Early mornings are beautiful up at the cabin. The sky turns from deepest blue to shimmering pink over the East Mountains of Manti while the tiny town twinkles below shining up through the haze to me as I stand in the cabin gazing down at the valley.

I am standing in my underwear. I have stumbled from the warm bed and my snoring husband to the kitchen. One of my earliest signs of pregnancy is that I am perpetually thirsty. I cannot explain why, I can only confess that I have gone through liters of orange juice and half gallons of milk in single nights as I have repeatedly risen from my bed to pour liquid, straight from the jug into my parched mouth.

This trip is particularly thirsty, as the high altitude’s dry air has made my mouth feel like the inside of a toilet paper roll. I open the refrigerator door, debating between draining a carton of milk or the blueberry pomegranate juice, when the smell of the fridge hits me square in the face. My stomach drops two feet, banging rudely into my lower intestines. As it rebounds back into place a nearly uncontrollable urge to vomit sweeps over me, and I gag in the beautiful stillness of the kitchen. Morning sickness; it is inevitable.

I remember the first time. I was absolutely giddy about being pregnant, and wholly unscarred from the string of complications that were to be my future. Naïve and stupidly excited for every symptom pregnancy had to throw at me, I giggled to myself as a wave of nausea rolled over me as I grocery shopped. Morning sickness, I mused. Wow. I’m really pregnant! Stupid, naïve, cheerful dummy, I had no idea that I would spend the next four months receiving intravenous fluids to keep me alive.

In the week and a half that followed I went from one tiny roll of queasiness to around the clock vomiting. This can’t be right, I reasoned, as I tried to wrap my head around what the pregnancy books had described and my total inability to take in sustenance. I called the doctor and explained that nothing had stayed down for a week. NOTHING. I was a hollow, drained shell of a human being who was out of her mind with dehydration.

We tried many cures, the doctor and I, and not much helped. I lost nearly twenty pounds in two months. I still have scars up and down my hands and forearms from the many, many IVs that kept me human during this time. All of the reasonable cures for morning sickness, like the standard saltine crackers, sent me lunging for a sink. A kindly statistics professor suggested diluted grape juice, and that did stay down for awhile. At least when it didn’t I got to change things up a little and puke purple. I threw up at least ten times each day.

Several months and drugs later I was down to vomiting only once or twice a day, and for this, I was profoundly grateful. It was in this period of time that I discovered that what I had was not morning sickness. It wasn’t even close. Vomiting nonstop during pregnancy is called Hyperemisis Gravidarum. It affects roughly 1 in 200 women. The combined effects of vomiting and dehydration take a very heavy toll on a woman’s body. Both are exhausting. I know everyone is tired during pregnancy, but when you compound that with the energy lost from throwing up, and the energy depleted by severe dehydration- frankly, there just isn’t anything left. Additionally, the body is literally starving, on top of which, a tiny baby is quickly using up any reserves the mother’s body may have stored, weakening the mother and compounding the effects of the HG. Severe dehydration causes psychosis, vomiting gives you the teeth of a bulimic, and the whole kit and caboodle can wreak havoc on a marriage. For most, the only cure is labor. There are people who have died from HG, and babies who have been aborted because of the severity of the symptoms. It isn’t a small issue. It’s huge.

When I became pregnant with my second child, I was ready. After the first battle with HG, I knew what drugs helped, and I knew how I could help myself. The last thing someone who is sick to her stomach wants to do is eat, but it helps me to keep a full stomach (doesn’t cure, by any means, but it can take the edge off). I went to my doctor and I was told that I couldn’t bee seen until I was 8-12 weeks along. I tried to explain that I would require serious medication and IVs before that, and I was ignored. I was ignored until I started making frequent ER trips to get juiced up, and to be prescribed amtiemetic medications. It was during this period of time that I discovered Zofran.

Zofran is a drug originally designed to help chemotherapy patients keep their lunches down. It has been successful with many HG sufferers as well. It costs $40 per pill, and can be prescribed at up to 3 pills a day. I have eaten thousands of dollars worth of Zofran, and it is worth every penny. Thank heaven my insurance covers it! Zofran is certainly not a cure all, however. It usually takes my HG down to the level of severe morning sickness. This means I’m miserable, but at least feel like a human being again.

This time around, I talked to the clinic immediately about the HG and asked for a prescription. I expected to be given the run-a-round as before, but apparently when you say it is your third time around, they believe you. The good doc even prescribed an additional drug for me to take with me on my vacation, just in case. I do not intend to wait until I require an IV to start treating my symptoms. I learned last time that I need to get a leg up on HG or it will get me. It is easier to cut off the symptoms before I become dehydrated or exhausted rather than try to recover from those symptoms.

So far, I have had only a few days of nausea. I threw up this morning. Now, I would love to hope (and believe me, I have spent a lot of time on my knees begging) for a pregnancy that I could enjoy. A pregnancy that is normal, with usual aches and pains and fat, and a queasy but not debilitating first trimester. But I know that this is a long shot. My body doesn’t appreciate being pregnant, and the moment the nausea and vomiting get out of control I will use everything in my arsenal to stop it. Education is key with HG, and so I foresee an easier pregnancy than before, not because my body will not rebel, but because I will court marshal it back into subservient baby making. Note I did not say easy pregnancy, or normal pregnancy. I said easier, something that I can hopefully manage, if not for my sake, for my kids.

After all this, I know you are probably asking why I would do this again willingly and with excitement. I do it, because it is worth it. Sometimes the hardest roads give the best rewards.