Small update – we haven’t been to a doctor since my 20 week visit with the Perinatologist in Syracuse but there have been some new developments in the twin pregnancy for anyone interested.
The Saturday before my Syracuse appointment I took a shower and during it felt an intense, burning, stinking pain on my stomach. I looked down and I had tons and tons of tiny little itchy dots on my belly. Thanks to some google research – it presented like a PUPPPs rash (Pruritic Urticarial Papules and Plaques of Pregnancy). Good thing is a PUPPs rash is completely safe for mom & baby but it just SUCKS because there is nothing you can do or any meds you can take for the itching other than some lotion. I mentioned this to the Syracuse specialist and he told me to mention it to my OB next time I saw him.
Fast forward a few days and the tummy rash is gone, no longer painful – so maybe it was just dry winter NY skin? Who knows, but I’ve upped my water intake and my slopping on of lotion. Unfortunately, the itching has gotten worse. Its now my scalp, upper back, but really bad on my palms and forearms.
I’ve done a lot of research with the twin pregnancy (thanks a lot to this book) and I knew that all the diseases & conditions that happen in pregnancy as a result of an overworked organ (Gestational Diabetes, preeclampsia, gallbladder issues, etc) are more likely in a twin pregnancy because, well… mroe babies to overwork said organs. So… I had heard of cholestasis and its symptoms. I started worrying I was showing signs.
Cholestasis is a rare liver condition that appears late in singleton pregnancies but in multiple pregnancies it can show up as early as 16 weeks! It can be scary and have complications for myself and the babies so I decided to call my doctor a week before my appointment so that I could have blood tests done. The nurse was definitely annoyed by me on the phone, “you’re only 22 weeks, but I will tell him (doc) when he is out of surgery…”. She called back 2 hours later saying that this condition can pop up earlier in twins and that doc has ordered blood tests for bile acids and liver enzymes. This test was done on Monday, November 20th.
I received my results via email on Thanksgiving – bile acids were 13.9 umol/L and the diagnostic standard for Cholestasis is anything above 10 umol/L. I received an email note, attached to the lab restults, from my doctor that because of the holiday, and because my results weren’t higher than 40 umol/L, he would discuss with me at my appointment the following Tuesday (so a few days from writing this email).
I’ve read a lot of things regarding this disease and pretty much I’ll have tons of blood work done each week to monitor that bile acid levels as well as liver enzymes (which right now, the liver enzymes are totally normal, thank goodness). In addition, if doctor sees it necessary I can start a medication to help lower the bile acids and finally, babies might need to be born even earlier than 36 weeks to prevent still birth (which his highest between 34-36 weeks for twins pregnancies with Cholestasis).
I’m, surprisingly, not freaking out. I’ll chat with my doctor more on Tuesday but I’m just glad I insisted on calling him to get blood done when I did. Twins are a whole different ballgame than singles.. I’m learning that fast!
Right now, the itching SUCKSSSS. It is worse at night and I’m in a benadryl induced sleep for the past week. Eczema cream is my best friend and I’ve been slapping that on every hour or so to help the palm and forearm itching. I’ve read that it can get so bad that you scratch so bad you bleed – but I’m definitely not there yet. Not even close, thank God.
On an awesome note – we have less than 2 weeks until the babies are 24 weeks gestation – which means technically, they could be born them and have a decent chance of surviving! Our big milestones I’m looking forward to are 24 weeks, 28 weeks (better chance of survival & they can be cared for in Syracuse), 32 weeks (even better chance and they can be cared for here in town, right down the road) and 36 weeks – scheduled deliver for the twins!
Baby A kicks and moves all the time, B doesn’t so much. Which kinda freaks me out most of the time but just today B has started moving a lot more. A lies up and down on my right side and B the same on my left. I actually had a lot of belly discomfort the past 2 days and felt like babies were flipping – I’m anxious to see if I’m right and that they’ve flipped when I get an ultrasound Tuesday morning. 🙂
That’s all for now – I’ll update more on Tuesday after my regular OB appointment.