Hypremesis Gravidarum (HG) A short survival guide

*I should say that I wrote this post a few months ago but it disappeared into the etha before I could publish. Nevertheless I do hope some of it is of use.

*At 7+6 weeks, when people exclaim ‘oh my gosh your tiny!’ a small pre pregnancy part of me squeels yes! with delight. The bigger pregnant part of me that is preparing to become a parent worries. Is it because it’s my first baby? Or is it because of the weight loss I had during my first trimester when I have hospitalised 6 times?

Whatever the reason, now more than ever I am focusing on staying well and maintained a reasonable level of health for not just myself, but our unborn child.

It hasn’t been the glowing, flowing, lovely pregnancy that magazines and films depict. At times its been absolute torture. Not just physically but mentally as well. As someone who’s spent a considerable amount of time over the last 6 months researching the condition. Here’s some pointers that hopefully other ladies or their supporters may find useful.

  1. It is NOT your fault. The verdict is still unfortunately out on why exactly some women present with HG and others don’t.** There are a number of theories, one being that we cannot cope with the rise in the HcG hormone that is essential for the creation of the placenta and baby’s first growth into an actual mini me. Other’s say it is heridary or more prevelant in women who have mental health illness and problems with their gastroenterology tract. I have both! But the important thing is not to blame yourself. I have spent months wallowing at times in my very own mental birthing pool trying to understand how I could have prevented it. Eaten better? exercised more? been less stressed? Whatever the reason behind HG appearing, it was ultimately unavoidable.

When you’re spending those miserable months alone at home, not able to do anything because let’s be clear – this is a fatigue illness as well as nausea & vomiting (N&V) do research. Find out everything you can and you will realise a) this condition has been documented as being around since at least the 1920’s and b) while only 1% of us suffer from it, there are women all over the world who are going through the same.

2. Support. I cannot stress just how important support is. For me, my main support has been my husband. For reasons I can’t go into here, my closest family have had to detach from me and as a result my mental health has been affected throughout my pregnancy. I knew my husband loved me. I didn’t realise just how much until just over a year after our wedding the vow ‘in sickness & in health’ really kicked in! HG is not a pretty sight. When the vomiting starts, there is nothing you can do. If you’ve got to the stage where even sips of water are making you violently wretch and vomit, it’s time to get the medical help. After a period of 4 weeks, I would be feeling great after managing to eat and drink ok and just be able to walk around the house unaided and attend to personal care. Then every weds/thurs without fail the nausea would increase and vomiting would begin. I would rapidly become dehydrated and go into ketosis (starvation mode) at which point, the only thing to save me was an IV drip of fluids and some IV or IM antiemetic drugs.

The first two times I was admitted to hospital, we managed to dress me. Yes I say we – at this point I could no longer do anything without physical help. After that, I gave up and walked into A&E in my pj’s and dressing gown where I would lie down on the hard plastic/metal chairs waiting to be triaged, vomiting into my new spangly vomit bowl (a tupperware box which became essential, especially in the car journey on the way there). He was there by my side the whole time. He had to advocate for me as I was that out of it, I could barely speak and I couldn’t be prouder. When I improved and could eat again, he would go and buy me items I could manage and one time I’d been in a few days, he bought me some new pj’s which literally made me feel like a new woman. All things that maybe you’d think he should be doing anyway. But the fact that he thought of those things to me was amazing. If you have HG and don’t have a partner then make sure any family or friends who can help understand what you are going through. I believe part of my family breakdown has been a lack of understanding. HG is a cruel illness. At a time when you should be happy and buying baby grows galore, you are transformed into a person who is grossly ill and can barely function. All the books and online advice about relatives and friends coming over with a dish or to do some washing etc, let them do it now!!! You will not be able to go back to normal until (most likely) the medication you are prescribed kicks in. For me that meant full time work and looking after a house, husband and two pets was impossible. Whoever rocks up at your side during your HG, grab onto them and don’t let them go. (ok, they have to leave at some point – and will probably sneak out when you envitably fall asleep),

There’s also a ton of support online. There’s lots of support groups on Facebook and the main support I found was an online forum run by a small charity called pregnancy sickness support.

It’s full of the other 1% asking questions about HG, offering advice about the condition and generally a safe, non judgemental place to ask for help, vent or support others going through the same.

https://www.pregnancysicknesssupport.org.uk

3. Food. It’s a pretty taboo subject in the world of HG as it becomes the bain of your life. For perspective, I’m a dietetic assistant by trade. That doesn’t mean I live off salad, but I do understand and follow the concept of healthy eating. HG turned my diet upside down. Anything green would make me hurl. All I wanted was stodgy, fatty, fast foods. Part of this was down to my new beagle like nose. I could smell my husband’s coffee from upstairs. The spice rack in the kitchen had to go, as I couldn’t walk into that room without again, yep, vomiting. So when I did manage to eat my diet consisted of jelly, bacon sandwiches, cheese on toast and wotsit crisps. My choice of fluids changed too. Gone was the british tea drinker who obsessively cared about her teeth. In with ice cold orange juice mixed with water. Whatever you find you can eat, eat it. I initially lost 10lbs in one week – my job is nutrition support. I help people to gain weight after a period of frailty or illness. I needed nutrition support! and if that was via Macdonald’s or jelly babies (my first craving) then so be it. ANY food at this point is a bonus. If you can eat it and it stays down, well done! Great job! Keep eating it! Seriously, I’m not joking. Every consultant I saw said the same, it doesn’t matter what kind of foods you’re eating right now. If you can eat it, that’s all that matters. Throughout all of this my baby has been fine. That’s the focus of the antenatal teams looking after you. But people do become worried when you haven’t eaten for days. If you start to feel better later on, then you can start to reintroduce your greens – hello petit poi!

3. Mindfulness, I know at a time when your biggest concern is not throwing up and being able to stay awake without the constant nausea, am I bonkers to suggest this! Well you’ll need something to cope with people’s well meaning but sometimes stupid opinions and suggestions.

You.will.get.gingered!

This goes back to food slightly but it is a well known annoyance and in joke with the HG crowd. Ginger is a well known natural tonic for morning sickness. It.does.not.work.for.hg! But everyone you know will suggest it, at least in your first stages of HG. I once had a midwife suggest ginger biscuits. When I told her it didnt work, her reply was “maybe try ginger cake”… It was at that point I stopped listening to her.

Dry crackers first thing when you wake are also suppose to be better than any pill. So as I say, either practice mindfulness or learn to scream in your car. Whilst there are consumer style groups within the NHS aimed at improving maternity and antenatal services, you can’t retrain and improve every member of staff.

Please feel free to comment below. Anything I’ve missed on this whistle stop tour? Have you had HG or know someone who has? How have you or they coped? I’d love to hear others experiences.

**Since writing this post, there has been a huge breakthrough in HG research. Scientists have found that there is a genetic link to HG and significant links in a sufferers DNA. This is great news for all who have the condition as it confirms it is a bonified physical condition. It’s not all ‘in our heads’! It’s a real awful condition and hopefully this will help support finding a cure.

http://www.bbc.co.uk/news/uk-england-cornwall-42902095

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I wish I could be like Kate……Oh wait.

I often wondered what it would be like to live the life of Kate Middleton. What must it be like to adjust to all the stipulations of royal life, life in the public eye, life scrutinised every day. I also felt sorry for her being ill during pregnancy and remember thinking ‘I hope I don’t get that when I’m pregnant’.

A passing thought that unfortunately for me, would become a reality.

I’ve been married 15 months now. We technically started trying to conceive straight away once married, that is, we stopped trying not to. Trying to get pregnant is an extraordinary thing. At the time, it does not seem so. In our case we spent our twenties trying not to get pregnant. We were far too busy, building our professional skills, changing jobs and moving from the rental market to becoming first time home owners.

Maybe I was naive, but I assumed we’d be ‘lucky’ and become pregnant straight away. It wasnt until a painful 6 months later that we finally did conceive. Technically it was 9 months, but 3 of those were very difficult, we were arguing and stressed and basically, nothing except sleep took place in the bedroom.

As a woman, going from dealing with an annoyance of a period each month to dealing with the sorrow of those cramps returning is enviable. I, like many, thought that if we couldn’t conceive naturally it must be me. Something must be wrong with me. But I’ve come to realise from talking to friends who are new parents, to friends still trying that everyone is different. There is help if needed and some people will have to forge a different path. I, myself am adopted for this very reason.

So when we did find out we were pregnant, then came feelings of joy (we’d bloody done it!) to feelings of panic and ‘oh shit, can we actually do this’. Becoming pregnant and navigating the labyrinth of antenatal appointments is a monumental task in itself. I say this as we live in an area where through national changes and budget cuts to our local NHS trusts, our local maternity wards were closed and moved to another larger area. As a result, our community midwives are based there, not in our area. Which comes with its own set of problems, as so far I deal with acute teams and the community team seperately. Which means I effectively have to pass the note between these teams continuously and it is draining.

Five weeks into the pregnancy I began to feel sick.

I thought this was normal. I’m pregnant, it’s morning sickness. I presumed I’d throw up and just be able to ‘get on with things’. Twenty four hours later and the nausea hadn’t gone away, I was unable to stop vomiting and anything other than lying still was making me violently sick. I knew at that point, this was not normal. It was mid evening and our GP surgery was shut, so my husband called 111. They directed us to our out of hours GP.

We drove to the local hospital and I was throughly checked over. I was diagnosed with vomiting secondary to a UTI and could either accept an anti emetic that the Dr explained was not licensed for pregnancy or be admitted to a ward for fluids. I choose the later. I was tired and dehydrated, I wanted the fluids which I thought would help. Little did I know at this stage that the ketosis I was experiencing would become a regular occurence.

I was admitted to a medical ward and stayed there until morning. I was given a bag of fluid IV and no sympathy, told that this just happens in pregnancy, the nurses had it with their own and just got on with it. I went to my GP the next day and she gave me first line anti emetic medication, cyclizine. I began to take these, but as my ketones probably weren’t at baseline (which is zero) when I was discharged, 3 days later I became sick again.

The only escape was to sleep. I slept all day and night, when I woke the vomiting restarted. My husband carried me to the GP surgery and it was at this stage that I was first diagnosed with hypermesis gravidarium (HG). A rare but severe form of vomiting and sickness in pregnancy that affects up to 2% of all pregnant women. Great.

I was admitted to a different hospital via the gynae assessment unit. The routine goes like this, you become so unwell that fluids, not even sips of water stay down and you can start vomiting stomach acid and bile. Imagine having a bad hangover and then you have food poisoning on top. You’re admitted to hospital where they give you fluids and drugs intravenously (IV) or intramuscular (IM) and they monitor the amount of ketones in your urine, take blood tests etc. Each time I have been admitted my ketones have been 4+ which is high. Each time I have been in hospital since, I have been admitted to the antenatal ward overnight and they have been tasked with ‘fixing me’ as the midwives coin it.

One thing is for certain. This condition is awful, I wouldn’t wish it on my worst enemy.

I have never felt so ill in all my life. It has left me bedbound and now virtually housebound. It takes away your ability to function day-to-day and work. It can be life threatening if not treated and is often misunderstood by the general public as well as health professionals. It has turned my life upside down and made me reevaluate how I will deal with things in life moving forward.

Since becoming pregnant myself, Kate has announced a third HG pregnancy. While I feel for her as a HG sufferer, I’m glad that someone in her position and status is stirring up the media and getting people talking about the condition. It is so debilitating and like many chronic mental and physical health conditions, not seen and misunderstood.

The IBS 25th Anniversary Conference 16th April 2016

As I continue on my journey with my dodgy bowels. I was informed a few months back via Facebook of an IBS conference, in Sheffield (commutable). So we went.

It was held at the Victoria Holiday Inn and the whole day was free!! We initially paid for parking and when David went to reception for change to top up the meter he was told no charge and refunded what we’d paid, winner.

Upon entering, there was a sign in area where all the name badges for people who had registered were laid out. It was a beautiful sea of the charities blue and white colours, alongside some very cheery volunteers who were coordinating the day alongside the CEO! A lady who was constantly buzzing around, keeping everyone on track, the CEO of the charity, the free magazine later revealed.

So we entered the foyer laden with a nice goodie bag. The foyer was set out with various traders, mostly pharmaceutical and some gluten free, dairy free product makers too.

One in particular was Delicious Alchemy. Who make gf and df cake and bread mixes. Based in Sheffield they are just starting out on the bigger market, but definitely one to watch as their products are amazing! Very tasty and egg free too? They substitute eggs, milk and oil for mashed potato! I would have never thought about doing that, clever squirrels.

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I made my way round and spoke to a few different reps. I was provided with 4 months supply of probiotics, copious amounts of pens, stress balls, mints and product info about other companies. Oh and the best thing in the world for someone with bowel troubles….a Bristol stool chart magnet! That went straight on the fridge.

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After a cup of decaff tea we headed for the auditorium where we sat down ready for the talks.

Next stop: Part 2: Lectures and (free) Lunch.

Berlin on a budget

Hallo!

So it’s been just short of a month since I arrived back in Manchester after spending 4 nights in Berlin, Germany. It was a birthday gift from me to my fiancé, as he’s been wanting to go there for ages so I planned a trip and off we flew. We are notorious for not travelling…ever. I did joke I would now yearly plan a short holiday for his birthday but despite the actual break being ok, not knowing were we where or how to get anywhere was a pain in the ass. I’m all for adventure and wandering. But cities tend to lose their charm after a while. I think it’s the sheer amount of people all amalgamated in one place.

That said, I found Berlin in comparison to London, UK or New York City, USA to be a pleasant host. So here is my how to guide to doing Berlin on a budget.

  1. Book in advance. Self explanatory but if you want to do a city break, mini break, long weekend. Basically anything short of a week in a city then you need to book ahead. I booked our flights at the beginning of November 2015. David’s birthday is 30th November so I was able to gift him the tickets on his birthday, I also took him into Manchester city centre despite being ridiculously ill and it pouring down for some culture at the new Cornerhouse HOME Mcr and then some boozy hot chocolate in said Northern typical weather. We flew with EasyJet and like always our flights were all no frills, pay for what you are willing to pay for. In total x2 return flights came in at £160 so £40 per head each way inc. tax. IMG_20160107_135549901The view that greeted us on our first venture outside. -7c
  2. Decide how you are going to get to the Airport and back. We decided to take our car and park at a nearby airport car park, run by a private company. The cheapest I could find was £25 for the weekend, with flights 5 days in total. If we’d taken the tram and bus it would have been £7 each, each way that’s £30 so we saved £5 and a load of stress. Despite being the cheapest option, AHP were brilliant and I would recommend them. In a nutshell, you drop off your car, they park it for you. Ferry you to your terminal on a free transfer bus and when you’re back you call them, they pick you up and your car is waiting. Really worth it after a long journey or wait to get through passport control.
  3. Book your accommodation, again do this early for big savings! Rather than have to check in and struggle to convey multiple needs in broken, embarrassing German. I decided to go the authentic route and booked an Airbnb for our trip. Which in Berlin is probably the best way to stay in the city. We stayed in Kreuzkölln which is on the South East side of the city. it cost £210 for 4 nights, so £26.50pppn. This provided us with an apartment equipped with a small kitchen, bathroom including bath and bedroom. No mod cons, bar the heating which we needed and a set of speakers along with wifi which encouraged us to go out and explore.IMG_20160108_094532080Our home for the weekend ~ A lovely flat in East Berlin
  4. Check pricing before entering. The majority of cafes, bars and restaurants in Berlin have menu’s outside their front door. Meaning you have see what they have to offer in relation to cuisine and price. If you are really watching your cash then there are plenty of street food vendors dotted around, particularly at train/tram stations and touristy areas. We had currywurst at Curry36, a small vendor near the Berlin Zoo in Tiergarden which set us back 4.50euros each for bratwurst and a fresh bread roll. When its -5 you’ll take what you can get, but this which is a classic Berlin dish is just warm, yummy comfort food regardless of the weather. If you do want to go somewhere for a meal, we found that the average meal for 2 came to 30-40euros with drinks. We had a 70-80euro budget each day so a daily sit down meal takes a big chunk when you’re on a budget, so mix it up and use street food to eat as you go. IMG_20160110_135827543Americano and chicken, rocket and chorizo panini, in one of Berlin’s many small cafesIMG_20160107_134454314woolworths – still going strong in Berlin! Went into administration a while ago in the UK
  5. Berlin’s public transport system is organised, efficient and cheap.                                   I was very impressed with Berlin’s public transport system. Despite having bus, tram and train services. They were all connected via a range of tickets. Again I compared the system to NYC and the London Underground. There are 3 rings, A, B and C. A and B cover most of berlin, with the outer ring C containing the airports. A daily ticket for A and B which will get you to most destinations within Berlin costs 7euros and allows travel on ALL methods of transport. Coming from Manchester where the public transport system is fragmented and expensive I found Berlin’s system to be a nice surprise. To boot, all transport is efficient and on time. The most we waited was 7-8minutes for a train. The rest of the time we never waited more than a few minutes. So there’s the U Bahn as an underground system, the S Bahn is the trains and there are buses too. My fitbit I received for Christmas revealed that my cries of torture and pain in my feet was not psychosomatic. As one day we didn’t use the U Bahn so much and walked a total for 30,000 steps, that’s 13.1 miles and 25+ flights of steps. If you want to get around off foot for free then you can do this via a bicycle. Bikes account for 18% of all traffic in Berlin. They are everywhere and there are bike lanes on public footpaths, each street lamp or railing is adored with hundreds of bikes, all shapes and sizes. You can rent a bike for a day, there are numerous companies around the city that hire from 8-10euros per day. Or, you can sign up to http://www.bikesurf.org, tell them when you’re coming to Berlin, pick a bike to borrow and borrow a bike from someone for free. You do have to provide ID to the website but there are no charges so a winner.
  6. Above all to ensure you get the cheapest option available plan in advance! Buy your flights well in advance, as well as accommodation if able and remember that Berlin IS a city and like all cities, will be expensive if you wing it.

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Change of direction

So after months of silently deliberating a point of focus for this blog I have finally found one. I have always wanted to include the subject of creativity within this blog. How it is formed, why some people can access it more frequently and easily than others and how my creativity manifests on a regular basis.

Throughout my twenties I have spent a considerable amount of time searching for the right choice. The right career, the right job and most importantly the right path.

However in doing so I have greatly neglected my right sided brain, the creative parts of my being and made myself miserable, time and time again.

This blog will document and illustrate my journey to complete the many unfinished projects I have surrounding me at present. Which will require me to step into the past and question my decisions. It should help me to organise my present and retain the focus I need to live in the now and to practise mindfulness, something I have been doing for the past two weeks with great results. Finally it will guide my way into the future and objects I may create or places I may go to seek out new skills and new challenges.

I aim to share my progress with each project I attempt to complete, whilst reflecting on the practise and process. I also hope to improve on the greatest unfinished project I have, myself.

 

Day 1 low FODMAPS diet

So it’s coming to the end of day 1. How did I do?

Well I had to make a trip to Tesco on the way to work for some breakfast. I bought some Tesco own brand oat porridge cereal which is gluten free! Only contains oats and fortified with vitamins, score!

http://www.tesco.com/groceries/product/details/?id=256184216

I had this with some lactofree milk. It was ok texture wise but a bit bland. I’m going to try it with cinnamon tomorrow.

http://www.lactofree.co.uk/

Next lunch.

For lunch I had a sandwich with Genius gluten free brown bread, the filling was Tesco’s ‘cheddar style’ spread. Tastes like a weird cheese, is actually made from coconut and potato starch..mmm.

http://www.tesco.com/groceries/product/details/?id=271881503

I think I would struggle a lot more on this diet if I had to start from scratch. But since I’ve spent considerable amounts of time on both gluten and lactose free diets, I know a lot of what to avoid in those categories. I can also have crisps *wipes sweat from brow* only plain flavours though which I can live with. So my accompaniment was some Walkers French Fries also 78kcals per pack, woop!

I had de caff tea and water throughout the day.

Tea was quick as the OH had to go to his fortnightly pub meeting to talk geekery (IT stuff) so I found this recipe on Love Food, Hate Waste:

http://england.lovefoodhatewaste.com/recipes/baked-eggs-peppers

I omitted the black olive stuff, topped with cheese and a bit of black pepper. I cooked some boiled rice on the side which I flavoured with lemon juice. OH loved it! And also commented that we’d had a meat free Monday meal…oh yeah, double score! He’s agreed to eat low fodmap dinners with me so long as he can have whatever he wants for breakfast and lunch. Which is fine by me and means a lot that he would support me. As much as I know a lot about nutrition and food, it’s still going to be really difficult. Especially when it’s my birthday and favourite holiday…Easter.

I’ve decided were having Easter late this year. Hot crossed buns, chocolate, flowers and champagne (tummy willing) will be had once we’ve passed the reintroduction stage.

I feel full and I haven’t experienced any pain* or bloating all day which is a bonus. *except totm pain, Mother Nature sure has her timing right!

I’m also super tired. I have been trying to eat little and often lately as I have slumps a couple of hours after eating. However today after a memory lapse early morning (not like me at all) I had no fodmap friendly snacks to gobble on. So snackless I’ve managed without but combined with 30mins on the wii fit and washing my hair, I am r e a d y for bed.

Not before I create a new board on Pinterest to house all the yummy recipes I’m going to find *crosses fingers.

Also I found some Udis gluten free & dairy free Cinnamon & Raisin bagels half price. So I bought two packs. I’m thinking I can have them as breakfast toasted or as a mid morning snack with some sort of spread. The look, the smell…it’s super exciting!

http://udisglutenfree.co.uk/

Any snack suggests would be appreciated. Until tomorrow, Adiós. x

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Monday, Bloody Mondays

As Alan Partridge so happily sung, is the day I start to sort out my digestive tract.

I’ve had ongoing problems with my stomach, well let’s not mince words, more specifically my bowel has given me a whole heap of problems for at least 7 years. I’ve been admitted to A&E for suspected appendicitis and had scans on my ovaries. In 2013 my symptoms became a lot worse. I was in pain most of the time and really bloated. I was bleeding (down there) and I’ve had loose stools ever since March 2013. That Xmas I was having 10 bowel movements a day. Other symptoms include

  • Fatigue
  • Dizziness
  • Muscle cramps
  • Joint pain
  • Low mood
  • Bloating
  • Nausea for hours at a time
  • Loss of appetite
  • Weight loss
  • Excess gas
  • Pain (like glass moving through my bowel on my lower right side abdo)
  • Loose stools
  • Blood and mucus in stools

Great huh?!

After a rather painful Christmas my partner dragged me to the GP. Now I’ve been to many doctors over the years who have fobbed me off. I’ve been on anti cramp medication, mint tablets and immodium all of which failed to treat my symptoms.

This GP listened. She did a PR exam which was very painful as well as examine my abdo which was also tender and sent me for a colonscopy. Long story short that was January 2014 and a year later I had a sigmoidoscopy, cameras both ways but neither actually viewing the site of my pain. After two rather abrupt and shockingly poor appointments with the Gastro doctor, I’m still nowhere near fixed.

I tried a gluten free diet which helped initially, all my symptoms vanished. I was so happy I cried. But after reintroducing things back into my diet the pain and bloating and nausea returned.

The Gastro doctor wrote to my GP and suggested I trial a low FODMAP diet under the supervision of a dietitian. I booked an appointment with the wrong GP. A GP I had seen at 26 who told me it was normal for me to be having blackouts….

She refused to refer me to a dietitian and printed off some useless american sheet re fodmaps.

So here I am about to start the low fodmap diet as a last ditch attempt to regain normal function of my bowel.

Luckily for me, up until recently I was a dietetic assistant. While I know I am NOT a dietitian, I do have more information and knowledge than your average Joe. I also have a few friends who are registered dietitians and trained in the fodmap diet.

So with their help, a diet sheet and the internet I am about to start an 8 week diet that will hopefully help to ‘reset’ my gut so I can reintroduce foods and find out what is so intolerant to my gut.

I’ll be posting my progress, thoughts and recipes here. Welcome aboard if you are interested.

*Please note, this diet should be followed under the supervision of a dietitian trained to support you. Please seek a referral if you are searching for an answer to your gut problems/IBS.

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Today I had afternoon tea. My last supper. With bread, cheese, crisps, pork pie, scotch egg and cake. I’m going to miss processed foods.