My Twin Pregnancy: Hyperemesis, PVCs, and other fun
I want to explain some of the complications I’ve been having. Before I do, I have 3 caveats:
- Not all twin pregnancies are difficult. Many women sail through their twin pregnancies with ease!
- Many twin mamas have even more difficulty that effects not only them but the babies.
- This is going to be a “pregnancy hurts” complain post. If you are in a spot in your infertility journey where that is going to trigger sadness or anger in you please stop reading. I know I’m beyond blessed to be carrying twins.
My “morning” sickness had been way worse than my pregnancy with Aellyn but, beginning at 10 weeks, things got way worse. I’ve actually had 3 main problems that are separate but exacerbate each other.
I started having heart palpitations at 10 weeks. These were no little flutters but skipped beats followed by hard thudding beats and racing heart rate. These episodes took my breath away which would then make me dizzy. Within a week I was having them hourly and they lasted longer than 10 minutes. They were keeping me up at night (and thus happening even when I was completely relaxed). I called my OB and he sent me to the ER. Ugh, ERs. The ER’s only goal is to make sure I’m not dying – NOT to find out what is wrong with me. They did blood work to look for low levels of several minerals that can cause palpitations and they did a CT scan, which carried the risk of exposing the babies to radiation (although it is considered slim because the radiation is very focused on my chest). At the time they were looking for a pulmonary embolism and the risks to the babies of me dying trumped the risk of the CT scan. Of course, after the fact you always want to kick yourself for the unnecessary exposure. The result? I was not dying. Hence, get out of the ER and follow up with a cardiologist.
A week later I went to see a cardiologist that came recommended from some local moms. They did an echocardiogram and I actually saw the erratic beating of my heart. I was sent home with a Holter meter for a 24 hours assessment of my heart. During this time between the ER and cardiologist appts. I had been vomiting more often – twice a day at least. When I left the cardiologists I didn’t even make it to my car (sorry to anyone who has to walk by the bush). By 7PM that night I hadn’t been able to keep down water or food for about 36 hours (note: my doctor has since told me that I should have called after 12 hours with out keeping down water or my prenatals). I called again and this time sent to the OB Triage.
At the hospital I was diagnosed with Hyperemesis Gravidarum (HG) or extreme vomiting in pregancy and given an IV of fluids and nutrients along with an antiemetic (phenegren). I have to admit I ignored my symptoms because I once had a blogging friend with HG her whole pregnancy. She actually had to be on an IV at home. She was never able to eat her whole pregnancy. It was so horrible and severe that I don’t think HG crossed my mind when I was so sick because – well, I wasn’t THAT sick. HG isn’t a simple diagnosis but my doctor considers it HG when, as wikipedia defines it, when “unrelenting, excessive pregnancy-related nausea and/or vomiting that prevents adequate intake of food and fluids.”
Your baby depends on you for nutrients and food so it is important not to deprive them of that. I was put on phenegren to control the vomiting and allow me to keep food down. Luckily for me they worked quite well as long as you took them in time to not throw them up (the alternative? a suppository). I have just recently stopped taking them several times a day. Now I take them when I start to feel queasy which has been every day or two. I’m praying the vomiting subsides by 20 weeks (only 1 more week!).
Back to the heart problems – during this overnight admission to the hospital I was still wearing the Holter meter that I had to press a button every time I had a palpitation which was every 5 seconds. Turns out dehydration can bring on palpitations. As can stress. It was the perfect storm.
After I was discharged from the OB unit I returned the Holter meter for analysis. I was having a LOT of palpitations (uh, duh, I knew that) but they were not dangerous to my heart. My cardiologist believes that since they are not damaging my heart that it isn’t worth the risk of medicating. My OB on the other hand thought the way they were interfering with my life was bad for the babies (interrupted sleep, for example). So at this point “Mrs. Homeopathic” was on antiemetics, a metric ton of tylenol for headaches, and a new medication for headaches that tylenol wouldn’t help (fioricet). I really didn’t relish taking another drug if there was an alternative.
I did a bunch of research on PVCs (premature ventricular contractions which is the medical term for my heart palpitations) to find an alternative. First off – reduce stress and stay hydrated. Just knowing I wasn’t having a heart attack helped calm me down. I was definitely in a PVC-fear-PVC cycle before that. The antiemetic was helping me stay hydrated but I was still having life-interrupting episodes. That’s when I read that some people have PVCs as a result to taking Zoloft. Hmmm. I’d been on zoloft for years now with no palpitations but how curious that zoloft could effect electrical impulses to the heart in some way. Maybe I needed to increase my dosage? I’d been thinking about it anyways because I was under a great deal of stress at work and with all the pregnancy-related problems. Couldn’t hurt to try right?
It ended up being a wonderful answer! I’m now on 150mg of zoloft and it has helped my mood (being really sick can really depress your mood) and reduced the frequency, duration, and severity of my PVCs drastically. Now I only get them when I’m too active. This is the same dosage I was on when pregnant (and nursing) with Aellyn so I’m not worried about the effect on the babies.
Now that I’ve gotten the PVC’s and vomiting a little under control my primary problem is headaches. I have had a headache non-stop for 9 weeks. Basically if I’m not medicated I have a headache. I wake up each morning with one and the first thing I do is take a tylenol (I normally avoid tylenol but it is the only pain reliever approved for pregnancy) if, after an hour, my headache is still in full force I take a fioricet. I try to avoid the fioricet since it has a barbiturate in it but so far it has relieved my worst headaches. Since my headaches are so consistent they aren’t worrisome to my OB (sudden onset of headache could be pre-eclampsia).
With all these symptoms it is like having the flu 24/7 for two months.
All that being said – the babies are doing great! I’m blessed to have only complications that make me miserable. It could be a problem with one of the babies, or my placenta, or cervix. I’ll take feeling like crap over danger to my babies any day of the week!
Ok, I feel like I’ve documented my problems and maybe provided some possible solutions if anyone else is in a similar situation. It is cleansing to get it off my chest! Now perhaps I’ll start to feel better and be able to blog about different things. Good things.
There are so many.