When two things don’t mix well… A memoir about HG and Primary Hyperparathyroidism by Nikki
Reaching a diagnosis of Hyperemesis Gravidarum (HG) was a long journey for us, but as Thomas Fuller put it, “A disease known is half cured.” We went through three difficult pregnancies with the usual runaround of “its morning sickness,” “it is normal,” “it’s the usual,” except it wasn’t.
In August of 2019, I became pregnant with our fourth child. We were expecting a difficult but rewarding journey. Little did we know that this time around things would be different.
After two months, I became a shell of my former self, barely eating or drinking, constantly vomiting, and confined to my room, having lost close to 7% of my pre-pregnancy weight. This could not go on for too long. As dreadful as it was, admission to the emergency room could not be avoided. Little did I know that instead of the usual rehydration procedures and the usual follow up monitoring, this short visit would turn out to be one spanning six weeks and concluding in a surgery.
I was extremely fortunate to have my OB/GYN, Dr. Alice Benjamin, who is affiliated with the hospital and oversaw my case from Day 1. Dr. Benjamin, who has since retired after delivering more than 10,000 babies, received the prestigious Order of Canada award. A CBC article reporting this significant milestone quotes her: ”But you never get tired of a birth, and that good outcome, and that first cry. You always wait to hear it. The whole room is silent. Didn’t you hear that first cry, the most joyous thing?” The article continues: “Half of medicine,” Benjamin says, “is common sense, not just following what’s in the textbooks. But many will say medicine is also about connecting with patients and making them feel heard and safe.” Something she has done countless times during her career.
This is exactly what I had experienced from the moment of admission. Dr. Benjamin made it very clear to the staff, who revere her greatly, that I am “her patient” and deserve good care…of course this is what all her patients encounter when reaching the hospital.
After (just) two horrendous days in the emergency room, consulting many doctors from different specialties, the diagnosis was clear: hypercalcemia (high calcium levels) due to primary hyperparathyroidism (overactive parathyroid gland), along with hyperemesis gravidarum. Indeed, a diagnosis I could barely understand at that time. I was told nausea and vomiting are two of the primary symptoms of hypercalcemia, and ditto, for HG. Together, what do you get? An amplified version of HG which isn’t fun.
I was informed the treatment would consist of parathyroidectomy (the surgical removal of one or more parathyroid glands) which is safest done in the second trimester, and in the interim, I would have to be hospitalized and my electrolytes managed and evaluated daily. Mentally, I was drained. Luckily, I’m privileged to be part of the most wonderful family who so graciously cared for our three other children, knowing that gave me the courage and strength to carry through these difficulties.
Physically, I was a shadow of myself, still in the emergency room on a chair (no gurneys available) with various hospital units in disagreement over which one I belong in, with me as the monkey in the middle. Finally, it was decided I belonged in “General Surgery” ending up being the only young person let alone pregnant women there (in the end I was briefly joined by another one).
This is how my hospital stay started, but as mentioned, it was the beginning of six agonizing weeks. Six weeks of being confined to a bed not because I wanted to but because I had no other choice. My days would start with early morning pricks, so my electrolytes could be monitored, followed by being weighed, and subsequently interviewed by a million people on how I felt today. (I know you meant well, I apologize for giving you the attitude you didn’t deserve.)
My breakfast would usually consist of freshly formed glacier crystals that the nurses so graciously retrieved for me from the unit’s ice machine. Occasionally, I would snack on the same, and if all went well, I would have another portion for lunch. On my lucky days, I would munch on blueberries or cherries when my mother went to great lengths running through every single store in search for some mid-winter fruit, which is almost non-existent. I also befriended some lovely pomegranates but that didn’t always end up well.
I was treated with several different antiemetic medications regularly and mostly intravenously, these include Gravol, Zofran, Reglan, and Bonjesta in addition to medications to control my increasing calcium levels and the so important thiamine, and, of course, multivitamins to keep me nourished. Thank God I was able to avoid a feeding tube.
I will forever be grateful to the entire staff of C8: Thalia, Kelly and the rest of the staff. I apologize for not recalling your names. You always treated me with the utmost compassion and care, going to great lengths to help with anything needed, even if it meant finding ketchup in the middle of the night or magically retrieving a yogurt pop when it was most needed. You made my hospital stay as comfortable as possible, and I really appreciate your mighty show of warm-heartedness.
And to you Dr. Mitmaker (my surgeon), lovingly stopping by to check up on me regularly or just to say hello and see how I felt, your reassurances and prompt medical attention were the tools that God used to restore me back to health. Today, I can be a mother to my children, a wife to my husband, and once again truly live each day to its fullest.
Post surgery, my severe vomiting and nausea almost instantly got better, and I was discharged two days thereafter. I still vomited occasionally but not as much as in the beginning of my pregnancy, and I was finally able to enjoy some of my favorite meals and snacks.
My doctor kept a close eye following me through the remainder of my pregnancy. At the end, she was quite concerned about the size of the baby and ordered me to gulp down two bottles of Ensure daily. When the doctor orders, who am I to refuse? Turns out it was a good idea.
At 39 weeks and 4 days, I was scheduled to give birth by induction with Dr. Benjamin at my bedside. Archangel Raphael overseeing, the event went smoothly, and we brought a full-term healthy baby boy weighing 3160 g and measured 55.5 cm. We named him Ephraim. The Book of Genesis relates the name “Ephraim” to a Hebrew word for “being fruitful,” referring to Joseph’s ability to produce children, specifically while in Egypt (termed by the Torah as the land of his affliction).
The HER Foundation website was a fantastic resource, guiding us in the right direction, and the Facebook group was a great support. I will forever be grateful to HER and especially Kimber at the helm. Now the world can see how one amazing woman took her experience to make many people’s lives easier!