If you read my first post, you know that I had hoped that I had survived PUPPPs and wouldn't have to think about it again. Not true.
First, other people do get PUPPPs. Less than a percent of pregnancies still means many people. Turns out a childhood friend has suffered through it and I was able to support a college friend who suffered through it and gave birth this year.
Knowing that I have it again for this second pregnancy has pushed me to use these next few months of itchy sleeplessness to reflect and share so that others who find themselves with PUPPPs know they are not alone in their itchy nightmare.
With that in mind, here are some things I learned the first time.
First, I had PUPPPs much earlier than I realized. Around 32 weeks I had itchy stretch marks. Like really itchy. I asked some other moms if they had itchy stretch marks during pregnancy. They said sure, once in a while. I asked if they had it to the degree where they would involuntarily itch because it was impossible not to? No, they said, not that bad, but sometimes it was itchy. However, it wasn't until the red itchy stretch marks became raised red and spreading that I realized my itchiness really was different.
Next, I didn't really want to have a problem. And an itchy stomach didn't seem like the worst type of pregnancy problem. So I started to explore what was going on and trying to figure it out, but I was busy at work, tired from not sleeping comfortably and preparing our house for a baby. My motivation to figure out what was happening increased as the severity of my symptoms increased.
Calling the nursing line for help was the first step for me. They suggested calamine lotion, aloe or Benadryl. I started to treat the affected area, but it seemed to get worse not better. Then it leapt to my thighs and worked its way up my chest. The suggested items didn't seem to help it. I tried Sarna anti-itch lotion and it got even worse.
When I couldn't sleep one night and felt like peeling off my skin, I got up. When I looked down at my body I was horrified to see what looked like boils or raised lesions rapidly spreading across my torso and legs. It was one of the weirdest things I have seen on my own body and very alarming. I did the dangerous thing and looked to the internet for help. I typed in pregnancy rash and up popped PUPPPs. It fit my symptoms exactly. It gave me some peace to know that whatever was happening to me had a name, was known and others had gone through it.
And yet...the rash and raised red welt-like things kept spreading. By morning they were between my fingers and toes and on every part of my body. My back was a little less affected and my face and neck seemed unaffected.
I called the nursing station again and explained the alarming spread of my symptoms. The nurse said a pregnancy rash was quite normal and there were no appointments available before my scheduled appointment in two days. In the meantime, I was to rest (um, sure, that's easy when your whole body is on fire) and apply topical creams to relieve itching, but there was no reason to keep calling or get in sooner. This, ladies, is a learning point for me. I should have been a better advocate. In the moment I was in too much pain, too tired and too disappointed to do much more than hang up. And with that particular nurse I may have gotten no where. But I should have called back and asked for someone else to hear my pleas. Someone else may have at least gotten me in sooner so I wouldn't worry as much and feel so abandoned in my agony.
So I turned back to the internet for more ideas on relief. I tried pine tar soap (good for 15 minutes relief for me), coconut oil (3 minutes relief), aloe (5 minutes relief), calamine lotion (hardly any relief), Sarna (made it worse), and oatmeal baths (dirty bath, no relief). I finally did find my longest lasting relief (up to 45 minutes) from a lukewarm bath with salt and baking soda.
Gradually the intensity robbed me of the ability to get any sleep at all and drove me to stay home from work and simply lounge with as little clothing as acceptable and take baths for relief.
When I finally got my appointment with the doctor, they were very unhappy with their nurse and very apologetic. They noted my rash was terrible and should have been immediately addressed and would be thoroughly addressed now that I was in their care. They tested me to rule out any liver dysfunction and more serious issues. They stress tested the baby. Thankfully the baby was healthy and doing well (a great relief to me). They felt that my case was very severe and I would be unlikely to get any relief outside of delivering the baby. The appointment had been with my nurse practitioner and they called in the doctor on duty (not my regular OB/GYN). His counsel was for immediate induction.
At that time, I felt I wasn't in a good place to make the decision. I had not come prepared to the appointment to be admitted to the hospital and have a baby right then. I was severely fatigued and my regular doctor wasn't available for consult for a couple days. My poor husband was very supportive of doing whatever it took to get me more comfortable but also felt like we needed to go home and get our bags for the hospital and such. So we took the steroid creams and prescriptions and headed home to get packed and get as much rest as possible. We set our appointment with my regular doctor for several days (5, I think) later when I would be at 39 weeks.
Looking back at it now, I would have showed up at the clinic in my discomfort and made a nurse tell me to my face that I didn't have a serious problem. Secondly, I probably wouldn't have been so stubborn about making it to 39 weeks. That time between 38 and 39 weeks was miserable. And in no way helped me meet any of my other goals for birth. It sapped my remaining strength and turned my body to new shades of red and bloody that I never hope to see again. But this is me. I had an extreme case that is not the usual for most suffering from PUPPPs.
But in case you are suffering PUPPPs and you do have an extreme case, I share this so that you know you are not alone and what I learned from going through it myself.
Next, I will share how PUPPPs impacted my birth experience.
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