What the PUPPP?

First published April 16 2016

My first trimester was over and I was feeling bloody good about it. Powerful. Like I’d been reborn a sexy, preggo supreme mama. I was seeing people, outside of the confines of my flat or my brothers flat. I was feeling rational again. I saw attractive women and thought about their boobs and not about killing them. When I was cycling I didn’t fly into a rage every time some prick in a 4×4 overtook me at speed. It didn’t send me into floods of tears when someone was drinking a nice big G&T in the pub on a Tuesday night. I had these cracking great big boobs and my usual body, plus a few lbs from first trimester overeating, but on the whole I was rockin it. Second trimester was going to be wicked. Starting with my first proper night out since the blue lines appeared. I met friends in a pub, had a small glass of white wine and danced until 2am! Powered by lime & sodas and sheer excitement I conquered that first night out like a pregnancy wizard and was even complimented on my impeccable form. That’s right, I thought, this shit is easy.

Sunday 27th March 2016. Easter Sunday with the in-laws. I was excited because I’d set up an Easter egg hunt for Dan around the flat, I’d been out and danced my tits off the night before and yet didn’t have a hangover and there were parentals on route with baked goods. It’d been a good weekend, actually. Except I’d developed this little itch. I mean the surface area was little, the itch was actually quite intense. It was on my very upper inner thighs, bikini line if you will, and it was doing my fucking head in. It wasn’t there yesterday. Maybe it’s from my tights and dancing and being warm. Probably just that. It’s pretty unbearable for a heat rash but my you know, preggo women and their wacky body temp. As the day went on the itch got more and more intense and I had to retire to bed and leave Dan to entertain the fam because I needed to go and rub E45 on my groin and try and sleep it off. Dan’s mum suggested putting natural yoghurt on it. I’m not going to do that. I love yoghurt. I’m not going to get it all mixed up in the world of crotch itch. Nah. It’ll die down soon.

I don’t sleep a wink that night, the itch has become so intense. And it’s moving. It’s attacking my bottom. My lovely smooth bum is getting rashy too. And resisting itching is like trying to keep your hand in a flame. It was agony. Bank holiday Monday was a less fun day as I tried to find solutions to what I now assumed was pregnancy eczema. I’ve never had eczema before in my life. A bit of mild acne over the years, that I can handle, that I’m prepared for. This fresh new hell wasn’t welcome at all! I had no idea how bad it was going to get at that point. I spent another two nights not sleeping. I missed work. It was on my arms and the back of my knees now too. I made an appointment to see the doctor who essentially told me it’s tough titties, pregnant women get itchy, and prescribed me a bottle of Aveeno. I’m starting to feel a bit downtrodden. The Pregnancy Wizard wasn’t itchy, she was awesome. But I am definitely itchy now. And I was itching just as much where the rash isn’t – i.e. where it will be next.

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PUPPP: it ain’t pretty, folks

Days go by and the itch intensifies, the rash spreads, I’m sore now too. I haven’t slept literally more than an hour a night for over a week. I’m feeling nutty. The docs have given me hydrocortisone cream and it’s doing exactly fuck all and I’m getting so desperate for some relief. I’m sleeping in the living room on the sofa bed and when I say sleeping I mean I’m crying, bawling the night away, wishing there was something that would just make it stop. I tried ice packs to alleviate it but they’re a momentary fix for what feels like chickenpox with added sunburn and mosquito bites. I went back to the doctor, Dan came with me this time, tired of watching me mentally deteriorate whilst I turned into a giant, red, lumpy toddler: too exhausted, physically and mentally to express myself in anything but shrugs, head-shakes and tears. Dan’d had enough too.

Now we’ve googled the heck out of this. And I’m not one for googling symptoms/illnesses because I either don’t believe what I read or get panicked, either way it’s pointless. But this itch has made me desperate and we’ve done our research and we’re 99% sure it’s PUPPP (or PEP). This is a heinous rash that usually presents itself in late pregnancy and basically ruins the woman’s life until she gives birth at which time it should clear up. Well I’m 15 weeks at this point. That means I’ve got at the very least about 22 weeks to go. Waiting to give birth is simply not an option, I need them to do something now. The doctor was stumped. The other doctor she brought in was also stumped. Neither of them have ever seen anything like it. They’re sympathetic but ultimately clueless and I get put on an urgent referral for a dermatologist. A two week wait. It’s going to be a long two weeks.

The next five days are the worst. Between us, Dan and I spend a small fortune on treatments. We buy pine tar soap and menthol aqueous cream that feel good for the first use and then subsequently burns to high heck every time I apply, so much so that my body starts to convulse from the physical pressure of dealing with that kind of pain on every inch of me. I feel like I now know what electroshock therapy patients must feel like. I lay on the bed after each application shaking, spaced out from the pain. Is it better than the itching? It’s different. These are my two choices. My dear friend Sophie comes over at the weekend with a selection pack of treatments for me to try. I’m so grateful and yet at the same time I’m utterly miserable because I know she’s wasting her time and money too. I know what I need, I need drugs. I need a course of oral steroids and if the doctors even try and offer me another topical treatment I’m going to seriously lose it.

I’m so depressed now. I fear the evenings and going to bed because it gets so much worse at night. My heart feels broken because the only solution I can think that would definitely stop the whole thing would be to terminate the pregnancy. I cry and cry every time this thought comes into my head but I’ve never been so desperate and I’ve never felt so helpless. Dan and my Mum are dealing with my breakdowns 4/5 times a day. Dan does his best to help, he does everything he can, taking time off work to help keep me sane and making sure we’ve got entertainment all day long. We watch Rosemary’s Baby (SUCH A BAD IDEA!) and I convince myself for a brief moment that Dan is part of this, the doctors are all part of this. Well at this point I’d have handed the baby right over. Satan can have him half cooked. I also wasn’t losing weight, like Rosemary does, I was gaining fast. Unable to sleep or barely dress to leave the house, what I was capable of was eating. I haven’t weighed myself and I won’t, there’s no point. But I’d hazard I gained a good ten pounds in a very short space of time, just from trying to keep my mind off the agony.

Nearly a week after my referral was made and I hadn’t been called with a date for my appointment. I was seriously cracking up now. I text my mum and tell her that she needs to come to London because Dan’s back at work and I’m not coping with the situation. I’ve never had to do that before, but the rash and the itching is everything when there’s nobody else around and not even the cats can comfort me. I’m lost. I did’t hear back from her straight away. My Mum’s a busy woman in an important job, but in that moment that wasn’t good enough. I needed someone to help me. I was going properly mad. So I emailed my midwife and I told her with no hesitation that I couldn’t cope and that I wanted to terminate my pregnancy because I was in so much pain, discomfort and misery. She called me almost straight away and told me that I need to go to the Maternal and Foetal Assessment Unit (MFAU) at UCLH where I’m registered for maternity care. Now I’d thought about this, I’m not dumb, I’d definitely thought about rocking up at the hospital and throwing myself on the floor, refusing to move until someone injects steroids into my bottom, but I’d called and they did not want me. The woman I spoke to made it explicitly clear I was not to come to the hospital and that the GP will help me. Well by this time I knew that was bollocks and the midwife had given me the green light so I was fucking going there. They could see me or carry me out kicking and screaming, if I could muster that much energy.

Sophie drove me to hospital and I feebly walked to up to MFAU, Dan not yet having arrived, I’d get this party started myself. I explained to the nurse at reception why I was there and she immediately panicked. She told me I needed to leave and that they couldn’t have a woman with a [possibly contagious] rash around all these pregnant women. I fell apart right there in the waiting room, I started sobbing and telling her my midwife had sent me and that I couldn’t cope and that I desperately needed to be seen. I did all of this in front of a packed waiting room full of expectant mothers, none of whom seemed to be completely losing their shit. Lucky bitches, I think. I think this but a few nights before I had a conversation with my friend who sympathetically lists every horrid symptom of her pregnancies and even tells me of a friend of hers who was producing so much saliva when she was pregnant she had to start carrying around a cup to spit in. Pregnancy is fucking wack.

They finally agreed I could stay and quickly ushered me into a room where I was instructed I had to stay, in isolation, for the safety of the other patients. That was fine. That was perfect, in fact. My own little itching sanctuary. My burden was already feeling lifted, now I was in hospital they couldn’t send me away without a diagnosis. GPs might have never heard of PUPPP but I was going to make sure I didn’t leave this world class maternity hospital until someone had confirmed I have this hell condition. Several nurses and a doctor came in and looked at me and umed and ahed, marvelling at my ridiculous body like something out of a horror movie and guessed I might have an allergy and some overzealous eczema. Dan asked them if they thought it could be PUPPP and the nurse says it could be but it wasn’t presenting typically for PUPPP, which usually starts on your nice big bump way into your third trimester. Well fuck off, mate, I’m not typical and this is PUPPP. We were waiting on the opinion of one doctor in particular, Dr Tetteh, and as sweet and supportive as all the other staff were being I was desperate for this person to arrive because if they’re the expert,  they’ll bloody know. I knew and I’m just some woman with internet access. He finally came in and the conversation between him and the other medical practitioners went roughly like this:

So here we’ve got Charlotte who’s developed an allergy type rash on her limbs an…

Ah yes it’s PUPPP.

Really because we weren’t sure as the rash didn’t start o…

No it’s PUPPP.

We were thinking of taking a TORCH screening just in ca…

Sure you can but it’s PUPPP.

And out he walked again instructing a prescription of oral steroids and some more antihistamines. I could have fucking kissed him. It was the biggest relief of my life to date that I’d been listened to, examined and finally diagnosed after two of the longest and most torturous weeks of life. The nurse did do a TORCH screen, whilst I merrily sat there in my grundies, me and Dan just relentlessly grinning at each other because something had finally be done. My arms were so ridden with this PUPPP lurgy that they couldn’t take blood from my arm and had to do it from the back of my hand which caused me to near pass out with pain as she wiggled the cannula around trying to get blood to flow. I had to lie down whilst she fanned me with one of those cardboard bowls and the other nurse rushed to get me sugary tea. I mumbled something about not drinking sugar because I’d gained so much weight but I didn’t care. Whilst Dan was off picking up my prescription and the glorious light of proper drugs was on the horizon, my heart was light and happy with relief and excitement that this was all coming to an end. I could have easily nodded off for the first time in two weeks whilst that nurse fanned me with a cardboard bowl.

I was made two follow up appointments for the following week. One to see a dermatologist and another to see a specialist consultant, purely because we don’t see this condition very often so when we do we really like to study it. Oh good. Glad to be of help. And I really do mean that. When I was reading accounts of other women’s experiences with PUPPP online, one phrase came up more than any other ‘I wouldn’t wish this on my worst enemy’, and that’s exactly how bad it is.

Now:

6 days into a course of steroids and itching has decreased significantly with night itching becoming more bearable each day and skin sensitivity getting back to normal. I can even bear to be touched again! Wahoo! I’m also taking daily supplements of dandelion root as a lot of women said this cured them, and although I’m sure it’s the steroids that are clearing my PUPPP I thought the dandelion might help to prevent future flare ups. Worth a shot. I ain’t going back there!

What did I try? (None of these worked)

E45

Calamine Lotion

Aqueous Cream with menthol

Aveeno oatmeal moisturiser

Diprobase

Dr Salt bath salts

Oilatum

Grandpa’s Pine Tar Soap

Fucidin H

Piriton

Benedryl

 

Thanks

I’d like to thank Dan, Sophie and my mother who all supported me so much and did everything they could to try and make it better for me. You three are just utterly wonderful.

I’d like to also thank UCLH who turned it around wicked quick when I finally turned up looking like a disease ridden zombie at the MFAU.

And thank you for reading. I hope it helps in some way.

 

 

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