From Unaware

to Expert on How to Care

for Hyperemesis Gravidarum Patients

Pop culture most commonly portrays pregnant women vomiting once or twice early on and then not only returning to normal life but actually glowing. When I became pregnant, I did not glow. I turned green! Always the optimist, I kept believing what I heard from family, friends and doctors – that my symptoms would ease at 12 weeks, 15 weeks, 20 weeks… The severity of my nausea and vomiting was normalized by my doctors, as I continued to lose weight and lack nourishment. In hindsight, I now see that I even medically gaslighted myself. Other than a day being rehydrated in the ER along with an Rx for phenergan which left me comatose, my cries for help were left unanswered. Those who did acknowledge the severity of my illness offered no treatment options. Ginger, crackers, BRAT diet and ice pops were useless to me.

I lost all sense of myself, including my career as a professional figure skater, my job in sales and my relationships deteriorated. My symptoms did not ease until after the baby and placenta were delivered. Like the flick of a switch, my body felt like mine again. (I’ve since learned that many HG survivors have long lasting effects from extended malnourishment.)

A couple of years later, I went into a second pregnancy believing what my previous doctor told me, “Just because it happened once doesn’t mean it will happen again.” It did though! I remember little from those nine months, but records show my repeated visits to the emergency room and inane advice that included “drink more water.” I have no idea how I took care of my toddler but can now tell you that she watched a ton of TV and still grew into an intelligent, beautiful adult.

Four years later, I went into my third pregnancy knowing what I would be facing, believing I had a solid plan in place and all my ducks in a row. Regardless, all these years later, I still remember the horrendous feeling of panic overtaking my body, caused from an injection of metoclopramide (Reglan) in the ER at seven weeks along, which I now know is a common adverse effect and have ways to mitigate that from happening. I had now failed promethazine (Phenergan), metoclopramide (Reglan) and ondansetron (Zofran) and was at a loss on how to get through the remaining seven months. Desperate for help, I discovered the HER Foundation while searching online, from which I learned the name of my disease state and gained a community of support. Just knowing I was not alone offered a sense of comfort.

When my youngest was a preschooler, I started my journey to becoming a pharmacist. It was during this education that I learned how we treat other diseases of malnutrition for patients in and out of the hospital when they cannot eat or drink. During these lectures, I sat there baffled that regardless of where I lived during my pregnancies, including New Hampshire and on overseas US military bases in Japan and Spain, I was left malnourished, dehydrated and alone. This even included the times that I did have a caring doctor. Options like IV nutrition, replenishing electrolytes, balancing acid/base requirements, the importance of proteins, risks versus benefits of medications and much else were never discussed.

Since earning my Doctor of Pharmacy (PharmD) in 2016, I have counseled hundreds of desperately ill pregnant women while working as a retail pharmacy manager and educated doctors and cared for hospitalized HG patients as a hospital pharmacist. In 2019, I learned through pharmacogenetic testing that I do not respond to ondansetron, knew I had to offer this personalized medicine service to women in need of medical support and launched HG Clinical Solutions.

Once women from around the world began to reach out to me with their maternal survival stories and cries for help, my eyes were opened to hundreds of thousands of women suffering through pregnancies that put them at a high risk of morbidity and mortality, yet these women do not qualify or have access to a high risk obstetric specialist, which happened with me.

In 2021, when I became a certified doula (CD), I learned that the United States has the highest maternal mortality rate of any developed country. They say that HG is “rare” but even 2% of the 3,659,289 births in the US in 2021 would mean that over 73,000 pregnant women are left malnourished during their pregnancy. Considering that up to 30% of pregnancies of women with HG do not make it to term, the number of women suffering each year is close to 100,000 in the US alone! A CDC report that same year unveiled that “the cesarean delivery rate increased to 32.1% in 2021. The low-risk cesarean delivery rate increased to 26.3%, and the preterm birth rate rose 4% in 2021 to 10.48%—the highest rate reported since at least 2007.” I am fortunate that my education as a pharmacist and antepartum doula is put to use to turn these statistics around, preventing these devastating outcomes.

I am forever grateful for my career as a pharmacist, collaborating with doctors, patients and other medical professionals, in many aspects of medicine and disease states, and of course, to ensure pregnant women have the support they need for the safest pregnancy possible through medication management and empowerment.

To ease the minds of current HG patients who are afraid to take medications and suffer from mom-guilt, I am proud to share that my three daughters who were born out of my malnourished, stressful pregnancies have grown into phenomenal young ladies. I ask each and everyone of you to be kind to yourself, support those in need, especially employers, and advocate for better medical care. My team and collaborators are ready and waiting to get you to the finish line and help your recovery.

Love to you all,

Danielle

Learn more about Dr. Danielle Raiman Plummer

Podcast Interviews


Writings

  • Find Dr. Plummer as a medication expert on websites that include Wearefeel, Eat This, Not That, The CheckUp, Shape, Bustle, SingleCare, Momtastic, UpJourney, Optum Perks Blog, TalkToMira, Momtastic and many others 
  • Her journey as a third generation pharmacist on Medium 

Connect Now

  • LinkedIn: https://www.linkedin.com/in/daniellerplummer/
  • Facebook: https://www.facebook.com/HGClinicalSolutions and www.facebook.com/HGPharmacist, @HG Pharmacist
  • Instagram: @HGPharmacist
  • Youtube: HG Pharmacist
  • Twitter: @HGPharmacist
  • Reddit: HG Pharmacist
  • TikTok: HGPharmacist, Dani_Rai
  • Pinterest: https://www.pinterest.com/hgpharmacist