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.
And He is fully able.
growing peeps 