Knocked Up – Knocked Over

my journey through pregnancy and hyperemesis gravidarum

Category Archives: The Protocol


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The Post We’ve all Been Waiting for!

So, it’s like this.  You see, there’s this place where all the storks live and on special days… No, no.  Let me start over.  So when a bird meets a bee… No, that’s not right either.  Let me try again.  When a mommy and a daddy love each other very much…

Have you figured it out yet?  Juan and I found out on Monday that I’m pregnant! 

All I can say is, “It’s a darn good thing I’ve been working so hard to get things done!”

I’m currently vacillating back and forth between, “YAAAAY!” and, “OHCRAPOHCRAPOHCRAP!”

I am in my 4th week, with the 5th starting tomorrow.  For those who aren’t familiar with how they figure it, they count Week 1, Day 1 as being the first day of your last period.  That’d be Christmas Eve.  Now you know way more about me than you thought you would!  Or not.  Isn’t the point of blogging to over-share just a little?  Just work with me here.

I know folks traditionally wait a while before telling everyone, but part of this plan in seeking support is to tell everyone straight away.  If we wait until 12 weeks to tell people about it, that will leave me suffering alone for way too long.  People can’t support us if they don’t know what’s going on.  We’re taking a risk.  I have a history of ectopic pregnancy, so right now, we’re kind of in a holding pattern to make sure things are all in the right place.  I’ll have an ultrasound either next Thursday to make sure it’s not implanted in my spleen or anything freaky like that, and then we’ll have another one the next week to see the heartbeat to make sure all is well on that end.  Following that, my doctor will be seeing me every week to make sure I’m staying on track and not getting sicker.  I love how incredibly proactive she it.

We’ve already told our families.  Their reactions ranged from excited to worried, but mostly really excited.  My mom, apparently, had a premonition and woke my dad up at 4 AM Wednesday morning to tell him.  I couldn’t get her on the phone Tuesday night, so I wasn’t able to tell her until Wednesday late morning.  She’s pretty worried, so we talked a little bit about what an awesome doctor I have.  We’re just trying our best to stay positive.  Realistic, but positive.

Today, I’m going to talk to the folks at work.  I’m lucky enough to have as my mentor the head of our HR team, so she is uniquely suited to coach me through this.  I’m going to meet with her at 1 PM for a coaching session, and then I go into my weekly 1-on-1 with my manager at 2 PM.  Talk about timing. 

Ask me if I’m nervous.

…

Oh, yeah.

Juan and I talked a lot about it, though, and they need to know upfront what’s going on.  He really encouraged me to tell them this week and not wait around even a little bit.  When the proverbial midden heap hits the windmill, they need to know what to expect from a work standpoint.  Last time, I tried and failed to tough things out until we were “ready” to tell people at 12 weeks.  This put a strain not only on my relationship with my bosses, but on the relationships with my co-workers.  They were being asked to pick up my slack and they had no idea why.  We’re trying to avoid that situation here.  Again, it’s a case of folks not being able to support me if they don’t know I need the help.

And I think it’s a good thing we’re being proactive.  I already don’t feel… quite… right.  I can’t describe it exactly.  The past couple of days, I haven’t been nauseated, just feeling off.  This morning, I woke up, felt okay, got in the shower, and then definitely felt nauseated.  I’m thinking it will be a week, 2 weeks tops, before all hell breaks loose.

The ptyalism is kicking in already.  That’s new.  I didn’t have that last time around.  Breakfast on Tuesday morning felt like sand in my mouth.  It was awful and I really had to force it down.  I switched to eggs on Wednesday, and that seemed to be much easier to eat. 

So what am I doing at this point to fight off the HG monster?  My immediate reaction, as per my protocol, was to change my vitamin routine.

Here’s what I was on before:

  • Morning: 1 New Chapter Every Woman’s One Daily multivitamin, 2 MG folic acid, 50 mg B6
  • Night: 2 MG folic acid, 50 mg B6

Here’s what I’ve switched to:

  • Morning: 1 New Chapter Every Woman’s One Daily multivitamin, 1 mg folic acid, 20 mg Pepcid, 25 mg B6, 6.25 mg Unisom (or .25 of a tablet), 550 mg ginger
  • Noon: 25 mg B6, 6.25 mg Unisom (or .25 of a tablet), 550 mg ginger
  • End of work day: 25 mg B6, 6.25 mg Unisom (or .25 of a tablet)
  • Night: 1 mg folic acid, 20 mg Pepcid, 50 mg B6, 12.5 mg Unisom (or .5 of a tablet), 550 mg ginger, 1 Colace tablet

I spoke to my doctor on Tuesday and she said that “off” feeling is a sign that I need to increase my attack.  At this point, I can increase the Unisom slightly (something I don’t want to do because of the sleepy side effects), add in the PrimaBella wrist band, and/or start taking the Zofran.  This morning, I started using the PrimaBella wristband.  So far, so good.  I’ve also brought extra ginger tablets with me, and an extra Unisom/B6 dose.  I’m still sticking with .25 of a tablet, but I’m taking them a little more often, about every 3 hours.

Tomorrow, I’m thinking I might bust out the Zofran.  Or today.  I’m not sure if I’m dealing with a serious case of denial about all of this.

So that’s it!  I will likely post earlier than Sunday to update you guys on how the work conversation went. 

Now we’re just waiting!


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The Importance of Having a Plan

I’ll be the first to admit this.  I am an information collector.  I collect information about certain topics obsessively.  I did this for breastfeeding, childbirth, pond/aquarium keeping, child-rearing, baby-wearing, urban legends, and, of course, HG.  I don’t necessarily have the info memorized, although I do remember a lot of it.  It’s more like I have a card catalogue in the back of my head that I can flip open occasionally to find the website to access what I want to know about.  I am not completely sure this is normal.  I do like sharing this info, though, so I wind up fielding a lot of questions from friends and returning their well-meaning interest with a deluge of information.  I’m trying to learn to give folks the drinking fountain version of things as opposed to the fire-hose version.

I’m also a serious planner.  I tend to worry through a scenario until I’ve come up with all of the potential courses that something might take and work my way through each and every little aspect until I’ve thought about something so hard and so long that there’s just nothing left to think about.  Juan, my husband, calls that being a worry-wart.  I just think it makes me a really good project manager.

All of this means that I’ve obsessively gathered HG-related information and obsessively massaged all of that information into a plan for dealing the HG during the next pregnancy.  I call it The Protocol, and it’s pretty thorough and in-depth.  It’s six pages of Microsoft Excel glory.  My doctor assures me that having something like this does not make me a raving lunatic thankyouverymuch.

This time around, it was really important for me to have some sort of plan.  Part of the despair and hopelessness I felt last time around stemmed, in large part, from not knowing what to do or when to do it.  I spent so much time wondering if what I was feeling was technically bad enough to call the doctor or technically bad enough to take the medicine or technically bad enough….  You get the idea.  I spent more time analyzing everything and feeling guilty about it than I did taking care of myself, and because of that, I waited too long for certain things like medication changes and fluids.

This time around, I felt like I needed to set up project plan of sorts to help give myself direction.  It took a year of writing, researching, re-writing, fiddling, re-writing some more, fiddling a bit more, tweaking here and there, and finally setting it into Excel format for readability and printing purposes. 

Going over The Protocol with my doctor a few weeks ago was an incredibly nerve-wracking experience.  Would she tell me I was nuts?  Would she just give it a quick skim and just smile and nod?  Worse yet, would she wait until after I left to roll her eyes and tell her nurses that I am one of those patients?  I had never met her before.  I had no idea what to expect.  By the way, did I mention earlier that I am an obsessive worrier?

She ended up doing none of those things.  Instead, she read through every single detail with me.  We talked over each line item, and aside from a few tweaks here and there and some additional information (mostly dosages), it was able to withstand her scrutiny.  I’m actually pretty proud of that.  She assured me that not only am I not crazy, but that the kind of early aggressive treatment plan that I laid out can, according to studies, reduce the severity of the HG.

The biggest thing that came out of this was the change in the way I feel about this future pregnancy.  My feelings of anxiety and downright terror were replaced with a sense of hope and empowerment.  I know what to do and when to do it.  I don’t have to sit there and wonder if my ketones are within the necessary range to get fluids or count the number of times I vomited to decide if it’s time to up the meds.  The path is mapped out for me ahead of time.  All I have to do is follow it. 

Why is it important to have a plan put together if you’re an HG patient?  Because when you’re in the thick of things with your brain foggy from the sickness, you shouldn’t have to try to find your way.  Just close your eyes, grab the guide-rope, and follow it to the end.

Without further ado, here is The Protocol in all its six page glory.  Of course, I can’t post the Excel file here, so I had to rewrite it a final time to post here as paragraphs and bulleted lists.  It ain’t pretty, but it does the job.  I’ve added it to the pages at the top of my blog for easy reference.

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