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 Posted: Tue Aug 17, 2004 11:31 am
The following are the 2 most recent posts to my blog on baka-neko.com
Please please please, if you're pregnant, and you itch like crazy and you've been itching for more than 2 weeks in a row, go get tested for IPC! Do NOT let your doctor tell you that being that itchy is normal.
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Well, today my husband just stumbled across some information that makes me feel less insane, but more worried (if that even makes sense). I think I'm going to go stop by the midwife's office today, even though my next appointment isn't until tomorrow morning.
If you've been reading my blog regularly, you'd know that I've been going grazy with itching since about halfway through my 6th month of pregnancy. Itching all day, all night, sometimes I can't sleep. I've even had panic attacks when I'm trying to sleep and I force myself not to scratch. I've chopped my fingernails to nubbins, so that I couldn't scratch as much - I'm still scratching bloody spots into my skin. Benadryl - nothing. Zyrtec and Claritin - nothing. Aveeno baths - nothing. Every moisturizing lotion known to man - nothing. Hydrocortisone cream - nothing.
No matter what I try, I'm still itching like crazy.
I think my husband is the only one who knows how much it really bothers me, because he is the one who stays up at night listening to me whimper and cry, even in my sleep. But everyone has been telling me "Itching during pregnancy is normal! Now stop scratching!"...
I swear it feels like an evil torture device, meant to drive me insane.
Anyhow, here's where I get to the website Matt found for me - www.itchymoms.com
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What is Intrahepatic Cholestasis of Pregnancy (ICP)?
ICP, otherwise known as Obstetric Cholestasis (OC), refers to a specific liver condition in which the normal flow of bile is impaired in a woman's body resulting severe itching and more rarely, jaundice. Although ICP has been reported as early as a few weeks pregnant, it is more common for it to begin in the third trimester, when hormone concentrations are at their highest levels. The figure for the percentage of women for whom ICP will recur in future pregnancies is still somewhat debated, but some sources claim it to be as high as 90%. ICP is also referred to as choleastais of pregnancy and pruritus gravidarum.
What are the symptoms of ICP?
Symptoms of ICP can vary in severity and type, but the most common ones include:
Itching all over, but often more severe on palms and soles
Dark Urine and/or Pale Stools (greyish in color)
Fatigue or Exhaustion
Sleep Deprivation from Itching
Loss of Appetite
Mild Depression
Less common symptoms include:
Jaundice
Upper-Right Quadrant Pain
Nausea
Severe Depression
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I've got it all except for the greyish stools. But then again, it's not like I stare at my poo all day long anyhow. (Yuk.)
The reason why I'm nervous about this is because of the issues we had Friday with Walter not moving, and his heartbeat being weak - apparently ICP can cause fetal distress in the last month, as well as spontaneous stillbirth.
I'm already just starting week 37... from what I've read, NOW is the time that many mothers with ICP are losing their babies. They go through labor only to have a dead baby placed in their arms.
That has got to be one of my biggest fears.
So I'm going to head to the doctor's office and ask them if they think I might have this problem. I really hope not, but it is a definite possibility.
So everyone, cross your fingers for me.
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Just got back from the midwife - before I even showed her the information I printed out from itchymoms.com she was prescribing a full liver panel blood test.
She looked like she wanted to kill my GP when she asked me "Why didn't you tell me about the itching sooner?" and I told her that my GP had said it was normal and to just grin and bear it. She's actually going to head to my GP's office and raise hell! I love Heather. She's the bestest midwife in the world.
So yup. It looks like I've got Intrahepatic Cholestasis of Pregnancy.
A big name for something so stupid.
As Heather explained it to me, essentially my body is allergic to pregnancy. My liver can't break down the extra estrogen my body is producing, and as a result, is over-producing bile, which is poisoning my body. The itching is the outward sign of that. Apparently this also goes hand in hand with my Rh factor issue - Rh negative moms often have issues with bilirubin (a part of liver bile that makes skin yellow when you're jaundiced). So in other words, I'm just the lucky 1 in 1000 that has the extreme form of liver retardedness (yes, that's my technical term for it) that causes this stupid itchy crazy reaction.
The good news though!
She checked my baby's heart and placenta again - so far, he still sounds healthy and happy and beautiful. She had me run over to the hospital to have the blood drawn for the liver function panel (to check all my levels). She said that we're going to try to keep him in as long as we can - the longer he stays in, the better he'll be after he's born. He's got a good likelyhood of bringing himself early, so if that happens, we'll let him come. If he hasn't arrived by week 39, they'll induce me, because we don't want to risk any infant distress that might put him in jeopardy.
I'm supposed to keep a very very very close watch on him. If I go more than 3 to 4 hours without feeling him move, I go to the Labor and Delivery emergency room and let them know that I've got cholestasis and my baby's not moving. First thing they'll do is try to wake him up (like they did last Friday). If that doesn't work, they'll break my water. If I don't start labor within the hour, they'll give me the Pitocin drip and induce.
Thankfully, he's almost full term, so he should still be pretty healthy even if he does come early.
I just have to watch him like a hawk.
But at least it's good to know I'm not crazy, and this itching isn't normal, and that it has a real cause! I'm not going crazy, I'm just allergic to being pregnant.
How dumb is that? Allergic to pregnancy.
*shakes her head*
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Posted: Tue Aug 17, 2004 11:52 am
eek I didn't know that even exsisted!!! A good heads up for my next pregnancy. I'm glad that everything is alright itchyness aside and that the little one is still healthy and moving. Yay for your husband listening to you, paying attention and not treating you like an overreactive pregnant woman. You've got a good man there. Here's to hoping the next couple of weeks go off without a hitch, or more itchyness.
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Posted: Tue Aug 17, 2004 11:58 am
Illiana_Galean eek I didn't know that even exsisted!!! A good heads up for my next pregnancy. I'm glad that everything is alright itchyness aside and that the little one is still healthy and moving. Yay for your husband listening to you, paying attention and not treating you like an overreactive pregnant woman. You've got a good man there. Here's to hoping the next couple of weeks go off without a hitch, or more itchyness. Yeah - I'm very very lucky to have my husband. He would just feel so bad because I'd be crying trying not to scratch while I'm sleeping - he knew it bothered me a lot more than I complained about it (and I think I complain a lot!) But I'd never heard of this until this morning, and to find out that not only does it exist, but that I've got it... Kinda scary. But a lot lot lot better to know what's wrong and how to fix it than to suffer needlessly. So if you have a mysterious itch with no rash that doesn't go away - go straight to your doctor, do not pass Go, do not collect 200 dollars. My husband is just very angry with my GP right now, because I've had to suffer for the last 2 months with this. If we'd have known then, there is medication you can take that will make the itching go away (problem is, it takes a couple weeks to kick in. My baby will be here in a couple weeks, so the medicine would do diddley squat!)
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Posted: Tue Aug 17, 2004 12:22 pm
Well the thing with pregnancies is that the hormones stay in your system for some time, so it may still be a good idea to get on the medication. That way after little one is born you won't be all itchy, or risking your health due to the retarded liver.
On a side note...Where did you get your sig and how does it work?
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Posted: Tue Aug 17, 2004 12:38 pm
Yeah, they've actually got a different medication I take after the baby is born that is supposed to bind to the extra bile and let me just pee it all out harmlessly. So I'm looking forward to not being itchy soon! I got the sig from Dynasig - TUF does cool stuff with PHP smile
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Posted: Tue Aug 17, 2004 1:30 pm
eek Omigod how terrifying ...
...and how scream ARG scream that your GP didn't listen to you. It makes me angry how doctors do not take women seriously when you try to tell them something is wrong and they just assume you're being a wouse and a whiner rather than thinking "hey, she knows her body and she says something is not right. If she says she is in a lot of pain or discomfort, maybe I should believe her."
I had that happen when I had to go to the ER right before Easter. I woke up at 4:30 in the morning CRYING in my sleep from a severe pain in my left ear. (I'm not a crybaby by any means and have a fairly high pain tolerance: I think tattooing practically tickles for crying out loud.) Chris had to run me to the ER because it just got worse and worse and by the time I got in to see the doctor I was ROCKING to try and make the pain go away. It was really bad. The doctor had the gaul to patronize me and ask if I was feeling a "little discomfort" in my ear ( I had rated it a 7/10 on the scale about an hour ago when I had seen the nurse and it was hitting an 8.5 by now) and he had this air about him like he thought I was being a baby...until he looked in my ear. Then he was suddenly nice as pie, made everyone look at it (because they were "probably never going to see THIS again" ) and THEN got me medicated and pain drops to make it stop. I had Bullous Myringitis which is really rare in people my age and is known to be ungoldly painful. B. M. is large blisters that form on your eardrum as a result of micoplamatic growths and usually happens to babies and seniors with really bad upper respiratory infections. stare To see someone my age have it was like winning the freak lottery.
Sorry for the long story, I was just trying to let you know that I get pissed at doctors too: for being so educated, they aren't always the smartest guys. (Yes, I have problems with men doctors but not women ones....they always listen to me.)
EDIT: well, not ALL of them. My pediatrician is still the best doctor I've ever had.
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Posted: Tue Aug 17, 2004 1:54 pm
Holy crap. I'm mentioning that at my next appointment. I've been itchy like crazy, and everybody just told me it was normal...so I never thought to bring it up with the doctor.
I don't think I have it...but...who knows. It's not a severe itching for me...just constant...especially in my legs. Having had conditions in the past that caused itchiness, I'm good at not scratching, but it certainly is annoying.
Makes me wonder how many people out there aren't aware of this. I mean, I'm a research-happy kind of a person...I can finish the doctor's sentences half the time. But this...I hadn't even heard of it. That's scary.
And I swear...I'm gonna beat the next doctor that doesn't listen to the patient. They may know how the body works, but we all know our bodies better than anyone else in the world. Some doctors seem to forget that.
Anyhow, good luck with you...and thanks for tipping us off on this...the more people that know, the better. 3nodding
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Posted: Tue Aug 17, 2004 2:50 pm
I thought I've read something about this, the itching on the palms and soles was striking a chord. From what I understand, you're just miserably itching. I mean, I know I was itchy, mainly from the dry skin that was a result, but it's definately something to think abotu for pregnant women! Thanks for the headsup!
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Posted: Tue Aug 17, 2004 7:14 pm
Besides, my thought is, if all it takes is one little set of bloodwork (heck the phlebotomist had all the blood she needed in less than 30 seconds, and I'm not easy to draw from!)...
Yeah. I HATE needles, but I'd say that it's definately worth it to any pregnant woman who is feeling any itching out of the ordinary to get checked for this.
Just makes me wonder how many women go undiagnosed because they're just put off as "another pregnant hypochondriac"...
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Posted: Tue Aug 17, 2004 7:40 pm
the dancing kitten Just makes me wonder how many women go undiagnosed because they're just put off as "another pregnant hypochondriac"... I'd like to take this time ALSO warn pregnant women of Pregnancy induced Gallstone Pancreatitis. If you have a sharp terrible pain right under your breast bone, as if you can FEEL the exact point of the bottom of it, that sorta goes around the bottom of your ribs into your back, lasts from 30 minutes to forever, and doesn't go away no matter what you do, it is probably pancreatitis. The problem is that the Liver Function Test shows up abnormaly in pregnant women who are just fine, so docs don't think twice. I called my doctor twice complaining that I thought I was dying, it was so scary, I was crying and wailing. She told me "Yeah, that indigestion in the last trimester can really get to you." It came on randomly, and I started becoming afraid to eat everything, because I thought it was indigestion and that food was causing it. Later a nurse told me it couldn't be "excruciation" I was just exaggerating. Well five weeks post-partum I had a bout that lasted TWELVE hours. They checked my LFT which should have been normal and found out I had pancreatitis brought on by Pregnancy causing gallstones. AND the part that made me laugh was that when I was in the hospital for a week on IV fluids eating a liquid diet to get the inflamation down so they could remove my gallbladder, everyone I saw who read what I was there for got all sympathetic and said "OH GOD, pancreatitis that HURTS!"
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Posted: Wed Aug 18, 2004 4:42 pm
Hooray! I've got some good news. I need good news.
So we got back the test results from the blood I had drawn yesterday (thank HEAVENS my local hospital has a lab that can do a full liver panel in 24 hours instead of having to ship it out and not knowing for 9 days...)
My clotting time = normal, thromboplastins = normal, albium(proteins) = low, phosphates = super high, bile levels = only a little above normal.
What this means to me:
1) The biggest risk factor associated with ICP is the vitamin K deficiency that causes blood to stop clotting, resulting in dangerous hemmoraging...
I don't have it! No bleeding to death for me or my baby! Hooray!
2) The bile acids are high enough to make me incredibly uncomfortable, but they aren't into the danger level where I would be passing excess bile to the baby through my placenta. In other words, he's got a much much much reduced chance of fetal distress from bile poisoning.
3) They scheduled me for weekly NST (non-stress testing) and AFI (amniotic fluid in inches) tests - that means I get an ultrasound every Wednesday till my little guy is born! He's so cute smile
Also, we think we know why he stopped moving on Friday... Because he did it again, but in the hospital while they were monitoring him (which is why a 20 minute monitoring session turned into an hour and a half...)
He was sitting on his own placenta. Silly boy. Apparently, whenever I rest either on my back or my right side, because of where the placenta is located (middle right side, curving around the uterus to the back), he ends up sitting on the placenta and reducing blood flow through his umbilical cord.
If I lay on my left side, though, all of a sudden he gets his full blood flow restored, and he becomes a happy baby.
So for the next 2 weeks, I have to just stay off my right side, and lay on my left.
So hooray! No bleeding or bile poisoning for my baby! I'm so excited about that.
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Posted: Wed Aug 18, 2004 5:58 pm
biggrin wow that is good news!
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Posted: Wed Aug 18, 2004 6:01 pm
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Posted: Thu Aug 19, 2004 2:17 pm
eek allergic to being pregnate... now theres one for you... i can see it now in the head lines once this information is wide sprea... j/k and no i'm not picking on you, i'm picking on the people who complain about having a baby...
i wish you luck. ::huggles:: and that everythign will turn out normal and he'll be happy and heathy!!
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Posted: Thu Aug 19, 2004 11:01 pm
i was never even aware of that......thank you for sharing that, i'm glad you're ok.
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