My work means I encounter women with reproductive health issues and fertility issues. Often these are young women who are trying to conceive or they are women who are simply trying to take back control of lives that have been overrun by debilitating conditions such as Endometriosis, PCOS and chronic PMT.  The predictability of being in a lot of pain for half of every month is beyond wearisome, it’s actually depressing. Add to that the necessity of having to navigate the day to day when you are in pain and experiencing heavy bleeding and you can see how being able to live a ‘normal’ life when you are on your period is a false reality for many women. But it is not something we tend to speak openly about is it?  And I can see the consequences of this silence in the older women I treat, women for whom dreadful monthlies are a thing of the past but for whom the memory of that time has never been released and the physical burden has never been resolved.  Both take their tole and I feel that too often I encounter women who are at first surprised and then relieved when I ask them if they used to suffer from horrible periods or if they had diffcult pregnancies or traumatic labours. All of these things show up on the feet and it is very emotional listening to a lady in her 70s recalling years and years of unspoken misery as if they were happening in her present. This is a subject I will return to but for now I have been prompted to write something because a client of mine has decided to speak up about her own gynae issues and then further share her current struggle to have her hyperemesis gravidarum recognised as more than just morning sickness. I asked her if I could share her experience and words of wisdom and you will find them here;

Hyperemesis Gravidarum – misunderstood and left in the dark

Realising I was pregnant with my long history of endometriosis and polycystic ovaries seemed nothing short of miraculous. I felt like the luckiest woman on earth. But, from this moment on, the road has been far from smooth and I have found myself battling yet another misunderstood and underestimated female condition.

Hyperemesis gravidarum (HG) affects a mere 1% of pregnant women1, so this could partly explain the lack of awareness and misunderstanding surrounding the condition. In my experience, the condition requires from the patient a strong resolve to ensure the diagnosis is reached and condition managed, whilst being devoid of all energy. Luckily, my experience with endometriosis, and being a healthcare professional myself, had prepared me well for the fight.

HG is not just bad morning sickness.
I experienced extreme nausea and vomiting throughout the night and day, with vomiting and then dry retching (when there was nothing left!). On several occasions blood would also be present, as my body strained under the daily retching attacks. Even turning in bed triggered more retching, so normal activities or working were out of the question. Just as bad as the sickness was the hypersalivation, which required a spit bucket to avoid drowning in my own saliva. This, no doubt, added to my dehydration, but I found it was impossible to manage this symptom any other way. None of the ‘usual’ advice helped: “Have you tried ginger?”; “What about dry biscuits?”; “Maybe if you get a good walk” …the list of morning sickness remedies was endless, but this wasn’t morning sickness so why would they help?

With bleeding lips, headache, difficulty passing urine and extreme exhaustion I attempted to seek help. Unfortunately, I felt that the rarity of the condition delayed my diagnosis and I was managed as mere morning sickness for some weeks. Certainly, my own training as a healthcare professional did not include detailed guidance on the diagnosis and management of HG, so maybe those looking after me had a similar level of knowledge on the issue. Thankfully online resources assisted me in my own self-diagnosis, including the HER Foundation and Pregnancy Sickness Support UK, so I was aware to continue seeking help and my diagnosis was eventually confirmed.

After being diagnosed, I went through several treatments before finding a combination that worked. I also required IV fluid and vitamins for the dehydration. Although I was very reluctant to take medications, I had to accept it was necessary. I am now so grateful for the options that were available to me but at the time this was hard to deal with. My baby was so precious to me and I didn’t want to do anything that wasn’t natural for them. However, one kind doctor took the time to explain to me I was putting them at greater risk by not taking the medications and the mummy guilt eased slightly.

Tips for coping well with HG

• Forgive yourself: As I’ve mentioned, I felt extreme guilt at first for taking medications during pregnancy, but I had to reach some level of acceptance that this was the best thing for both me and the baby.
• Use unscented products, such as shower gels, moisturisers etc. This was a life-saver for me, as showering was another trigger time.
• Use minimal toothpaste and an electric toothbrush with floss: Foaming toothpaste was another trigger for my HG, but I found using minimal paste with an electric brush minimised this while still ensuring a good clean.
• Diffuse lemon essential oil or simply place a few drops on a handkerchief: The citrus scent seemed to distract my body long enough to hold it together to make it to my appointments, or almost.
• Self-care: Although your energy will be low, try to include something in your day to help cheer you up from the miserableness of HG. Listen to your favourite album. Have a loved one with you. Read or watch some tv if you’re able. I was lucky enough to have a fabulous reflexologist nearby who could come to me and provide some comfort, even if it was with a basin to hand. You need to look after yourself as much as possible and remind yourself this is temporary.
• Avoid all your triggers, whatever they may be, as much as possible.
• Remind yourself of the reason for all your suffering: My wee miracle is the one thing that would always keep me going, no matter how weak I was. I know they will be worth it all.

What’s the real ‘remedy’ for HG?

HG requires greater awareness, greater research and more education for healthcare professionals on distinguishing HG from morning sickness and its differential management. In fact, it seems greater research and investment is required for female conditions, overall. This is evident from a recent article in Forbes, 2 and could be viewed as a subtle form of gender discrimination which prevails in this modern age. Add to this the complexities of obtaining scientific evidence for health conditions during pregnancy (given that it’s unethical to include pregnant women in clinical trials) and it is understandable so many HG sufferers feel left in the dark and mismanaged. With pregnancy literally a necessity for the future of the human race, surely it’s time this changed?