After my rough week last week my sweet Mama surprised us by deciding to fly down to help me for the remainder of my pregnancy! This means that she will definitely be here when the babies are born and she’ll stay for as long as we need her. For now we get to have some special mother daughter time before the babies come. Talk about getting spoiled!
Being pregnant is the perfect time to get pampered and spoiled by mom
Over this past week my mom has been reminding me to take my vitamins and is preparing little meals for me throughout the the day. She also insists on doing the dishes so I can stay on the couch with my feet propped up. I was so tired after taking a shower the other day, so she offered to blow dry my hair. It was so relaxing- and it reminded me of why I love going to the salon to get my hair done. We’ve decided that we will bring the hair dryer to the hospital when I go into labor- since it is definitely something that calms and relaxes me.
Obstetric Cholestasis update
As far as my OC symptoms go, nothing new- still itchy. I do feel like I’m having better days though where I am only super itchy at certain times rather than all the time. This is progress! I am happy to announce that my blood work showed that one of my bile salt levels has gone down a little bit! I’m now taking the maximum dose possible (2100 mg per day) instead of the 1800 mg I was taking last week. My bile salts are still elevated, but I’m encouraged that the higher dose of Ursodiol must be working to at least partially bring down my levels. Even though the itching is still there, I’m feeling less stressed knowing that hopefully the babies will not be as affected by the bile acid in my blood!
Other 32 week pregnancy symptoms:
Edema (Swelling in my feet): oh my goodness I didn’t know it was possible for my feet and ankles to swell so much! I’ve noticed that my shoes haven’t been fitting very well for a while now, but this week it was almost impossible to find any shoes that would fit. I’ve been resorting to some cheap plastic flats that have no support, but at least I can squish my feet into them. My ankles also have been really swollen- especially on my right leg. The skin gets so tight that it hurts to bend or rotate my ankle and my jeans feel tight around my ankles too. Also if I press on my foot or ankle (and lower leg) the dent remains for a really long time! Elevating my feet helps temporarily. I need to check with the doctor to make sure everything is okay, but I’m guessing this is just part of the last stretch of pregnancy.
What else is going on at 32 weeks pregnant:
-twins are moving like crazy- and hurting their mama (ribs, cervix, bladder etc)
-having to pee immediately at this moment or else I might pop (waddling to the bathroom and holding onto the walls to sit down)
-needing my husband to help push me up off the couch to stand up
-ordering a breast pump through my insurance company- which one to get? Medela vs. Freemie
-moving- starting to move into a new place- these babies better wait to get here until we are all moved in!
-leaking nipples (especially the right side)
-veiny hands and arms. Hands turning red in the shower and pulsing from all the blood pooling- scary but normal for pregnancy.
-crazy puffy feet and ankles (blood pressure was high and the cuff hurt last time the nurse checked it)
I almost wish I took some pictures of my swollen feet to show you, but I’m too embarrassed to share them on my blog because they are so gross! So here is my growing belly instead:
Although I did not post these photos last week they were taken last Wednesday when I was 31 weeks pregnant with my twins. It has been a difficult week emotionally and physically. Having a dear friend pass away is not something I’ve had to deal with many times- and even though this is not the first friend I’ve lost it doesn’t make it any easier. This is why I felt like I needed to take a break from my blog and just process things before continuing to write. I still feel guilty writing about my how happy I am to be carrying these two babies and how much I am eagerly anticipating their arrival. I do want to continue to press on and stay consistent with my weekly updates, so here is a recap from last week.
Week 31 pregnancy symptoms: Dealing with Obstetric Cholestasis
As far as my physical symptoms for this past week- I’ve also been pretty miserable and overwhelmed with how to deal with Obstetric Cholestasis (OC). In a previous post I described the itching in detail. That has been pretty much the same even while taking the Ursodiol medication. After being on the increased dose of Usodiol (600mg every 8 hours) I am still experiencing the same amount of itching (mainly on my hands, feet, ankles, arms, belly- well, it’s basically everywhere). I have found some ways to get on top of the discomfort and soothe my skin so that I can stay somewhat sane.
6 things that have helped me cope with Obstetric Cholestasis:
#1: Scratching does NOT help! It is so hard to not scratch, and sometimes I wake up scratching in my sleep- which is pretty much unavoidable. I do know that once I start scratching I can’t stop and then the burning and itching becomes much more intense.
#2: Resisting the urge to scratch is mainly a mental exercise. I have to focus on other things, try to distract myself and stay calm. As soon as I get upset about the itching it overcomes me and I want to rip off my skin. This leads to me turning into a child throwing a tantrum yelling “make it stop”!
#3: Soothing massages help distract me from the itching. I’ve been asking my husband to run his fingers through my hair or tickle my back whenever he has a chance. This really helps to calm me down and keeps me from focusing on the irritating itchiness.
#4: Benadryl helps with sleep. I have been assured again and again by my doctors and other friends who have been pregnant that it is safe to take Benadryl during pregnancy. I have been hesitant to take any type of medication during this pregnancy, but I finally gave in and started taking Benadryl regularly. It doesn’t actually relieve the itchiness, but it does make me drowsy enough to fall asleep at night (and during the day when I desperately need to catch up on sleep). I guess OC is helping me prepare for interrupted sleep after the peeps are born.
#5: Soaking in a warm(ish) but not hot bath helps relax and soothe the skin. If the bath is too warm it can make me more itchy, but if it is just about body temperature it feels pretty nice on my skin. I am able to float in the tub and escape the itching. I have been taking a bath as soon as I wake up- when the itching is unbearable, at night before bed when the itching starts to get worse. I sometimes take multiple baths during the day or in the middle of the night when I wake up scratching myself. I always use Dr. Bronner’s Pure Peppermint Castille Soap as a body wash and this leaves my skin feeling cool and tingly- which helps with the itching too.
#6: Aloe gel is soothing on my skin. Rubbing the gel from a fresh aloe plant works too. I also have been using the Honest Company Healing Ointment- especially in areas where I’ve broken through the skin from scratching too much.
This post is probably pretty boring for those of you who are not suffering from OC. But, hopefully this post will be helpful for those of you pregnant mommies who are dealing with OC during your pregnancy.
Finally I’ll leave you with my 31 week bare belly shots:
This is not my usual weekly pregnancy update. I just wanted to check in and give you all an update on what’s been going on over the past few days. I’ll start with the most eventful item which was my fist visit to the hospital.
Last Thursday (right after my 29 week post) I was walking through the parking lot to my car when I felt a strong pain like one of the babies was kicking me hard down by my cervix. Immediately following the sudden “kick,” or whatever it was, I felt a very strong cramping in my lower abdomen. This cramp was low but I also had the more familiar tightening of my whole abdomen. It took my breath away (like the Braxton Hicks that I’ve felt for a while now) but this cramping was something I hadn’t felt yet. It was more like a really intense menstrual cramp that also sent cramping pain through my lower back (similar to the back pain I used to get during my periods.) I had to stop walking and breath deeply for about 30 seconds, then I got in my car to sit down and continued to watch the clock. I think it lasted for about 1 minute. The intense cramp then loosened, but I continued to feel dull cramping in my lower abdomen and back (and a lot of movement from the babies).
This was around 4:30pm just as I was getting off work. As I drove home I had more Braxton Hicks (my whole abdomen tightening) but since I still had the abdominal and back cramping I’m not sure if these were actually considered Braxton Hicks (since I’ve heard that Braxton Hicks are not usually painful). I figured I should call my doctor just to check in and see if this was something worth coming in for. Sadly the office had just closed and I couldn’t seem to get through to anyone through the answering service (since I’ve never called in after hours about anything during this pregnancy).
When I got home I laid on the couch with my feet up and drank water (as instructed by a friend who had dealt with frequent Braxton Hicks during her pregnancy). This didn’t seem to stop the cramping or the Braxton Hicks. I needed to run to the store to get some ingredients- I was planning to have some friends over to make caramel apples- and I was pretty sure I would be feeling better by 8pm so I made my husband drive me to the store. Walking around the grocery aisles caused my cramping to increase and I realize that it probably wasn’t wise for me to go shopping. Back at home I stayed on the couch with my feet up and my friends made the caramel apples without me, they were concerned but I assured them that I might go in to the hospital once they left.
At 10:45 the girls headed home and I again tried to call the after hours line at my doctor’s office- and still couldn’t figure out how to get through. I felt stupid for not knowing what to do in a situation like this, but I just really haven’t needed to call the Dr. until this point. I ended up looking through all of my papers and pamphlets for my hospital and found a note saying that after calling the office you have to stay on the phone until the line goes dead and then someone will answer- oops- didn’t know that! So I finally got through and they notified the on-call doctor. I got a call a few minutes later from my doctor and after listening to my symptoms she told me I needed to come in. I asked if I could wait until the morning to come in, but she insisted that because I’m pregnant with twins and it’s too early for me to have them that we needed to check it out. I was also concerned with the situation due to my possible Obstetric Cholestasis because it can sometimes lead to premature labor but I was trying not to let my mind go there because it was just too soon for the babies to come.
I had to wake up my poor husband and we headed to the hospital. Thankfully the hospital where I will be delivering has a floor specifically designated as the “Women’s Assessment Center” so we didn’t have to go to an ER. When we arrived we found out that I was 1 of 2 patients on the entire floor, so we got pretty immediate care. I was quickly checked in and set up in this room:
My first hospital bed
They hooked up my belly with monitors so they could keep track of the babies heart beats and also measure if I was having contractions. It took a while for the nurse to lock onto the babies’ heart beats because they were swimming around so much in my belly!
All hooked up to the monitors
The babies heart rates were fine, nice and steady- so they were not in distress- thank You Lord! My monitor showed that the tightening I was feeling were indeed contractions and they were occurring every 5 minutes. They say you should come in if you are having contractions every 10 minutes, so I guess it’s a good thing that I came in when we did.
Monitoring the babies and contractions
I did have a moment of concern when I found out I was contracting so often and realized that the tightness I was feeling wasn’t just from the babies moving around. I began to silently pray for the babies to stay put. It was too early for them to be born. Overall my husband and I felt relatively peaceful though especially since the babies heart rates were stable and not distressed. So all that was left to do was get my cervix checked.
I know women say this is painful so I was ready for it to be unpleasant. I wouldn’t say that it was painful as much as it was extremely uncomfortable and made me feel overwhelmed with the desire for it to be over. The good news was that my cervix was still completely closed! The doctor said it wasn’t thinning or opening due to the contractions so I was free to go! I am so thankful that my body is doing its job to keep these babies in the oven longer.
We were also able find out the results for my bile acids test while we were at the hospital. It turns out that one of my bile acids was elevated. This means that technically I do have Obstetric Cholestasis (OC). Because we did the blood test and started on the medication only a few days after my first symptoms of itching the doctor feels like we can keep it under control. I will continue to get weekly blood tests to check my bile acids and liver function. I will also begin weekly Non-Stress Tests (NST) on Monday. The NST are basically exactly what I had done on Thursday night- where I get hooked up to the monitors and they check the babies heart rates to make sure they are doing well while resting, while moving or during contractions. This test also can tell whether the babies are getting enough oxygen.
As for my OC, I have found that some days are worse than others. On Thursday I wasn’t as bothered by the itching, but this could have been because I was more focused on the contractions. Yesterday and today the itching has been back in full force and maybe worse than I’ve experienced up to this point. I’m not sure why some days are more unbearable than others. I am continuing to take my Usodiol pills three times a day and I cover myself in a nice thick layer of aloe vera gel multiple times a day.
My husband researched other liver conditions (like jaundice) and found that some were helped by light therapy. So I sat out by the pool for an hour today (it just happened to be 78 degrees today in the middle of November). We’ll see if there is some long term benefit to being in the sun because there was definitely no immediately relief today. Regardless of what we are able to do to lessen the itchiness I feel like I am having an easier time mentally accepting that I may just be itchy for the next 6-8 weeks. I’m more than willing to bear it for a full 8 weeks if it means my little boys will not come too early!
I’ll still share a short update with belly shots in a few days when I hit 30 weeks. Thank you all for your prayers for these babies and for my new condition. Knowing that you all are standing with us is such a supply and a comfort.
Last week as I wrote my weekly update my typing was slowed down by the swelling in my fingers and hands. I was sore after typing, but I barely notice the pain anymore thanks to my newest pregnancy symptom- itchiness. This week I can’t even get through one sentence without stopping to rub my hands together and try to scrape the itch off of my burning red palms. I itch EVERYWHERE! Mainly on the palms of my hands and the bottoms/sides of my heels.
One word: ITCH
I am aware that pregnant women develop itchy skin on their bellies, so at first I thought the itching was just a normal part of pregnancy. I don’t have dry skin on my hands and feet and I’ve never experienced this type of relentless itching before so I mentioned it to my doctor at my last appointment on Monday. I had only been noticing the itchiness over the weekend (that came with a nice whopping cold bug that knocked me out all weekend- and I’m still recovering from that) but again- the misery of being sick while pregnant doesn’t come close to the incessant skin irritation I’m experiencing.
Before I go on about what it feels like I’ll try to explain what I’ve learned about this new symptom. It is a condition called Obstetric Cholestasis (OC) or Intrahepatic Cholestasis of Pregnancy (ICP). I had never heard of this before my doctor mentioned it on Monday and over the past three days I feel like I’ve read all of the material available on the internet- which actually isn’t a lot. This condition is apparently not very common. It affects less than 1% of pregnant women- but it is more prevalent in women who are pregnant with twins or multiples. I did find a support website for women with this condition that was helpful.
What is Obstetric Cholestasis?
Basically Obstetric Cholestasis (OC) occurs when the bile ducts to the mother’s liver do not function properly (possibly due to the elevated estrogen and progesterone hormones that are especially high during the third trimester). If the ducts to the liver don’t allow the bile to move through to the liver this can cause a build up of bile acid in the system that can eventually get into the blood stream. This isn’t usually harmful to the mother (it mainly manifests itself in the form of the itching I’ve already described.) The danger of OC is that the bile acid in the blood can harm the babies. It can cause spontaneous preterm labor and if left unmonitored it can be fatal to the baby in the final weeks of pregnancy. Some babies born to women with OC are oxygen deficient at birth and require immediate oxygen or resuscitation. There have been some cases of stillbirth after 37 weeks gestation in women with OC and for this reason most physicians will induce labor before 37 weeks.
How to diagnose/treat Obstetric Cholestasis?
I haven’t been officially diagnosed, but this seems to match my symptoms perfectly so I’m pretty sure that I will get a call from the doctor in the next few days to confirm our suspicions. I had two different blood tests done. One was the liver function panel and the other is to measure bile acid levels in the blood. My liver function panel came back normal (for a pregnant woman) the alkaline phosphatase was slightly elevated, but not enough to concern the doctor. The bile acid test will be a more clear indicator if I in fact am suffering from Obstetric Cholestasis. Rather than waiting for the results of the blood test the doctor immediately started me on three doses of Ursodiol daily to begin to attack with the problem that we think we are dealing with. Hopefully the mediation will counteract any elevated bile acid levels in my blood.
I know I’ve gone on and on complaining about how the past few days have been unbearable- mainly because I need to vent out my frustration and feelings of helplessness in trying to cope with this. Honestly when I consider constant itching for the next 2 months it makes me want to rip my skin off to get away from it. I feel like there is not much I can do except wait for the babies to be born and that is really the only “cure”.
Helpless
Beside the discomfort though, more seriously, I hate the itching because it is a constant reminder that there could be high levels of bile acid in my blood that is flowing to my precious little babies. This to me is the most infuriating and helpless feeling I’ve had during this entire pregnancy. All I’ve wanted to do over these past 7 months is protect my babies and give them a safe, healthy environment to develop in. This condition that I may have could be preventing me from doing that one thing- and instead I feel like I am poisoning them. This thought truly makes me want to rip off my skin and get all of the bile out of my system or get a blood transfusion or something in order to keep these little ones safe. I feel helpless. All I can do is pray that the medication they gave me will help lower the levels enough so it doesn’t harm my babies.
Losing sleep
Last night I slathered on aloevera gel and tried to resist the urge to scratch at my skin. Eventually I was able to sleep for about 3 hours when I was woken up from a dream. In my dream I was buying our infant car seats and for some reason I was “testing” out the quality or safety by ripping them to shreds with my finger nails. I then became aware that in reality it was my legs that I was clawing at- to the point of making them red, raw, puffy and slightly bloody (sorry that’s a gross image). It was still 2 hours before my alarm would wake me to get ready for work but at that point there was no way I could get back to sleep. The itching and anxiety was too much.
Desperate
I found myself at the kitchen table trying to eat a bowl of cereal (so I could take my Ursodiol pill with food as recommended). I could only take one shaky half bite and then drop my spoon and scratch at my thighs, then another bite and then scratch at my ribs and back. I started to cry as I realized that this is truly something I can’t deal with. I can deal with the pain and discomfort of pregnancy. The migraines, nausea, nerve pain, stomach pain and swelling were all things that I could handle up to this point and I knew they wouldn’t harm the babies. This new situation however is making me desperate for the Lord.
Trusting
I realize that I need Him to calm my anxiety regarding the health of our babies. I need Him to help me bear the seemingly unbearable itchiness of cholestasis. I need Him to take over my natural abilities and desire to thoroughly plan out the next few months of this pregnancy and my birth “plan”. I need Him to take control. I need Him to supply me with grace to pack up my apartment and move into our new place (did I mention that we are moving in a few weeks?) Well, the point is I can’t do any of this on my own and I greatly need to rely on my Lord to carry us through and get our babies born healthy and home safely.
growing peeps 