PUPPPs Relief Mission

PUPPPs is my thing.
I don't really want it to be my thing, but after having it with ALL of my pregnancies, it's my thing. I am a mom of 4 little girls, and I'm pregnant with my fifth sweet, tiny person. There are so many women out there suffering from PUPPPs and very few places dedicated to information about PUPPPs. My goal is to provide a one-stop-shop for information and conversation about this horrid rash.

June 30, 2014

Relief!


See my poll over on the right?

Well, if you answered "other" and have some helpful tips to share, please do!

This post is all about the comments. Feel free to share remedies or treatments that worked the BEST for you! 

Fire away!

Research Blurb

One of the things that is frustrating about PUPPPs is that there is very little research done on it since it is "harmless for mom and baby." Obviously, whoever decided this had never experienced it. We need answers! WHY does this happen?? If we found out why, then we could treat the root cause instead of trying to pacify the symptoms! 

I have a nursing background, so research fascinates me. Whenever I come across research, I'll post it here. But I'll also try to summarize it for the less nerdishly inclined. 

Here is a case report done by some folks at Columbia University:

Read the article here.

It tells the story of a PUPPPs sufferer who developed the rash in the 3rd trimester and had a COMPLETE healing before her pregnancy was over. It only took a week! It sounds like her relief came from a mild steroid lotion (fluticasone) applied a couple times a day. The author was eager to see more docs try Fluticasone, since it was not the typical drug most OBs prescribe for PUPPPs. Now, this was only helpful for one woman. Some doc out there needs to do a follow-up study seeing if it helps lots of women!

However, it might be worth asking your OB about it. 

The article also went into a summary of other research they had combined. Even the author admitted that these factors were "controversial." No one seems confident in them. Here are the high points:

  • No relationship to mom's weight gain. (said one study)
  • More common when mom gains too much weight. (said another study)
  • More common in twins and triplets.
  • More common in pregnancies where mom is carrying a boy.
  • Possible relationship to high blood pressure in pregnancy.
  • Rash is usually not seen on the belly button.

All those points are laughable to me, since NONE of them apply to me, but perhaps they are helpful for another PUPPPs sufferer out there. 




Humor is the Best Medicine...


Oh, how PUPPPs adds to it all...


The only thing worse than PUPPPs would be PUPPPs with a full body cast. Just take me away to the padded room and straight jackets, please.



Ice packs are your friend...


One thing I started with the first round of PUPPPs was keeping a small cooler of ice packs by my bed at night. It was the only thing that would calm the itch when it woke me up. This way I'd be able to go back to sleep faster and get longer chunks of sleep at night. I slept with it there long after the itch was bearable at night, like a security blanket. I recommend at least 5 ice packs to make it through the night. 

Here are a few that I really liked. 

This one is made of clay and had a nice elastic strap to keep it in place after you fall asleep with it on. It stays cold reasonably well.


This guy isn't the longest lasting, but I liked that you didn't need to wrap it in a towel. It is also very flexible. 


Now, this sucker lasts a LONG time. Rock hard after hours. But it isn't flexible like the others, and you will need to have something between it and your skin, so keep that in mind. Even if you don't use in on your rash, it will keep your cooler super chilly so that your other ice packs are plenty cold in the wee hours of the morning. 


I can't over-emphasize what a difference this method made for my sleep! No getting out of bed to take cold showers. No getting out of bed at all! I'd only wake up long enough to crack the cooler lid and slap on an ice pack. Having nursed 3 babies through the night til 10 months old, I can say it's a rather similar amount of sleep. (Not that you need practice at sleep deprivation!!) But sleep equals sanity, and sanity is something all PUPPPs sufferers need in giant helpings! Wishing you all better sleep!

June 29, 2014

My PUPPPs Story: Baby #1

I think there's no better way to start this blog than by sharing my PUPPPs experience with the other suffering mommas out there. It's an all-consuming rash. It takes over your life. I found I couldn't even stir a pot of food for dinner without squirming with the intense need to scratch. The comments of well-meaning friends and relatives can be hard to hear. "Have you tried...?" "Oh, I had hives one times. I know how you feel..." Yes, I've tried it all, and no, I don't think you quite understand. 

Amazingly, though PUPPPs is considered rather rare (1 in 160 pregnancies, see this link about PUPPPs prevalence), I've personally known 2 other women with it. In them, I feel I have true empathy. My husband is also particularly allergic to poison oak. Some of his bad bouts with that nasty plant oil seem to approach similar levels of misery. He is full of empathy and support. 

Here's my story. I'll go one baby at a time...

Baby #1 (in 2008)

I had a textbook normal pregnancy up until around 36 weeks. I began to develop an itchy purple-reddish patch on my upper abdomen. I thought maybe it was fungal. I showed it to my midwife, who was perplexed but not concerned. I tried a couple over the counter creams and natural yeast remedies. No luck. In fact, it was spreading. 

I still had no idea what PUPPPs was. I was getting itchier. When my husband and I went on a babymoon, I had my first sleepless night. I was amazed that the itching kept me awake. I'm glad I didn't know what was around the bend. 

Here I am at 36 weeks, just beginning to wonder why I could barely hold still for the picture without scratching.

Within a week or two, the rash was nearly everywhere. All over my torso, legs, arms, neck, in my hair, on my ears, and in all the unmentionable places. Red. Puffy. Scaly in places. And INTENSLY itchy. It often felt like bugs were crawling on me. I was starting to feel crazy. 

I called my midwife, desperate. She said it was probably PUPPPs, but wanted to run tests to see if it was cholestasis of pregnancy (Learn more about cholestasis here.). PUPPPs is harmless to mom and baby (except for mom's suffering), but cholestasis has been known to cause stillbirth. So, to the hospital we went. We spent a day on the OB unit, getting bloodwork and monitoring. The consulting OB wanted to induce immediately. It would "cure the itch immediately" and would be playing it safe in case it was cholestasis. At this point, I was close to 39 weeks. My husband and I decided to wait for the bloodwork. We didn't want to be pressured into induction without some time to think. The bloodwork came back negative. PUPPPs it was. 

By this time, I had searched the internet for treatments and tried a few of the natural remedies. Oatmeal bathes. Epsom salt baths. Sarna cream. Those didn't even touch it. Then the not-so-natural...Benadryl cream. Cortisone cream. Nope. I made another desperate call to the midwife. She wasn't sure what to do at this point. I remember that she consulted a few doctors at this point. Then, she hesitantly prescribed a heavy duty version of Benadryl to help me sleep and prednisone to calm the rash. Ugh. Prednisone. I am a nurse. I know about that nasty drug. I was very concerned about taking it but truly couldn't imagine another day with PUPPPs. 

Two days later, I had my first precious baby girl. 



Everyone was right. The itch didn't bother me one bit in labor. Ha! It did return after, but it was lessening. I did not continue the prednisone. After about a month, it was gone. I was sure my skin would be permanently scarred. I repeatedly scratched til I bled. Many of my maternity clothes were stained with blood. But my skin healed so well that you couldn't tell what it had been through. It had been quite the experience. I never wanted to do it again. But all the statistics told me it was mostly a first baby thing. We were excited about having a large family, so I kept my mind open to more children. 

That was my most classic experience with PUPPPs. It fit the standard pattern of first time pregnancy, third trimester sufferers. The only thing that didn't match the statistics was that I had a girl. In some studies, roughly 70% of sufferers have boys. (See this link about PUPPPs statistics.

In my next post about my story, I'll tell about baby number 2. PUPPPs hit at 22 weeks that time!