Sick of “morning” sickness

If pregnant people need to eat for two, why do so many of us puke morning, noon, and night? Guests: Marlena Fejzo, Ph. D., geneticist, and Research Director at the HER Foundation. For show transcripts, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠vox.com/unxtranscripts⁠⁠⁠⁠⁠⁠⁠⁠⁠ For more, go to ⁠⁠⁠⁠⁠⁠⁠⁠⁠vox.com/unexplainable⁠⁠⁠⁠⁠⁠⁠⁠⁠ And please email us! ⁠⁠[email protected]⁠⁠ We read every email. Support Unexplainable (and get ad-free episodes) by becoming a Vox Member today: ⁠⁠⁠⁠⁠⁠⁠⁠⁠vox.com/members⁠⁠⁠⁠ Help us plan for the future of Unexplainable by filling out a brief survey: ⁠⁠⁠⁠⁠⁠voxmedia.com/survey⁠⁠⁠⁠⁠⁠. Thank you! Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

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• 1:13Speaker 02

  I'm Julia Longoria. This is Unexplainable. And this one's gonna get a little personal.

• 1:22Speaker 02

  That is the sound of me about to hurl. I really don't like making things about me, but that's not the reason I'm about to barf right now. If you've watched TV sitcoms or rom-coms in the last few decades, there's only one real reason a woman like me would be unexpectedly puking for a studio audience.

• 1:45Speaker 03

  She's been barfing for an hour.

• 1:52Speaker 03

  Do you have like the flu? I don't know. And I hope you're not pregnant. That sounds like morning sickness. Miranda?

• 2:01Speaker 03

  I don't know why they call it morning sickness when it's all [bleep] day long.

• 2:06Speaker 02

  Yep, it's morning sickness. And I can assure you, it's not just in the morning. I haven't been able to track down whoever coined that term, but I hope they have the afterlife's equivalent of diarrhea. Misery loves company.

• 2:23Speaker 02

  An early pregnancy, I was vomiting every day or every other day, mostly in the evenings. At week 15, I gave my pregnancy tracker apps the middle finger as they congratulated me on the end of my nausea. For lots of people, it stops in the second trimester, but not for me. I just puked everything I'd eaten that day.

• 2:46Speaker 02

  Some people have helpfully told me to eat more protein, just as others told me to eat less protein. Friends have gleefully announced that it must be a girl, while other family members maintained, "Well, that means it's a boy." My doctors have been just as unhelpful. Some pills prescribed to me seem to be helping some days, but other days, I still retch multiple times. The question I'm left with, shouted dramatically at the heavens, "Why?"

• 3:17Speaker 02

  Today on Unexplainable, you're gonna have to bear with me as I, Julia Longoria, turn my pain into art, or at least into journalism. And I'll ask, why? Why do pregnant people, who are presumably eating for two, why do so many of us barf so much?

• 3:51Speaker 02

  Pregnancy nausea has been in the human record since about the year 2000 B.C. But the story of how we finally got some kind of scientific answer to why starts with a woman in the 90s. If you could think back to the Marlena before you, you know, before you ever got pregnant, when you were maybe trying not to get pregnant, what is, what is your earliest memory of the term morning sickness?

• 4:21Speaker 04

  Just what I saw in television shows and movies, people saying, ha, ha, ha, she's pregnant.

• 4:31Speaker 04

  Like it's an aha moment.

• 4:33Speaker 02

  Marlena Fejzehzo is a geneticist. And like so many of us, she didn't think much about pregnancy nausea until she found out she herself was pregnant.

• 4:42Speaker 04

  When I woke up, I ran to the bathroom and I sort of laughed after thinking, this is morning sickness, ha, ha. But within a week, I realized that it was not very funny. I had nonstop nausea and vomiting, so I couldn't get out of bed until around noon without vomiting. When I called the nurse, she said, this is normal in the first trimester.

• 5:14Speaker 02

  From the sounds of it, Marlena's nausea was significantly worse than what I've been experiencing.

• 5:19Speaker 04

  I ended up going to the emergency room twice for intravenous fluids. In that pregnancy, I was able to keep something down every day. It did go away in the second trimester, and the rest of my pregnancy was really not so bad.

• 5:35Speaker 02

  By the time Marlena had seen a doctor, she was in her second trimester and she was already feeling better. She never brought it up and her doctor didn't ask about her nausea. Marlena gave birth to a healthy baby boy, and she never thought about pregnancy nausea again until two and a half years later.

• 5:54Speaker 04

  I walked by a gelato store, and I didn't feel like going in. I thought, I must be pregnant, because normally that smell would be delicious, and I would have to go in. But I just did not feel like going in. And I was like, this is not normal. I must be pregnant. And I took a pregnancy test. And sure enough, I was pregnant. It got bad really fast. Pretty soon, I could not eat, drink, or move without violently vomiting. It was like that feeling that you have a few seconds before you vomit that I had all the time, where I'm just constantly about to vomit. And I had to spend every waking second trying not to vomit. Because once I started, I couldn't stop.

• 6:39Speaker 04

  And it would last hours and just be very violent, because there was nothing in there to vomit. So my body would reach further and further down my intestines to try to find something to vomit up. So it was very violent. And I had to do everything I could to try to stop that cycle from happening, because it was very hard to stop.

• 7:01Speaker 04

  It was torture.

• 7:03Speaker 04

  I didn't keep any food down for over a month.

• 7:08Speaker 02

  This time, Marlena told her doctor about it.

• 7:11Speaker 04

  The OB, he gave me the diagnosis. He said I had hyperemesis.

• 7:17Speaker 02

  Hyperemesis gravidarum. What was going through your mind when you heard the word hyperemesis? Did you know what that was?

• 7:25Speaker 04

  I don't think I knew what it was at the time. Must have been the first time that I'd heard it.

• 7:32Speaker 02

  Hyperemesis gravidarum, or HG, is an extreme form of pregnancy nausea that affects about 2% of pregnancies worldwide.

• 7:42Speaker 02

  What I personally have gone through in my pregnancy is nothing compared to this condition. And when Marlena got sick in 1999, just like now, there weren't any proven treatments for it.

• 7:55Speaker 04

  My doctor, he offered that I could have home health care, tried seven different medications at once. Actually had a Zofran pump in my leg because I couldn't swallow the medication without vomiting and I lost the fat in my thigh so quickly that they had to move that pump to IV. Eventually, my doctor gave me a feeding tube.

• 8:23Speaker 02

  A feeding tube?

• 8:24Speaker 04

  It goes through your vein. It's pretty dangerous because it gets inserted above your heart and if it gets infected, you can have serious consequences. So they try not to do it if they can, which is why I think my doctor waited so long, but I really was starving to death.

• 8:42Speaker 02

  This was extremely scary. A small percentage of people die from HG.

• 8:47Speaker 04

  I was in bed, lying flat at home. I couldn't even sit up. I couldn't go to the bathroom. I couldn't brush my teeth. I also had something called hypersalivation, so just buckets and buckets of saliva coming out of my mouth. So I had like, and it was really acidic. So I had kind of burn marks all over my face. And my doctor prescribed that suction machine that they have at the dentist office. I had to have pretty much 24-hour care. I mean, my husband took care of it at night. He had to wake up in the night to change my tubing and everything. We hired someone who took care of my, my son because I couldn't, I couldn't even see my two and a half-year-old.

• 9:30Speaker 04

  My, my husband would just bring him in at night to say goodnight to me.

• 9:34Speaker 02

  At one point in this fog, Marlena has a faint memory of getting a call from her doctor.

• 9:42Speaker 04

  I suppose I did at one point talk to my doctor on the phone because I know that he did tell me that. People who have this are trying to get attention.

• 9:54Speaker 02

  Wait, I'm sorry. What? He said this on the phone to you?

• 9:58Speaker 04

  Yeah, yeah. He said I was exaggerating my symptoms to get attention.

• 10:03Speaker 02

  He said this directly to you?

• 10:05Speaker 04

  Yeah.

• 10:05Speaker 02

  Are you like factually like in your hospital bed at home, talking to the doctor with a feeding tube in your? Like, where?

• 10:13Speaker 04

  Yes. Because I was only in one place the whole time. I couldn't even turn to my side. So I was lying flat on my back in my bed, talking to my doctor and he,

• 10:25Speaker 04

  you know, said that to me and starts telling me about, you know, he's actually even done this study. He's trying to be like scientific with me. Like, I've done a study on this. I never saw that study.

• 10:35Speaker 02

  Did you look for it?

• 10:37Speaker 04

  Later I did. I never found it, not at that time. But he said he had done a study that showed that women with hyperemesis were infantile and just wanted attention from their mothers. And

• 10:50Speaker 02

  Wow.

• 10:51Speaker 04

  It's really the reverse, where a lot of women with hyperemesis will end up moving in with their mothers because the mothers are the ones that will take care of them and take care of their children when they're going through this. But it's, it's not because they want attention from their mothers. It's because they don't have a choice. Right? You can't cook when you're extremely nauseous. So you need someone who's willing to do that for you.

• 11:17Speaker 02

  Like, what are you talking about?

• 11:19Speaker 04

  Exactly. Yeah. So,

• 11:23Speaker 04

  but it's actually pretty common for doctors to say that to their patients, unfortunately, even to this day. And I didn't have any energy to argue with him. I mean, I couldn't even barely stand up for more than a second.

• 11:40Speaker 02

  How did you feel in that moment?

• 11:42Speaker 04

  I, I was definitely angry because obviously it's imprinted in my brain and I remember it so well. But I was also really too sick to really, I mean, I was really struggling every second.

• 11:56Speaker 02

  Yeah.

• 11:56Speaker 04

  So, yeah.

• 12:00Speaker 02

  During this pregnancy, she never saw the inside of her doctor's office again after her very first visit when she got diagnosed. She had gotten an ultrasound at that first visit.

• 12:11Speaker 04

  That was the last picture of my baby that I ever got because I lost it in the second trimester.

• 12:23Speaker 02

  When you lost the pregnancy, how soon was it before you stopped feeling nauseous?

• 12:30Speaker 04

  It was immediate. It was crazy. Literally that day, I could eat again. And it was so strange because I was like, it's so easy to eat. And yet, it had been so hard to even just be near food.

• 12:43Speaker 02

  That must be so heartbreaking and so...

• 12:47Speaker 04

  It was very weird because it was like, I felt so good to be able to eat again physically, but I felt so bad having just suffered so much for no reason.

• 13:04Speaker 04

  It took me about a month to recover. But when I did recover, I started looking into what was known about it.

• 13:13Speaker 02

  Marlena is a geneticist. Up until this point, she'd been so sick and weak. She hadn't taken a scientific curiosity about why she was getting sick and what she could do about it. Now, out of a haze of hyperemesis, she put her scientist hat back on.

• 13:31Speaker 04

  And then I just searched PubMed for medical articles related to nauseum pregnancy and hyperemesis. But there was very little out there at the time.

• 13:44Speaker 04

  I just was like, OK, I have to work on this because there's nothing out there and I need the answers.

• 13:52Speaker 02

  So you were like, I'm going to go find the answers.

• 13:54Speaker 04

  Yeah, exactly.

• 13:58Speaker 02

  Answers after the break.

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• 17:43Speaker 02

  To be clear, I have not been diagnosed with hyperemesis gravidarum. My symptoms come nowhere near to what Marlena went through. But it has become bad enough that I've found myself researching the long history of pregnancy puking to try to understand why we seem to know so little.

• 18:06Speaker 02

  Apparently, the Greeks wrote about pregnancy nausea on papyrus circa 2000 B.C. Roman doctors, at one point, recommended a hot wine bath to combat the illness. Don't knock it till you try it, I guess. Fast forward, though, to the 1950s and 60s, and something happened that had a bit of a chilling effect on pregnancy nausea research.

• 18:32Speaker 04

  The thalidomide disaster. So, the drug thalidomide was given in the 50s and 60s for nauseating, vomiting, hyperemesis in pregnancy. And unfortunately, that drug led to babies being born with severe limb deformities.

• 18:48Speaker 02

  For decades after that, as far as I can tell, we didn't do much else to figure out why pregnancy nausea happens. But it's pretty clear, even from what little was out there when Marlena did her search, that pregnancy nausea is not in your head, contrary to what her doctor claimed.

• 19:06Speaker 04

  People said to me while I was sick that it must be psychological because only humans have it, but that is just not true. So, there's evidence from veterinary journals that dogs, cats, and monkeys all have a early period of appetite loss, just like humans. The most extreme example is the octopus. They actually lay their eggs and then starve to death and die.

• 19:35Speaker 02

  For humans, I read, pregnancy nausea in general is associated with positive pregnancy outcomes, leading some scientists to believe that it's evolution. We puke to protect our babies. Like, if we eat less, then we won't need to go out and hunt and gather and risk getting eaten by predators, I guess?

• 19:55Speaker 04

  Clearly, we don't need that anymore as humans. You know, maybe animals still need it, but for us, it's just click Uber Eats. Our food is very safe and easy to get without risking our lives. So, it's a mechanism that I think we should try to evolve away from.

• 20:16Speaker 02

  Leave in the past.

• 20:18Speaker 04

  Yeah.

• 20:19Speaker 02

  I could not agree more. But Marlena's doctors seemed to still be stuck in, maybe it's all in your head. She was determined to dump that hypothesis. But if you want to get rid of a bad theory, you got to come up with a better one. And that's not easy. At this point, Marlena was very early in her career, a postdoc at UCLA, who was not focused on pregnancy nausea. She didn't have any funding to go into this. She just had a hole in her heart from her last pregnancy and a burning curiosity. And what did you do next?

• 20:55Speaker 04

  I wrote a survey with all the questions I could think of related to hyperemesis.

• 21:02Speaker 02

  She wrote a survey intended for people who'd been diagnosed with hyperemesis gravidarum, asking a lot of questions.

• 21:08Speaker 04

  It was very long. It was like 30 pages.

• 21:11Speaker 02

  But the main things she was curious about.

• 21:13Speaker 04

  What is the recurrence risk?

• 21:15Speaker 02

  If you have this once, what's your chance you'll have it again?

• 21:18Speaker 04

  I asked about medications and which ones were effective and what the side effects were.

• 21:24Speaker 02

  And most importantly, for her potential research.

• 21:27Speaker 04

  Did it run in families? I wanted to do a genetic study and so I needed evidence to show that it was genetic.

• 21:33Speaker 02

  If she got anecdotal evidence that hyperemesis gravidarum ran in families, then she could go out and get some funding to try and prove it.

• 21:42Speaker 04

  My little brother was a statistician and he put the survey up on his website. And we started getting faxes back at that time.

• 21:52Speaker 02

  This was around the year 2000, before things like Survey Monkey and Google Forms were common. So Marlena and her little brother had gotten creative.

• 22:01Speaker 04

  I had a lot of trouble publishing my survey results because people didn't believe the internet and who are these people that are like filling out these things? And how do you know they really have what they have? But like, why would someone sit down and fill out a 30-page survey if they didn't have it?

• 22:18Speaker 02

  And over the course of two years, they got over 800 responses back.

• 22:26Speaker 02

  And what did you, what did you find?

• 22:29Speaker 04

  So we found that there was a 17-fold increased risk of having it. If your sister had it, women that had it once had it again in 80% of their pregnancies, which also suggests a genetic component.

• 22:44Speaker 02

  Next, Marlena set out to find biological proof that this was genetic. That meant collecting surveys wasn't enough. She had to collect DNA samples.

• 22:54Speaker 04

  And so people were sending in saliva samples from all over the country.

• 22:59Speaker 02

  This was still a sort of pet project of hers. So she got permission to store these samples in the fridge at work in one of UCLA's labs. And when she got enough samples, she applied for official funding to try and sequence them.

• 23:13Speaker 04

  I applied for funding from the NIH. I applied twice and was rejected twice, unfortunately. So I had all these saliva samples sitting there.

• 23:22Speaker 02

  And once again, 10 years into this pet project, Marlena got creative.

• 23:27Speaker 04

  My brother gave me a 23andMe kit for my birthday in 2010.

• 23:32Speaker 02

  23andMe, the direct-to-consumer genetic testing business. It had been named the invention of the year a few years earlier, and it had started a bit of a craze. Over 15 million people have sent the company their saliva. Marlena approached 23andMe with a small request.

• 23:51Speaker 04

  I asked them to include hypermesis in their surveys, and they were very receptive to it.

• 23:59Speaker 02

  A few years passed, and Marlena got some data back.

• 24:02Speaker 04

  We found the first connection with the vomiting hormone, GDF-15.

• 24:09Speaker 02

  Having at this point raised $0 from the NIH to fund her research, Marlena had identified a gene that looked like it might play a role in HG, a gene, GDF-15, that made the vomiting hormone.

• 24:23Speaker 04

  A hormone that everybody has, whether you're male or female, and whether you're pregnant or not.

• 24:28Speaker 02

  For men and women, it's associated with stress.

• 24:32Speaker 04

  This hormone is why you often lose appetite when you're under some kind of physical or mental distress.

• 24:38Speaker 02

  It's probably why some people stop eating during finals week, for instance.

• 24:42Speaker 04

  When it gets high enough, we think that it's a signal that's telling your body either to expel a poisonous food and not eat that again, or in our hunting and gathering days, telling you, hey, stay in your cave until you feel better.

• 24:59Speaker 02

  23andMe customers who said, yes, I have HG, seemed to share a similar variant of the vomiting hormone gene.

• 25:07Speaker 04

  It was really an aha moment.

• 25:12Speaker 02

  It turned out, we already knew that placenta makes a lot of this vomiting hormone.

• 25:18Speaker 04

  So it already had a connection with pregnancy.

• 25:20Speaker 02

  She didn't yet know how exactly the vomiting hormone played a role, but it was something. So she published her findings.

• 25:28Speaker 04

  After my paper came out, I was contacted by a scientist from the company Regeneron. He said he was very interested in my paper and could they do anything for me? And so I said, well, actually, I have all these DNAs in my freezer that haven't been sequenced and I had actually applied to the NIH again and they denied me funding.

• 25:52Speaker 02

  She'd been denied funding yet again.

• 25:55Speaker 04

  Even though they funded a study very similar size on erectile dysfunction genetics. So I was not happy about that.

• 26:05Speaker 02

  But the biotech company Regeneron would help her. They sequenced those saliva samples that she'd been storing in the university fridge for years, and yet again?

• 26:15Speaker 04

  Same gene showing up.

• 26:16Speaker 02

  The vomiting hormone gene surfaced. Very strong evidence that the vomiting hormone and its corresponding gene were the stars of the morning sickness show.

• 26:31Speaker 02

  But how? What exactly was going on with the hormone? Why was it causing certain people to get really, really sick? To get to the bottom of this, Marlena did another study. Again, she was not funded by the NIH. But this one involved researchers from around the world.

• 26:50Speaker 04

  Our next paper was international collaboration of many researchers, where we figured out what was going on.

• 26:57Speaker 02

  And after years of Marlena just DIY-ing it, the team finally found an answer.

• 27:03Speaker 04

  People with hyperemesis have lower levels before pregnancy.

• 27:07Speaker 02

  For people who got really sick during pregnancy, like people with HG, they were making very little vomiting hormone before they got pregnant. So when they got pregnant, the levels shot up, and that change was an utter shock to the system. So like, they had a low... It had to do with like, the sort of change in the level of the hormone.

• 27:32Speaker 04

  Exactly.

• 27:33Speaker 02

  Rather than how much?

• 27:35Speaker 04

  Exactly.

• 27:37Speaker 02

  How convinced are you that you have found the cause of hyperemesis? And I guess like, is it also the cause of morning sickness, quote unquote, more generally?

• 27:50Speaker 04

  Yeah, so it is the cause of all nausea and vomiting in pregnancy, as well as other forms of nausea. I'm convinced of that.

• 28:03Speaker 02

  She says other factors might also contribute to it, but she's convinced this is the main cause.

• 28:12Speaker 02

  I was honestly kind of shocked to hear her say this. She figured this out almost single-handedly? Eventually, yeah, she had a team of researchers. But it's thanks to her curiosity about her own health that we know the cause of morning sickness. That she knows it, and I know it, and now you know it.

• 28:35Speaker 02

  So why does the medical establishment act like we don't know the cause of morning sickness? When I asked my doctor about the cause of nausea, he said there could be lots of contributing factors, which I guess is true, but we have a pretty good idea for the main cause. And Marlena says she has some pretty good ideas for how we could treat the root cause of pregnancy nausea, thanks to an experiment that a colleague of hers at Cambridge did. He gave mice a high dose of vomiting hormone, and they predictably got sick. But when he gave them just a little bit of the hormone before giving them a high dose, the mice seemed to be desensitized.

• 29:15Speaker 02

  Marlena applied for NIH funding last year to try and test this treatment on actual patients, to try and desensitize patients with a history of HG. Shocker, the NIH denied her proposal. And another shocker? That's not stopping Marlena from trying to find an answer herself to her remaining unanswered questions.

• 29:37Speaker 04

  I am doing a study of women that are trying it on their own, because many people are trying it on their own anyway with their doctors and are contacting me, saying they're trying it.

• 29:47Speaker 02

  Based on your research, basically? They've decided to just give it a go?

• 29:52Speaker 04

  Yes.

• 29:53Speaker 02

  Is insurance covering it for them? Or they're just kind of going on their own?

• 29:58Speaker 04

  For some people, I think it is. Some people it isn't, but you know, people want to complete their families and they want to be able to carry their pregnancies healthfully and safely. I mean, I can totally understand why these women are doing it.

• 30:11Speaker 02

  Yeah. And I am curious, just hearing your story and hearing about your research, if your experience with your second pregnancy affected your decision to try to get pregnant again?

• 30:25Speaker 04

  Oh, yeah, definitely. In my second pregnancy, my body killed my baby. So I feel like I'm not going to take that risk again and risk my body killing another potentially healthy pregnancy. So I ended up doing surrogacy, gestational surrogacy, and I was very lucky to have twin daughters as well. So I was able to complete my family, which, you know, really allowed me to feel happy and be able to work on this and give back. So I'm very grateful.

• 31:00Speaker 02

  And I mean, you know, the experience that I guess I'm going through right now, just like even any pregnancy, and I'm sure it's on a heightened scale with with folks who have HG, but like, talk about unexplainable, right? Like, pregnancy is like so mysterious even to the person, especially to the person who's pregnant. Like, you have so little communication or feedback or information about the fetus or the baby. And to me, I guess, like, I've been reflecting on how like, this sickness almost feels like one form of feedback, and it's easy to feel like, oh, I'm, am I doing something wrong?

• 31:40Speaker 02

  Is there like, meaning in this? I don't know. What do you say to people who are looking for meaning in the vomit?

• 31:48Speaker 04

  Yeah, no, I definitely think we don't need that anymore. I think that it's just a mechanism that our evolution has not evolved out of fast enough.

• 32:02Speaker 02

  It's like your appendix or something.

• 32:04Speaker 04

  Yeah, I don't think we need it anymore, that heightened sense of smell and that extreme nausea and vomiting. You know, maybe animals still need it, but we do not.

• 32:23Speaker 02

  This episode was produced by me, Julia Longoria. We had editing from Jorge Just, mixing and sound design from Christian Ayala, music from Noam Hassenfeld, and fact checking from Esther Gim. Meredith Hadadon runs the show, and Bird Pinkerton backed away slowly from the platypuses as more and more kept coming out of the tall grass. "How could you?" she yelled. One platypus stood up and said quietly, "We had no choice."

• 32:54Speaker 02

  Thanks, as always, to Brian Resnick for co-creating our show. If you have thoughts about the show, send us an email. We're at [email protected]. You can also leave us a review or a rating wherever you listen. It really helps us find new listeners. You can also support this show and all of Vox's journalism by joining our membership program. You can go to vox.com/members to get ad-free podcasts and a whole bunch of other good stuff. Plus, you'll be helping keep this place running and make sure journalists like me get paid. Unexplainable is part of the Vox Media Podcast Network, and we will be back next week.

• 33:47Noam Hassenfeld?

  Support for the show comes from Sonos. No matter how much you know about frequency response or harmonic distortion, the thing that's going to make you fall in love with a speaker is how it makes you feel. And Sonos has that it factor, you know? It's this seamless system that makes things sound good in every room. That obviously takes some serious engineering, but it also takes a big-picture understanding of how and why we actually listen to things. The birthday playlist, the new TV show, the exciting new game you just got. And for the nerds out there, Sonos does have amazing frequency response and extremely low harmonic distortion. Visit sonos.com and build your system. Sonos: Love the sound, feel the system.

• 34:37Speaker 06

  New and exclusive holiday decor just launched online at The Home Depot. Check out the viral Grand Duchess collection with smart holiday lights you can control from your phone. Easily customize the twinkle across trees, wreaths, and garlands to match your holiday vibe. Create stunning light effects, then switch it up with the tap of your fingers. Even the man in red will be impressed. Shop the holiday decor you want, online only, at homedepot.com.