PUPPS update

WARNING:  This is a pretty lengthy post… but I want to be able to remember this someday.  Or more importantly be able to tell Madison or Chloe in case they get it someday when they are pregnant.

PUPPS (Pruritic Urticarial Papules and Plaques of Pregnancy).

It’s awful.

I had it at the end of my pregnancy with Chloe.   It was bad enough to merit a prescription and a barrage of lotions and home treatments, that eventually did provide relief.  Then I had a short bout of it again when I was pregnant with Josiah, but it was short lived since I was able to track it to a certain lotion I had been using.  So as soon as I stopped using that lotion it cleared up.  Interestingly, I didn’t get it at all when I was pregnant with Madison.

And now… in my 4th pregnancy it has reared its ugly head again.  And this time, I’m not entirely sure what triggered it.  But it came on fast and furious.  It primarily has affected my arms and upper chest (around my clavicle bone).   I do also have it on my belly, legs, ankles, back, hands and even my face this time.  That was particularly awful… it spread from my jaw line up to my lips and even onto my nose.  Apparently that’s rare.  Lucky me.

But it has been considerably worse on my arms and chest.  I noticed it first just over a week ago, although looking back I can now see signs that I might have had it earlier.  I had mosquito bites that weren’t going away… that probably weren’t actually mosquito bites.   I also had a tiny patch of red bumps/sores that were itchy on my left arm just above my elbow that I talked with my midwife at the last appointment.   She said it looked like Eczema.

However, it was about a week ago that I knew beyond a shadow of a doubt that this was PUPPS again.  I remembered how the spots looked, how intensely they itched and then how red hot my skin would be.  It only took 2 days before I wasn’t able to sleep well.  By Saturday night I was up every 20-40 min. reapplying lotion and had a wet cold washcloth to keep on me all night (flipping it over when one side would get too hot).

Not pleasant.

By Sunday it was so intense I had to skip church and I called the nurse line to find out what else I could do.  By this point I had tried: Aveeno Oatmeal lotion, Cortizone 10 Cream, Aloe with lidocaine, Aveeno Oatmeal bath packets, Sarna lotion and drinking V8 juice.  (I know that last one is strange, but there were other pregnant women that swore it helped, and I figured why not try it?)  I had already ruled out a huge selection of lotions my first time (with Chloe) so I was able to rule out a bunch of lotions right off the bat that I knew didn’t work well last time.

The nurse I talked with on the phone listened to me asking a few questions here and there and then said, “Huh.  Let me put you on hold for a minute…”  And then when she came back on the line a couple of minutes later she said (kind of in a excited tone), “I have to say in my 25 years of being a nurse I have never had a call about this, although I’ve read all about it.”  Not entirely reassuring to me.  But she did say I could take Diphenhydramine tablets (the active ingredient in Benadryl) to help me through the day.  Then I should get in the next day with my doctor to be checked.

So, that’s what I did.  On our Anniversary date we headed to a nice dinner (which ended up being Sonic, ha!) and stopped at a store to pick up the tablets.  The only downside was that it made me incredibly sleepy.  But the tablets plus 2 showers, 2 baths, and a slathering of Sarna lotion and I was able to make it to Monday when I was able to make an appointment with my Midwife.

She took one look at me and said, “Oh, you poor thing.”  She confirmed what I thought and was able to prescribe me a special lotion and tablet to take at night to help me sleep.    I was ecstatic.

So we made a bee-line for the pharmacy and I picked up my prescriptions.  And for the first time in days I slept.  Not straight through, but so much better.  And every day since then I have been getting better and better.  I’ve still been taking the Diphenhydramine tablets in the day along with cool showers and the lotion she prescribed, plus the Sarna lotion when I need it (which is beginning to be less and less)  and drinking V8 juice.  But it’s working!!!  I probably won’t go completely away until after the baby is born, but I feel like it’s completely manageable now.

I tried to take a picture of my arm on Sunday morning but it turned out a bit blurry.  It made my arms all lumpy–a bit like cottage cheese under my skin.  My chest was blazing red like I had been literally burned.  At one point I wondered if I had accidently given myself a “cold” burn from putting ice packs on my skin all morning.   It didn’t occur to me to take a picture of that though…

My current theory is that the outbreak of PUPPS this time around is somehow related to sun exposure.  The parts that were the most affected were the parts that were exposed when I mowed the lawn earlier in the week.  I obviously don’t think the sun actually GAVE me PUPPS, but I have a feeling they made it worse.  At least that’s my current theory.  Although at this point it doesn’t really matter.  I’m just so happy that they are going away!

(Edit:  I’m adding the names of the medication the midwife prescribed, in case anyone is wondering:  Clobetasol Propionate 0.05% Ointment & Hydroxyzine Pamoate 50 Mg Capsule)