I am not a hypochondriac. In fact, I am generally nonplussed about stuff that happens with my body and just assume that it’s normal. This includes getting scraped up (cleaning wounds? That’s for ninnies!), splinters (it hurts to pull them out!), etc. I don’t like taking medicine, and only do in extreme circumstances (like, after I have a c-section). I figure that if I do a pretty good job of eating healthy foods, eating a balanced diet, and regularly exercising and sleeping, my body will respond appropriately and not mess up. I’m also not fastidiously clean. I mean, I wash my hands at appropriate intervals (post bathroom, pre-cooking), and shower semi-regularly (hey, I have three kids…). But I don’t worry too much about dirt or bacteria or sharing drinks and food. And I rarely get sick—which I attribute to my body having an incredibly strong immune system in response to my lack of fastidiousness.
Now, I just began my third trimester of pregnancy with my fourth baby. When all is said and done, I will have spent four years–almost 12.5% of my life so far–pregnant. And I generally have loved being pregnant, just loved the whole process in that super annoying way that makes other people hate me just a little bit. I want to write a blog post about the best parts of being pregnant.
I won’t be doing that today though.
This pregnancy has been more challenging than the first three. I don’t know if it’s because it’s the first time I’m pregnant when I’m in my 30s. I don’t know if it’s because I got pregnant while we were in the middle of one of the most difficult, emotional, and stressful periods of my life, what with living in a temporary apartment with a school system that wasn’t meeting Oliver’s needs, dealing with Hazel being a sad zombie because she missed her friends in Chicago, buying our first home, packing and moving for the second time within a year, and not knowing anybody and feeling far away from all of my friends. I don’t think it’s because I have three other kids at home, although I’m sure that contributes to me being really tired.
Regardless of why, this has been a rough ride. I had a lot of nausea in the first trimester, and some wicked migraines. There was nothing I could do for the nausea except wish that I was throwing up because at least then I’d feel like it was a productive way to spend my time. (And, you know your nausea has to be pretty gruesome to be wishing to barf. Just sayin’.) And the migraines! Tylenol was ineffective—if anything, it just increased the nausea. I finally found some relief from it by using a blend of essential oils (I’ll blog more about that another time), but I hated the smell of it. So, I’d have to want to avoid the migraine enough to withstand the strong smells… it definitely felt lose-lose.
My belly popped out early, which isn’t a terrible thing except that it means that I’ve spent a lot of time with clothes that don’t fit right. Also, it opens to door for strangers to give me their unsolicited feedback about my body. Honestly, though, I don’t mind that because it amuses me. But my body shape has been weird this time around. Fortunately, I’ve mostly only expanded in my belly. I still wear the same jeans I was wearing before I got pregnant (these days I don’t button the top button). But they’re getting uncomfortable. That said, maternity pants literally fall off of me. It might be that the elastic is worn out from being enormous at the end of other babies… but I really don’t want to spend a ton of money on pants when I am confident this is my last pregnancy. So I feel like I don’t have any good wardrobe options. (I should bite the bullet and go shopping, but trying on pants is challenging with a toddler.)
But then, a couple of weeks ago, the icing on the cake arrived. My belly started itching.
Now, that’s normal, right? The skin is stretching (welcome, new stretch marks!), all sorts of changes are happening. Some itching is normal. So I ignored it, like any good non-hypochondriac who generally assumes all things are normal with her body.
I got itchier and developed a rash on my belly. The itching was pretty intense, so I tried putting Eucerin cream on it—they say to moisturize during pregnancy, and the bottle claims to be anti-itch. I assumed the rash was because I have a mild form of dermatographism, which causes me to have a histamine reaction to scratching and repetitive rubbing sensations. I really assumed that I was itchy in the normal pregnancy way, which was making me scratch without thinking about it, which was giving me an allergic reaction.
Then I woke up one day last week in the middle of the night because I was too itchy to sleep. And I had scratched enough in my sleep to actually draw blood (whoops). I mentioned it to Kullervo at breakfast the next morning, while I was still incredibly itchy. He said that that didn’t seem normal; this was getting to be excessive. And he suggested that I call the doctor.
Now, again, I’m not a hysterical person who calls the doctor at every weird symptom. But I called, and they asked me to come in. This was on a Thursday morning, and it had been raining hard for 12 hours. The roads were so backed up that the thirty minute drive to my doctor’s office took an hour. The doctor looked at me, and said that it looks like I have PUPPP (but don’t worry—it clears up soon after delivery, more than three months away), although it could be something more serious. She wanted me to get some blood work done to rule out worse alternatives. Of course, they couldn’t do the blood draw at the office. So I left with Hank, we got soaked on our way to the car, and we drove to the lab, where we got soaked on our way in. A phlebotomy student took my blood (and was very nervous about Hank), and we got soaked getting back into the car. (Buckling your toddler into his five point harness in the pouring rain is not the most fun way to spend an itchy, rainy day.)
So, I came home, armed without any knowledge of PUPPP or what else I might have that is worse than wanting to rip my skin off of my body.
So I did what any good, new hypochondriac would do. I googled it. Pruritic urticarial papules and plaques of pregnancy. Or, according to my research, cholestasis of pregnancy, which is a liver disorder (and which, I have since found out that I do not have).
Whatever you do, if you want more information about PUPPP, don’t do a google image search. It’s gross. It’s a rash—they’re always unsightly. And some people get it everywhere. It originates in stretch marks, and they don’t know why it happens, although it appears to occur almost exclusively in the first pregnancy, and in the final couple of weeks of pregnancy. It’s possible that it is an allergy to the placenta, as steroid antihistamines often seem to help, but which I’m reluctant to take. I felt cheated–this is NOT my first pregnancy. And I am NOT in the final couple of weeks of pregnancy.
Now, when I say that it’s itchy, I mean that if you haven’t had this, you don’t know itchy (unless you’ve had some other excruciatingly itchy rash). I’ve had a lot of people tell me since I found out, “oh, yeah. I know how that is. I was really itchy when I was pregnant too.” Or, “Oh, I have springtime allergies and my nose is SO ITCHY then. I know how you feel.”
You really, really don’t.
I appreciate your empathy and sympathy and all that. But you don’t know, unless you are waking up multiple times a night because you are too itchy to sleep, and have filed your nails down to nonexistence in order to make sure that you don’t scar your body up (post-PUPPP scars from scratching are normal). Unless you have googled your condition to see any ways that people have found relief, and asked on your neighborhood listserve if anyone happens to have a particular brand of soap because your husband isn’t home from work yet (of course this hits in his busiest work season of the year—extended tax filing season) and you’ve put the kids to bed, and the store that was supposed to have this magical soap that you have hung all your hopes on doesn’t have any.
That Thursday was a bad day. I cried and cried—out of lack of information, intense uncomfortableness, bad weather, and generally feeling overwhelmed. I also cried at the kindness of the people around me—one neighbor who I had never met ordered that soap for me and had it shipped overnight so that I could get it more quickly, and wouldn’t let me pay her for it. Another neighbor offered to go out on a quest for things that could help. And an old friend who had experienced it with her first pregnancy was my lifeline until Kullervo got home, telling me things that she had done that had worked, and giving me a protocol of how to deal with it. So I cried because I felt sorry for myself, and I cried because I never expect people to give of themselves—even in small ways—so freely, and it always takes me aback. And, of course, I’m pregnant and hormonal and all that.
A week later, I still have this rash. Thankfully, it hasn’t spread—it is still isolated to my belly. It is still waking me up at night, which, between that, a cold that has me coughing all the time so that I’ve lost my voice completely, and having to pee at least twice a night, means I’m not sleeping much. But I do get brief periods of respite during the day—an hour here or there when I am able to forget about it, as opposed to a week ago when it was just a constant.
I gave myself that first weekend to cry, to mope, and to feel sorry for myself. I am not good at being miserable all the time, so I told Kullervo that by Monday, I was going to have a good attitude about it, dammit, even if I had to fake it.
If you ever have this, or know someone who does or who gets it, here are the things that have helped me. I run a bath with both witch hazel and Aveeno oatmeal bath, and wash my belly multiple times with Grandpa’s pine tar soap. It leaves me feeling pretty raw, but it helps a bit. In the morning when I am incredibly itchy, I use original Sarna cream. It smells unfortunately and uncannily like Arm and Hammer cat litter, but it burns/cools (it has camphor and menthol) enough to give an hour or so of relief, if you can tolerate the smell. I’ve heard the unscented doesn’t work as well. At night, when I wake up in the middle of the night, I use doTerra brand Deep Blue essential oils (made of a mixture of wintergreen, camphor, peppermint, blue tansy, blue chamomile, helichrysum, and osmanthus essential oils), which burns (especially if I use the lotion—that’s almost unbearable), but provides a similar relief to the Sarna without the nasty smell that I just can’t deal with at night. My doctor prescribed me a topical steroid cream which I have yet to use (I’m hesitant to use steroids while pregnant—or ever—so that’s a method of last resort that I have on hand), and a prescription for a steroid pack.
I consider myself fortunate that my case of PUPPP doesn’t seem to be as severe as others that I’ve read about, heard about, or seen pictures of online. I’m hoping that it doesn’t get any worse than it is. And I’m thankful that I didn’t get it with my earlier pregnancies, because it might have made me reconsider reproducing again… and so far I have some pretty phenomenal kids.
PS… there are no pictures on this post. That’s on purpose, because the best options for a picture related to this post would be me in a muddy looking bathtub (thanks, oatmeal and pine tar), or a belly shot of my rash. Neither is particularly attractive.