1 post tagged “puppp”
I'm just warning you that I am writing this as a future guilt-trip for Aidan and Alanna...you might not enjoy this...or you might...if you're mean...
I don't know why I started thinking about this tonight...
Aidan and Alanna's due date was 9/17/04, which placed me at 37.5 weeks gestation--full term for twins. In early August, our friends threw a baby shower for us, and my parents were visiting. I was just shy of 33 weeks, feeling huge...and very hot. And itchy, for that matter. My belly itched, which didn't surprise me...it was stretched so tight, you could bounce a penny off of it, so I kept lotion on it as much as possible. But I had these patches on my thighs that just itched like crazy. So of course, I googled something like "itching+pregnancy" and PUPPP came up.
Pruritic Urticarial Papules and Plaques of Pregnancy
Sounds pleasant, doesn't it?
Not being prone to self-diagnosis (I leave that to Jason, if I can coerce him), I thought "no way. please. no way." If you're interested in learning more about PUPPP, click here: http://www.emedicine.com/DERM/topic351.htm
All that you really need to know is that is an INTENSELY itchy rash that occurs during pregnancy. It's horrible and unrelenting. Typically it occurs during the third trimester of first pregnancies, more frequently in those carrying multiples. The cause is unknown, but some suspect it is due to the rapid stretching of the skin during that last trimester.
I digress. We went to the shower on Saturday evening, and in EVERY picture, I'm scratching my legs. One of Jason's colleagues, who was a dermatology resident, kindly took a quick peek and said it could be PUPPP. Slowly, the itching spread...down my legs, all over my torso (except my belly button...a classic presentation, apparently), my arms, between my toes and fingers. Each day it got worse. I could not WAIT to leave work, and I sent Jason out for oatmeal bath concoctions hoping for some relief. I hardly responded to him when I walked in the door...just went directly upstairs to run a bath. Fat lot of good that did. I discovered the only relief was Benadryl, which knocked me out. I was sort of a junkie; about every four hours, I could feel the itching coming on again.
On Wednesday I had plans for lunch with friends, followed by an appointment with my OB/GYN. So I downed some Benadryl around 7:00 and thought "Here's hoping I wake up in time for lunch!" as I curled up on the couch. I did, and I was lovely in August, big as a house with a rash all over me. I reassured them that I was not contagious, or so I thought. So we had lunch, and then I headed to the doctor. Jason met me there, and we ran into our friends, who were expecting a baby in December 2004. I remember her saying I looked terribly uncomfortable, which I was. Finally we were called back, and my MD, also friend of Jason's, took one look at me and asked why I didn't call her. "It's PUPPP." And there is no "cure" for PUPPP...you just have to wait it out...it resolves after delivery on its own. GREAT. As we were finishing up "the routine," she then informed me that I was going to the hospital for bedrest for at least a week. Typically I had prepared myself for that possibility before every appointment, but with all the itching, it didn't even cross my mind. I was so upset. Why? I have no idea why I started to cry. Must've been the hormones.
The beautiful thing about this is that they had to deliver steroids by IV to strengthen Aidan's lungs in case I went into labor. For whatever reason, this helped the itching! Even my doctor was surprised. After a painful punch biopsy of my foot to rule out another pregnancy-related rash, I headed off to the high-risk pregnancy ward for a week in Parkland...where more babies are delivered than anywhere else in the country...also the best place to be if your child has to go to the NICU...also a county hospital, so all the loveliness that goes with that. I had the best nurses though; they were so sweet. One even gave me a little dress-up tiara, for reasons I now cannot recall. But I still have it.
I wasn't there long before the dermatologist I mentioned above came to visit and ask if the dermatology residents could take a look since I had such a classic case of PUPPP. Of course, Jason being a resident, learning from patients, I couldn't refuse. So at least 10 residents meandered through, some asked if they could take pictures...yes, photos... of my gigantic, spotted, itchy (though not so horribly anymore) belly. Some of which were then forwarded to Jason, and subsequently inserted into a Powerpoint presentation for one of the Internal Medicine teaching conferences, Potpourri, for all to see. They would present unusual cases and see if faculty or housestaff could guess the diagnosis. These are the little clips I can recall him telling me, as he laughed:
A devastatingly handsome man walks in with his wife.... She has recently experienced rapid weight gain.... She presents with small red pustules (I'm guessing this is where my belly shot came in) on her extremities and torso... She complains of intense itching...
No one figured it out, as I recall...except maybe the people who knew me.
The itching gradually subsided to a very tolerable level as long as I continually used some cream the dermatologist gave me (the biggest tube they could prescribe) and kept myself well-moisturized. Four and a half weeks later, along came our two little angels, and they are worth every ounce of itching I experienced!
I only know one other person who had PUPPP, and when we discovered the connection it was so wonderful to have someone who KNEW how bad it was. I'm sure most people imagine it's just an annoying kind of itch, but it is far beyond that. Fortunately we could laugh about it together now!
