On Saturday, May 2nd, the palms of my hands and soles of feet began to itch, and on Tuesday, May 5, we had an OB appointment. Our OB was out of town on vacation, so we were scheduled to meet the other OB in his practice. We really liked her. When she walked in to our room, I was furiously scratching the sole of my right foot. Before even introducing herself, she said "how long has this been going on?" "Since Saturday afternoon." Then she asked how bad it has been, and if it's kept me up or otherwise interfered with my day and life. I told her the truth- I hadn't slept since Saturday night because the itching was so bad. She insisted we have a blood test before leaving. She listened to Little Man's heart tones, which sounded good to her, but seemed extremely low to me. Typically, his heart beat is somewhere between 145-155, but at this appointment, she recorded him at 125. I was displeased and concerned, so we were hooked up to the fetal monitor. Two hours later (it took so long because he kept moving so the monitor wasn't super effective, until they finally found a good spot to listen), it was decided that his heart tones were sounding good, and we learned that variations in the beats per minute are actually a good thing. I asked when we should expect to get the results from our blood test, and the nurse said that the doctor had ordered them "stat" so we should hear from the office by the end of the day (5pm).
At 4:45, I still had not heard from the office, so I called, and was dismayed to find that they had already forwarded their phones to the answering service for the night- 15 minutes early.
Jennifer, me, Stephanie S, Stephanie W,
and Anna at Stephanie S's baby shower.
Wednesday morning, I called first thing when they opened. I was told a nurse would call me. Around 10:30am I called again, a little more perturbed, and was told, again, that a nurse would call me. Then at 11:15, on my way to have lunch with a friend, I called again, and refused to hang up until someone told me something real- as opposed to their standard line. I was told that the doctor had my results and that she needed to speak with our regular OB, and that I would hear back within three hours. About an hour and a half later, on my way back to work, I get a call from a nurse in the office, who sounds hurried and worried. "Can you come in today, before 2, to meet with the doctor to go over your blood test results?" Instantly I knew there was something to worry about. If there wasn't they would have said "your test results came back negative and everything's fine! Have a great day!" I hung up with the nurse, and called Husband to see if he'd be able to leave work to go meet with the doctor.
We got there, and they did the typical pee-in-a-cup, get-weighed, check-blood-pressure routine. I was surprised, as this wasn't a typical appointment, but I guess you do those things no matter the reason you go? They sat us in Room 1, and we waited for the doctor. She came in, looking nice, and not at all worried until she started talking. The words "Cholestasis of pregnancy," "high risk OB," "high risk pregnancy," "bed rest," and "extra monitoring" were tossed around. Truth be told, I didn't hear much of it. It's a good thing Husband was able to go too. He asked good questions.. that I can't remember. I remember that we were told we'd have an appointment with a High-Risk OB tomorrow (Thursday), at 2. I remember that I was given a thick pack of papers to fill out before then, and that I was told not to go back to work today, or to go in the following day. I was also told to expect longer appointments because each one would include ultrasounds and fetal monitoring, and to expect more blood tests, more often. And I was told that we would have two OB appointments per week, not exceeding 3 days between them.
The five of us at my church baby shower. I have to admit
it's nice to not be the shortest in every group.
I ended up going back to work only to talk to my superior to tell him I wouldn't be in the following day and why, and to grab my work laptop to bring home.
The high-risk OB appointment occurred on Thursday, May 7 at 2pm. I got there before Hubs, and I was triaged (which sounded like a funny way to say that they took my standard pregnancy vitals- weight, blood pressure, urine sample). Hubs was there when I finished with that. Next up, we had an in-depth ultrasound. So detailed and such a powerful machine, that the ultrasound specialist could see hair on my little boy's head! HAIR! Yay! We learned that at each of these visits, we'll get a cd with ultrasound images, which, I must admit, is a teeny tiny perk. Then the doctor came in. She wasn't warm or friendly, and no happy feelings resonated from her. She was knowledgeable and quick with her answers to our questions (which I had three pages of, with 2-3 blank lines in between for answers). She simply confirmed what our other doctor told us, explained what they'll be monitoring for at each appointment, explained that I'll need to do kick counts 3 times per day, every day, and explained how she wanted them done, and when to call. She ordered another blood test to check for something that was left off the previous one.
Cholestasis of pregnancy, according to the Mayo Clinic is defined as:
"Cholestasis of pregnancy occurs in late pregnancy and triggers intense itching, usually on the hands and feet but often on many other parts of the body. Cholestsasis of pregnancy can make you intensely uncomfortable but poses no long-term risk to an expectant mother. For a developing baby, however, cholestasis of pregnancy can be dangerous. Doctors usually recommend early delivery."
Hubs sleeps uncomfortably while we wait
for test results during our last hospital visit.
The symptoms are simple. For me, I have intense itchiness all over my body. Imagine the biggest, worst, most intense itch you've ever had. All over your entire body. At one time. And scratching doesn't help. The symptoms for Hugo are much less severe, until they aren't. The symptoms he can experience are early birth (preterm labor) or still birth. Because of this, we will be delivering early; more on that later.
Overall, there is no relief. Because the itching is not a topical problem (like a rash or allergy), topical treatments, like lotions, and Epsom salt baths, don't work. I was offered a medicine that would help me sleep though, but it's likely to basically put me in a comatose state, considering DayQuil puts me to sleep for a few hours.
The illness, itching and all, goes away within a few days of delivery, which we've been told can be anywhere between tomorrow and Father's Day (37 Weeks).
Speaking of early delivery, 37 Weeks is the optimal number the doctors would like to get us to. It's not guaranteed. It's not promised. And we've sort of been told that it's really not likely. It all depends on Hugo, and how he's doing. At 32 Weeks right now, our doctors are wanting to get to at least 35 Weeks.
At each of our appointments, which are twice a week now (Mondays at our regular OB, and Thursdays at the high risk OB), we will get ultrasounds and fetal monitoring. The ultrasounds are checking the amniotic fluid levels, overall movement, weight, and size of Hugo. The monitoring will be checking his heart tones for good variations. Anywhere between 120 BPM and 160 BPM is where we want to be. If, at any point, Hugo starts to show any signs of distress - that is, fluid levels are low, he loses weight or isn't moving as much, he doesn't have 10 movements in 2 hours (checked during my kick counts), or his heart tones don't look good, our doctors will intervene.
The level of urgency will decide the method of delivery. Both doctors have stated that a vaginal delivery is the first choice, and a c-section is the second choice.
The deciding factors will be:
Level of urgency - if Hugo is showing serious signs of distress and is in danger, a c-section will be performed right away. If there is time, vaginal delivery will be attempted.
My body - depending on how early Hugo shows signs of distress, my body may not be prepared enough to handle a vaginal delivery, even with an induction.
Someone got a haircut
The other, Creepy Uncle at The Family BBQ symptom I've been fighting is a lack of sleep. In the last 10 days or so, I've probably gotten 1-2 hours of sleep per night, if even that much. The itching is fairly unbearable all day, but as soon as I decide it's time for bed, it intensifies even more somehow. I can't relax enough to fall asleep because I'm constantly fighting the urge to scratch an itch somewhere on my body. And I've learned- if you scratch one place, another place will definitely need to be scratched too. And another, and another. And so on. Most nights, over the last 10ish, I try to sleep for about two hours. Then I usually get up, sit on the edge of the bed, have a good cry, then lie back down. An hour or so later, I get up, take a warm lavender-scented Epsom salt bath (knowing it won't help the itching), in hopes that the lavender will relax my body and mind enough to allow me some sleep. About an hour later, I get up, sit on the couch and cry before deciding to organize the nursery a little more. Sometimes I make mine and Hubs' work lunch around 3am.
Husband has been sweet. He's purchased multiple calming lotions, anti-itch sprays, and gels. He's done research to find what's helped other women who've suffered cholestasis of pregnancy. He scratches my back. He scratches my toes (the tops of my toes, and the spaces in between them are so itchy, all day, and I can't reach them very well, and honestly, I want to cut off my toes so I don't have to feel it).
I've tried taking half an adult dose of Benadryl at night (one pill instead of two), and while it definitely makes me very sleepy, it doesn't make me sleepy enough to disregard the itching. Also, it doesn't help with the itching.
At our OB appointment Monday this week, I literally broke down into tears when our doctor voiced my biggest fear- that there was nothing he could do to help with the itching. It took almost 30 minutes to calm me back down. I truly think the tears were fatigue- and exhaustion-induced, and not actual sadness, and I fear that it may happen again tomorrow at our second appointment this week.
I have made some decent progress on the quilt.
The only release I have in this is:
The knowledge that I didn't do anything wrong to cause it.
The knowledge that we have a team of doctors vigilantly monitoring me and Hugo for my safety and his health.
The knowledge that it will be over sometime in the next 1-5 weeks.
In all of our pregnancy-induced illnesses (January's hospital stay due to hyperemesis, our Week 28 quick visit to the hospital due to questionable leaking fluid, our Week 30 overnight stay due to possible pre-eclampsia, and this cholestasis), I've done my best to remain positive and try to look happy and rested and well. I rarely discuss the aches and pains of pregnancy, or the sicknesses or situations or hardships we've faced. Husband is amazed that I can put on that face. I do it, though, because I know how blessed we are to be able to conceive and carry our child. I know how blessed we have been to have been able to make it to 32 Weeks pregnant. I don't want to be the person who constantly complains about being pregnant.
I knew that person.
I hated that person.
Because while she complained about her "mistake" and how it was an "accident" and all her symptoms (which were the common pregnancy symptoms, like peeing a lot, light swelling, tiredness, and back ache), my husband and I tried and tried so we could be in her shoes.
Hair on Hugo's head!
How far along?- 32 weeks
Total weight gain?- 24 pounds, still.
Symptoms?- Heartburn, dizziness, slight nausea, itchiness, not sleeping.
Sleep? - Nope.
PEAK of the week? - Learning that Hugo has hair!
Pit of the week? - Crying at the doctor's office.
Missing anything? - Dreaming, not itching, not being dizzy and lightheaded, wine, console (though not the hours)
Food Cravings - Steak. Cold water.
Anything making you feel sick or queasy? Pizza.
Happy or Moody? Moody. 100% due to the lack of sleep. I'm crabby and I hate it. Hubs can't touch me, lest he make that spot itch.
Looking forward to? - Baby shower this weekend!
Upcoming Events?- Baby shower this weekend; the birth of Little Man sometime in the next 5 weeks.
