Friday, September 14, 2012

{Morning Sickness part 1}

Up until 2011, I had 4 pregnancies, 3 lasting until term and 1 ending in miscarriage at 6 weeks.  Each pregnancy I struggled with nausea and vomiting.  I didn't want to seem like a "wuss."  I didn't want to speak up only to be told it was normal or to be labeled as a whiner, etc.  I was taking zofran for all of them and still threw up usually 3-5 days until 20-22 weeks, then I would usually have a few days in between and if I did throw up, it was usually just once daily.  It came back again for the last 8-10 weeks (except the nausea and vomiting didn't return at the end with my last baby).  I had 2 or 3 weeks in the peak of the nausea and vomiting where the earliest I kept anything down was early afternoon and probably half of those days during that stretch I didn't keep anything down until right before bed time.  I felt guilty talking to my Dr. about it because I thought that was normal.  He was always very kind and asked at every appointment how the morning sickness was.  I would sheepishly tell him I was still pretty sick and his response was always "do you need more zofran?"  NOW I adore my OBGYN and will not see any other in town as my preference.  He wasn't doing anything wrong or venturing from his training in medical school.  It was my fault for not bridging the gap.  I wonder if I quantified it for him how he would have reacted.  "All I kept down yesterday was____, and the day before ____"  I think I would have gotten the help I probably needed, but didn't get because I was uninformed and a chicken.  I never had huge weight drops in the first trimester of pregnancy, but I certainly didn't gain much until I passed the daily throwing up part.  I wasn't a classic case that way to alert my Dr. to a potential problem. 

It's no surprise (now knowing what I know) that the past 2/3 babies I carried to term ended up as high risk pregnancies, from what I believe lack of adequate nutrition.  I woke up with bright red bleeding one morning when I was about 26 weeks along with the second baby.  Being a Resistered nurse, I knew what that meant and immediately phoned the Dr. office.  After an exam to rule out the cervix being the source of bleeding and an ultrasound, the Dr. confirmed that it was the placenta.  I had part of the placenta detach from the uterine wall.  (Placental abruption).  In my situation, it wasn't enough to put me into labor or compromise the baby's well-being.  We held our breath through weekly appointments and we were truly granted a miracle to maintain the pregnancy until I was induced at 38 weeks.  We were blessed with a healthy, full-term baby!

The exact same scenario of waking up to bright red bleeding happened again during my third pregnancy at 16 weeks this time.  It was again the placenta.  This time it had pulled away in two places and on later ultrasounds you could literally see the placenta flapping in the amniotic fluid.  It was held in place in one part and the portion that pulled away was basically cupped around it.  We began seeing the perinatologists at 20 weeks and had bi-weekly appointments with Dr's. until 28 weeks, then weekly appointments.  We were given very grim hopes for our baby, the most optimistic a 32 weeker.  We defied all odds and maintained his pregnancy until I was induced only 4 days before my due date.  He had only about a 3 inch square of the placenta that was still functioned.  There is no medical explanation how that placenta held up during contractions, let alone continued to nourish my baby (who was 8 lbs 9 oz by the way!).  Truly another miracle we prayed for and God willed it.  We were blessed with another healthy, full-term baby!

As I'm sure you can imagine, these pregnancies of the nausea, vomiting, and literally life on the line have put a physical and emotional strain on my little family.  I didn't realize until with hind-sight that I literally put my life, as well as two babies' lives, on the line.

With both abruptions I was told by medical professionals who were doing their job as medical professionals that they had no idea what caused the abruptions, that there was nothing we could do to help change the outcome of the pregnancies/health of our babies once we had abrupted, and that there was nothing I could do to prevent this from happening in future pregnancies.  From a medical approach there is no information on what causes the abruption (other than major physical trauma like a fall or car accident and I didn't have that with either).  The only glimmer of hope was some emerging research finding links between clotting disorders and placental abruptions and also pre-eclampsia.  All 10 vials of blood donated to the lab for the clotting tests offered no answers.  Everything was negative.  It was very discouraging news to a couple who had planned for a big family, with children close together. 

What do the placenta issues have to do with morning sickness you may be asking?   Can you imagine my excitement when I found the reason for abruption on the Brewer diet website HERE?  From someone who studied Anatomy and Physiology, it made perfect sense to me!  Did I mean to provide inadequate nutrition for my babies?  No.  But I did.  For me, the inadequate nutrition needed to be tackled on two levels.  1.  I needed a better knowledge of adequate nutrition during pregnancy actually meant.  2.  I needed to kick this nausea and vomiting.

After nearly 12 months of researching, consulting with a dietitian, making changes to my (and ultimately my family's) diet, and follow-up with my mid-wife, we had the green light to try for our first pregnancy after stumbling onto the Brewer diet (and what I believe to have been the root cause of my difficult pregnancies).  I remember approaching it with great anticipation and enthusiasm to finally have a healthy pregnancy.  My husband and I remembered the morning sickness hitting quickly with our other babies, but we were amazed that it hit within 3 days of conception.  THREE DAYS!  (We had about 2 weeks or so of abstinence previously, so maybe it was sooner than 3 days). :)  I kept my chin up, but about a week into the pregnancy (3 1/2 or so weeks gestation) I had my first casualty with the toilet.  We could not believe I was already throwing up that early on I was getting so discouraged.  I was banking my healthy pregnancy on being able to keep up with the brewer diet and was falling very behind with each passing day because of the nausea (and now vomiting). 

Being religious, I did something I had never done before in previous pregnancies.  With the new knowledge and desire I had gained over the past year, I now saw the morning sickness as more than just "I hate this and feel like I'm going to die," but now it was "I need to get this under control now."  I fell to my knees and prayed one of the most heartfelt prayers I had ever given.  I had faith in a loving God who is keenly aware of me and my situation.  He knows the end from the beginning and He has the solutions, but I had never bothered to ask before.  I KNEW that this morning sickness could be taken from me, but what I didn't know was how.  Would He completely remove it from me?  Would He lessen it for me so it was bearable?  Is there something else yet to be learned?  As I lay down to sleep that night I was pondering the situation.  A thought along the lines of "if you keep doing the same thing, you will keep getting the same results" kept rolling around in my head.  After a few minutes, I thought through my usual morning routine.  I had tried "it all" trying to combat morning sickness with the first 3 babies (plus one miscarriage).  Like any text book says under nausea, I always stayed in bed and had something with carbs (crackers or dry toast) before getting out of bed, then I would give it time to settle before getting up (about 15-20 min).  The thought kept coming to try protein.  I remembered a suggestion a friend once gave me to try a protein shake before getting up.  At the time I brushed it off because if I had more than a few sips of liquid at a time, I would quickly become Old Faithful.  EVERY TIME.  This thought came to my mind at that moment and as I shared the thoughts with my husband, he was up and dressing at a very late hour to run to the store to get me some drinks for the morning. 

The next morning, we were both more than a little nervous when he brought it to me instead of the carbs.  We used a bendy straw and it was nice to even be able to position it and lay down 100%.  I would take a small sip and swallow, followed by another small sip and a swallow.  It would usually take me about 5 min or so to drink it.  I stayed in bed, and once I felt it had settled, I started my day.  I didn't feel too bad.  Definitely not needing to run to the bathroom.  It stayed down! 

I also had the thought of protein on the front of my mind, so I would eat as close to 10 (or more) grams of protein every hour until I felt very light nausea.  This was usually around early afternoon, so a great time to catch a late lunch.  10 grams isn't as hard as it sounds.  2 eggs, 1 cup of vanilla yogurt (yogurt with fruit hits my gag reflex), a cheese stick, high protein pancakes or granola, nuts.  I would not eat anything unless I added protein with it.  This also doesn't sounds as daunting as it may appear.  I used to think protein=meat.  Not so, again...the above examples, but also throw a slice of cheese on your sandwich or with your eggs.  Add nuts and cheese to your salad.  Simply drink a glass of milk.  If you start looking, you will see very easy and creative ways to add protein to what you are eating.

At 6 weeks we lost the baby.  From what I recall, I don't believe I threw up again (other than at 3 1/2 weeks) and only had constant underlying nausea that was very livable compared to previous pregnancies.

We waited a cycle and conceived again.  This time I not only had the knowledge about the power of protein in fighting nausea, but also several new tools in my arsenal. 

*My husband found these capsules at our local health food store, actually during our youngest son's pregnancy.  Our Dr. approved them, but I never took them because they are huge.  I pulled them back out during this pregnancy and after only a moment of inspection realized the capsule can be opened and the powder mixed into something else.  It contains vit. B6, Ginger, Peppermint, Red Rasberry,  artichoke, and Milk Thistle.  The first few combat nausea.  Artichoke and Milk Thistle are strong antioxidants and help with liver support during all the hormonal changes (and may also help with nausea as well).  I've found the best way to use the morning ease is to open the capsule and mix it with yogurt.  I've tried it in drink and it's too gross for me, but the yogurt covers the flavor well enough that I can swallow it.  I've learned from experience that the longer you wait to eat it after mixing it with the yogurt, the more stronger the taste will be.  DO NOT MIX UNTIL YOU ARE READY TO EAT IT! :)

*These little babies are based on acupressure.  I'm assuming most are familiar with acupuncture...?  Acupressure utilizes the same specific points on the body to treat illness or ailment, but with pressure(no needles).  Seabands were invented to offer continuous acupressure to those who get sea sick.  They were later tested for morning sickness and found effective.  I actually have a brother-in-law who is a PA and did research on sea bands during his schooling.  The little white button on all the wrists pictured above is the pressure point.  Without even pushing on it, it delivers a small amount of pressure (the bands are elastic, so snug on the wrist).  When my husband was home and I felt like I was about to run to the toilet, he would push on both wrists where the button was, and as long as the button was lined up where it was supposed to be (instructions included with the purchase), I NEVER threw up.  It amazed me.  Sometime he would have to hold it for a few minutes and push as hard as was comfortable for me, but it always prevented a casualty.  When he wasn't home, I couldn't figure out how to deliver enough pressure on my own with my crossed arms. :)  I noticed a huge difference when I started using sea bands at about 9 weeks during my second pregnancy.  I would wear them day and night other than to shower or washing dishes, etc.  If I forgot to put them back on, the nausea would get very strong very quickly again until I realized I was missing them.  Sea bands can be purchased at most pharmacies and health food stores. 

*We delivered our third baby with HYPNOBABIES and had an amazing experience.  I found out that they have a CD track for nausea.  I would turn the CD on as the last thing I did for the night and listened to it faithfully most nights.  I also turned it on during the day a few times and had it as "background noise" trying to listen for the cues because it would always put me to sleep so quickly.  She helps you program a cue to completely eliminate nausea instantly by putting your fingers in the "ok sign" and stopping what you are doing and taking a deep breath.  From my previous experience with hypnobabies, you cannot expect to listen to it once and for it to be effective.  The more you listen to it, the more effective it will be and the quicker it will work for you.  It's taken me time to unravel the morning sickness issues in my life and I realized, as hypnobabies clearly helped me see, that Iwanted to be sick.  Yes.  You read that right.  That's a hard pill to swallow and slap on the that I wanted to have high risk pregnancies, as well as my responsibility in my neglect of nutrition, and that's a hard pill to swallow.  These were all subconscious choices, but I've come to realize, even though no harm was intended, harm was done.  My choices lead to the outcomes.  We create things for ourselves mentally and spiritually before we create them physically.  Beliefs--->thoughts--->actions.  Hypnobabies, and especially this track, helped me realize what I was (and ultimately had) created for myself in my previous pregnancies.  It filled me with desire to want the positive and not want a healthy pregnancy.  Definitely highly recommended from this Mama! :)

*During this journey of revamping and trying new things, I was introduced to essential oils.  I had never heard of them, let alone used them before.  I began using a blend of oils in April of 2011 and still have not had to any of my 3 kiddos to the Dr. since (other than well checks) because of the antiviral and antibacterial properties of those oils.  We were frequent flyers at the Dr. office and would usually have to go at least once a month for a cold that turned into an ear infection, etc.  Having experienced the blend (On Guard), I gradually dipped my feet more and more into oils and I'm glad I did.  We had an open mindset to try to treat whatever sickness, symptoms, ailments, came our way with oils first, but planned to back it up with medication.  We have been amazed that we haven't had to back it up.  Some times it's taken patience and a bit of experimenting to find the right oil(s) or method to use it because everyone is different.  If you are interested in knowing more, read aguest post I recently wrote and contact me! :)  BUT, I had finally grown my confidence in the power of essential oils, so with this pregnancy, I dove in.  I tried Peppermint, Ginger, and also Citris Bliss.  The Ginger and Citris Bliss were not my oils for nausea, but worth a try any way.  They helped quite a bit, but the peppermint would literally knock it flat for me.  If I had kept up on my protein and was keeping something on my stomach and still had nausea, I would use the peppermint and within minutes it would be gone and gone for about an hour or so.  AMAZING!  A few cautions on using essential oils during pregnancy: make sure to consult with your health care provider or a certified aroma specialist.  Always use a carrier oil (such as olive oil) to dilute the essential oil in.  I usually used 1 TBS carried and 2 drops essential oil.  It's recommended to not ingest essential oils during pregnancy.  If you are serious about using oils during pregnancy, purchase some books to refer to!

 I have one for oils in general: 

as well as one specifically for oil use during pregnancy.

I highly recommend both.  There is a chart in the essential oils for maternity that lists which oils are safe to use when.  I was horrified about 6 weeks into my pregnancy to see that peppermint should be avoided during the first trimester.  I didn't use peppermint for about 2 weeks.  The nausea (and vomiting) worsened.  Not as difficult as my previous pregnancies, but not as easy as this pregnancy had started.  After talking with my friend who knows much more about oils than I do (and got me started in this wonderful journey), she said that if it was working for me, it may be worth the risk.  The book is very conservative and errs on the side of caution.  She also talked to someone high up in the doterra company and she said that pure Therapeutic grade oils are safe (like doterra), but using oils without that level of quality should be used with caution.  Doterra test each bottle to not only certify that what's in there is in there (required by the FDA), but they are also the only company to go beyond the FDA requirements and verify each bottle---that there are not contaminates (like weeds that may have accidentally been harvested with the plants) and no oil, alcohol, or water has been added to dilute the essential oil.  Knowing that the label truthfully reflects what is in the bottle gave (and gives) me peace of mind. So, I used the peppermint.  You can rub it (with the carrier) on the bottom of your feet or I loved to rub it on my tummy (with carrier).  Sometimes I even took my thumb and turned the bottle upside down (releasing a drop), then put my thumb on the roof of my mouth.  This worked well if I was out in public or unable to access the carrier.  Even just opening the bottle and inhaling deeply was sometimes enough for me. 

Another great way to fight the nausea with the peppermint is use it for aromatherapy.  (mentioned above, just smelling the bottle with the lid opened counts).  We purchase a diffuser. (pictured above from Doterra).  You put water and a few drops of the oil and it will make a fine mist.  (It's the same idea as a cool mist humidifier). At the time, it was somewhere in storage, so I actually just took a small sauce pan of boiling water and added a few drops, then turned the heat down down.  If I was starting to feel sick again, I would bump it up to get it boiling again and/or add more oil.  Make sure to watch it closely and not to let all of the water boil out! :)  You'll smell it if you miss smells like burning pan! :) 
I would definitely recommend essential oils!  Educate yourself, then give it a try!

Other things I did differently this time around:

*I mentioned this briefly, but it is very important.  Keep eating and eating and eating.  Eat small, frequent meals.  I've read this in the "text book" section under nausea of every book, but it didn't work for me before.  I really feel like adding protein, as mentioned above, was the key.  I would eat every 1-2 hours max.  I would eat before the nausea would hit (ok...that wasn't entirely accurate.  I usually had some underlying nausea unless I was using the peppermint or the hypnobabies cue, but it wasn't about to throw up nausea like I would get without keeping up on small, frequent meals).

*Get enough rest.  I always found a direct correlation between fatigue and nausea.  Again, being in the first trimester, you are always tired, but I'm talking so tired you can't move tired.  Don't let yourself get to that point.  Do everything you can to get a nap---even if it's just dozing for a few minutes while the kiddos watch a movie, etc.  I have a wonderful husband who will usually try to let me sleep in.  My kids have suddenly decided to sleep in until 7 or later, but in previous pregnancies, they were early-risers and that made it difficult to combat the nausea with the fatigue adding to it.

*More thoughts on protein shakes:  I loved slim fast.  I didn't try competitors to compare other than the generic brand.  I found the equate brand at walmart and actually preferred it over the slim fast.  It was a smaller amount to drink, which was a plus.  It was the hospital grade, so it was packed with lots of good things (plus 13 g protein instead of just 10 from slim fast).  HOWEVER, with less liquid and more nutrients, it was very concentrated.  The slim fast didn't bother me warm, but the eqaute brand needed to be cold or I couldn't drink it.  Later, I wanted to search for a cheaper solution.  Truly $1-ish a day for 40 weeks doesn't accumulate to the same bill as seeing perinatologists and weekly OBGYN visits, but it's still painful to spend that much.  I began looking into protein powder instead of the shakes.  I couldn't find any I liked that were close palatable.  I finally found one that tasted great, but after looking closer at the label there was a pregnancy and breastfeeding warning.  I wondered if it was just that it may be substituted for meals at a time when that would jeopardize mom and/or baby health.  After checking with the dietitian, she said it's the sugar and with 2 miscarriages under my belt, it would be wise to avoid until 22 weeks.  I didn't have time (and haven't since made it a priority) to research more on an alternative solution.  Maybe more to come later...?

*Eat even when you don't feel like eating.  This was a big difference this time around compared to my previous pregnancies.  I would always wait until something sounded good, and usually by then I was too nauseated to keep it down.  I was surprised that when I stayed away from offensive foods and ate something even though it didn't sound good, it decreased my nausea quite a bit.

*Stay hydrated.  I focused on getting 8-10, 8-oz glasses of water this time around.  I usually had to just take a few sips at a time between meals, but I could usually do it most days.  Get a sports bottle or mug and sip all day long.

When we went into our first appointment with the midwife, we were shocked to find no heartbeat.  It was heart-wrenching especially after the previous miscarriage so recently and expecting all to be well with the baby.  The above advice will have to be left hanging for a time.  I'm not sure if I felt so much better because of the hormone levels not being as high as a normal pregnancy.  BUT I still did throw up 5 times in the 9 weeks of pregnancy and even through up over the weekend between discovering the fetal demise and the D&C.  Also, the pathology came back and the Dr. was unable to completely rule out a molar pregnancy.  With molar pregnancies, mom usually experiences worsenausea and vomiting.  Keep that in mind for your own situation. I may truly be sick enough to need IV's (but at least now I am aware of that, unlike my previous 3 babies).  HOWEVER, I may not have any problems. 

It's important to keep tabs with your Dr. or mid-wife.  They need to know how sick you are!  You need to let them know (and also if you are consulting with a dietation) if you all behind in your diet.  I printed out a nausea and vomiting journal to stick to the fridge.  If you are throwing up quite a bit, write it down, quantify it. What time did you eat and what?  What time did you throw up?  Give that to your health care professional if and it will give them a better idea of what you are/aren't keeping down.  It's better to speak up, even though (not from personal experience) the IV's or even heplocks may not be "fun," but this is your baby's health!!!  Also, see the smoothie label for a few ideas of how to keep up with the brewer diet.  I was't ever able to "chug," but I could always take small sips, so this might work for you!

Bottom line with fighting nausea is not to give up.  I thought it was just the way it had to be when I was pregnant.  Even though we haven't gotten a baby out of the past two pregnancies, I have gained confidence in myself and my ability to study things out and seek to find answers and solutions for my own life.  Again, being religious, don't forget to ask.  He truly cares and wants to help you in your own individual path to combating this difficult challenge.

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