Why it pays to blog regularly

You know how "they" say you don't remember the pain of childbirth? Well, I totally should have been giving you PUPPP updates every second or third day...because I can barely remember the agony of PUPPP at its worst. Yup, remember - by some miracle, the rash is mostly gone.

Let's try to reconstruct a timeline, shall we? (and in the process, apparently, create the longest post ever.) I first noticed a problem a day or two before Thanksgiving. We'll call it November 20. At that time, there were a few raised, red, slightly itchy spots on the undersides of my breasts. (Ooooh, will that sentence score me weird porn hits?) I chalked it up to a heat rash irritated by the friction of a slightly-too-small bra (because 38F is so tiny) and resolved to: (1) get fitted for a nursing bra in the very near future; and (2) show the rash to my OB, just in case.

Thanksgiving itself was tolerable, though I probably reached into my shirt to adjust the girls a few more times than strictly appropriate in front of my inlaws. The rest of the weekend was also tolerable, though by no means did the rash go unnoticed. My main form of treatment was baby powder. The next part of the story you know already.

And that's when it started to get really bad. Thursday night, November 30, I could barely sleep. On the advice of this site, some time around three o'clock in the morning, I mixed a paste out of baking soda and water and painted it all over my chest. The paste itself was very soothing, and shockingly, after it dried and I rubbed most of it off, the effects lasted long enough for me to get a few hours' sleep. Midday Friday I repeated the treatment, again to the same effect, though I discovered that there was no good way to treat the undersides of my breasts or the top part of my belly (where said breasts generally rest their weight). A bra was completely out of the question. I walked around topless at home, and when I had to go out I layered a couple of snug cotton T-shirts (the bottom layer turned inside-out to avoid irritation from the seams) and maybe a sweatshirt or looser shirt if I wanted to avoid looking completely indecent.

Then, in the space of the few hours that afternoon, my abdomen went from having a few dots here and there to sporting four dense patches of rash, each about two inches in diameter. That was the bad thing. The good thing was that the PUPPP Relief Soap and Cream came in that day's mail, and within about ten seconds of my seeing the package I was in the shower and lathering up. Let me tell you...that stuff feels good. Even after the first use, it definitely eased up the itching for a couple of hours.

We had been invited to dinner that evening in the home of some friends, and I spent a good portion of the meal lounging on their couch with an icepack shoved down my shirt and trying not to perform an adhoc mastectomy with their diner knives. And trying not to complain, as I'm pretty sure this couple is currently dealing with fertility issues and of course the last thing any infertile woman wants to hear is a pregnant woman complaining about her pregnancy. (This doesn't apply to ayone reading this post, since you can always just close your browser or find another page.)

By bedtime, the patches were starting to grow together. (Seriously, time-lapse photography would have been put to good use here.) I managed about two hours of sleep before I woke up clawing at my skin, squealing and whining. Screaming may have been more appropriate, but we had a guest sleeping over and I didn't want to disturb her. Disturbing Ezra was no problem, though; I reasoned that as long as I wasn't getting any sleep, there was no reason he should either. He spent several hours awake with me that night, swapping ice packs, reminding me to focus, pacing my deeping breaths.

Now here's the part where about 20% of my readers gasp in horror and the rest are all: "Buh? So what?" When, by about 4:30 in the morning, I still couldn't sleep, or even go more than thirty seconds without scratching, Ezra started nudging me to get into the shower. (The short answer to the "buh" readers is that showers on Shabbat are generally a no-no. Ditto lotions. But also ditto scratching your skin until you bleed.) It took about twenty minutes and he evenutally had to quite literally drag me in there, but I finally gave in...and, wow, did that feel good. I kept the water lukewarm and used the handheld showerhead, but the combination of running water and the fantastic new miracle soap made things so much better.

I'm trying to remember whether I also used lotion on Shabbat, but I'm not sure. I think I did. See, this is why I should blog more regularly. Anyway, within an hour of the end of Shabbat, I had mixed up another batch of baking soda paste (this time with some cornstarch thrown in for good measure - and that makes the whole thing both easier and harder to apply). And I had a call in to the OB on-call for my practice that night. The moment she called back and told me I could take a low dose (25 mg) of Benadryl, I set Ezra out to the drugstore to buy a bottle. The antihistamine effect, in addition to the drowsiness side effect, make this a wonderful sleep aid.

By Sunday morning, an Orthodox Jewish friend of mine who had also suffered from PUPPP during her first pregnancy had called the rabbi she spoke to at the worst of it to inquire about what treatments I might be allowed to use on Shabbat. See, there are all these allowances when you're sick - and not only does PUPPP count as a sickness, but being pregnant puts you in a special category of "sick" as well.

I really think that that Shabbat was the peak of the PUPPP, overall. Regular use of the PUPPP soap over the next few days caused the oldest parts of the rash to fade to a milder pink by about Monday. Of course, by then, the newest parts of the rash - up to the middle of my neck and surrounding my belly button - had reached their peaks. It was hard to stay ahead of the rash, but as soon as I discovered any new area of outbreak, I added that region to my soap-and-lotion regimen. I also discovered that my slightly-healed breasts could again tolerate a bra, if I kept a cottom camisole underneath. Yup...that was weird. But necessary on a few occasions, so I managed.

To make a long story short (too late): three or four showers per day along with religious application of the associated cream has caused almost all of the affected areas of my body to fade back to a color only a tinge redder than my usual skin tone. PUPPP itchiness is gone from most of those regions, though the frequent showers have created lots of dry, flaky skin, which itches in its own special way. My nipples and areolae have a very special kind of burning itchiness, to the point where even though I was mostly "normal" last night, I spent nearly an hour clawing (my new favorite activity) at my nipples both in and out of the shower. Within days of first receiving the PUPPP soap and cream, I ordered another two bars and a nine-ounce tub of the cream, and they couldn't come fast enough. I've still been using Sarna lotion, but only on the very itchiest patches and usually only when I need to be numbed...either before going out for a couple of hours or just before bed. I take a single tablet of Benadryl at bedtime most nights - I can't imagine it's doing much harm to the kidlets, and certainly no more harm than their mother may do to them in a murderous rage induced by several consecutive days of itchy-ravaged sleep deprivation.

As for the Shabbat stuff - let's just say that there really is a lot that can be permitted in this situation. I won't post the specifics, because I don't want someone in a slightly different situation to assume that it would all apply to her, but by all means email me and I'll put you in touch with the rabbi my friend put me in touch with.

Wow - if you made it this far, you deserve a cookie. Go ahead and bake a batch, and then send me one too.