an extremely bad night of nausea. The nausea kept me up until 1:00 a.m., and then woke me back up at 3:00 a.m. for the rest of the night. Needless to say, I was a panic-stricken mess after that. Thankfully that was mostly a one-time event. I learned that I had to sleep propped up quite high to avoid really bad night-time nausea. (That was new. And weird.)

Something that I experienced during this time of early pregnancy was chills. Does anyone know what I mean by this? I'm not talking about head colds, but that horrible experience of going from normal-one-minute to, within the space of about five seconds, bone-wracking whole-body shaking from intense cold (even if it's not cold temperature-wise). It lasts for 5-10 minutes and has a long recovery period (about an hour), and is absolutely exhausting. I had never experienced chills until my fourth pregnancy, and now it recurs any time that I am in a weakened state - early pregnancy, any time I'm struggling with severe nausea, during the early postpartum period, and whenever I am very sick. I'd love to hear if anyone else deals with this.

Early pregnancy seems to hit me like a semi-truck. It's not a gradual increase of symptoms - it's sudden, all at once, and hard. Sometimes it actually gets better after that initial full-body impact. Apparently my body does not take kindly to the initial surge of pregnancy hormones.

The nausea continued to get worse weekly. Not a fun time. I started taking three doses of Unisom (in half-tabs) in week 4, continuing through week 20, when I tapered down to two doses. I tapered down to one dose in week 22, and discontinued entirely during week 25.

In the Big Success Pregnancy, I took one half-tab dose of Unisom from week 9 to week 16. 

See the difference?

Vomiting, measured in episodes, totaled at 46 episodes* of vomiting during week 8 through week 25, with one outlier in week 30.

(*A friend once asked me how to measure "number of times vomited." Answer - I don't know, and still don't! But I have decided to count it in episodes, meaning that when I go to the bathroom to throw up, I count that as one episode, regardless of how many times I threw up during that episode. Make sense?)

In the Big Success Pregnancy, I didn't throw up once.

 Again, a big difference.

I should note, in case anyone doubts it, that I am extremely grateful that this pregnancy was non-HG. Throwing up 46 times over the course of a pregnancy is nothing in comparison to active HG. Some HG mamas throw up that much within the space of a day or two. I am, however, noting that this pregnancy scored considerably worse with regard to NVP than my last.

Here is a chart comparing the two pregnancies:

	“Big Success Pregnancy” (#5)	Most Recent Pregnancy (#6)
Dates	February – November 2014	June 2016 – February 2017
My age during the pregnancy	32-33	35
Pregnancy Outcome	Healthy Live Birth at ~ 39w0d	Healthy Live Birth at 37w5d
Diet utilized before conception	Very Low Carb	Trim Healthy Mama
Other pre-conception protocols	- Probiotic - Supplements	- Probiotic - Supplements - Magnesium therapy - Super-foods
First nausea	3w6d	2w6d
Number of vomiting episodes during entire pregnancy	0	46
Vomiting occurred during:	N/A	Weeks 8-25 with one outlier in week 30
Vomiting frequency	N/A	1-3 episodes per day when occurring
Medication	Unisom: Weeks 9-16 = 1 dose	Unisom: Weeks 4-20 = 3 doses Weeks 21-22 = 2 doses Weeks 23-25 = 1 dose

You can see the difference: With this last pregnancy, the nausea arrived nearly a week sooner, I took more medication for a longer time, and I experienced a much worse outcome. I really missed that added support of the longterm pre-conception VLC diet.

I should say that I hopped back on the VLC bandwagon as soon as I first experienced pregnancy nausea. But the VLC diet is not meant to be a measure to take when one is already pregnant (though I think it can help) - it's really meant to be done for a considerable time pre-conception. I didn't have that pre-conception hormone stabilization behind me, at least as much as last time, and I paid for it.


The Gender Question

Our Big Success Pregnancy (#5) was also our only (known) girl pregnancy.* That creates some problems with confounding variables.

(*We do not know the gender of baby #1, who we miscarried at eight weeks.)

Technically, the statistics show that HG is more likely to manifest with girl pregnancies.

However, the increased risk is extremely slight. A friend of mine, a fellow HG mama, told me that her boy pregnancies are always harder than her girl pregnancies.

Time will tell. If we are ever blessed with another girl, I will have the opportunity to see if there is a consistent trend.


Notes on Supplements

During the early days of pregnancy, I made a daily schedule for taking my supplements and medications. The same supplements at the same time, every day. I cannot recommend this practice highly enough. During the first trimester, when I was in a constant state of panic, and when I was truly feeling awful, having a daily schedule of supplements was a godsend. It helped to anchor me to the present and get me through my days in an organized fashion.

Here is my the supplement-food-medication schedule that I used during this pregnancy:

(Some items are listed by specific time; others were just a "do this sometime, in this order" sort of thing.)

*4:00 a.m. protein shake
*5:00 a.m. nuts and cheese

(The protein shake, nuts, and cheese were kept in a cooler by my bed every night so that I could have a solid intake of protein in my system before doing anything crazy like getting out of bed.)

*Upon arising: Unisom, Bio-K probiotic, magnesium spray
*All day: apple cider vinegar water, water with lemon, magnesium spray
*With breakfast: cocolaurin, apple cider vinegar tablet, magnesium, digestive enzymes, lacto-fermented food
*Protein shake with 1 tbsp. coconut oil
*Trim Healthy Mama muffin made with cinnamon and coconut oil (both antimicrobial)
*Coconut cream
*With lunch: cocolaurin, apple cider vinegar tablet, magnesium, digestive enzyme, coconut cream, lacto-fermented food
*Baking soda in water with 1 teaspoon colloidal silver
*Protein shake with 1 tbsp. coconut oil
*Magnesium drink
*Epsom salts bath
*With dinner: cocolaurin, apple cider vinegar tablet, digestive enzyme, lacto-fermented food, coconut cream
*5:00 p.m. vitamins
*7:00 p.m. Bentonite clay in water
*9:00 p.m. 2 hard-boiled eggs, protein shake with 1 tbsp. coconut oil, Unisom+B6+melatonin

Frankly, I can't believe I kept up with this schedule. It was long and complicated, and all that I remember is a haze of nausea and exhaustion. But just writing out what needed to be done was so helpful, and I plan to do it again.

Don't think that I came up with this schedule cold - it was really developed item by item, in a very organic way. Add something here, take away something here, oh, and let's add this other thing over here. I started with what I knew, added other things as they came into the picture, and made changes as needed.

This schedule changed over time in two ways:

(1) At the beginning, items were removed as I could no longer tolerate them. For example, the two boiled eggs at bedtime. It's a great piece of anti-nausea advice that I read in a book somewhere (i.e. keeping solid protein in your stomach overnight to regulate your morning blood sugar levels), but there's a small problem - after a brief period of a few days, I couldn't get them down. The first time I threw up, actually, was in trying. (Ah, throwing up in the sink. So fun.) So off the schedule they went. My morning muffin with coconut oil and cinnamon similarly went out the door fairly early.

(2) After the worst of the nausea started to abate, items were removed as I no longer needed them. (Hurray!)

If you're contemplating pregnancy, or are in the middle of one, a written supplement schedule can be an incredible blessing.



Notes on Nausea Recovery

During week 12, I was still continuing to feel worse every week. This was alarming, as I usually peak around week 10. I added CBD oil to my supplement repertoire this week, and I think it helped.

I started to feel a bit better during week 13. This was encouraging.

During week 16, I cooked my first dinner since the first week or two of pregnancy. During week 17, I made it back to church. During week 18, I took the children to our first outing by myself.

I continued to feel nauseated and exhausted for the entire pregnancy. It was a tough time. After the birth, the nausea took about a month to recede completely.


Thoughts on Superfoods

During the pre-conception time for this pregnancy, I see - in hindsight - that I became pre-occupied with superfoods.

Superfoods are foods that are reputed to have especially high nutrient levels of some sort or another, and thus have a positive influence on restoring health.

I believe that my preoccupation with superfoods stemmed from guilt. I knew I wasn't being faithful to the VLC diet, and I wanted, subconsciously, to do something to make me feel less scared (of repeat HG) and less guilty.

But let me tell you, friends, that chasing superfoods is an exhausting and never-ending business. There is always another superfood to discover. And as the never-ending list grows, one then has to actually eat said superfoods, which leads to a never-ending to-do list.

Here is a short list of some of the superfoods that I came up with. (There were more. This is just from memory, a year later.)

• Brazil nuts
• Nutritional yeast
• Gelatin and collagen
• Coconut oil, coconut cream, coconut cocolaurin
• Seaweed
• Walnuts
• Blueberries, blackberries
• Green vegetables
• Cruciferous vegetables
• Okra
• Asparagus
• Avocados
• Rice bran
• Apple cider vinegar
• Lemon juice

In preparing for any upcoming pregnancies that the Lord gives us, I will focus on a healthy diet (which will by default include superfoods), but I will not chase superfoods themselves. It's a tiring pursuit that ultimately did not result in any real benefit. 

Conclusions:

My primary conclusion is the same as last time: We can fight the fight against hyperemesis gravidarum. It is not our inevitable fate. There is hope.

For you ladies out there who have been through the nightmare, don't give up. Join the Preventing Hyperemesis Gravidarum Facebook page. Check out Pink Stork Solutions. Research. Read relentlessly on the subject of natural health. Seek out other HG mamas and compare notes. Keep going, keep reading, keep praying, keep trying.

My specific conclusions from this pregnancy.

(1) The VLC diet works extremely well for me in preventing hyperemesis.

(2) The Trim Healthy Mama diet was also helpful, but not as good as the VLC diet in HG prevention.

(Note: There is the possibility that I have leftover positive effects from my strict two years of VLC dieting, and that may have affected our outcome in this pregnancy.)

(3) The probiotic approach is also extremely helpful (essential!) for me.

(4) The super-food approach didn't really help at all.

(5) Supplements are important, but not - for me - quite as important as diet.

(6) I cannot count on past successful non-HG pregnancies to protect me in future pregnancies. Constant vigilance is the order of the day.


My plan for the future:

Our newest little one is almost four months old, so I am now in early planning stages for baby-number-next.

We don't know, of course, if the Lord will bless us with another baby. This week I will be turning 36, so my childbearing years are definitely numbered. The baby that we have could conceivably be our last, or we could have another seven. Both extremes seem rather unlikely.

Regardless, I want to be ready.

I am currently transitioning from my "eat anything, yay!" postpartum mode back into Trim Healthy Mama. My birthday present this year is going to be a copy of Briana Thomas's Necessary Food (check out her blog, YUM), and I am looking forward to getting back into Trim Healthy Mama mode.

Eventually, I would like to get back into Very Low Carb (VLC) mode. The above information seems, to me, to show that the VLC diet is the most effective for hyperemesis prevention.

The big problem, of course, is that the VLC diet is an absolutely miserable experience. Unless you are one of those rare persons who thrives on a super-low-carb diet, being carb free is 100% awful.

It's not that low-carb food is bad. It's not. Most of my favorite meals are low-carb. But being low-carb itself, and eschewing a majority of available foodstuffs, is a miserable experience for the majority of humanity, myself included. It can be maintained only by an exercise of extreme willpower, and most of the time, I don't have that kind of willpower.

But I should. And I need to. At least during our childbearing years.

Again, time will tell.

I should say that I do not believe - for most people, at least - that very-low-carb is healthy for long-term living. We do need carbs. This diet is great for healing, and for HG prevention, but I don't think it needs to be lifelong or long-term. In fact, it could probably be harmful in the long run. So even if I do go back to VLC living, it will be for short-term HG prevention only.

In the next month or two, I plan to update my HG prevention plan (supplements, etc.), which I will publish on this site. Since our conception this time was so much earlier than usual (19 months), I want to be ready. And HG prevention isn't something that can be achieved in a week or two, or a month or two. It needs serious time. I hope to be in serious HG-prevention planning mode by the time baby is six months old.

Additionally, I have a couple of health concerns that need to be addressed - something that can happily coincide with HG-prevention prep:

(1) Baby weight - I have more than a little baby weight that needs to go.

(2) Fatigue - I have recently sensed the creeping return of my other health arch-nemesis, fatigue. This is a very difficult problem, and one that I do not want to worsen or continue.

I have some work to do!

Ladies, I would love to hear about the pre-conception work you're doing to prevent hyperemesis gravidarum. Please leave a comment and fill me in on what you are learning!

Love to all, dear friends!