Tuesday, October 3, 2017

Praying with Dirty Diapers

It's been almost one year since we found out we were expecting Zelie. The other night, I was reading old blog posts while trying to convince her to go to sleep, and I ended up re-reading the posts from when Gabriel died. Remembering the grief of that time, and now holding my Zelie... I realize what a miracle she is. 


But it's not as if she's a replacement baby. She is our fourth child, a unique person in her own right. While having her heals some of that heartache, it also reminds me what I never got to experience with him...which in turn makes me more appreciative of her. After miscarrying Gabriel, then thinking we were miscarrying Zelie, then having such a difficult pregnancy, I don't take a moment with this baby for granted.


Having Gabriel as my child has changed me. And now, having this little girl in my life has changed me even more.

But all of this doesn't negate the hardness of mothering young children. It is easier to face that hardness having faced the alternative - secondary infertility, miscarriage, hyperemesis gravidarum. When having children doesn't come easily, it heightens your awareness of what gifts they are.


But this vocation stretches me in ways I never dreamed possible. This vocation makes me realize how selfish I am, how lacking in true humility, and how much I need God. I suppose that's the whole point of a vocation, right?

But I need a framework for understanding that this work I am engaged in isn't drudgery. It is anything but. Recently, I was at a meeting of a mom's book club, and someone reminded me that we're called to make everything we do into a prayer. 

Of course. The Little Way of St. Therese. How could I have forgotten?


But I have a graduate degree, my second theology degree from the University of Notre Dame. I always had excellent grades, and a long list of accolades. I found my worth there. I still look for my worth there.

But my worth isn't there. My worth is in how I love, and in the fact that I am loved by God.

And the only work I do that actually matters, is the work of loving. Jesus emphasizes the value of giving a cup of cold water with love, because the little things matter.

In fact, little acts of love matter more than any accomplishments from my past. After St. Thomas Aquinas had his vision of the beatific vision while working on the Summa, he abandoned his project and called all his work "straw." If you've ever encountered the Summa Theological, you know it is magnificent. "Straw" is the last word I would use to describe it. But when faced with God's love? What isn't straw in comparison?


I really don't like experiencing hyperemesis gravidarum. But I am so grateful for my pregnancies, for the opportunity to experience real suffering, for the sake of loving another.

In a way, I sometimes have a twinge of sadness after an HG pregnancy, because my spiritual work is so straightforward during it. I suffer because I love my baby. I have ample opportunity to offer up suffering. It's awful to experience, but I grow a lot.

Do you know what's harder? Offering up that extra ten to fifteen pounds, lingering and making me feel like I am no longer my young, thin self. But even there is the challenge to love as Christ, who said, "This is my body, given up for you." Because, that is still what it is. A tired body, a body that's softer around the middle, a body still experiencing occasional bouts of nausea - it is still a body that is loving. It is a body given up for another.


That is, after all, why we have these bodies of ours. They are made to glorify God. They are made to show His love.

 Of course, everyone's vocation calls them to glorify God in different ways, at different stages of life. But living out our love and offering our actions as our prayer to God, transforms the everyday moments.

I love praying morning prayer when I first wake up. But sometimes, the prayer God wants from me first is changing a dirty diaper.

Because, guess what? Changing a dirty diaper, with love, is a actually a pretty big thing. It is more important than an alphabet soup of degree abbreviations after my name. It is more important that any of the other job titles I hold.

Small things with great love. It is enough.


Thursday, July 20, 2017

A Birth Story and Humility

Miss Zelie is officially a month old today!!
This is basically where she spends all of her time, and it has been so, so healing for my heart.



High time for a birth story!

So, just over a month ago (on June 19), I was 37 weeks and 5 days pregnant and....soooo done. Anyone who talked to me knew I had felt that way for weeks. My hyperemesis gravidarum got worse again in my third trimester (although not as bad as it was in my first), and I was up to sticking myself with a needle at least twice a day, because my body was not happy with my Zofran pump.

My doctor sympathized, and since I had been measuring ahead for so long AND was already dilating and effacing and had been having prodromal labor...he suggested stripping my membranes (i.e. separating the bag of waters from the wall of the womb). He said if I was actually ready to deliver, it would kick start labor. Worth a try!

Over the next 24 hours, I kept having stretches of contractions, but it didn't seem to be turning into anything. A little before 9:30 on Tuesday morning, I felt some painful contractions, but assumed it was more prodromal labor. Andrew wanted to replace the bathroom fan, so I said he could go to Lowe's and buy a new one. I would take the girls to swim lessons.




In the meantime, I worked on switching the clothes around in the girls' new dressers, but I had to keep stopping to squat through contractions. It was taking forever because I was getting contractions every minute, and they were getting more painful. Maria's labor had been only four hours long and I was convinced I wouldn't have another precipitous labor like that. But I realized I should probably time the contractions... just in case there was a pattern.

There was a pattern. They were about a minute long, less than a minute a part, and not letting up.

My texts to Andrew went from something like:

"Still having contractions, but probably nothing."

"Maybe something. Kind of hurts."

To:

"Call the babysitter. Maybe head home."

"Come home now! We need to go to the hospital!"

As soon as the babysitter arrived, we headed to the hospital. We got there around 11:30 a.m. and I waddled in to triage while Andrew parked the car. It took forever for them to check me in, because the contractions were so close together.

Then, the nurse checked me. I was 5-6 cm. Definitely in labor! I pulled out that Zofran pump almost right away. So glad!

The next couple hours were a blur. I wanted an epidural because this labor was as intense as Maria's, and I had barely managed that one. I had never had an epidural before, but I had had daily pain with the Zofran pump for the past six months, and I felt like God was calling me to humility... I needed help managing the pain, and that was ok.

The epidural came while I was already shaking in the pain of transition, and it was bliss. Zelie's heart rate dipped, though (probably because I wasn't squatting anymore!) so they had to give me some oxygen. They checked me right after they got the epidural in (around 12:50 p.m.) and I was already 8 cm! Almost complete.

The doctor was called, and by the time he came in, I was ready to push.

"How long did it take you to push out your other girls?" he asked.

"Oh, around half an hour," I told him.

"Oh, okay...so we have time! Okay, give me a practice push. Let's try in this position. Okay, good! I can see the head. Do you still feel like pushing?"

I did. "I can see her face!" Andrew said.

"Wait!" the doctor said. "I need to get on my gloves! I'm not ready!"

"I can't wait!" I said.

And out popped Zelie Jane...and a huge gush of amniotic fluid all over the floor and the doctor. "I just got these shoes yesterday!" he joked.

I heard a little cry, and they placed her tiny newborn self on my chest. She had a headful of dark hair and was so perfect.



She wasn't pinking up, though, so they took her over to her bassinet and rubbed her vigorously. Her heart was going strong, but she laid there not really breathing, and bluish. Then all the nurses and doctor's pagers beeped.

"Wait," my doctor said, "Who called a Code Blue?"

"I did," one of the nurses said. And then, a flurry of NICU doctors rushed in and gave her an oxygen mask. (They later explained to me she wasn't actually coding, but that's what they do when they need NICU doctors to arrive fast. Still terrifying and not something I ever want to experience again!)

"Is she alright?" I asked. Simultaneously, I begged Gabriel to pray for her.

She pinked up enough that she didn't need to go to the NICU just then, but they were going to come back and check her in half an hour.

I spent that half hour doing skin to skin and getting her to nurse a little, and within a half an hour, she was doing well and got to stay with us. Hooray!

I was so grateful for her big brother's prayers. A few hours later, her godparents brought her sisters and it was love at first sight!


And now we can't imagine life without our sweet, sweet Zelie. :-)

Wednesday, July 12, 2017

Introducing...

It's been three weeks, and I realized I haven't yet introduced our newest little love.

Zelie Jane
Born June 20th at 1:31 p.m.



She was baptized this past Sunday and was gladly welcomed into the seminary family, too. In fact, her godparents work for the seminary, and have become so close to our family that the girls call them "Aunt" and "Uncle."



It was the first time we've used the Extraordinary Form for Baptism. It is achingly beautiful, but I wouldn't have been able to do it before Gabriel. In the EF of Baptism, the godparents hold the child and answer for her - an acknowledgement that the Baptized is her own person who can speak for herself (or have her godparents do so).

Baptism is one of the things that sustains me in pregnancy. It is an ecstatic moment for me to hold my child as the water is poured over her head and she becomes a daughter of God. I had to hold back tears, not being able to hold Zelie at that moment.

Before Gabriel, I wouldn't have been alright with that. Despite the fact that the Extraordinary Form for Baptism is beautiful, and offers additional blessings (and exorcisms!) for my daughter, I would have wanted to selfishly cling to have that "moment" with her at Baptism.

But the reality is - Ordinary or Extraordinary, both forms of Baptism are a kind of death. They are a giving back of our child to God, just as Hannah did with Samuel. In that, Baptism is the beginning of acknowledging an unavoidable reality - my children are not my possessions. They are children of God, entrusted to me for a time. They may bring me joy, but that isn't the reason for their existence. Ultimately, Andrew and I are only a part of their journey back to God. We are an important part, but only a part.


It was my Gabriel who helped me understand that, my Gabriel who I could only request a conditional Baptism for (a conditional Baptism offered by a doctor, in an operating room, without his mother conscious or his father present). We had to entrust Gabriel to God long before we were ready, and it was the hope of that alone that made it possible to let him go.

With Gabriel I learned that although my love will always go with my children, they do not existence merely for my benefit. One day, each of our three daughters will fly the nest. Whether they fly to a house down the street and give us grandchildren running in and out of our doors, or they fly to a cloistered convent hundreds of miles away - either way, we will eventually have to let them go. We'll have to let these three girls live out whatever vocation they are called to, even if it means enduring the pain of separation.

Baptism is only the beginning of that. Yet, Baptism clothes that process in a kind of grace. Maybe we are offering back to God the child he gave us - but God is never outdone in generosity. 

But for now? For now, I'll hold this child close, well aware of the gift she is, and appreciating her even more after the loss of her big brother. For now, I will be grateful that God has permitted me to care for and raise another little girl.

And do you know what? All the suffering of this pregnancy was totally worth it.



(Btw, birth story coming soon...but there were traumatic moments involved, so no promises on how soon the story will be shared!)


Monday, June 19, 2017

Not Enough on My Own

37 weeks, 5 days pregnant today...but who's counting?!

As the long stretches of silence on this blog attest to, this pregnancy has stretched me in ways I didn't think possible. In trying to process it all, I alternate between being traumatized by various aspects to feeling strong and grateful for being able to do things I haven't previously been able to do.

My Zofran pump is the perfect example of this. I think back to all the times I've stuck myself with a needle, to the pain that caused, and also to the pain, welts, bruises, and burning sensation it's caused...and I just want to curl up in a ball and cry. But then, I think about the difference the pump has made, how sick I would be without it, and how amazing it is that the love I have for a little girl I have yet to meet, motivates me to stick a needle in my skin (sometimes multiple times a day). Then, I am flooded with gratitude and in awe of the graces I've received this pregnancy.

Because, that's basically what this pregnancy has been for me. I've walked a tightrope between being gripped by sadness and fear and being overwhelmed by hope and love. There isn't much space in between.



In these final days (or weeks) of pregnancy, I feel this even more acutely. The end of pregnancy is hard for every mom. But in addition to those normal struggles is weird HG stuff. There's the ongoing nausea and feeling like puking. But, it's HG, so it's also being worn down by all the HG triggers. It's missing being able to read a book without the smell and feel of the paper making you too nauseous to continue. It's constantly shushing or shooing your children because their little voices and hugs make you feel like throwing up. It's getting sick from a light being on, or from looking at a screen.

And it's also the well meaning comments... especially people reassuring you that it's ok if it's still weeks until you deliver your baby, when you're hoping it will be hours. It's being asked your due date a million times, and being reminded that there are still days and days between you and an end to perpetual stomach flu.

To add to all of that, I've been feeling so afraid of labor lately. Afraid of the pain, and afraid of the unknown.

Until today.

I had my weekly doctor appointment, and although I had looked up Mass times in the hospital chapel and knew Mass was earlier, I decided to pay Jesus a quick visit, anyway.

Except that, as I knelt in the chapel, more and more people trickled in, grabbing a Missal as they entered. Then a priest came. Then...there was Mass!

After Communion, I was praying... praying for my four children and husband, and begging God for the grace to keep going. And then, it washed over me- beautiful peace and sudden conviction that I needn't be afraid. I felt renewed grace to offer up my suffering, and suddenly didn't feel terrified of labor anymore.



It was just a moment of grace, pure and simple. But that moment changed everything.


I may still have days or weeks of HG left. I may have a painful labor ahead. I may even have another bout of post-partum depression ahead.

But it is just the cross. And Christ has already conquered the cross. There is no need to be afraid.








Friday, May 19, 2017

No Greater Love (When Your Vocation Finds You)

It was probably right around ten years ago, when I remember experiencing a deep longing for God, especially while in prayer. I was at a place where I had been seriously praying to know my vocation for a while. I brought these moments of longing to my spiritual director at the time. 

"What do they mean?" I remember asking her. "What is God calling me to?"

I felt like God was very definitely calling me to a life of holiness. I wanted to know what that would look like. I wanted to take this deep longing for God seriously.

"Am I called to religious life?" I asked her. I had always felt a draw to marriage, but if God was calling me to great holiness...well, certainly that meant religious life. Married life was too ordinary.

My spiritual director (herself a religious sister) smiled knowingly, and told me there was no rush. She wisely said that we should wait about five years, and then if I then felt called to religious life, we could discern that more deeply.

The following year I met Andrew. 

In that time of discernment, something I often prayed for was the grace to love as God loves. Kind of a lofty prayer (and, like praying for patience, is one of those God tends to take TOO seriously) but it was what was on my heart. I just wanted to love, the way that God had created me, personally, to love.

Andrew was different than any man I had ever met. Our relationship was different than any I had ever had. With him, I could be completely myself. Not only did he respect that, but he was on the same trajectory. He had been praying to know his vocation, intermittently discerning the priesthood, and he wanted to live a life devoted to God. When we got engaged, we often ended our letters and emails to each other with, "I am so glad that you're the one I get to journey to heaven with." Engraved in our wedding rings was the motto of our marriage, "Totus Tuus Domine" - "All is Yours, Lord." 

We dreamed about our marriage, about our children, about how God would lead us.

When I think back to those days of discernment, I realize that I couldn't have picked this vocation if I had tried. I didn't find Andrew, he found me. And with that, God basically handed me my vocation, wrapped in a love I didn't understand at the time.

Four hyperemesis gravidarum pregnancies later, and I look back on those memories with a gratitude I couldn't have imagined. Andrew and I needed that time to fall in love with each other and God's plan for us. We needed to find deep peace to draw on when it felt like the cross was a bit too heavy.

Although this is HG pregnancy #4, this particular pregnancy has stretched me in ways that I never thought possible. The HG has taken its toll, in more ways than one. Daily nausea since October has worn me down. My worst round of anemia yet has made me weaker than usual, and humbled again and again. My Zofran pump and sticking myself 1+ times a day has seriously tested my sanity. 

The weird thing about HG is that you literally go from being a perfectly healthy, normal young adult to being very sick for nine months, then - if all goes well! - back to perfectly healthy again (although the lingering effects of HG are very real, as my kidney stones and ongoing nausea after Maria's birth demonstrated). On the one hand, it makes me so much more grateful for my usual health. I've found myself in places and situations that I don't necessarily belong, that have given me a glimpse into the far greater suffer of others. I get deliveries from home health, had an iron infusion in the hospital's cancer center, and have received Anointing of the Sick three times this pregnancy. With each of these experiences, I'm grateful that "all that I have" is mild-moderate HG. I'm grateful that I don't have severe HG, at danger of losing my life and admitted into the hospital for weeks at a time. I'm grateful that I only had to go to the cancer center's infusion department for IV iron - not cancer. I'm grateful that I'm receiving home health for only a few weeks more...not for months to years more. I'm grateful that I don't have diabetes and have to wear a pump for the rest of my life. I'm grateful that I've received Anointing of the Sick to get me through the roughest patches of HG - not because I am preparing for death.

But this gratitude doesn't remove the very real trauma of HG. It doesn't keep me from getting flashbacks to earlier in this pregnancy, when I was sobbing and praying that I would be able to find something to eat and drink that day. It doesn't take away from the weird mental distancing I've had to do to deal with my Zofran pump, its needles, the burning, and the large, painful welts I get from it. It doesn't take away the tears I sometimes cry at the end of the day, when I just want a break from feeling so miserably nauseous every day.

But it is worth it. It is so incredibly worth it. I am glad that I've done it four times, and I will be more than willing to go through it again. And that sounds truly crazy, but it's true. The reason?

Love.

Because I'm not just blindly suffering. I'm suffering for the love of individual people. And my love for them makes my suffering seem like nothing - a small price to pay in exchange for the privilege of getting to play a part in these four remarkable people coming into existence. It's worth it because of them... 


...and it's worth it because of him...



And it's worth it because of her.


And it will be worth it for any future children, too. 

I'm not sure which saint said this, but I heard this quoted on the radio this morning, during the replay of daily Mass, "Suffering is brief. Joy is eternal."

I can't help but thinking that, if I (God willing) reach heaven one day, I will have wished that I suffered better, with greater love. I think I will be grateful for the opportunities I was given to suffer for love. 

This morning, I was headed to get my first IV iron infusion, and I had thoroughly scared myself, thanks to Dr. Google. I was so afraid that I was going to have an awful reaction, or that my baby girl would react poorly or something. I turned on the radio and listened to daily Mass as I drove. Then, I heard one line from today's Gospel that changed everything,

"No greater love is there than this - to lay down one's life for a friend."

I felt peace wash over me. This infusion and all the weird and unpleasant stuff I've dealt with this pregnancy aren't pointless. They are for love, love of a particular child. And this love in suffering, it is answering a prayer I prayed long ago - to learn to love like God. Still a long way from getting that down, but suffering in love for these four beautiful children of mine has changed everything.


An IV of wonderful, wonderful iron!

I'm not a saint. I hope to be one one day, but I'm still pretty far from it. Yet, I look at where God has led me, and at this vocation of mine - and I'm speechless by the ways it has made me grow in holiness. Holiness in religious life is possible, but God knew what I didn't know - that only through marriage and motherhood could I be stretched and pulled in the ways that I needed to be in order to grow closer to Him. When the nurse was hooking up the IV for my iron infusion, I realized how familiar needles are to me, and tegaderm tape, and tubing, and the connectors between tubing, and even swiping an alcohol wipe on my skin before a shot. Because of my Zofran pump, those things are all part of my daily life this pregnancy. For a moment, that realization felt very strange. I never thought I'd be able to do something so medical, on a daily basis. 

But then, in the next moment, the line from the Gospel popped into my head, "There is no greater love than this - to lay down one's life for a friend."

My daughters (and my baby son in heaven) aren't merely my friends - they are my sisters and brother in Christ. They are people I love immensely. And they are people that I am glad to suffer for. I just look at my two oldest children living their lives - dancing and singing and playing and learning - and realize how little my suffering was in comparison to their lives. I don't know what my Gabriel's life looks like now - but I hope and pray it is a life spent experiencing the beatific vision. I hope it is a life surrounded, eternally, by love. How could the little suffering I endured for him to exist compare to that reality? I feel the kicks and rolls and wiggles of my youngest daughter, see her daddy's face light up when he feels her foot press back against his hand, see the delight on her sisters' faces when they get to feel her kick or hear her heartbeat, and already I know she is worth it. Her life matters. In view of the amazing reality that is my baby daughter, my suffering seems like a very little sacrifice.

A dear, dear friend of mine (who is a religious sister) has been one of the people who has kept me going this pregnancy. Every time she sees me, there is a deep joy and gratitude in her eyes. She has prayed for me and baby every step along the way. When I saw her recently, she told me, with tears in her eyes, "I always said that I would do anything for love. You've shown me what that means."

But I want to protest, "It's not me! It's all grace, don't you see??" Because I still lose my patience with my children, I still complain about this stupid daily nausea, and I'm still not as loving and selfless as I could be. But, you see, God is teaching me to love in suffering in the easiest, gentlest way possible. He has given me a cross that looks heavy, but is really very light in comparison to so many other people's crosses. Because suffering is awful, but suffering in love is so much easier. 

I still feel miserable. I'm sure I'll continue to complain, and be cranky, and lose my patience. But one look at these faces, and I know that this suffering is like nothing. It's not because of the delight they give me (although they do fill me with delight). Losing Gabriel broke my heart, and the life of a mother is filled with many little sufferings and separations. The joy they bring me is not because they bring me fulfillment - it is simply the delight of knowing that I've been allowed an opportunity to play a role in their stories. I don't know yet where God will lead them, but I am grateful to be able to play a role in their stories. Therese, Maria, Gabriel, and this baby...their lives (in this life and the life to come) are of immeasurable worth.

And that makes it all worth it. 



Saturday, March 11, 2017

A Mother's Heart (On Grief and Joy)

I'm not sure what it was that triggered it.

I was driving home from the library with the girls the other day, and it was glorious out. We saw temps rise into the 70s this week, and we soaked up the sunshine and fresh air (before this morning's snow!) while we could.

In the course of running errands, we drove past both the funeral home that prepared Gabriel's remains (the place we went that awful day his remains were delivered), and the cemetery where he is buried. But the real trigger was the fresh air blowing through the rolled down windows. The weather reminded me of the day we found out that his little heart had stopped beating.

Suddenly, stuck at a stoplight with my two older daughters chattering in the backseat, and my youngest daughter kicking in my belly, it hit me - my son's body is in the ground.

It was the first time, in a long time, that I was hit by such a strong wave of grief.


Later in the week, we saw some friends who were expecting when we were expecting Gabriel. They now have an adorable little guy who was born a few weeks before Gabriel was due. As I sat in Mass looking at him, I suddenly realized - that's about the size my little boy would have been, if he had lived. Suddenly, I was hit by another unexpected wave of grief.

I realized, as I sat there, that my little boy has never cried, and will never cry. He is loved, and so, so we'll cares for. But I was really hoping that I would get to be the one who cared for him...and I'm not. I know he is happier than I could ever make him, but selfishly, I still wish I hadn't been asked to let him go so soon.

A mother's heart can be so complicated. I'm trying to accept that my pain will never go away, because my love for him will never go away.


As I write this, I feel the strong kicks of my Gabriel's baby sister. She is the baby of the whole pack, and I'm sure already beloved of all three of her big siblings. We went in for a growth check for her earlier this week (to make sure she isn't being affected by my HG) and she looked absolutely beautiful. Her strong, playful personality has just been shining through on these ultrasounds. She brings me so much joy, this youngest daughter of mine.


I think the joy (and chaos!) of this pregnancy has distracted me from the rawest edges of my grief. The other day was a reminder for me - this new baby of mine cannot take the place of the child I have lost. She is her own unique person, and she brings her owns joys with her. She is also the only person in our whole family (Andrew and myself included) with a big brother. Gabriel will always be special to her, and she to Gabriel.

(23 weeks!)

It is a strange journey, this pregnancy after loss. Unquenchable grief mingles with immense joy and delight. I never know what end of the spectrum a given day will bring. What I do know is that all this suffering seems as nothing in light of the children who exist because of it. My love for these four little ones has made me braver than I ever thought possible - brave enough let go of these little ones, bit by bit, as they grow up. Brave enough to endure day after day of tears and high emotions and tantrums. Brave enough to face the reality that I must love them, even though I could lose them. Brave enough to embrace and walk away from the casket of my first born son. Brave enough to be open to another child, and her life. Brave enough to endure the nightmare of hyperemesis gravidarum, and months of nausea and medicine and daily needle pokes in my stomach.

And brave enough to know that the only way I can do any of it, is by letting go and relying on God's grace. As St. Paul reminds us...God's is truly enough - enough to carry me further than my weak little legs could ever go.

Wednesday, February 15, 2017

So, You Need a Zofran Pump? (And Other Hyperemesis Gravidarum Minutea)

Congratulations! If you are reading this post, you or someone you know probably needs a Zofran pump.

If you're using a Zofran pump, you're probably one of the 0.5-2% of all pregnant women who suffer from hyperemesis gravidarum. So, you can consider yourself one of the elite. The specially chosen.

Regular readers know that this is my fourth HG pregnancy, but it is the first pregnancy that I've needed more than one medication to manage my symptoms. This pregnancy I have rotated through five different anti-nausea medications, and am currently on four different ones. Even while on multiple different medications, I still threw up and lost weight in my first trimester. I can only imagine how much worse it would have been without that medical support!

So, first a really important note. Please, please don't comment on this post about the safety of Zofran. And please don't hound any HG moms in your life about it either. Zofran, and any other anti-nausea medications used to treat hyperemesis gravidarum, are not used lightly. Hyperemesis gravidarum is, historically and still in modern cases that are untreated, a potentially deadly condition. It is not to be taken lightly. Before current treatments, hyperemesis gravidarum was often a death sentence to women. Not so any longer! But it is still a very serious condition, that requires proper treatment to sustain the life of both mother and baby. No use of medication is without potential risks, but the risks of not properly treating hyperemesis gravidarum are far more significant.

(As a side note, the actual incident that resulted in the lawsuit surrounding Zofran involved an instance where a patient was given a significantly larger dose at one time than she should have - the equivalent of being on a Zofran pump for several days, given at once. Obviously, that would be problematic, and is more of a reflection of malpractice than anything else.)

So, first of all, if you need a Zofran pump - all kidding aside - I'm sorry. I'm sorry your HG is so rotten that it's come to this. However...there is hope that it might make a big difference for you! So, it's also a little bit of a good thing, too. My second trimester is definitely more manageable than it was with my second pregnancy, and I think that the pump is playing a part.

When I found out I needed a Zofran pump, I scoured online for every pump tutorial I could find. I knew it was subcutaneous, so I knew I would have to be sticking myself with something. But I didn't have the faintest clue as to how that actually worked. And, while I am not afraid of needles, I wasn't relishing the idea of actually sticking myself with one. (Side note: I show a picture of the needle itself in this post, so you can see how small it is, but there are NO pictures of me actually sticking myself. You're welcome.) 

So, in my search, I could only find tutorials for one kind of Zofran pump. (Here's a great video tutorial for that other kind of pump.) Then, my home health nurse showed up...with a different kind of pump. And I couldn't find any tutorials on it! So, here is a tutorial for how to use my weird pump, in case your home health company uses the same kind. (I think my nurse told me this one is usually used for chemo treatments, but I'd imagine there are other companies that use it for Zofran, too.) It is really similar to the other kind of pump that is used, but it's actually easier to switch medicine cassettes (no loading of syringes necessary!). So, without further ado...let's dive on in!


This is my handy-dandy pump. The whole main part is the pump itself - what keeps track of dosage and the mechanisms that get the job done. You can barely see a strip of white at the bottom. That's the top of the cassette that contains the actual medicine. I just cut it off because it's basically covered in a sticker with all my prescription information and I figured you didn't need that. ;-)


Here's what my set-up looks like, when I'm gathering supplies for a site (the place where the catheter is inserted in my skin) or cassette (the actual case with the medicine, which doesn't get changed every day) change. I'll walk you through each item step by step.


This is the sharps container. You can't just throw your used needles away in the trash, so you have to put it in this handy container. I usually put in my used catheters, too, since that's a biohazard type waste, but I don't know if everyone does that. When it gets full, you give it back to the home health company and they bring you another one.


One of my weird triggers this pregnancy is washing my hands. Thankfully, I can wash my hands with soap and water most of the time now, but there was a stretch where I could only wash them in the morning and had to resort to hand sanitizer to avoid puking from the feeling of water on my hands. Why am I tell you this? Oh, right...just reminding you to wash your hands or use hand sanitizer before you change your site! 


An alcohol wipe so you can get your skin super clean like the nurse always does before you get a shot. You get to pretend to be a nurse, lucky dog!


Tagiderm. It's a clear, plastic kind of tape that covers your site once your catheter is inserted. It didn't give me huge problems when I first started using a pump, but now it's super itchy. You can always talk to your home health nurse for suggestions for dealing with the itchiness, but I find putting regular lotion on old site usually soothes the skin.


This is your actual sub-q site set. It has the tubing and needle you need to get hooked up to the good stuff. 


Step 1: Stop the pump! This means that no Zofran will be pumped out when you disconnect the tubing.


Step 2: Get set up to prime the tubing in a minute. I kind of felt like a genius when I figured out how to do this. My nurse couldn't figure it out, either. I used to have to completely unlatch the medicine cassette to get the option to prime the tubing. Then, I realized that when the pump is stopped, you can select options, press enter, and you're all set to prime. Woo-hoo!


This is how the screen will look when you hit enter. Don't click the Y button yet! You're all set to prime the tubing once she switch to the fresh one.


This is how your site looks when you open it. I have no idea what the point of that plastic circle on the bottom is, so please enlighten me if you do know. The cylinder at the top of the tubing is what we're after here. DO NOT touch the cylinder itself! To attach the new tubing, hold the actual tubing, not the cylinder. If you touch that little cylinder, disinfect it with alcohol or alcohol wipes, so it's sanitary, again. 


Step 3: Switch the tubing. On the left, you can see a thicker tubing and a thicker cylinder (you can touch the outside of that one, but not the inside). One the right, you can see the littler cylinder (the one you can't touch) and the thinner tubing. The thicker tubing is what is attached to the medicine cassette. The thinner tubing is attached to the site. When you switch sites to a fresh one, you want to unscrew these tubes from each other, and screw in the new tubing to that thick tubing. Confused yet? When you're done, it'll look like this again. 


Step 4: Prime your tubing. Right now, your new tubing is filled with air, and you don't want air or air bubbles in your tubing. To avoid that, you "prime" it, or pump a small amount of medicine through the tube to fill it up. This is the side view of the catheter/needle. The blocky looking thing on the right is what you pinch and retract once you have successfully inserted the catheter into your skin. The left blue part is covering up the needle encased in the catheter. Once the catheter is inserted, the needle is retracted from your skin. 


See the little needle in the center there? 


Here's another view.


To prime your new catheter once you're hooked up to the medicine tubing, point the needle downward (into your plastic case that the site came in, or on to a piece of tissue), and click the "Y" button on the pump. I usually have to press it three times before I see a spurt of medicine come out of the tube. Once you see that, you know that the tubing is air free!


Once your tubing is primed, peel off the sticker from that white circle around the needle, and take off the blue cap. This is the needle you're going to put into your belly (or leg...but belly is usually easier because the skin is less tough). It's tiny, isn't it??? Not scary. If you relax and pinch a really large chunk of skin (pinch an inch) you usually won't even feel it going in. Even if it does sometimes hurt, it's quick and not too bad. You can do it! Before you insert the needle, pick a spot on your belly, rub the skin liberally with the alcohol wipe, pinch and inch of skin, relax, and stick the needle right in the middle of the pinched skin. Relax and put it in straight, and you'll do great!


When you pinch the top, the needle retracts and looks like this. Thankfully, that whole thing doesn't have to go in your belly! You only put in the tip. And you're done already! You're a champ. Click that top left tab over the top of the needle.


And throw that used needle away in your sharps container!


This is what the site looks like when the catheter is inserted! Put the tagiderm tape on top and you're good to go. I'm not showing you my whole bruised and welt covered belly because I'm too modest, so you just get to see this little corner. 


I usually alternate sides of my belly for sites. Because Zofran is a skin irritant, it causes redness, bruising, and welts, and the sites need to be changed often. I find once a day or so usually works well, but some moms need to change them more frequently. The irritation is a small price to pay for keeping food down and being able to talk and sit upright! It isn't fun, but it isn't awful and you kind of get used to your stomach looking like a punching bag. Icing old sites or applying heat can help.

After you install the new site, you'll still have the old site and tubing hanging off of you. Pull that out of your belly, and it will look like this. Just a tiny little catheter! The catheter is stiff, but somewhat flexible. If you insert it correctly, it should cause pain once in (although occasionally the Zofran will sting when first pumped in). If it's really hurting, it's time to switch your site! Sometimes a tiny bit of clear liquid or a few drop of blood will come out of the old site (especially if it was getting really irritated and not absorbing the medicine well). Sometimes nothing comes out. Some women like to squeeze out excess Zofran after removing the catheter. Do whatever works for you. You shouldn't need to put a bandaid on it. (I have only briefly needed to once, when the site was just a really bad placement and ended up bleeding a lot when removed. That is not normal, and probably won't ever happen to you....but don't freak out if it does. The bleeding should still stop fairly quickly.) I always throw my old catheter away in my sharps container.


Start the pump, and you're good to go! The first pump of your Zofran may sting at your new site, but don't worry...it usually won't sting after the first pump. If it keeps stinging a lot, you might want to just switch sites again. 


This is what the screen looks like when you are all done! You want to make sure it says, "running" and also check the reservoir volume number, so you know when you'll have to change it. Note: if you change the battery (it will beep to tell you when you need to) it will reboot as "stopped" not "running." So always make sure your pump is actually pumping! 


Then zip up your case and you're good to go! Anyone who has seen me up and about recently has seen me with this trusty case slung over my shoulder.

That's it! Changing the medicine cassette is basically the same process, except you have to unlatch the reservoir by turning a dial on the side. The reservoir pops out and you pop a new one in. Other than that, the whole process is basically the same. 

You can do it! And I hope it helps you as much as mine has helped me. Fight on, warrior mom! You've got this!

For more hyperemesis gravidarum info, check out Help Her, or take the assessment on the Diclegis website to get your PUQE score. HG looks different for every mom, and some HG moms don't actually throw up a lot! These resources can help you figure out if you have HG and where you fall on the spectrum. And don't hesitate to contact me with questions, either. ;-)





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