Speculative Speculum

For those who completed the hyperemesis gravidarum genetic study, further information is being requested for additional studies:

“Dear study participants,

This is the first study to look at child outcomes from HG pregnancies. HG cases AND friend controls, please fill out the child follow-up survey at the following link separately for EACH child. The survey has approximately 100 questions, will take 5-10 minutes per child, and covers many common and rare conditions.

SURVEY LINK:

https://docs.google.com/forms/d/1uk_9jcfgPVaNfbEwL-qCa5YVRNTQCGE8SND5ji8oLXI/viewform

If you do not wish to participate, and we hope this is not the case, please respond with “NI” (Not Interested), so we know you received this email and we will not send you future emails regarding this survey.

THANK YOU VERY MUCH FOR YOUR VALUABLE TIME IN HELPING US ANSWER IMPORTANT QUESTIONS ABOUT HG.

Check www.helpher.org for information on the first HER 5K run in May and other news.”

This survey is great because it might be able to show how HG affects the fetus and might promote better care when women request help from their providers if a strong correlation between our children’s disorders and HG is found. For our family, we have a son who is sensitive to tastes and another one who never developed a tooth. If these are related to HG or not, it is good to have this data recorded.

D4 is going to be 3 months tomorrow! I can’t believe how time flies when you’re having fun! Work is going great, and breastfeeding is still going well. My son’s school is closing after this year due to a budget deficit, and we are looking forward to sending our children to another school in the district. This first year of kindergarten has been very rough on D1, us as parents, and apparently the school. D1 is the best kid at home, but at school he seems to not be able to do anything that his teacher likes. We’ve gotten nothing but negative letters, phone calls, and emails ranging from complaints about how he likes to dress to acting “childish” in class. I’ve been tempted to pull him out of school a dozen times this year since this environment doesn’t appear to be good for us or them. It will be great to start anew with a different school and teacher. From this experience, I can understand why parents choose to homeschool their children.

The other kids are doing okay, and MCAT studying is going smoothly. I registered for the July 26, 2013 exam to be taken at the university closest to my home. I’m so exicited to get this beast taken care of. Furthermore, I thought more about where I am going to apply. There is another MD school (Western Michigan) opening! Yay! I also created an e-mail account specifically for medical school applications so that I don’t miss a single notification.

There isn’t much new around here. I’ve been thinking a little bit about the next medical school application cycle that begins in June. D1 turned six and got a Nintendo DS for his birthday. D2 and D3 have been getting into things, but I think that they are getting stir crazy from being inside so much all winter. D4 (two months old) is growing big and smiles and coos often. I also turned the big “30″ last week. I don’t feel any different, but man that’s getting up there! My family made my birthday extra special. I love them so much! My PEG tube site is also healing more and doesn’t leak.

I’ve also started studying for the MCAT the most seriously since the fall when I got invited to a medical school interview without even having an MCAT score and then rejected. I’m documenting my progress under “MCAT Journal” so people can see how others study while working and having children.

I finally was able to get my PEG tube removed. It felt like I was giving birth through my abdomen, and I don’t think that I can watch any of the Alien movies again without thinking about my PEG tube. I’m still sore, and it bleeds/leaks. The surgeon really had to pull on it to get it out. Now it looks like I have two belly buttons. It’s a good thing that I am already married, and I don’t have to worry about what I look like. So far, I’ve lost 28 pounds since I had D4. I’d like to lose at least 20-30 more over the next year and hopefully without doing much. Yay for breastfeeding!

I made myself a meme to make me feel better since I just got the letter of rejection today for medical school. The letter must have been in my husband’s car or something. It was postmarked for 12/6/12, so a week after I had my interview. My portal says that my file is under review. I really had fun interviewing, but I guess they didn’t have the same interest in me as I did with them. Good luck to everyone else on the interview trail! I’ll apply again this next cycle.

The great thing is that I don’t have to take the MCAT until the spring. I can just snuggle with my kids and relax. Maybe PEG tubes, pregnancy, and lots of kids scare off ADCOMs? Or maybe it’s because I haven’t taken the MCAT yet? Or maybe they don’t like my personality? Or maybe they don’t like nurses? Too much speculation! All I can do is stay positive and try harder next cycle starting with an amazing MCAT score and maybe reconsider nurse-midwifery as a more realistic alternative. I’ll work with women one day or bust!

I’ve just been chilling at home. My maternity leave…er 30-day personal leave ends on Friday, and I go back to work on Saturday after having D4. I’m ready to return; I miss my ER peeps. I’ve been doing a lot of “spring cleaning.” It’s much easier to move around nowadays! I feel great and maybe even feel better than what I went into pregnancy feeling like although I still have the PEG tube. It sometimes gets in the way when I’m holding D4 and when I’m breastfeeding her. I was supposed to have the PEG tube taken out on Tuesday, but my doctor was called in for emergency surgery for one of the patients on the floor. My appointment was rescheduled for next week. This is the fifth time that I thought that my tube would get removed. One day I’ll be tubeless! For now, I just think of it as an extreme piercing.

D4 weighs 9 lbs and 7 ounces, but I still have to take her in weekly even though she has been gaining a normal amount. She’s a really content baby for the most part, and she is now four weeks old. Everyone always says how big she is. D1 almost knows all of his pre-Dolche sight words. Right now, he’s having trouble with “here, come, said, and my.” D1 gets to stay up two minutes for each word that he gets correct. He was supposed to know all these words before kindergarten, but I didn’t know that his school required this. D2 and D3 have been handfuls and into everything.

This is a response to “Advice from Will Smith” by Hyperemesis Survivor:

“If we are going to survive this, you must realize that fear is not real. It is a product of thoughts you create… danger is very real, but fear is a choice.” ~Will Smith’s character in After Earth

There are many emotions felt by those who have hyperemesis gravidarum (HG)–a form of severe nausea and vomiting during pregnancy- from guilt to loneliness to fear. To those who have already experienced or who are in the midst of their time with the illness, hyperemesis gravidarum can be scary business. You vomit until the point of emaciation and you wonder if you and your baby are going to be okay when all is said and done. Some doctors assure you that your baby will be fine. Most do not and some even suggest termination.

Fear occurs when you react to what you think might be true and believe that something harmful will come out of the experience. Hyperemesis should then be the definition of fear for most of us unless we learn to redefine our beliefs about ourselves and the circumstances by which we find ourselves in when we are suffering from HG or when we are about to enter into a state of HG when considering taking on a future pregnancy. Specifically, the term given to the condition of being afraid to vomit is emetophobia.

I was fearful of many things when I had HG such as the fear of having a baby that had something physically or mentally wrong as a result of the fetus not receiving sufficient nutrition; the fear of my health permanently being altered by HG; the fear of the nausea never ending; and the fear of being judged for not being able to handle the nausea on my own. Some fears were based on previous experiences with HG such as having the fear of being treated poorly by healthcare professionals, the fear of being treated like the HG is simply a mental illness that should not be managed medically, and the fear of being perceived as a bad mother because I could not eat like a normal pregnant woman.

After my third and worst pregnancy dealing with HG that resulted in hospitalization for three months off and on; the inability to walk very far on my own; and having anxiety whenever the thought of pregnancy would enter my mind due to the trauma of feeling so misunderstood for so long, I knew that I had to evaluate how I could better handle the way that I think about HG. This was especially pertinent since I wanted to make my life’s pursuit helping other women get through their challenging pregnancies in the best way that they can.

Things changed considerably by the time that I became pregnant with my fourth pregnancy. I learned to be fearless and do things my way. I let no one tell me what I should do whether it was my nurse, doctor, or best friend. I realized that I gave away my power whenever I compromised too much by undergoing treatments that I knew would not work and when I did not advocate for myself for the treatments that I felt would be beneficial to me and my baby.

Likewise, I gave away my power whenever I would let other people’s opinions and beliefs about me override how I felt about myself. Overall, I strived to maintain feelings of being content and at peace with my situation no matter what it was. If I could not figure out how to cure the HG itself, at least I could react differently to how I handled the extreme nausea and vomiting and I how I handled the harsh criticism of others.

At times, I even felt joyful that I could maintain a sense of gratefulness and happiness while in the middle of being physically very miserable. In the end, I learned to turn a very difficult time into one where most of my pregnancy memories are good ones. My fourth pregnancy was a success in terms of having a healthy baby and getting through it being emotionally stable. Even the way that I view my third and most challenging pregnancy has changed, and I no longer view it as being so terrible.

If you are having a difficult time with HG, I would suggest reframing your experiences as an opportunity to practice overcoming whatever fear that you may have. The number of fears potentially associated with HG are endless. Are you scared of dying? Of having a less-than-perfect baby? Of having a dead baby? Of being treated differently or being misunderstood by family and medical professionals? Of not having the support from your loved ones? Of not obtaining adequate medical treatment? Of losing your income? Of not being able to take care of yourself or your other children? Of being hospitalized and having painful therapies? Of the vomiting never ceasing? Of having your children taken away from you? Of losing control over your own body? Of feeling like abortion is your only option? Of having HG again in another pregnancy?…Think about how you can use your time wisely and learn how having HG can aid you in ways that do not produce fear and make you a better person. For me, my main fear was concerned with being judged by others as being an unfit mother and of being mentally ill. Of course, deep down inside, I do not believe these things. I feel that I am, at least, an average mother and the same as most psychologically.

I learned to just be myself and not take on the opinions of others because they are not my own. Who cares if I make people mad and if they are unhappy with me or think that I am a terrible person? These are not my concerns, so I stopped worrying about them. Things got easier for me from there. I better handled the nausea when not stressed over the constant disapproval showed to me. Over time, the criticism even became less frequent or maybe I just stopped noticing when people were being cruel. In a way, I showed kindness to myself by not letting people get me down.

I walk away now, with the gift of not minding at all what others think of me. I have heard just about every negative, hurtful thing a person could say to a pregnant woman and these things no longer phase me. This is something that I would not trade. It was worth a pregnancy consumed with berating to bring me into a new level of self-confidence that will forever benefit me as a mother and when I am a physician taking care of my own patients with HG. Everyone can get through HG, and it can be done without fear. Women can live more joyfully with HG when they choose to let go of the things that they are afraid of, and I believe that we can best do this by supporting each other and being true to ourselves. The nausea is enough. We do not need to burden ourselves with fears that we create for ourselves.