On Day 14
I saw both my OB and a dermatologist after sharing the PUPPPs pain, and lo, it turns out this is the most severe case my OB had ever seen. No wonder it didn’t seem like she had a sense of urgency in offering alternative solutions. All her other patients did fine on hydrocortisone and Benadryl so she didn’t realize how bad it really was.
They snagged us a same day referral (just had to ask, thanks Kaiser!) to the dermatologist because while OB still thought it was just the worst PUPPPs ever, she also wanted the derm to confirm that it wasn’t anything she was missing. We dashed over to the derm who took a look and agreed that it wasn’t likely to be anything else. Lucky me, I’d just been cursed with a horrible case of something they can’t cure, and she told me that most of the cases they see tend to take 4-6 weeks to resolve, no matter when it starts. :O
So we had a couple options: more topical stuff but prescription strength, or actual steroids.
I have done courses of steroids in the past for pain treatment so the side effects weren’t a huge concern for me, but I wasn’t baking a human critter at the time so we all wanted to avoid that option for now.
Mind you, it’s all about the timing. For some reason, on the day of the appointment, the skin had backed down about a notch and a half. If it had been on the actual miserable miserable weekend where I wanted to skin myself, I’d have gone straight for the ‘roids and damn the torpedos. Hell, if I KNEW that inducing would resolve it, I’d have been in a surgical cap and gown and standing just outside the OR tapping on their window. It was that bad.
But having it deescalate from “every MOLECULE of skin hurts or itches or both so that I can’t stand, sit or lay down without something being completely irritated” to the next level of “most skin hurts or itches or both, but there might be one way to sit or lean for a bit” made a huge difference.
Just that maybe 20% reduction in pain and discomfort was enough to make me feel more like a human and actually see straight again. It was much like the first time I was drugged out on narcotics for pain and was barely conscious.
Things did seemed to help
Grandpa’s Tar Soap, 2-3x/day
Steroid cream, 2x/day, kept refrigerated
Eucerin cream, 2x/day, kept refrigerated
Aveda All Sensitive lotion, 2x/day, kept refrigerated
Things that might have helped but who knows, so I did it anyway
Drinking V-8 (and otherwise mindfully hydrating)
Generic colloidal oatmeal cream for eczema, basically the generic of Aveeno
Benadryl and Zyrtec
Things that were totally no good
Gold Bond anti itch lotion, holy moly was the feel of mentholated lotion terrible
Oatmeal bath, I couldn’t tolerate cool water, but the lukewarm water was still too hot and sent my skin into overdrive
Claritin, just didn’t do a thing (then again, the Benadryl just helps make me sleep once in a while)
After 2.5 days on the steroid cream and other routines, I noticed a major reduction in the angry rash look on my belly and hands. There doesn’t seem to be a strong correlation between what it looks like and how it feels though: the belly looks better and is less itchy but the bumps and masses on the hands went down, leaving dark splotches, and they feel three times itchier. And the rash on my legs has both spread and gotten worse. So none of this makes much sense.
It got to the point where I just resolved to stay up and work all night because all I was doing was tossing and turning uncomfortably, replacing ice packs for hours. The theory was that going to bed which focuses the mind intensely on the itch was the reason it was exponentially worse. Turns out, nope. The increased night time discomfort still flared up even though I hadn’t gone to bed. Sleeping an average of 2.5 hours a night sucks.
On the other hand, I got a lot more work done just assuming I wouldn’t sleep til 5 am (I was right) and pottering about accordingly even if I was supremely uncomfortable. And I stopped having to waddle around as an awkward victory penguin, arms raised and held away from my body lest anything touch anything.
Small victories, like being able to take my own plate and glass with my own hands all the way to the table, were duly celebrated and appreciated. It’s sad when that’s a victory but I’ll take it.