As mentioned in previous posts, week 38 was nearly unbearable. I estimate I slept 45 minutes or less per day. My pain level was an 8 or 9 and I wanted out of my skin in the worst way.
Like many moms, I had a birth plan and it hoped for the best - no interventions, minimal drugs if any and to allow baby to come when she was ready. PUPPPs took me way down to the not ideal parts of my birth plan. First step was coming to grips with the need to be induced. Everything about PUPPPs points to the fact that true relief cannot begin until the baby is born.
Without sleep, I was fast losing endurance and strength that I knew I needed for labor. I really wrestled with the fact that PUPPPs wasn't endangering me or the baby, so why intervene? And yet, for my itchy friends, you know the need for relief is palpable. So much pain, so much itching, so little sleep or relief. Birth is not without pain so that seemed like a poor reason to intervene on its own, but it was ultimately the lack of sleep and persistence of my husband that got me to the place where I was ready to admit PUPPPs had changed my nice birth plan.
The doctors seemed relieved that we had chosen induction. We were admitted, and immediately other impacts of my PUPPPs were felt. First, they needed a vein. It took three people to determine exactly how and where to do that as my body was so swollen and rashy that they simply could not see any of my veins. Finally they settled on one barely visible spot in the crease of my elbow. This was not ideal for so many reasons. One, terribly uncomfortable. Two, have you ever gone 30 hours without bending your elbow. I doubt it and I found trying to not even slightly bend my elbow while laboring, let alone resting and breathing, to be nearly impossible. It had to be secured several times and the monitors went crazy every time I went to 178 degrees on my arm instead of 180. Annoying for me and the very patient nurses.
Next, as I was induced and watching for the signs of labor, it was very difficult to feel them. Because the pain of the rash was so great, it took a long time to be able to discern the pain from contractions. I needed lots of support and monitoring to be able to labor.
As it took longer and longer, I was tired and had been in pain for a long time, so we requested an epidural. I was already hooked to lots of monitors so one more line did not feel like a huge deal, especially if it could give me some relief that I could channel into labor. It did help in that regard, but we were already nearly a day into labor.
I gave birth at a teaching hospital where I received good care. Word did get out that a severe PUPPPs case was in the wing and I received many visitors. I am usually a pretty private person, so I thought that it may bother me to be a display model for so many students and practitioners. However, I was so uncomfortable and so mad at my PUPPPs, it was easier to share my condition with those who were interested and could help give better care to others suffering from PUPPPs in the future.
I labored for about 30 hours and estimate that I had over 50 practitioners in my room at one point or another with about 12 at once toward the end. Longer story cut slightly shorter, the baby got stuck and interventions were not working to get her out. Finally an emergency c-section was done and our baby arrived. She was small, beautiful and worth it.
A few hours after birth, my swelling and redness started to recede. It was not a vanishing act by any means, but it did lessen in a visible way. After a major surgery, they strap cloth boots with electrodes to zap your legs for circulation. The 12 or so hours with those boots was agony for this itchy momma.
The nurses and doctors had lots of questions about my pain, but it wasn't until day 3 that pain other than my itchy pain was noticeable to me. That may also be why it took me 6 days to realize that the tongue swelling and other problems I was having were related to my allergy to a pain narcotic. Again, the prevalence of the PUPPPs simply overwhelmed the other things happening in my body.
Most discouraging to me was that PUPPPs didn't simply vanish within a couple weeks of birth. By day 3 I was very encouraged that my PUPPPs had receded significantly and seemed to concentrate back to my belly and thighs. And then, I took a shower (wonderful feeling) and five minutes into it my milk came in all at once. It was like water balloons filling. Immediately after that it was like my PUPPPs coming back in a giant wave. The rash rippled across my body spreading red itchiness up to my neck to the tips of my fingers and back in between my toes. The discharge doctor had seen me before my shower and I summoned her back after the shower. She was in a bit of shock at how rapidly the PUPPPs had returned and immediately prescribed me stronger steroids to help reduce its affects. My PUPPPs came back at about 75% of full strength from its worst. It did decrease, but at 2 months past birth, I was still at about 40% coverage and strength.
It wasn't until I weaned my daughter at 7 months that I reached full relief. Again, I had hoped to nurse longer, but I was really tired of itching and as a working and pumping mom, I finally gave in to the itching and juggle of timing and dishes. Why did I wait so long to give up nursing? I wasn't certain it would end the itching and after the severe 38 week to birth itching, I felt the diminished rash was survivable in comparison.
Bottom line, my PUPPPs was very severe and should not be the normal PUPPPs experience. And I still have a healthy baby and was able to get my body back and the itching did go away. I have some itching scars and am just generally a more itchy person than I remember being before PUPPPs, but life can and does go on.
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