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Thursday, July 14, 2011

Pregnancy Ailments You Should Know About!

I'm no pregnancy expert, but I have been around the block - twice. While doctors, nurses, and moms everywhere proclaim, "Every pregnancy is different!", mine have been eerily identical (with one or two minute variations). So while I may not have all of the answers, I'm pretty seasoned in the ways pregnancy has affected me.

There's no doubt that you've heard about the obvious downsides to gestating a human - even if you've never been pregnant yourself. They're portrayed, dramatically, in every soap opera, movie, and sitcom with a female demographic in mind. And the second you get a positive on your home pregnancy test, people who have been there, done that start warning you about all the ways you're "in for it" over the next 40 weeks. So I'm not going to tell you squat about morning sickness, back aches, heartburn, or hemorrhoids. No...I'm going to tell you about two of the seemingly hidden (yet fairly common) side effects of pregnancy that no one thought to clue me in on!

The first, and definitely more common of the two is - Anemia.

Chances are, you'll be tested for this particular issue. Somewhere in your second trimester, you'll either be put through a finger prick test or a blood draw to check your hemoglobin levels (I've had it done both ways). Hemoglobin is the magical protein in your blood that carries oxygen from your lungs to the rest of your body. Kind of important, wouldn't ya say?

Hemoglobin is measured in grams per decilitre (I don't know what a decilitre is, just the messenger, ha!), and doctors like to see us women above 12 g/DL. If your test falls below this number, they will suggest a change in your lifestyle. Their recommendation depends on how severely below 12 g/DL you are - it can be as simple as instructing you to eat more leafy green veggies and red meat, or it may include a more strict diet - or even adding iron supplements to your daily life.

Iron is required to create and maintain normal function of your red blood cells, and is contained in hemoglobin. In order to get your levels up, you need a lot of iron in your life! In addition, you need good Vitamin C levels, as it helps your body absorb the iron. Anemia can be a struggle for women even when we're not pregnant, but when we are - it becomes a more dire situation. Failure to bring your levels up prior to delivery can mean more severe bleeding, and anemic crashes - both of which are things I've experienced firsthand and don't recommend to anyone!

When I was pregnant the first time around, I was tested via the finger prick test at 28 weeks. It was quick, and the nurse who administered the test gave me the results only minutes later. My hemoglobin level was a 10.6 g/DL - which I was told was too low. She handed me a sheet of paper that provided me with a detailed list of iron-rich foods, and other foods that help you absorb the iron. I'll never forget the way she scolded me when she told me to be strict about eating things from the list. She concluded her speech with a warning - "Trust me, you don't want to be put on iron supplements". 

I left my appointment that week feeling deflated and confused. Why had no one warned me to keep my iron levels up before that point? I'd been given remedies for everything under the sun, and yet - I was blindly led to a confrontation with an ornery nurse who seemed offended that I wasn't taking better care of myself. I didn't even know what iron was before that point - other than one of those pesky elements with an abbreviation I had to memorize for 11th grade Chemistry (I haven't forgotten...Fe). Suddenly I had to consider things like eating liver and prunes, and avoiding mean nurses with the painful finger prick machine! And what was so scary about the iron supplements? I had no clue - but I assumed they were massive horse pills that would land you in bed with nausea after the way she made it sound!

I did my best on the food end of things, but it still wasn't enough. In addition to being clueless up until this point - no one told me how hard it was to rebuild your hemoglobin levels or compile good iron stores. No one told me what the consequences were, and since I felt fairly symptom-free, I was admittedly too casual about the situation. The morning of delivery, my levels had dipped all the way down to 9 g/DL, but my doctors failed to say anything - presumably because it was too late to fix it, anyway. Then, the morning I was released from the hospital they tested me a final time, and I had crashed all the way to 6 g/DL - HALF the minimum level! 

Usually a treatment for a level that low is a blood transfusion, but considering that I was breastfeeding, I felt weird about the idea and begged them not to. Instead, they agreed to release me if I promised to take two iron supplements a day for 60 days. Despite my previous fear of them (thanks, mean nurse) I easily agreed.

Recovery was difficult - and very slow. Common symptoms (all of which I had) are - paleness, shortness of breathe, fatigue, lightheadedness, dizziness, loss of energy, mood swings, leg cramps, fast heartbeat, and heavier postpartum bleeding. I worked through all of that, faithfully taking my pills every morning and every evening, waiting to regain my strength. It's extremely difficult for your body to recover from such a crash (sometimes up to a YEAR!), so to say that I learned my lesson is an understatement!

I never truly recovered from anemia - even feeling slightly more symptomatic each time it was "that time of the month". Despite everything I went through, no doctors ever retested me! I know now that I should have requested it, but at the time - I was quite clueless!

When I became pregnant for the second time, anemia was on my radar! AS SOON as I felt symptomatic, I put myself on iron supplements. And for the record - they aren't bad! If you take the "slow flow" type (which gradually releases the iron into your system), you'll most likely be side effect free. After I was tested during this pregnancy (this time with a blood draw at the same time as my glucose test), my level was at 10.4 g/DL - and my doctors asked me to increase my supplements to two a day. I was happy to see that they were more proactive about it than my previous doctors (I moved and thus switched practices between pregnancies). 

At my last appointment, I asked my doctor if I'd be re-tested anytime soon to see where I stood. She said no, not until I was in the hospital, but considering I've been building up my iron levels for months - I should recover much more easily. I'm quite interested to see how well it goes.

Anemia is a fairly simple condition, but left untreated it can lead to a lot of hardship for your postpartum recovery and daily life. I think it's unfortunate that us women aren't told more about it - whether in pregnancy or regular health care, since it can affect us at any time and take a lot of work to recover from! 

Another condition I've had the "pleasure" of experiencing is something called PUPPS.

As you progress in your pregnancy, you may find that your expanding belly skin is quite itchy. This has been true for both of my pregnancies. Sometimes this is completely normal, and sometimes it can be a bit more. For my first pregnancy, it was generally harmless - my skin was just too tight and dry, and I couldn't help but scratch! My doctors suggested that I use an anti-itch cream to tide me over, and to keep the area hydrated with lotion or Vaseline. Considering my first son stretched my skin so sufficiently (he was a 9lb 5oz baby), I hadn't had to deal with many of the same skin issues for my second pregnancy. I didn't endure more stretch marks, didn't have months of endless itching - it was quite a nice break, actually! 

When I hit 34 weeks, however - that changed. Seemingly overnight, a pink, bubbly, itchy hive spread across the lower section of my belly. It was BEYOND itchy! I kept waking up in the middle of the night with my hands furiously easing the itch. I waited a couple days to see if the area really was a hive, all while slathering on Vaseline. It only seemed to get worse, so I did some googling and checked with a friend who described a similar situation with her most recent pregnancy. I was pretty much convinced that I had PUPPS, and resolved to talk to my doctor about it at my next appointment. 

PUPPS stands for Pruritic Urticarial Papules and Plaques of Pregnancy. It presents itself exactly as I described - much like a hive. It tends to appear in a stretch-marked area of the belly skin (I have PLENTY left over from my first pregnancy!), and eventually spreading to the thighs, butt, and more of the belly. The itching is quite intense, and can look pretty gruesome! Unfortunately, the only cure for it is child birth. It doesn't completely disappear until your baby arrives. However, you can treat it!

My doctor confirmed that I indeed had PUPPS, and prescribed a steroid ointment. Within a few uses, the hive started to shrink in appearance and texture, and the itching has decreased immensely! In fact, I almost feel as though I don't need to use it anymore - but I put very light coatings on it to ensure that it doesn't spread elsewhere. I have a few very small patches on the tops of my thighs that I'm hoping don't expand any further!

PUPPS usually only shows up in first pregnancies - though this obviously wasn't true for me, nor was it true for my friend. The theories behind the cause of this condition are that rapidly expanding skin has a negative reaction that triggers the development of the hives. (Since this baby seems even BIGGER than my first, that explains the appearance of it in a subsequent pregnancy in my case!) Another interesting theory is that male fetal DNA acts as an irritant to the skin, resulting in the hives - much like an allergic reaction. Apparently, expectant mothers with PUPPS are carrying boys 70% of the time. Both of my pregnancies have been with boys, so I fit that statistic!

There's no way to avoid the condition, but you can do your best to hydrate your skin as it expands and hopefully it won't plague you! Luckily, only 1 in 200 pregnancies develop PUPPS.

While neither of these pregnancy ailments are dangerous or life threatening, they are irritating and make the struggles of pregnancy much more difficult! Knowing about them in advance means that you can report symptoms to your doctor as soon as you notice them - increasing your chances for recovery and minimizing damage. And if you know a first time mom who is interested in your veteran experience, don't forget to warn them about these conditions when you're giving them remedies for their battle with morning sickness!

Post submitted by Jenn, National Blog Manager for The Mommies Network and quirky stay-at-home-mom who blogs at The Very Best Housewife.

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