Turkey

Gabe: Well, thanks to some good friends, and to Karen's determination, we were able to do a real Thanksgiving get-together and enjoy some real Thanksgiving food. We definitely weren't going to cook up our own turkey and sides this year, but after a miserable day, Karen decided to go for it. We headed down the road, her medications in full-effect, and she was able to put away some turkey and mashed potatoes. Which meant I was able to pack in large portions of everything.

But, yesterday was definitely a down day compared to what she's had to deal with so far, and things seem to be getting worse. Today, Friday, was Karen's first full day entirely in bed. All day. She's still able to take in some food, but if things keep deteriorating at this pace, I think we'll look back at the first two weeks of HG as the good old days, before things got really serious.

A heartbeat!!

Karen: Just got back from our visit with the perinatologists in the city. The ultrasound showed our little pumkpin with a strong beating heart!!! Phew, what a relief. The mass on my right side turned out to be neither tubal nor fibroid, but a cyst, common in early pregnancy and already starting to shrink. So we are good to go!

That white blob, inside that dark sac would be our little pumpkin, only 6mm long! The little tics you see at the bottom of the scan is the heartbeat.


After the scan, we met with a perky young perinatologist who reviewed my history of hyperemesis, and compared my protocol to hers. They match up beautifully with one exception. She wants me admitted immediately if the need for an IV arises. She says she'd rather I spend a couple of days on fluids and IV meds, then have to go in once or twice a week for quick fluids in the ER or an infusion center. Fine by me, this says that my team is on top of things and is taking me very seriously. I couldn't be more pleased.

Luckily, things seem pretty medically controlled at this point. The nausea is near constant, but at a level I can handle. And there has been NO vomiting yet...WOW! Now, I am only 6.4 weeks, so things could change very rapidly and at any time. But so far so good....better than last time for sure! Still, its no cake walk, I'm in bed or on the couch all day and already my muscles are screaming to be used. The restless leg at night is almost as bad as the nausea! So I'm going to try doing some laps in our tiny condo, just to keep things moving.

So hopefully there won't be much drama for the next few weeks. If there is, Gabe will be sure to hop on and let you know. Happy Thanksgiving! We have much to be thankful for!!

Here we go

Karen: Just a quick update on how I'm feeling. For the last couple of days I've had constant nausea, not anything debilitating yet, but its there and though my meds knock it down significantly, I can tell its just messing with me right now, waiting to pounce on me just when I start to think this time may be different. I'm taking about half of my full dosage of medication (Zofran to control vomiting and Unisom/B6 to control nausea). I'm trying to stay hydrated, but am already barely able to choke down 40 ounces in a day. Though nothing sounds remotely appetizing, I manage to keep down little meals throughout the day.

I'd say the biggest clue I have that HG is looming is the ridiculous exhaustion that's come over me.  If I attempt much more than moving from my bed to the couch, I am overcome with dizziness and a faint feeling. The only other time I've felt anything like this was the last time I was pregnant!

More to come on Tuesday, when we get our third scan.

Ultrasound: good news....kinda

Karen: So we went in for our second scan today. The good news is that we saw SOMETHING in the uterus. The "eh" news is that we only saw the gestational sac and yolk sac, no fetal pole, no baby bean. She also dated me at 5.2wks, rather than the 5.6weeks I thought I was. Bummer.

So the saga continues. Next week I'll be seeing a Perinatologist for a THIRD scan (three scans by six weeks must be some kind of record!), and a consultation to discuss how we're not going to let me get as sick this time. I'm feeling pretty crummy already, not able to eat or drink much during the day and taking my meds already. But in the evenings, my appetite returns with a vengeance and I managed to gain one pound in the last 1.5 weeks! I'll need that extra pound! Oh, and Gabe and I received our preservative-free H1N1 vaccinations today, so there's one less worry for me....now if only we can get Miya covered!

Here's a really crummy iphone shot of my scan, but there's not much to see anyway, besides that little black hole (the sac).

Please keep your fingers crossed four our scan next week!!!

Work is going to work

Gabe: The one major stress outside of the HG itself has always been around my ability – or potential inability – to continue making a living while being home to help Karen and care for Miya throughout the pregnancy. My company has approved a work-from-home arrangement, starting as soon as it needs to start, with full pay as long as I'm still able to work. If I can't keep up a regular pace from home, they'll shuffle me down a few hours a week. Which is is fine – I'd like to keep working, and be paid for the contributions I'm able to continue making. If I drop to 80%, I'll happily take 80% of my salary in order to keep this flexibility. All in all, they've been great – completely understanding and supportive beyond what could have been reasonably expected. So now we can just focus fully on the pregnancy, and on battling the HG.

And yeah, the last few days have been quietly intense. Fibroid tumors are totally benign, but can interfere with pregnancy in many ways. Of course, the mere thought of a tubal pregnancy was enough to throw our psyches completely out of whack. Not knowing exactly what's up, but knowing that something's going on...not fun, not glowy, not positive. But the optimism is back today, for both of us.

Looking Better, Thank Goodness!

Karen: So I got my hormone levels tested again today and they have more than doubled since Tuesday, which is a very good sign! Looks like we're looking at a fibroid tumor, rather than an ectopic pregnancy. Though it carries its own risks of complications, I'll take the fibroid happily!! The last 48 hours have been so revealing to me. I've been sick with worry, shrouded in a sense of gloom, and I realize just how much I really want this baby!! I'm already so attached to her/him, it's pretty incredible.  So now we just wait for my ultrasound in one week to confirm that this precious little bean is where it should be!

Mass on Right Fallopian Tube?

Karen: Just a quick update. Saw my OB for the first time today at 4wks 4days. Though my hormone levels were still too low to show anything, she decided to take a look by ultrasound. As we expected, she saw nothing in the uterus. However, she did see a large mass on the right ovary. She had two theories: fibroid, or tubal pregnancy. Yikes, was not ready to hear that one, especially with all the strange cramping and sharp pains I've been having! I don't think anyone on earth has ever wished so hard to have a fibroid!!

On a good note, she seems wonderful and will take good care of me through the pregnancy. She's willing to do whatever it takes to get me through HG, and has assured me that she won't let me experience the pain and weight loss I suffered last pregnancy. Let's just hope there's a pregnancy for her to monitor!!!

Ramping Up

Gabe: So even though we've been through this all before, enough time has passed that HG feels foreign in many ways. That being said, I think we know a LOT more about what's ahead this time than we did in 2002-3. Most of that comes from Karen's thorough research and involvement with the HG community online.

All I can do is prepare for as-bad or worse, and hope (realistically, optimistically) for a second HG pregnancy that's just the slightest bit more manageable than the last one. We don't expect lighter symptoms, but I feel like we can get out ahead of the HG with focus and hard work – some luck, for sure. And of course, with a mountain of courage on Karen's part.

My biggest contribution will be my presence, and as a result, my availability to help out with...everything. If my company gets behind a work-from-home arrangement, Karen and I (and Miya) can do this together – without going broke. Which is important. I'm hoping to find out what's possible with my work situation this week...

Still lots to learn on my part. And as the symptoms kick in, I'll need to learn-up on the specific treatments that Karen will need me to help with. Picc lines freak me out, and being responsible for managing one (air bubbles, avoiding and recognizing infections...yikes) is very intimidating. First OB appointment is tomorrow though, so I can start asking questions.

Sooooo, here we go!

Some green moments

Karen: So I'm now only 4 weeks 3 days and am already having moments of nausea and dizziness. The episodes are short lived and controlled by my medication (must be much like normal morning sickness!), but they are certainly little flashes of what will be my existence this winter.

I'm feeling sort of like a ticking time bomb, ready to blow at any moment, not knowing what the trigger will be. The last few days I've lived a half life, making no plans beyond the next few hours, panicking at every strange twinge or turn of the stomach, frantically trying to wrap up projects and jewelery commissions.

Going to see my OB tomorrow for the first time. We have so many questions and concerns; Why am I cramping all day, What are these sharp pains, Will she want me on home health care or in the hospital, Does she prefer PICC lines or NG tubes, Will she be willing to try corticosteroids even though she's never used them before...But mostly, I want her to get to know me, before I'm a crazy incoherent sick woman!

We've decided to include photographs on this blog. I never took monthly belly shots in my last pregnancy, but I'm sure going to try this time. So here you'll find both a 4 week belly pic, as well as a head shot of me at 4 weeks, healthy and happy. It'll be really interesting to see how my face and body changes over the next 36 weeks!

4 Week belly, complete with the extra 5 pounds I packed on in anticipation of the weight loss!



New haircut, happy cheeks!

Our history and Outlook

Karen: Today we discovered that we are expecting our second child. We made the decision to add to our family just three short weeks ago, hoping for, but never expecting success on our first cycle! But sure enough, this morning I had "a feeling" so I peed on a stick and voila, I am four weeks pregnant.

Our last pregnancy was seven years ago. It's taken that long to muster up the courage to do this again. I suppose that for seven years, I've suffered through a type of post traumatic stress disorder and only recently has desire overcome fear.

I was 24 when I first became pregnant. We'd been married for over a year and felt ready to begin the next chapter our our life together. It took over six months to conceive and only when we decided to stop obsessing, charting and predicting ovulation did it finally happen. We were blissful and bursting to tell loved ones the great news. For two weeks I was able to "glow", with no detectable symptoms to complain about.

Then, at six weeks, I became suddenly and violently ill. This was not like any kind of morning sickness I'd heard described. I thought I must've had food poisoning. The nausea was relentless, the vomiting was a total body experience. I was bedridden within 24 hours, and within one week, had lost nearly 8 pounds. We were not due to see my midwife for another week, but having gone without any food and little to drink for a full week, we decided immediate medical attention was necessary. We went to the ER. A few hours later, pumped full of fluids and vitamins and armed with a diagnosis of Hyperemsis Gravidarum, we were released back home.

Still, I remained bedridden, despite frequent IV hydrations, serious drug therapy and weekly visits to my midwife. This went on until my 16th week, four weeks beyond what my midwife had assured me would be the end of this. When I walked into her office, assisted by Gabe, with a lemon held up to my nose to keep all other smells away, I was FINALLY taken seriously. She promptly left the room to consult with a Perinatologist (a high risk pregnancy doctor) and came back with two options; long term hospitalization, or a fairly experimental drug therapy using corticosteroids. Though it was no guarantee, we opted for the steroids. I just didn't want to spend what may have been the rest of my pregnancy in hospital care with intravenous nutrition or worse, a feeding tube.

Lucky for us, the steroids worked! Within two days, I was eating broth. Within a week, I was eating solids. And though I required medical control of my nausea for the remainder of the pregnancy, I was able to get by with just "normal" morning sickness. However, my diet was limited, and I was only able to consume high fat, high carb foods until the very end. This led to borderline gestational diabetes, as well as the development of gall bladder disease at 36 weeks.

On June 5, 2003, two days after my 25th birthday, I gave birth to a beautiful, healthy baby girl. She was perfect and worth every miserable moment of my wretched pregnancy.

So, here we go again! This time we are armed with knowledge. We go in with eyes wide open, knowing what we are facing, and bearing the tools we need to fight this. We have written a protocol which will be given to every medical professional that cares for me. It explains how we'd like my condition treated. What worked last time, what didn't. No need to waste time trying drugs that failed, or had intolerable side effects. We have invited our family and friends to be a part of this, a support group, and will not be afraid to ask for help.

This blog will serve as a record of this battle with HG, a means of keeping "in touch" with loved ones, and a resource for those who have suffered, will suffer or know someone who has suffered through this horrific condition.

Wish us luck!