Two weeks ago, the soles of my feet started itching. We’re talking keep-me-up-at-night itchy here. Over the next few days the itching spread all over my body. I itched in places I couldn’t scratch: between my toes, inside my ears. Even my eyeballs itched.
I wanted to scratch off my skin.
I also wanted a decent night’s sleep.
When I went to my doc last Friday, I asked her if there was something I could do about the itching. She gave me a low-dose Benadryl prescription and ordered some blood work. “Just to rule out a liver disorder,” she said.
Being the hypochondriac I am, you’d think the words “liver disorder” would have freaked me out. They didn’t. Well, okay, they did, for about five seconds. But then I remembered that I’ve sailed through 32 weeks of this pregnancy with no complications, despite my most active imagining of the worst, so I told myself this would be more of the same.
It wasn’t. My blood test came back positive. I have a rather rare condition called cholestasis of pregnancy. My liver is unable to effectively process all the pregnancy hormones in my body, so it’s releasing bile acid into my blood. The acid is lodging in my skin (hence the itching). The real concern, though, is that it will cross over into the babies’ placentas and lodge there, causing stress on their little bodies.
As I read about cholestasis, I got totally freaked out. Understandably, I think. Stillbirth is one of the possible outcomes of this condition. And fetal distress. And hemorrhaging. And preterm labor, for which I’m already at higher risk, simply because I’m carrying twins.
My first thought was, let’s do a C-section and get them out of there. But at 32 weeks gestation, the dangers of prematurity are a much higher risk to the babies than the danger posed by my cholestasis. So they’re staying put…for now.
However, since fetal distress can occur very quickly with this condition, I’m being monitored super closely. I have twice weekly non-stress tests in addition to a weekly appointment with the doctor.
And I have to sit down several times a day and do kick counts – literally counting how many times the babies move in 15 minutes – to make sure they’re behaving normally. If they’re not, it’s to the hospital I go.
On top of all this, I got a call yesterday morning from the nurse at the OB clinic. On Tuesday, I’d had to undergo the indignity of collecting all my pee for 24 hours and storing it in an orange jug in the refrigerator. (Doug thought this was so disgusting, he shivered every time he opened the fridge and saw that jug. For some reason, it didn’t really phase me, and I’m usually the germ phobe.) The doc wanted to make sure I didn’t have elevated levels of protein in my urine, an early sign of pregnancy-induced hypertension (PIH).
I have very low blood pressure and none of the risk factors for PIH, so I was (once more) unworried by this test – until the nurse called and said the urine analysis came back with elevated protein levels and the doc wanted to see me stat. (I begin to think that if I’m not worried, I should be. This is a horrible realization for a hypochondriac. It reinforces my tendency to assume the worst.)
I called Doug and started to cry. I haven’t slept well in nearly two weeks (the itching continues, despite two prescriptions and a topical drug), and I’d already been through an emotional zeitgeist this week, and I’d been at the hospital 5 of the past 7 days, and I was really scared. PIH is nothing to mess with.
After dropping my kids off with a friend, I traipsed back to the hospital for the sixth day out of seven and had another non-stress test (which the babies passed with flying colors) and my blood pressure taken every ten minutes for an hour and a half. The doc came in, asked me some questions, looked at my blood pressure readings, and said we should keep an eye on my protein levels (which means I have to repeat that awful 24-hour urine collection) and monitor my blood pressure at each of my non-stress tests, but for now it appears I don’t have PIH. Hallelujah!
In the midst of the yo-yo of emotions that Doug and I have been through this week, we have much to be thankful for, and since it’s the first Friday of the month, I thought I’d share some of those things:
991. Friends who watch my children while I’m at the hospital: Cindy had them for seven hours on Tuesday, God bless her.
992. Both babies are head down, so we’ll be able to attempt a vaginal birth and won’t have to have a breech extraction.
993. Princess parking right in front of the hospital when I was at the end of my rope on Wednesday.
994. Cool weather. (I’m probably the only person in Seattle rejoicing that this was the rainiest June on record.)
995. My friend Susan cleaned my house while she watched my kids on Wednesday.
996. My friend Amy came over and made dinner that night.
997. My friend Karen watched my kids yesterday afternoon on two hours notice when I found out I needed to schlep back up to the hospital again.
998. A fabulous homemade lasagne delivered to our door yesterday – the day this week when I most needed it.
999. I don’t have PIH.
1000. The babies are healthy and big for their gestational age, especially for twins.