Friday, November 9, 2018

Intrahepatic Cholestasis of Pregnancy, of course it is.


I stare at myself sleepily in the bathroom mirror, wincing in anticipation of what I’m about to do. I examine my shoulders, hoping to see something that would give purpose to the insane itch that roused me from sleep. I sigh, disappointed, no dry skin, no rash, just the bright red marks left on my pasty white shoulders from the 20 minutes of clawing away at them to relieve an invisible itch without leaving my warm bed. I soak two facecloths in ice cold water and slap them on my, now burning, scratch marks. The cold shocks me completely awake and any hope of keeping a toe in dreamland is dashed. But for a glorious instant, relief rushes over me.  

The itching started off innocent enough. I simply chalked it up to a normal pregnancy discomfort. It wasn’t there all the time, so I didn’t think much of it. But as the weeks progressed, I started to notice that it wasn’t random, the itching was got worse at night and it ranged from a mild scratch to “oh my god can I please just rip my shoulder skin right off”.

At 32 weeks I mentioned it to my OB, who sent me over to the lab to do bloodwork for a rare, liver condition that sometimes develops in pregnancy, Intrahepatic Cholestasis of Pregnancy (ICP). Neither of us were overly convinced it was ICP because while itchiness tended to be worse at night (one of the hallmarks) it happened on and off throughout the day and, more importantly it didn’t present on the soles of my feet or palms of my hands (the most common locations).

However, if this pregnancy is any indication, I should really buy a lottery ticket because when the results came back, I was diagnosed with ICP; a condition affecting only 1 in 1000 pregnant ladies. ICP annnnnnnd Gestational Diabetes (GD), insane itching without the option of stress-eating? I hit the jackpot, lucky me.

For those of you who aren’t familiar with ICP, here’s an infographic that breaks it down.
Image from ICP Care
While ICP isn’t the worse thing that can happen in pregnancy, it does mean taking Ursodiol twice a day to lower bile acids, extra monitoring of the baby and likely an early delivery of baby Robertson. In fact, he or she could be here as early as 3 weeks from now! I’m glad I didn’t continue to shrug off the itch, because while being itchy seemed like a pretty benign thing, I’ve since learned that it can be a really big deal. So, if any pregnant ladies are reading this and can relate, let your health care provider know.  

While I was anticipating a bit more time to get the house in order, I’m also excited for this itching (and the diabetes) to be gone! The next few weeks will be a whirlwind of appointments, organizing schedules, copious amounts of online shopping for baby gear I’ve put off buying and perhaps even delivering a baby. I’m scared and excited and relieved all at once, and while only 1 in 1000 of you will have the unfortunate chance to experience ICP, I think that that cluster of feelings is one most expectant parents can relate to!