Topic : 04/12 Twin Tug of War

 Dr. Phil,

I did not have what you would call a typical pregnancy. After finding out I was pregnant (@6 weeks) I began vomitting severly and was unable to keep any food or fluids down. I went to the doctor who diagnosed me with Hyperemesis, and was prescribed Zofran ODT , but since I was unable to keep anything down I was becoming dehydrated quite quickly and was admitted to the hospital for IV fluids. At that time I was given a Zofran pump, and started to slowly feel less nauseous. That feeling was quite short lived, however. I still was unable to eat, and could barely get down a glass of fluid in an entire day. I was losing weight, but at that time the baby was fine, his heartbeat was nice and stong. About two weeks after I recived the Zofran pump, I was hospitalized the second time for a total of 8 days. At this point, I had lost 20 pounds from my pre-pregnancy weight. I had a PICC line placed and was placed on TPN for 18 hours a day, so I could at least get the proper nutrients and calories that I needed to provide for my baby. WIth the combination of the Zofran pump and the TPN I started to feel a little better, although I still threw up at minimum twice a day and could barely keep fluids down. And you could forget about food! 

On the day of my 20 week ultrasound appointment, the office had called me early in the morning to reschedule because the u/s tech was ill. I had a overwhelming feeling of dread and dissapointment, but rescheduled for the following week. That same day my home health nurse came out to change my PICC dressing and draw my bloodwork for the week so they could adjust the TPN if needed. During that visit, she was unable to locate his heartbeat, and called the doctors office who told me to come in immediately. At this point my DH was trying to reassure me that everything was going to be ok, and I was trying so hard to believe him. When I arrived at the office my doctor fired up the u/s machine and I heard the words I had been dreading." I'm so sorry. There is no heartbeat." I sobbed uncontrollably for what seemed like a lifetime and then was admitted to the hospital the following day to have labor induced. Our little angel, Jakob Allen was born still on Feb.21, 2007 at 11:29 A.M. weighing only 10 oz. and measuring 10.5 inches long. He was perfecly formed, and upon initial assessment gave no indication for his death.

It has been 7 weeks since delivery and we are still waiting on the results of the autopsy and fetal evaluation. I don't know if we will every find out what caused Jakob's death, but the reports can at least give us the closure we long for.

I feel it is of grave importance that we shed light on this debilitating disease. I had wonderful support from my family, doctors, and friends, but I do realize that some were not as lucky. One day I hope that this can be cured or at least well-managed enough so that no one has to know what it is like to spend most of your pregnancy an the bathroom floor; unable to eat, work, and live.

With great thanks,

Jenn

First of all, thank you Dr. Phil for bringing attention to this horrible condition, and hopefully this will be the start of some major attention on this issue.

I would like to start by thanking all those HG survivors, their husbands and family members and even doctors out there who have helped the women in their lives that have suffered and lived through HG. For without you, surviving this horrible ordeal would have truly been impossible.

For MY husband, family, doctors, caregivers, boss…and anyone else who supported me through this tough time, from the bottom of my heart, you will never know how much your understanding, devotion, and support was what made me never lose complete sight of the light at the end of the tunnel, although there were times when that light was 99.9% of the way out. What follows is the battle I went through with HG, some of the details, to this day I have not been able to share with anyone, not even those closest to me…

At 4 weeks after conception (Nov. 15) I took a home test which came back with positive results and I was ecstatic. I was so happy that nothing could bring me down, until week 8 hit. The first time I threw up I thought, you know, I can do this, its only going to be a few weeks of morning sickness, no big deal, bring it on. But things just went downhill from there. Usually doctors don't want to see you until 10 weeks gestation, but only at week 7 ½ things were getting bad. I called my doctor (Dec. 6) and she prescribed Zofran. I started taking that, and for a few days it seemed to work. I went on for the next week or so throwing up but doing ok, but then the vomiting became worse and more frequent until one weekend things just became unbearable and I wanted to go to the ER because I couldn't even function. It took 4 attempts to get a good IV started (mind you I am terrified of needles) because I was so dehydrated. Two days after that stay I was just as bad again, but this time my doctor sent me to an IV infusion therapy center and I was to receive 4 hours of fluids. Around this time I was supposed to go to get my first ultrasound, and was astounded when I was told to drink 16 oz of fluid. How was I supposed to keep that down when all I was doing was throwing up nonstop? Nevertheless, they were able to do the ultrasound by using a different method, other than on the belly. I saw my baby for the first time and for just those few moments nothing else seemed to matter, I was on my first high in days. A few days later I had to go back to IV therapy again. Again another two days had past and was feeling just as bad, so instead my doctor admitted me to the hospital.

On Dec. 19 I was admitted to the hospital and learned that I was going to be placed on a PICC line(peripheral intravenous central cathetar) and TPN (total perenteral nutrition) for 16 hours per day. During this stay, I was emotionally a wreck. All I did was cry. Of course family came to visit and tried to cheer me up, but all I wanted to do was cry. After countless hours of doing nothing but crying and watching tv and seeing all these food commercials, steaks, shrimp, pizza… each one looking just as delicious as the next, just the thought would make me puke. And of course it didn't help that hospital staff just kept bringing meals into the room until I finally had to yell at someone to get it out, and don't bring me anything. Staff just kept insisting I eat jello, or take a sip of this, take a sip of that. How many times do I have to tell you don't even bother, its just gonna come right back up…what do I have to do, throw up on you for you to get the picture? 4 days into my stay, bruised on both arms and hands from all the IVs the picc line finally came, and man, for being afraid of needles I was petrified of them inserting this line which goes in through your elbow, up your arm and into your heart. I cried and screamed for the whole process. The next few days, being hooked up to all these lines I barely got any sleep. By the time I was released, the day before Christmas, all I wanted to do was go home and get in bed and sleep…sleep for the next 7 months. The next day, Christmas came and my mom insisted that I come over and spend Christmas with family and not curled up in bed crying. So, TPN pump and all I went over there for the day and spend most curled up on the couch crying, thinking to myself everyone else is happy why did you have to bring me here so I could just sit around and watch everyone else be happy and bring them down? As the day progressed I became more and more bitter. By the time dinner was ready (turkey, stuffing, potatoes and all the fixins) I laid upstairs in my sisters bed (just sick at the smell of the food) and totally lost it. I cried the biggest and loudest tears I have ever cried in my life. My mom sat with me, my husband sat with me…but nothing helped except crying harder. At one point my mom tried some tough love " while you are getting TPN the rest of us have to eat to survive". The normal me, would have flipped my lid at that statement, but the sick me… it was all I could do to just try to comprehend what she just said. So I just cried some more. Looking back I think she was just frustrated that there was nothing she could do. What mother wouldn't get upset seeing her baby like that? So the next week came visits from the various home health nurses, which would follow twice a week for two weeks and then once a week. Because the throwing up all the time nonstop was so harsh(throwing up blood from the stomach, from the lining being so irritated from just throwing up) and I could take absolutely nothing by mouth…water, ice, food, medicines, you name it, I was also hooked up to a subcutaneous reglan pump. That entailed more pricks every three days in the leg to switch out the tubing. At one point we tried a zofran pump, but that was worse than the reglan pump so we decided to stay with the reglan through the pump, since it was helping somewhat. My health at this point was deteriorating so much that chunks of the skin on my lips were just peeling off, I got an infection at one of the old reglan pumps sites on my legs, which meant that I had to hook up to more iv bags filled with antibiotics, since I couldn't take them by mouth. I could only muster the strength and energy to get up and take a shower once every three days, and I couldn't even do that myself. I had to have help wrapping the picc line site with plastic wrap and keeping the other pump out of the water. Even getting in the shower meant more throwing up. Just the heat of the water made me sick. There were so many nights that my husband had to go sleep in our spare room because my tossing and turning and not getting a good nights sleep was keeping him from sleeping. I never told this to him, but I was actually relieved that he was sleeping in the other room because my sense of smell was so heightened that just with him sleeping next to me, I could smell his natural body scent and it would make me sick. Now, im not saying he stunk or anything like that, but everyone has their own scent/pheromones that they give off and that's what I was picking up on. This would happen even right after he got out of the shower. As much as I didn't want him next to me, I wanted him there because I felt that maybe we were growing apart because I was so sick and I was draining him physically to keep up with me, and emotionally because all I would do is cry and there was nothing he could do to make me feel better. This was rock bottom for us. I say us, because even though I was the one going through this problem, everyone felt the affects, and there was nothing they could do to help no matter how much they wanted to.

At week 12, I tried another approach. A friend of ours is a certified hypnotist, so I thought ok, he thinks he can help, what do I have to lose, give it a try. Well that did nothing to help either. I was willing to try anything and everything to just make all the bad feelings go away. My mom would come over during the day and clean and keep up with housework and whatnot and try to get me out of bed, but I had no interest at all. My family couldn't understand how I could lay around all day and not want to read or watch tv…they couldn't understand how all I could do was stare at the ceiling and lay in bed. When my husband would get home from work and come up to talk to me all I would do is cry. "Why cant I have just one good day" or "when is it going to be July" and "never again, this is it for us". I had no interest in anything…all I wanted to do is sleep, because at least when I was asleep, and sound asleep, I felt nothing, it seemed like the only way to get the time to pass. For the first few weeks after getting the picc line I would lay in bed and my stomach was just constantly grumbling because it was empty and had been empty for quite some time. This was the case all the time, I just kind of learned to ignore it hoping that the grumbling would go away.  Then came all the dreams, dreams of food, because somehow the grumbling just made me think of food, and when i would wake up from those dreams i would throw up because just the thought of food made me sick, and then my stomach would grumble some more.

Financially, we were beginning to hurt as I had not been to work since mid December and it was now a month later. I started dragging myself to work for an hour or two a day, because that's all I could take. So pumps and all I would have to get up, get dressed and go out in public like this, not to mention actually function like a normal person. I would carry around in my purse a throw up cup so that when I threw up at least I had a something to do it in. This went on for about another several weeks or so until around week 17 when one day I was determined to sit myself down at our kitchen table and eat and drink and eat and drink no matter how many times it came back up until something stayed down. After having no food or water or anything by mouth for 10 weeks I wasn't sure my stomach would even know what to do with something. So I gave it a shot, time and time again until not even my determination would prevail. Several days later it was like a switch had just flipped off, I started eating, very small bits, but they stayed down. I was on a high again. I could eat, and keep it down, even if only a tiny bit. I began to keep a log so next time I went in to my doctor I could show her all that I ate. As my picc line started becoming clogged and as I could keep more and more down, finally by week 19 I was able to have the picc line removed. WOOOOHOOOO! And the subcutaneous pump…GONE! No more needle pricks, no more tubes, no more throw up cup. I was free! I could shower myself. I could sleep again, without the stomach noises, without the throwing up, without smells bothering me. I was myself again! And I could take medicines by mouth. So I started the daily routine of reglan, zofran, and medrol. I began working full time again.

And then week 26 came. Working full time was dwindled back down to working one or two hours a day. We had to take out a second mortgage to be able to pay the bills that we never were able to catch up on from the first 10 weeks of me being sick. I remember driving home one day thinking to myself I'd rather be back in the hospital then having to drag myself in and out of work. The switch that miraculously flipped off, flipped back on. My husband and I now like to refer to it as the eject button. You know the little button inside of all HG sufferers that the baby loves to play with. The one he or she pushes to make everything come back up because it cramps their space. Well once again, came the IV therapy sessions and the IV sticks and another week long hospital stay that I wished I had not wished for a day couple of days ago. Another picc line, more TPN, more throwing up, more crying, more being miserable. Just one huge horrible blow. Just when I started to believe things would be ok. The only difference this time was that I could take medicine by mouth and somehow that managed to stay down. How? I will never know because everything else came back up…but the medicine stayed down. Thanks goodness though because I really did hate that 3 day routine of getting pricked in my leg and being hooked up to another pump. Then came the depression. After having gone through all of this before and knowing what I was up against again I was even more miserable. My husband finally realized that I needed more than just the physical help, that I needed some kind of mental help and suggested to my doctor that she put me on antidepressants. So I added Zoloft to my collection of medicines, and it helped. After a week or two I started not to cry as much, although you better believe I still had my fair share of crying. I even decided that I hated the grumbling feeling so much that I was just going to eat and drink no matter that it would still come up. Weeks past and every day I would eat at meal times and promptly throw it back up. The good part about this was I could eat and eat and eat and eat whatever I wanted, how much I wanted, whatever I was craving and not have to worry about gaining weight during the pregnancy because it would come back up. Eventually I chose to eat things that didn't bother me coming back up. The way I saw it was, if it came back up bad I would avoid it. AVOID CHOCOLATE AT ALL COSTS! At dinner time I would sit down with everyone else and eat and run to the bathroom, and come back for seconds…and run to the bathroom….and come back for dessert. As the weeks progressed and I got closer to my due date it became harder and harder to throw up because the pressure from the baby and the pressure from throwing up…if I had anything in my bladder, it wouldn't stay there, so I had to be very careful about how I threw up, so I wouldn't "spring a leak". Since the second hospital admission my doctor decided enough was enough, that she would induce at 37 weeks. Well, as I was nearing week 34 or 35 and seeming to be in ok spirits, she decided to wait one more week. I was pushing so hard for week 37, but she wanted to be safe and give my son one more week. I was upset with this because one more week, when you are going through HG is A LONG TIME!! Around week 36 I had a sonogram where my amniotic fluid was starting to go low, so I scheduled another for a week later and was advised that if I felt decreased movement to go to the hospital right away. A few days later I wasn't feeling my son kicking so we went to the hospital. I was having very mild contractions, and his movement was a little decreased but nothing to keep me there for, so I was sent home. Two days after that was my sonogram and I was told the fluid was too low and the placenta was not capable of sustaining the baby so I was sent to the hospital that night to be induced. Week 37 at last! I got what I wished for day in and day out, no waiting one more week, the baby would be out and I would be all better, at least I prayed. So at 4am I was given pitocin and labor began very rapidly. By 5am I was screaming for the epidural and because I was dehydrated from not getting the TPN the night before they wouldn't give it to me until I had IV fluids. Well my picc line decided to fail so they had to give me yet another IV and the nurse was fooling around with trying to get the picc line working. I was begging for the epidural and statol and all she would do was mess with my picc line. Forget that stupid thing, give me something. So finally around 9am I got the epidural, was fully dilated and ready to go. By 10:22 a.m I had delivered a HEALTHY 6lb 8oz baby boy. I was blessed with a fast labor after all I had suffered through. The best part was around 11:00 when they brought in lunch. I ate every bite, and every bite stayed down. Then dinner, and dinner stayed down. Then breakfast and lunch the next day and those stayed down, so out came the picc line. The baby was out and couldn't hit the eject button anymore!!!!!! I felt so good, better than any day while pregnant, that I was even released the day after giving birth, instead of the second day after.

Now its 9 months later and everyone is doing great! For as much medications as I was on, I have a super healthy baby, the happiest and cutest baby in the world. I read somewhere that HG SURVIVORS are blessed with some of the cutest and greatest disposition babies, and that's definitely the case with my son. Looking back, I wouldn't trade a second of what I went through for any little change may not make my son the way he is today. As much as I said I will never do it again, I LOOK FORWARD to doing it again. Nine months of sickness is nothing compared to the joy and love that your child will bring you…

To my husband… first and foremost thank you for the best son in the world. Thank you for the countless nights you spent hooking me up to all the lines and bags and helping me just do the normal stuff most get to take for granted like taking a shower. Thank you for realizing when I needed help when I couldn't ask for it myself and taking it upon yourself to get me that help even if that meant you thought I would get mad at you. Thank you for showing me what "in sickness and in health" truly means!

To my mom and family and friends… thanks for all the support and encouragement and all the entertainment, it helped make things just a little easier at times. To my mom, thanks for all the times you helped us get through with the nursing stuff or cleaning around the house, or just making me get out of bed. Thanks for all the dinners you made, and just because I threw them up, doesn't mean they weren't good.

To my Doctor, thank you for doing all you could to help me, and for not just blowing me off as I've heard about from so many others. Your total understanding and willingness to ask other Doctors for their opinions or recommendations is total professionalism!  To my boss, thanks for not letting me go even when things were hard for you to maintain business. Thanks for letting me come and go as I was able, not many employers at all would do that. Thanks for the great health insurance that covered 100% of everything, otherwise I would be working every hour of every day to pay off everything.

 I had Hg with all three of my pregnancies. It was the worse time of my life. I am finding out that I was one of the lucky ones. I was sick for about 4 months each time then it would just stop. I was in and out of the hospital at least 15 times. I would throw-up every five minutes. I Would go to the ER and get fluids. I would feel a little better for a couple of hours then it would start again. With my last pregnancy I stayed in the hospital for 5 days. I went 7 days without eating or drinking. While in the hospital, I had to be nourished through an I.V. I had two children that I could not take care of. I was lucky to have a great husband and mother who helped me do everything.There were days I just cried all day. At times I just wanted to die.  I would just lie in a dark room for days.I could'nt go to sleep. I would just lie there and throw-up constsntly. I thought of having an abortion several times and that is something I would never do. You just get so sick and you can't function. You just want it to stop.I have read about women who did terminate there pregnancies and I can totally understand. I am convinced that it takes alot of support and understanding from your husband and family. My sickness ended after about 4 months and I had healthy babies. I would just like to tell women who are going through this that it will end. When its over and you hold your baby, its all worth it. You never forget what you went through, but it will make you stronger.

I would agree that the children's well-being matters and is tantamount.

There are a few things I'd like to point out

* The children know Allison, she had a "open" adoption and has had visitation rights. In fact, she still retains her parental rights. She maintains and there's evidence that her children do in fact have a relationship with her.

* Yes, the transition would be hard. But the BIG question about the kids is: how long or how old will they be before they come to resent... perhaps HATE their adoptive parents? Children have a right to the relationship with their blood parents. Sometimes that can't happen (for many reasons like death of a parent, parent who just does not make a safe, responsible parent). I truly believe, no matter what the circumstances, a child will likely have lost right they are due if they can't be with their parents, or have them in their life. If I found out the circumstances when I was older- as her son and daughter will some day- I'd be ANGRY and resentful. Such anger and resentment ISN"T going to do those children any good. I might even say I'd feel like my "parents" stole me. What kind of environment or childhood will that give THEM?

* Children are at risk for detachment issues simply BY being out of their biological parents care. Wouldn't they already be at risk for this? And isn't that largely the adoptive parents are responsible for having given THEM?

* Allison nearly immediately changed her mind and revoked the adoption. If the adoptive parents were truly ... well... in sync with my sense of morality... they would not have kept the children.

* How will the kids know, that the only reason they don't have THEIR mom is because Florida has really questionable adoption law? And that their mother was temporarily ill? And that she's in (or was in) jail? Are those reasons why the children's natural rights to their relationship with their mother should be disregarded?

Camera I do appreciate that you have a dissenting opinion, however your words sound cruel and steeped in anger over what has happened in your own family.

Perhaps, as the PP mentioned, the adoptive parents should have taken a moment to question their choice to ignore Allison's desperate attemps to revoke the adoption...an adoption that she signed in a moment of deep despair and that she IMMEDIATELY tried to revoke. 

This case is a lot different than a mother whose children are removed from the home, and then she wants them back because she got her life together finally.  It is a lot different from even the mother who planned and chose adoption all through pregnancy and then month after the birth changed her mind.   And in many states, both of those above scenarios is completely plausible, if not actually common.  In Florida, the laws are archaic at best...and just do NOT have the children's interest in mind as you say is tanamount.

Lastly, I do agree that an 18 month old has developed strong bonds, however I also know that there is strong evidence in the general adoption psychology literature that proves new bond formed even as toddlers can be as strong and healthy as those formed wtih parents who have had children since infancy.  Many international adoptions are actually OF kids who are in that age range and I'd bet their adoptive families would be offended at the notion that they don't have a bond with the child.  I also would argue that the children themselves would not recall the situations that happened in their life at around 18 mos to 2 yrs of age, so without any proof of long-term issues in children whose home/parent situation has changed as a toddler, I can't support your position that Allison is HARMING her babies in any way.

If you can share some documentation of detachment and paranoia in a large sample size of children moved from one home to another at 18 mos, then I will stand corrected.  If not, then I don't think your own situation is representative of what would happen to the Quets twins.

And why in the world would their own mother not have the "right" (as you put it) to raise her children?  She has attemtped to change custody starting right after she was talked into signing adoption papers.  Was taking them to Canada smart?  No way.  But I still support her desire to regain rightful custody of her own babies--custody that really, in the end, was only stripped of her because of very backward adoption laws...laws that most certainly do NOT follow Soloman.

Dearest Clare,

I haven't been in your shoes. I don't know how it is to have been so sick. But I think you should maybe consider adoption to complete your family. You sound like you have such a loving heart and could give a child a much needed and loving home. I hope you think about it. This maybe God's way of saying to help a child in desperate need of a love only you can provide.

Misty

Hyperemesis gravidium would cause her to lose vital electrolytes thru vomiting.  That combined with vomiting around the clock might just put a big fat dent in her judgment.  If she felt pressured to give those twins up, i'd imagine she'd feel very threatened. 

When you feel threatened and youre not 100% clear in the judgment department, you'd probably be apt to act on impulse.  I think it's the same thing as someone with PPD (which she also might have had, poor woman), wanting to kill her baby.  I think she needs psychiatric help and I think putting her in a jail cell isn't going to help her with her physical and psychiatric problems.

Sorry, I meant Hyperemesis Gravidarum(spelling error).   (HG) is excessive nausea and vomiting during pregnancy caused by sharp increases in Estrogen and HcG hormones during the first trimester of pregnancy.  I found a pretty good site for more info...

http://www.pennhealth.com/health_info/pregnancy/000198.htm