Tuesday, August 24, 2010


Ever since last Tuesday my body has been itching like you wouldn't believe. 

I stuck it out for about 6 days until I went to the doctor yesterday.  It started out with my feet, hands and elbows... so weird.  Then my abdomen, inner and outer thighs, back, chest, etc started feeling like they were on fire as well.  Thursday, little red bumps began to form all over and then they so conveniently turned into blisters on Saturday night.  Yes - I said BLISTERS!

Sleeping... is non-existent. Who can sleep with blisters on their rear-end?

Night time seems to be the worst.  It's like at 8pm a switch is flicked on and my body starts freaking out.  It hurts all day but night time is just plain awful.

SOOO... I went to the doctor.  I had to wait around all day yesterday until 4 pm for my appointment.  When the nurse took me back and lifted up my shirt to find the Selah's heartbeat she was really taken back.  "OUCH!"... were her exact words.  My skin is so tender that she made me bleed when she had to measure me with that handy-dandy tape measure they use.

The doctor came in and examined me.  PUPPP is what I was told I have.  Pruritic Urticarial Papules and Plaques of Pregnancy - PUPPP.

Some pregnant women may also experience more intense itchiness during pregnancy. This is often seem in conjunction with itchy, red bumps and larger patches of a hive-like rash on their bellies. This is known as pruritic urticarial papules and plaques of pregnancy (PUPPP) or polymorphic eruption of pregnancy and will effect about 1% of pregnant women.
PUPPP will usually effects women who are in their first pregnancy, carrying twins, and is usually at its worst during the third trimester. 

What causes PUPPP?

PUPPP Theory One: Some investigators suggest that the rapid abdominal wall distension damages connective tissue and causes an inflammatory response.

PUPPP Theory Two: One study has shown that male fetal DNA can be found in skin biopsies of the rash. Since 70% of women with PUPPP give birth to boys, a new hypothesis is that male fetal DNA acts as a skin irritant.

So my doctor thought that my case of PUPPP was severe enough to give me oral steroids.  She told me that if this first one week's dose doesn't work then we will move on to the next one... because this will last until the end of my pregnancy.  TWO. MORE. MONTHS.

BUT... this may not be completely what is wrong with me.  PUPPP's usually starts from the abdomen and works it way outward.  Mine didn't.  Also, I am not having a boy or multiples which is usually the case with PUPPP.  At the end of my appointment my doctor had me go to the lab so that I could do some lab work for a Liver Funtion Test to determine a diagnosis of ICP.

What causes ICP?

Intrahepatic cholestasis of pregnancy is caused by an impairment of bile secretion in the liver. As the bile backs up in the liver, the level of bile acids increases in the bloodstream. These bile acids are deposited in the skin causing the intense itching. Cholesterol, triglyceride, and bilirubin levels are also increased.

Several complicated mechanisms have been proposed to explain this impairment of bile secretion, but it appears that genetic and hormonal factors are involved. Women who have a mother or sister who has had ICP are at a higher risk of developing this condition. Also, estrogen interferes with the clearance of bile from the liver, and progesterone interferes with the clearance of estrogen from the liver.

Effect on the baby?
The liver of a healthy fetus has a limited ability to remove bile acids from the blood. The fetus normally has to rely on the maternal liver to perform this function. Therefore, the elevated levels of maternal bile cause stress on the fetal liver. Intrahepatic cholestasis of pregnancy increases the risk to the baby of meconium staining during delivery, preterm delivery, and intrauterine death. Women with ICP should be monitored closely, and serious consideration should be given to inducing labor as soon as fetal lung maturity is confirmed.
What does all this mean?
I will receive my test results either tomorrow or the next day to find out if my liver is healthy.   If all is well with my liver, then I will just have to find a temporary fix to relieve my itching until October 18th. 
Please pray for Andrew, Selah and I as we all deal with this itching.  My frantic itching is keeping Andrew awake and I am sure Selah doesn't like it as well. Also, pray that October 18th gets here soon. REALLY SOON!


Jessica said...

oh my goodness Terra! I will be praying for you, Andrew, & Selah daily! Your story started to sound like Job in the Bible for a minute there - just getting worse & worse... but God was faithful to Job for his perseverance & he will be to you too! He's got a plan, just wish we knew what it is :)

Love & Prayers,

Gena Zepeda said...

Terra, I had ICP..only they did not diagnose it until after AJ was born..I ended up having my gall bladder taken out, but I had a very severe blistery rash from head to toe for months...and it was incredibly itchy! When AJ was born he had really bad jaundice as well. He was in the ICU nursery for 3 days because of that and he swallowed some merconium during labor before the c-section. I am just now getting over the rash, it comes and goes.

cwoida said...

I found that the only thing that helped my hive-like rash during pregnancy was Goldbold medicated lotion. My hubby had to slather it on me every night so I could sleep. Sleeping on an air mattress on the floor helped some too believe it or not. It kept me nice and cool, being to warm seemed to make me itchier. Good luck! Mine went away with in a week or so of having my beautiful baby girl and thankfully didn't happen at all with my second pregnancy!