The last few months of my pregnancy turned a bit crazy. Everything was shaping up for a typical third trimester till I finally asked my OB what was safe to take for these incredibly awful itching fits I was having, especially at night. They had been getting worse for weeks and I'd finally reached my breaking point. She suggested benedryl and claritin and told me to let her know if it was worse at the next appointment.
Indeed, the meds did not improve the itching so she ran some blood tests. She mentioned a couple of possibilities, among them ICP, which would require an early induction. I scoffed. She knew I'm a hands off patient. I would never consent to an early induction. Then she said the word all pregnant women fear - stillbirth.
I did what any person would. I immediately hit the internet and binged on every piece of information I could find. Unfortunately, what I found was conflicting. There seemed to be a few houses of thought on ICP. Some believe the disease is overly hyped and risks to the baby are due to other undiagnosed issues that tend to coincide with severe ICP. Others believe it is under diagnosed and the criteria for diagnosis should be widened. The one thing I did read over and over again was that the results of the blood test used to diagnose ICP can change quickly. It can go from a normal level to what is considered by most doctors to be dangerous overnight with no warning.
I found a couple of support groups through the ICP Care website. Over the next few weeks I watched women comparing bile acid numbers, seeing how they truly could triple or quadruple in a week. I found women whose doctors were proactive putting them on medicine to lower their bile acid when their levels were lower than mine. Then I saw women like me. My doctor was among those that only felt worst case scenarios needed treatment. So my levels, to her, were not worthy of diagnosis or treatment. By the fourth blood test she had decided my levels weren't going to change (they were only slightly increasing with each test) and further testing was unnecessary.
At this point I'd been getting an average of 2-3 hours of sleep a night for months. Not much in this world is more persistent than a hormonal woman, except perhaps a sleep deprived, hormonal woman. I called my nurse pleading with her to do another blood test. I was bawling by the end of the phone call. My doctor had told me we would keep an eye on it, but here, in the last weeks, when levels were most likely to spike she abandoned me. My nurse convinced her to do one more draw.
It is recommended that women with ICP deliver by 38 weeks. I went into my 38 week appointment ready to argue. I was told that I was being stupid, but that she was willing to induce. She was tired of me calling for results and tired of me insisting on getting retested. According to her I did not have ICP.
I went in to be induced that night. At check in the nurse asked why I was being induced and after my convoluted answer covering the whole situation she summed up with, "So... elective induction." After a long pause I answered, "Yes, I guess so."
By far the easiest, shortest birth I ever had. Under 12 hours! Want to know the funny thing? The final blood test came back a few hours after I gave birth. My bile levels had finally gone out of what my doctor considered normal range (mind you these were results from blood drawn over a week before). My doctor only came to see me once after the birth where she said, "Well, at least we don't have to draw any more blood." The rest of my stay she sent her intern.
Moral of the story: Listen to your instincts.
Moral number two: Don't argue with a pregnant woman.
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