March 19, 2020 § Leave a comment
If going through childbirth taught me anything at all, it taught me that control is an illusion.
Truly. From even the first weeks of pregnancy, I knew I wanted to do an unmedicated birth. To me, birth wasn’t a medical procedure as much as it was a ritual, a rite of passage. I wanted the raw experience. I think more importantly, I wanted complete control over everything.
I bought all the books. For months, I read about unmedicated birth (whoever called it “natural” childbirth? All childbirth is natural, people) and read birth affirmations and watched YouTube videos of women talking about their unmedicated birth experiences.
Alex and I signed up for a three week childbirth class that taught us so much about the three stages of labor. That was another biggie for me. I wanted to know exactly what would be happening – again, the illusion of control. If I knew how childbirth worked I could control everything, right?
We did all the breathing exercises. We filled out the preregistration forms. We did a hospital tour. Over the last month I made a long checklist for our hospital bags and packed them meticulously. I went through everything in the nursery and checked boxes, crossed ts and dotted is.
Everything was in order. I had everything under control. Now all that had to happen was for me to go into labor. My type A perfectionist self was felt ready. My nine-month-pregnant, tired, hot, uncomfortable self felt beyond ready. Little did I know that my perfectly outlined birth plan was about to go flying out the window.
My last appointment with my doctor was at 38 weeks and was on September 12th. By the end of it, my doctor said he expected to see me back the following week, the 19th.
“Damn it!” I said, loudly, upon hearing this. I had no filter anymore. My doctor smiled apologetically.
“You’re about 80% effaced but not dilated yet,” he said, which means the cervix was pretty thinned out but not open to allow the baby to pass from the uterus to the birth canal. “We’ll see what happens over the weekend.”
Four days later, on Monday morning, the 16th, I woke up and went to eat breakfast and was sitting at the table as usual when I was struck with the uncontrollable urge to walk.
It was bizarre. I went outside and walked in circles in the backyard for something like thirty minutes. Lucy trotted at my heels while I walked and wondered if this was what it was like to go insane. I’m still not sure where the urge came from. But I wanted to keep moving.
The contractions started later that day, just before 7pm.
For those who don’t know exactly what a contraction is, by the way, its technical definition is when the uterine muscle contracts and tightens as it tries to push the baby out. When the contractions ebbs, it’s the uterus relaxing. And contrary to what movies depict, it’s not the water breaking that determines when a woman is in active labor – it’s the consistency and intensity of contractions.
At first it was difficult to discern them from Braxton Hicks contractions, which I’d been experiencing for several weeks by then. There was no rhyme or reason to the duller Braxton Hicks contractions, but these… these that started in my lower back like cramps then wrapped themselves around to the front of my bump like claws squeezing my insides… they were real. And they came about every twelve or thirteen minutes. They lasted about 60 seconds each.
Alex helped me time them and we determined there was too much time between them to go to the hospital yet. Janet, our labor and delivery nurse instructor who had taught our childbirth classes, had drilled into us that when the contractions had been coming at four minutes apart for at least an hour, thatwas when we were to go to the hospital. So we waited. Unfortunately this meant we had to wait through the night.
I didn’t sleep. I closed my eyes for a few minutes at a time but as the contractions progressed the pain did, too. If I drifted off for a minute, I was quickly brought back to earth by the steadily increasing pressure.
By morning, if I remember, the contractions were down to about eight or nine minutes apart. I was breathing through them but by midmorning I was walking all around our house and groaning with every contraction. We canceled an appointment we’d had with our financial advisor and prepared, with mounting excitement, to go to the hospital.
By about 1pm, my contractions finally hit the magic number. Four minutes apart. I was walking around, standing up, stretching, lay down, curling into a ball… anything to help with the pain. Alex took out bags to the car, texted our moms so they could raise the alarm amongst our families, and walked me out the door. So convinced we were that this was it, September 17th was going to be the day, that we stood and spent a few minutes with our heads together, soaking in the last time by our house as just the two of us.
We got to the hospital a little before 3. Contractions were still coming about every 4 minutes and we were so convinced that this was the start of active labor that Alex went to give the car to the valet and get our hospital bags. The front desk offered me a wheelchair but I insisted I could walk up to the maternity ward on the second floor.
They checked us in then handed us over to triage, where I changed into one of the famous hospital gowns and they strapped two bands around my bump – one to monitor baby’s heartbeat and the other to track my contractions.
A nurse came in and examined me. The exam was one of the most painful parts of the day, but it wasn’t nearly as bad as the words she said afterward.
Alex and I stared at her blankly.
“Not—not at all?” I stammered.
“Nope. 100% effaced but no dilation. What we can have you do is walk around for an hour then check back in here to see if you’ve progressed at all. But we can’t admit you unless you’re at 3 or 4 centimeters.”
Numbly, we found ourselves agreeing, then Alex helped me get out of the bed and buttoned up the back of my hospital gown. I felt dazed. Everything I had read, everything we’d learned at our class, indicated that when contractions were four minutes apart, a minute long, and that continued for an hour meant you were around three or four centimeters dilated and considered to be in active labor.
We walked, or rather Alex walked while I waddled. We went in circles around the maternity ward, Alex getting me ice chips as I needed them and taking my cup from me as a contraction would hit so I could kneel over and put my hands on my knees. There were tons of empty rooms, which we would remember as being incredibly ironic the next day when we’d spend two hours waiting for one.
After an hour (or so Alex said – time was not a factor for me then), we went back to the triage room. The nurse came back in, put the bands back around my belly, and said my doctor was on the way to check my progress. She left and when she came back into the room some time later she told me my contractions were beautiful, the best on the monitors in the nursing station with the high, even peaks. Even in my tired state I felt a tiny twinge of smugness. Surely that meant I was ready to be admitted.
My doctor came in. The nurses had contacted him to let him know I was in triage since the number we’d tried earlier was the wrong one (doctor handwriting for the win).
He checked me and said those awful words again.
“I’m afraid not,” he said. He looked concerned. “Did you sleep at all last night?”
“Go home and try to rest.” He offered to write me a prescription for Ambien, but, me being weird about taking anything stronger than Tylenol, I refused. He understood, but stressed that it was important that I get as much strength as I could before returning.
We packed up. Alex helped me change back into my maternity dress – just about the only thing I fit into at that point – and hugged me close. I can’t remember if I cried or not. By that point I’d been in labor for over 20 hours. I couldn’t believe we were being sent home.
We stopped at Sauce on the way home to pick up some food. It was around 6pm, and I hadn’t eaten since earlier that morning.
The contractions were still coming. And the night of the 17th/ the morning of the 18thwas one of the longest nights of my life.
By midnight I was starting to involuntarily curl up into a ball, or bolt upright, or jump out of bed to move, or do whatever I could to ease the pain. It got harder to breathe. I tried to think of Aurora, so close yet so far away from me, tried to imagine holding her, touching her, seeing her for the first time… and my visions of her would fade with every burning, crushing, agonizing contraction that overtook my back, sides, front… even my legs were weak and shaking after they would fade away. Poor Lucy followed me everywhere, licking my face, whining… she knew something was happening and tried to help.
Around three in the morning I sent Alex to the couch downstairs to sleep. I was waking him up every five minutes with my cries of pain and as he started to resist leaving me I said I was going to need him somewhat rested the next day. Looking back, I laugh at how the only time I’ve made him sleep on the couch was the night before our daughter was born. At the time, I remember being glad he could get at least a little sleep.
But only a little sleep. Before 5am, I’m convinced my water broke ever so slightly (sometimes it’s hard to tell). I was still timing the contractions and still, they came every four minutes, sometimes five. The pain, however, was intensifying.
I went downstairs to the couch and told Alex I think we needed to go. He got up immediately and put our hospital bags back in the car. I went and sat on the bed upstairs. Nerves, exhaustion… everything was getting to me and I went through the motions of throwing up out of anxiety – only there was nothing on my stomach to come up.
Alex rubbed my back and wiped my face, just as he’d done all those months of my morning sickness. I remember crying in self-pity as we sat together, and he comforted me.
Just before 6am, we got on the road to the hospital again.
“I don’t know how you’re doing this,” Alex said quietly as we drove away from our neighborhood, just the two of us, for the last time.
I was squeezing my hands together. “You can do anything when you don’t have a choice,” I said through gritted teeth.
I don’t remember much of the car ride. Each contraction took my breath away. My stomach was churning and pain was clawing, squeezing, burning my insides. Knowing I wouldn’t get to eat during labor, I tried to sip on a protein shake but couldn’t get anything down.
The sun broke over the horizon as we made the turn into the hospital. Alex left the car at the main doors and ran inside. There was some confusion at the desk about check in, I remember him saying later. I’m not sure of details. I just remember getting into the wheelchair from the car and being wheeled inside by one of the people at the desk, and Alex swearing angrily at them all as he took the wheelchair from whoever it was who didn’t know what they were doing. He got me up to the maternity ward and checked us in.
I was wheeled into triage where a horrible sense of déjà vucame over me as the bands were again wrapped around my bump. A nurse came in and – in one of the more painful exams of the day – checked my cervix for dilation. And then…
“One centimeter,” she said.
Everything fell and sunk inside me. “One??” I wailed.
“I’m sorry, just one,” she said.
By then I’d been in labor for almost 36 hours. “How is that possible?” I cried. “How am I not at least at three??”
She looked so apologetic. We hypothesized that it was possible that while Aurora was head down, as she was supposed to be in preparation for birth, she was facing outward instead of facing my spine like normal, or “sunny side up” as it’s called. Possibly, my body was in labor for so long, without progressing, because it was trying to flip her around.
Just like the day before, they released us to walk for an hour. I lasted twenty minutes. They let me have apple juice in addition to ice chips, to keep my blood sugar up, but I was so weak with exhaustion at that point and every contraction was taking more out of me than I could bear while standing. Alex supported me back to the triage room where I curled up into a ball on the bed and tried to breathe.
Things happened in waves. Another nurse came in to examine me. Alex asked her what the hell was happening.
“Well, we can’t admit you unless you’re in active labor, and these Braxton Hicks contractions—” I fought the urge to slap her then, “—mean we do need to wait for you to dilate more—”
Thank God my doctor came in just then, or the headlines the next day might have been interesting. Another contraction was coming and I was groaning in pain, squeezing Alex’s hand, imaging swinging my fist into that nurse’s face, when my doctor took one look at me and said, “We need to get you to a room.”
He did the cervix exam, confirmed I hadn’t dilated much more than an additional centimeter, then asked if I’d slept the night before. I said no and he looked concerned.
“So you’ve been in labor since Monday evening?”
“We need to get you to a room and get you some relief. You need rest. Do you want an epidural?”
I hesitated. Any control of the situation I had left was rapidly slipping from me.
“You need sleep,” my doctor insisted. “You still have a lot of work to do. You have to push that baby out. You can’t do that without rest. You’ve been in labor a long time.”
That was an understatement. I was nearly 40 hours in at this point. Alex was murmuring the same words to me gently, and I found myself nodding in agreement. I had no idea then what my doctor meant by my having work to do. Up until that point everything that I had gone through in pregnancy had just kind of happened to me. But I knew deep down nothing was going to change until I got rest. And with the contractions still coming every four minutes, rest was not something that would come to me.
If I remember correctly, by the time my doctor left the triage room I had actually progressed to about three centimeters, though I think he said that to make me feel better. But the fact remained that I had been in labor for too long.
At some point they put me on a penicillin drip since I had tested positive for B strep and I needed to be on antibiotics. And then we waited for a room.
For two hours.
Suddenly, everyone in the state of Arizona must have decided to have babies right then, because there weren’t any open rooms.
Those two hours we waited were a living hell.
In movies and TV shows, women scream in pain when they’re in labor. On screen, the directors show them having the ability to draw in a long breath through controlled inhaling then release a drawn out, perfectly pitched yell. They stop at convenient times to talk, or to breathe deeply, before screaming again.
Those movies and TV shows are bullshit.
The sounds I was making were involuntary, primal. More than screams. They burst out of me chaotically, sporadically as the waves of pain came and went. I don’t have a word for them.
The contractions were coming more quickly now, perhaps 3 minutes apart, and with each one I thought I was going to die. Pain – nothing like I’ve ever experienced – wrapped around my back and sides and the front of my bump, like hands of fire clenching my insides and twisting them, churning them, wringing them out like giant hands straining wet cloths of every drop of water. The hee hoo hee hoo breathing we’d learned and made fun of during the childbirth classes was the only kind of breathing I could attempt. And I realized during those two hours that no amount of reading or taking notes or watching videos could have ever prepared me for this. The birth plan I had written and the perfectly consecutive stages of labor I’d learned about seemed like a joke. I had no control over this. None.
“I can’t do this,” I remember gasping out at some point.
“You are doing this,” Alex told me over and over. “You’re doing this. You’re doing amazing.”
Finally, finally, they took us into a delivery room where I met my first angel of that day: a nurse with blonde curls who walked me through the door and sat me gently on the edge of the bed with calmness and confidence. I don’t remember most of what she said to me but I do recall her explaining gently what was happening as the anesthesiologist and his assistant taped up my back and began to work their epidural magic.
Right before the needle went in, I felt the beginnings of another contraction, and I panicked.
“There’s another one starting,” I said and the angel nurse gently put her hands on both my shoulders to keep me in the correct position for the needle. “It’s okay,” she said, voice soft and calming. “We’ll get through it together.”
Something happened at the base of my spine and sharp pain – along with the intensity of another contraction – seared through me. I screamed and both Alex and the nurse quietly soothed me, over and over: “It’s okay. It’s okay…” as the anesthesiologist said something to his assistant about redirecting the needle.
Then it was over. The nurse gently turned me to get my legs onto the bed before they went numb, and the anesthesiologists left the room, and Alex was by my side as the nurse examined me and made sure I was comfortable. Another contraction came, but it wasn’t as painful, and before long I was asking, “Is that another contraction happening right now?”
The nurse looked at the monitor. The bands wrapped around my belly charted Aurora’s heartbeat and my contractions, so anyone who looked at the monitor could tell when a contraction was coming before I would feel it. “Yep! How does it feel?”
“Duller. It doesn’t hurt.”
I lay in the hospital bed and gazed up at the ceiling. Out of pain, I felt I could do anything in the world. Alex had texted my parents, who were out in the waiting room, to tell them I had agreed to an epidural. I found out later that they both cried until they knew I had received it, knowing the amount of pain I was in. At one point my mom brought my poor husband lunch and I insisted he go out to the waiting room to eat while I rested.
My times here could be slightly off because at a certain point, I wasn’t looking at the clock anymore. Things happened as they happened – units of time were meaningless. Perhaps a half hour or so after the epidural I received another nurse, Sandy, the only nurse whose name I remember. She, like 99% of the nurses at the hospital, was absolutely amazing. Labor and delivery nurses are truly the unsung heroes of the medical field.
“I’d like to have a baby by 7pm,” she said as she checked me. I was about at three centimeters still. “We’ll see how the next few hours go. For now, rest.”
I lay on my side in the hospital bed, feeling the odd sensation of dulled contractions every few minutes. Alex rested in the chair/cot concoction next to my bed. I closed my eyes and didn’t sleep, but was able to rest without pain. Looking back, had I not had those few hours of stillness, I could have never done what I had to do.
What felt like a short while after the epidural, I felt it. Pressure. I told Sandy, who came in and out of the room with regularity, and she assured me that while it wasn’t likely I had progressed enough at that point, she would check me just to be sure.
But sure enough… I had gone from three centimeters to seven in just short time. She was astonished. It seemed like my cervix had finally caught up to the intensity of the contractions thanks to the epidural. She hastily went to let the doctor know and check on her other patients before coming back in to check on me.
Another hour passed, or maybe it was only a few minutes.
“I feel like I need to push,” I said out loud, not really to anyone in the room. It couldn’t have been more than a few hours after the epidural. But I knew. I knew it was time.
Sandy came in the room.
“She says she wants to push,” Alex said.
“I feel like I want to push,” I said.
“Let’s check again. You were just at seven but it’s possible—”
She checked. And then promptly yelped:
“Okay, I’m going to call the doctor!”
“Am I at ten?” I asked, blinking.
“You’re at ten,” she said as she ran out of the room. “Her head is right there!”
I lay in bed, still, breathing as I reeled in the knowledge that I was so close to holding our daughter. Alex stood at my head, holding my hand, beaming.
“She’s almost here. She’s so close. You’re doing such an amazing job.”
I looked up at him and asked what might have been the silliest thing I’ve ever said, but it was a thought that occurred to me – in the emotional moments before Aurora’s birth – as something very important.
“Do you think she’ll like me?”
Alex smiled and kissed my forehead. “You’re her mommy,” he said. “She’s going to love you.”
Sandy came back. It was just after 4pm. I was going on my 45thhour of labor.
“Okay. We have some time to do a few pushes before the doctor gets here.”
Somehow, in all of our childbirth classes and in every book I’d read, I hadn’t learned exactly how to push. I don’t think that’s something that’s taught, honestly. It has to be experienced.
Sandy told me that I needed to push with the contractions, and to do it in the way she was about to show me otherwise I’d risk breaking blood vessels or tearing. “Push for ten seconds, rest for three, push for another ten, rest for three, then push for a final ten before the contraction ends. Okay?”
“Here we go, here’s a contraction coming now. Put your hands behind your thighs, elbows off the bed—just like that, you got it—take a deep breath and don’tlet it out, head on your chest, bear down—and push.”
There is a quote that I found while looking up birth affirmations that makes me cry to this day, the only birth affirmation I remembered in the chaos of movement going around my room as I pushed.
“Women in labor leave their bodies and travel to the stars to collect the souls of their children, and they return to Earth together.”
And that’s it.
That’s how pushing felt.
I didn’t feel like I was in the room anymore. I was somewhere else, traveling to the stars like they said, and part of me really doesn’t remember details.
I pushed hard enough that I wouldn’t be able to stand up straight for three weeks afterward since my diaphragm was so sore. I remember them giving me oxygen between pushes. I remember my doctor coming in, and he and Alex and Sandy counting to ten together as I pushed with the contractions. At one point they told Alex not to count so fast; in his excitement he was running all the numbers together.
I was running on empty at that point. I’d had no food in almost 24 hours and next to no sleep in two days. The thing about pregnancy, I realized as I pushed, is that for me, the difficulty had clung to the last second. The only thing that got me through each stage of pregnancy and labor was the thought of meeting my little girl. And she was so close. So close.
“That one nearly had it,” my doctor said as a contraction ended. Something in his voice worried me, and I found out later that the cord had wrapped around Aurora’s neck twice on the way down. “Let’s do it on the next one.”
“Is she okay?” I asked, lifting my head off the pillow.
“She’s fine,” Alex said soothingly. Sandy told me, “You’re doing such a great job. She has so much hair.”
“Feel her, look!” Sandy said and she put my hand down where I could feel, to my shocked disbelief, a tiny little head.
And it clicked. Everything clicked.
I burst into tears. “Is she really right there?” I sobbed.
“Yes, she’s right there!”
The doctor looked at the monitor. “Here we go. Let’s do it on this push.”
They collect the souls of their children…
Movement was happening all around me. Another contraction was starting, building—
“Almost there. Get ready—”
…and they return to Earth together.
The contraction hit. Alex, the doctor, and Sandy began to count.
For the last time, I bore down.
And gave it everything I had.
Aurora Lisa Ferri, born 4:52pm, 19.75 inches, 7 pounds and 7 ounces.
August 29, 2019 § Leave a comment
*Disclaimer: slightly graphic pictures of arms and legs ahead*
Mommy blogs saved me big time on this one. When I was diagnosed with PUPPP at 33 weeks pregnant, the only solution I was given by a health practitioner failed me miserably. But a wealth of information about this terrible rash existed on the interwebs from women who’d actually experienced it; so, I thought I’d join the line of those blessed souls in the hopes of helping someone else who has to deal with it. Be warned: long blog post ahead.
PUPPP, which stands for pruritic urticarial papules and plaques of pregnancy, is a terrible rash something like one in 200 pregnant women develop in their third trimester. It typically starts within the stretch marks on or around the baby bump but—as I found out the hard way—it can spread everywhere else. Think hundreds of huge, angry, red welts that itch and burn with the intensity of a thousand fire ants, ten thousand mosquitoes, and a few rounds of chicken pox all thrown into one. It is a living hell I wouldn’t wish on anyone.
The fun thing about PUPPP is that a) no one knows what causes it; and b) it doesn’t go away until after the birth of the baby. From what I’ve experienced, not a great deal of knowledge exists in the medical field about it. In fact, I read some blog posts from women who went to their doctors for a solution and witnessed them actually Googling the rash since they had no idea what to do. Literally everyone I told about PUPPP—many of whom had been pregnant themselves—said they’d never heard of it.
For me, it started innocently enough. The week before I was diagnosed, I saw my doctor and complained that the front of my baby bump had been red and itchy for a few days. He inspected the skin and said I had inflamed stretch marks, and that a regular strength hydrocortisone cream would take care of it.
Well, it did, for a time. Not a big deal, right? The skin has to stretch during pregnancy, so I didn’t think anything of it. But then a week later, in addition to the inflamed stretch marks on my stomach, the inflammation had spread to my hips and lower back. To top it off, I suddenly had weird bumps going up and down my arms and legs.
The next day, the bumps were starting to look kinda bad, and the itching got more intense. They were also spreading, rapidly.
I went back to the doctor. I was 33 weeks and one day along, and my doctor took one look at my arms and legs and said, “PUPPP.”
After explaining what the hell it was (in that no one knew what it was), he said that if I were closer to my due date he’d induce me to stop it. But, with that date being seven weeks away, he sent me to a dermatologist who could look at the rash and prescribe some kind of topical relief.
So downstairs in the building I went, where I had the fun experience of being asked a handful of questions by two beautiful, clear skinned medical assistants while I, the red bumped and sweaty whale, squirmed miserably in my gown. When the dermatologist walked in, she examined me, confirmed PUPPP, and did something that lifted some of the clouds over my head: she assured me that PUPPP does not hurt or affect the baby in any way.
She then offered to prescribe a topical steroid. Fearing the effects of a steroid on my baby, I asked about other methods and she told me I could try Benadryl, Zyrtec, calamine lotion, and sarna lotion, and to call back the next day if those weren’t successful in stopping the itching.
Long story short, they weren’t successful. By the next day, things had gone from bad to worse.
As we are all oft to do when things go from bad to worse, I called my mommy. While I debated with myself over whether or not to get the damn steroid (I was terrified it would hurt the baby, even though the dermatologist and my doctor had approved it twice-a-day use for ten days), she went on a Google search crusade for all-natural treatments. What she found ended up saving me: (tldr: Grandpa’s pine tar soap, black cherry juice, and milk thistle in addition to Benadryl and Zyrtec (and a few other odds and ends) to get me through the rough parts. I’ll go over all of this in detail below–promise!)
Meanwhile, in desperation I went ahead and got the topical steroid in addition to everything else and tried it only for it to make the rash worse.
By day five, I thought I was going to die.
Never in my life have I experienced agony like this rash. I didn’t eat. I didn’t sleep. I couldn’t do anything. I was taking seven, eight showers a day, scrubbing furiously with the magical pine tar soap so many other women had sworn by, but not getting instantaneous relief. I was taking antihistamines, doing the all natural methods others said had worked for them…. nothing. The pictures, mind you, only show my arms and legs. I didn’t take pictures of the rash that spread to my hands and fingers, feet and toes, lower back, hips, thighs, and baby bump.
I whined and cried a lot. I began to wonder if PUPPP was actually worse than the first trimester (now that the worst of it is behind me, I’ve concluded that it was not, but it came pretty close). I began to wonder if I’d make it to the end of my pregnancy with my sanity intact.
But by the 11th (day six), I was down to three showers with the pine tar soap a day, no Benadryl or Zyrtec, aloe vera gel and coconut oil, and the itching had lessened slightly… the natural cures had finally begun to work.
As bad as the rash looks here on day six (four days after my diagnosis), that was actually my turning day. Things had gone from horrifically bad to just pretty bad. I’d been using Grandpa’s pine tar soap for four days, taking milk thistle three times a day, had drunk enough black cherry juice to sustain a small country, and was slathering on coconut oil and aloe vera gel every hour like my life depended on it.
By the next day, things had gone from pretty bad to relatively bad.
The inflammation was starting to die down and I was actually starting to sleep for a few hours a night.
By August 16th (day eleven), nine days after my diagnosis, things had gone from bad to okay.
Which leads me to the main point of all of this: a topical steroid didn’t lessen the effects of PUPPP for me. Nothing any doctor or dermatologist could recommend to me worked. So let me tell you what did.
One last thing worth discussing first, and it has to do with my theory about what causes PUPPP based on what I did to reduce its symptoms (it won’t fully go away until after I give birth). It involves the liver.
The liver does many things. Among its jobs is to deal with substances in the body from nutrients and medicines as well as toxins: “Once [these substances] reach the liver, [they] are processed, stored, altered, detoxified, and passed back into the blood or released in the bowel to be eliminated” (source). According to the American Pregnancy Association, pregnancy hormones can negatively affect liver function in that they slow or can even stop the flow of bile: “The gallbladder holds bile that is produced in the liver, which is necessary for the breakdown of fats in digestion. When the bile flow in the liver itself is stopped or slowed down, this causes a build up of bile acids in the liver which can spill into the bloodstream” (source).
In a nutshell, during pregnancy, we are expelling not only our own toxins but the toxins of an entire other human being. So if my liver was already struggling to detoxify substances in my body due to pregnancy hormones slowing down my liver’s natural functions, it would have become even more overtaxed trying to detoxify substances from my baby’s body, too.
Now, because I’m not a doctor, I can’t say with 100% confidence that my rash and an overtaxed liver were connected. All I know is that the toxins had to go somewhere.
When my doctor first saw my rash, the first thing he did was poke at my liver and ask if it hurt. It didn’t, but what he was checking for was cholestasis, a liver disease pregnant women can get that involves very itchy skin and that does negatively affect the baby. What’s happening within the skin – our largest organ – can reflect what is happening on in inside of our bodies.
Hence my theory of why perhaps in my body, the toxins in my body tried to release themselves through my skin in the form of awful welts.
Do I know this for a fact? Of course not. All I know is that natural liver detoxifying supplements and foods I consumed during my week of PUPPP hell made my rash fade.
So without further ado, let’s dive into what worked for me and what didn’t.
One last disclaimer: I am not a doctor. I have never studied medicine, nor do I have any authority to give advice other than my personal experience. Please talk with your care provider about the following treatment options if you want to attempt any of them.
Things That Worked For Me
This stuff is number one. This stuff is a freaking lifesaver. When my mom googled PUPPP and said this soap was what had worked for a lot of women with PUPPP, I just went and bought it, no questions asked. I swear by it, worship it, have fallen in love with it and will vouch for it faithfully forevermore. Not at first though. Take note: it takes a few days to kick in.
Also of note: You’ll also smell like you’ve been eating beef jerky by a campfire for three days and nights. Worth it, I promise you.
Anyway, during the worst of the rash I took something like seven or eight showers a day in cool water and scrubbed the hell out of my skin with this soap. This is important: make sure you let the soap sit before you rinse it off. (And at my mom’s advice, after each shower I’d put coconut oil on, too – more on that below.) As the rash died down and my need for showers became less frequent, I’d put the soap in a Tupperware container by my bed with a washcloth. When I woke up during the night due to the itching, I’d rub a little of it on the worst spots and it helped.
Worth mentioning here is that warm or hot water absolutely destroyed me during the bad days. cold water, as cold as you can stand it, is your friend.
After each shower with Grandpa’s pine tar campfire-smelling goodness, I put coconut oil on my wet skin and pat myself dry with a towel. Coconut oil is a great antioxidant (it contains vitamins A and E) and soothed my skin immensely. You can find it at any grocery store in the baking aisle – I recommend just getting the cheapest one!
Aloe Vera Gel
Sometimes, even the soap wasn’t cutting the worst of it and the coconut oil didn’t help either. A little bit of this was so soothing. I found mine at CVS , though I saw it at Target and my local grocery store too, usually with the sun screens. Though if I could have found an aloe vera plant and chopped off part of it for personal use I would have.
Black Cherry Juice
My mom said with any kind of inflammation, it had to be treated from the outside in. In other words, just stopping the symptoms wasn’t enough. I had to treat the cause of the rash, which – as I mentioned above – we related to an overtaxed liver.
Black cherry juice, among its other properties, is supposedly drunk to reduce inflammatory diseases. During the worst of the rash, I probably went through a half a gallon a day in the hopes of reducing the inflammation in my skin. I found mine at my local Vitamin Shoppe as well as my grocery store.
Note: if you get the concentrate, make sure you dilute it with water and not pound back a small glass of it like you’re taking a shot only to gag and realize you’ve swallowed the equivalent of syrup like I—*cough*—I mean, like someone I know did. And if you find the regular juice too gross (like I did for one particular brand), dilute it with water, take a deep breath, and chug.
Milk thistle, for me, was very gentle in that I experienced no side effects in taking it three times a day. It is an all-natural supplement that is used to protect and strengthen the liver and studies have shown that it can reduce liver inflammation (click on the link to see the studies).
Now, as a precaution, I’m down to twice a day and I’m convinced it is helping to keep the worst of the rash at bay.
Benadryl and Zyrtec
Desperate times called for desperate measures. For a few days during the worst of the rash, I went hardcore on the antihistamines, taking two Benadryl in the morning, two in the afternoon, and a Zyrtec at night. They helped for sure. I know this, because I was actually able to sleep for a few hours at night because of them!
(I stopped taking them as soon as I could possibly bear to go without them. I hated that my baby didn’t move as much after taking them since they made her sleepy!)
To reiterate here: be sure to talk with your doctor if you’re considering using either drug. The dermatologist I saw confirmed both were safe for pregnancy, but your pregnancy could be very different from mine.
Things That Didn’t Work For Me (but might work for you)
This was the topical steroid prescribed to me by the dermatologist and approved by my doctor. I was an emotional wreck deciding whether or not to use it because in my every Google search I came across the phrase that it should be used “only if the potential benefit justifies the potential risk to the fetus”. But, desperate, I tried it.
The very first time I used it, it seemed to help a tiny bit. But the second time, my skin literally felt like it was burning. It was so strong, that within minutes of me slathering it on I was in the shower desperately scrubbing it off.
That said – everyone is different. It may work for you! You do need a prescription though. A doctor or dermatologist should be able to call it in to your local drugstore. With my insurance, I think I paid like $12 at CVS.
This is technically another steroid cream, though over-the-counter and easier to get. For me, it just aggravated the itching. However, it did work for a short time on my inflamed stretch marks prior to my diagnosis, so there is hope that it would work for you!
Oatmeal Baths (and warm water)
Warm water was my arch-nemesis during my battle, but so was oatmeal, for some reason. I tried an oatmeal bath both in warm and cooler water and both times I only lasted a few minutes before getting out of the tub and jumping into the shower to scrub with my pine tar soap instead. Oatmeal, however, has anti-itch properties and it could a life saver for you! I tried both putting oats in a sock and letting it soak in the water and pouring oats directly into the bath.
Things That Kinda (?) Maybe Sort of Worked?
This is the big question mark category: a list of things that I tried in desperation along with the many other listed things. I’ve got inconclusive evidence to suggest that any of the following singlehandedly stopped my PUPPP from getting worse, but they are worth a mention here in the chance they help you:
This was recommended by the dermatologist I saw. It’s hugely successful in combatting bug bites, but I’m not convinced it did a whole lot for my hives from hell. Worth mentioning is that for a few days, I was trying a thousand different things each day that probably just canceled each other out after a certain point. But calamine lotion is worth a try if you can leave it on your skin without adding anything to it. It may help! Any drugstore or grocery store should sell this.
Aveeno anti-itch concentrated lotion
Actually, this was the very first thing I bought for the inflamed stretch marks on my baby bump, the week before the rash spread and the crap hit the fan. For a few days, it did the job, until it didn’t. Still didn’t stop me from spreading it everywhere in the hopes that it would do something-anything-for the itching. I don’t think it helped during the worst of the rash, but if it brings temporary relief, then it’s worth it!
These I will say actually did help a bit. When things were at their worst, in desperation I’d use ice packs on the really itchy places. For some reason during one of the bad days, my feet were the worst of all: they were red and nearly bleeding from scratching and for a few hours, making them numb with cold was the only thing that helped. As a whole, ice packs weren’t solely responsible for reducing the rash – but they sorta helped.
Things That I Didn’t Try But Might Work For You
- Dandelion Root Tea – another supposedly gentle method of boosting your liver’s function.
- Sarna Lotion – the dermatologist recommended this to me but I never tried it.
- V8 Juice – okay, actually this I did try, for like a second. But drinking pure V8 juice was putting myself through another type of hell that I just couldn’t do (I switched to V8 Tropical Splash, which I’m sure isn’t as effective but you win some, you lose some). However – I’ve read in a few other blog posts about PUPPP that V8 juice really helped.
- Witch Hazel – somewhere I read that soaking a cotton ball with witch hazel and dabbing it on the itchiest parts of the skin actually helped, but I never tried it.
Other Random Bits of Advice
Here’s the big one, y’all: communicate with your doctor. Please don’t try to self-diagnose. Intense itching and rashes in pregnancy can mean a number of other things other than PUPPP such as cholestasis, which I mentioned above. And even though PUPPP isn’t harmful to the baby, my doctor still ordered a blood test to make sure everything else was okay.
- Don’t wait. If the front of your bump itches – get thee to a doctor. For me, that was the first sign that PUPPP was approaching and I really wish I had known more in the off chance I could have started treating it sooner. In fact, if your bump is itchy I would recommend just buying the soap and scrubbing with it as a precaution, if nothing else.
- Eat lots of detoxifying foods. I tried to eat lots of walnuts and blueberries and drink my water with juiced lemons, all good methods of natural detoxing since a full blown liver detox while pregnant was out of the question.
- Drink lots of water!
- Try – very hard – to not put processed foods into your body during the worst of it. For me, this meant staying away from my beloved Pringles and cookies while trying to focus on fresh fruits and veggies and lean meats. Now, don’t get me wrong: if I had the odd craving for some kind of junk food during this ordeal, you bet your ass I got that and stuffed my faced with it. PUPPP sucks. Don’t make yourself more miserable than need be. But if you can, try to mostly give your body the nutrients it needs to fight the inflammation.
- Stay positive. This was hard for me, so I’m a bit of a hypocrite saying it. But take it from me: it gets better. I promise.
I’m now 36 weeks pregnant and while I’m occasionally itchy and have some splotches of welts here and there, the difference between a few weeks ago and now is night and day. I can function again. I can eat and sleep and go places.
As of now, I wash with Grampa’s Pine Tar Soap once a day and stick to that one shower a day since I think any more would continue to really dry out my skin and make the itching worse. I still put on coconut oil but follow it up with St. Ives hydrating lotion. And I also still take milk thistle twice a day. And as I said – the difference is incredible.
So – I hope this is helpful and hopeful to you if you are in the midst of a battle with PUPPP! It sucks, and I’m sorry. At the end of the day though, the ultimate prize is a baby… and I would relive my worst day of PUPPP every day if it meant I got to hold my happy, healthy daughter eventually.
Best of luck to you! You got this, mama.
August 27, 2019 § Leave a comment
36 Week Bumpdate
🎉We’re officially in month 9!🎉
Baby is the size of a papaya! Her circulation and immune systems are ready to go and while her digestive system is fully developed, it won’t be used till birth since she’s getting her nutrients from the umbilical cord. The waxy protective coating on her skin has nearly faded. And she’s growing still! She’s putting on as much fat as she can between now and d-day (which means I’m hungry all the time, of course)!
– Penguin waddle, y’all. It’s real. 🐧
– Low blood pressure/dizziness
– Back pain and random Braxton Hicks contractions
– Pelvic pressure and soreness – the bump is so heavy now!
– Dry, itchy skin/PUPPP
Things to remember
– At our appointment last Thursday my doctor gave us his personal number that we’re to call when I go into labor. He talked us through when it’s time to go to the hospital and we briefly discussed my preferences for birth: one more conversation that made us realize further that this is really happening!
– I also went through my b-strep test, which is routine now but wasn’t done back when I was born. Beta strep was the infection from which I nearly died as an infant and the reason I spent 11 days in the NICU. So while I didn’t like the test, I am very grateful for it!
– Last week we toured her pediatrician’s office! I chose Phoenix Pediatrics based on their policy of not letting unvaccinated children in their office—my nightmare is our baby catching a preventable disease that could kill her due to her vulnerable immune system. The doctor who spoke to us also gave us advice on how to be gatekeepers during her first few months of life to guard her from sickness, which made me feel a little better.
– Speaking of putting fears to rest, we did our infant CPR class at the hospital yesterday which was SO informative and helpful. We also sent our preregistration forms in so we’re all set for the next time we pull up to the hospital!
August 20, 2019 § Leave a comment
Week 35 Bumpdate
Baby is the size of a pineapple! 🍍 Her liver and kidneys are fully functioning as is her hearing. In fact, my app suggests reading and singing to her so she’ll recognize certain sounds when she’s born! As of our last appointment, she is 4 pounds, 12 ounces and she’ll be packing on fat from now until birth, though she won’t get much longer than she already is. And today the daily fact is that her index finger is as long as a gummy bear. 😍
– PUPPP. From now until delivery I’ll be dealing with this. Thankfully it’s not as severe as it was last week!
– Back pain.
– Trouble sleeping, due to PUPPP but also baby girl is so active and does headstands on my bladder all night. 🤣
– Braxton Hicks contractions, which will increase in frequency from now until the actual contractions!
Things to remember
– At our appointment last week my doctor was pretty horrified to see how my rash had progressed since he saw it at its beginning – and this was days after it had begun to heal! He offered the possibility of inducing me at 37 or 38 weeks in the hopes of ending it sooner. We’ll talk about it then, but as of now I have no intention of being induced. Baby girl needs her final touches! Because I’ll be dealing with PUPPP until birth and because my rash was pretty severe he did order some bloodwork to make sure everything checked out.
– We had our joint family and friends shower on Sunday and I’m still not over how amazing it was! The excitement for this little girl is incredible!
– My big projects for this week are continuing to work on the nursery, addressing baby announcement envelopes and thank yous, and filling out our hospital preregistration forms. Next week we’ll be starting to pack the diaper bag and getting the car cleaned so we can install the car seat.
– Speaking of her nursery, there is so much inside of it now and one of my favorite things to do is to just sit in the rocking chair and look at her clothes and books. I try to imagine holding her and reading to her, dressing her… it’s all very surreal.
Five more weeks, two until I’m full term. Time is flying. We’re all ready. We’re so, so ready to meet her. 💓
August 13, 2019 § Leave a comment
Week 34 Bumpdate
Baby is the size of a butternut squash! I’ve felt her drop this week, meaning her head is slowly descending into my pelvis in preparation for birth in just six weeks (though we think she’s going to be early!). She’s gaining more fat, listening to us talk more intently, and her bones are hardening besides the ones in her skull, which won’t solidify until after birth.
Symptoms and things to remember:
I’m combining both categories for this one. Sometimes I sugarcoat things in my bumpdates but this is something I can’t: this past week has been the hardest week of my pregnancy since the first trimester.
On Monday, I noticed that the inflammation on the front of my stomach was spreading a bit. Weirdly, on Tuesday night, I was finding little bumps all over my arms and legs. By Wednesday morning, I had full fledged hives – that were rapidly turning into massive, red welts – running down my legs, thighs, feet, toes, arms, hands, fingers, lower back, sides, and baby bump. The itching was more intense than anything I’d ever felt before in my life and the welts were literally everywhere besides my face, neck, chest, and upper back.
I went to my doctor and was immediately diagnosed with PUPPP, which stands for pruritic urticarial papules and plaques of pregnancy. About 1 in 200 women get this horrific rash in their third trimester of pregnancy, and what’s fun about it is that 1) no one knows what causes it; and 2) there is only one cure: giving birth. My doctor took one look at my welts and told me if I were closer to my due date he’d induce me. But with my due date being six weeks away, he sent me to a dermatologist instead.
I’ll spare details of my battle with PUPPP this past week but suffice to say all the prescribed medicines have done nothing while the all-natural ones my mom and I found online have been life saving. One week later, I am starting to get the hives under control, am mostly off my antihistamines, down to 3 showers a day, and am almost sleeping through the night again. It’s even hard to tell in the picture I have a rash on my arms. Things are only looking better, and for that I’m extremely grateful. But man. I wouldn’t wish this hell on anyone.
Some other things to remember from this week:
– On Sunday, my ranch family threw me and baby girl a shower! It took my mind off of PUPPP for several hours and I had an amazing time being with people I love.
– Baby girl is pushing like crazy! I think she pushes rather than kicks because she’s running out of room. 🤣
– It’s getting harder to walk as she gets even bigger. We go to the doctor again Thursday, and our guess is that she’s over five pounds now.
– I ordered some necessities for our hospital bag yesterday. In a few weeks we need to have that thing ready to go!
Have I mentioned that we are just so ready to meet our little girl?? 🥰
August 6, 2019 § Leave a comment
Week 33 Bumpdate
Baby is the size of celery – although after our doctor appointment last week I’m inclined to think she’s even bigger! Last Thursday she was weighing in at 4 pounds, 7 ounces. She is head down already and is moving around like crazy! Her immune system is fully developed and she’s swallowing up to a pint of amniotic fluid a day, keeping her eyes open while awake, and going through even more brain development this week. I just know by her kicks and pushes that she wants out! 🤣
– This is a new one: inflamed stretch marks! I have the equivalent of hives on the front of my bump and they are driving me insane! My doctor isn’t worried though which is good.
– Heart palpitations and dizziness sometimes.
– BIG legs and ankles due to swelling from extra fluids.
– Believe it or not, I’m not as ungodly hungry as I was all the time a month or so ago. This is because my stomach is getting smaller as she pushes everything around!
– Anticipation! This is also a new one. It’s like someone flipped a switch and suddenly there seems like there’s no time left. I’m anxious to get everything we need and her nursery done ASAP.
Things to remember
– Based on her current development, my doctor pushed my estimated due date up three days! I’m now officially due on Sept 21, putting me at 33 weeks and 3 days today. Some people are starting to make guesses of when she’s going to arrive. Alex thinks the 13th, my mom the 22nd.
– What’s funny is that her legs are measuring a week and half ahead than the rest of her since they are so long! We definitely have a tall baby!
– I got my Tdap vaccine at my doctor’s appointment which will help strengthen her immune system further, and Alex will be getting a tetanus booster in the next few weeks since obviously we want to surround her with vaccinated people when she’s born. I’m going to be so paranoid about protecting her immune system since newborns are so vulnerable.
– We’re going to a new parents’ meet-and-greet and the end of the month to meet her pediatrician!
Things are becoming much more real as we get closer and closer. Someday SO soon she’s going to finally be in my arms and I don’t think I’ll ever let her go! 💓
July 30, 2019 § Leave a comment
Week 32 Bumpdate
Baby is the size of a squash! If she isn’t already, soon she’ll be getting into head-down position in preparation for birth. Her digestive system is fully developed and her bones are hardening by the day. And she is packing on fat! She weighs close to four pounds now.
– Heart palpitations. Pretty normal since my heart is working overtime these days!
– With that, dizziness. Sometimes I can’t stand for too long at a time without feeling like I’m going to pass out. It’s getting harder to breathe as she gets bigger!
– My skin is stretching and it itches. Speaking of skin – the stretch marks, you guys. All the stretch marks. 😬
– I’m hot all the time, even with fans on and our AC at 77. Sometimes I literally stand in the freezer during hot flashes.
Things to remember
– We took our maternity pictures yesterday! We had so much fun and I can’t wait to see the pictures. We took them where Alex proposed to me: at Sedona’s airport vortex!
– She’s big enough now that she’ll push on me and if I put my hand against the movement I can feel little body parts. Sometimes I picture her pressing her little hand against my skin and I put mine on top of wherever she is. I want to cry when this happens. I just want her to be here so badly so I can put my hand against hers for real!
– We finished our childbirth classes last week. We have one more class we’re doing at the hospital (infant CPR) and then the next time we pull up to the hospital will be delivery day.
– I’ve known all along that Lucy knows I’m pregnant (the cats I’m not 100% sure) but this past week she’s been acting way more protective of me than usual and I know it’s because she senses baby is coming. If she hears something outside that she doesn’t like she literally runs to me, puts herself between me and whatever she finds scary, turns so I’m at her back and barks and growls at whatever she thinks is coming. We do not deserve dogs. 😭
Only eight more weeks! 4/5 of the way there!
July 23, 2019 § Leave a comment
Week 31 Bumpdate
Baby is the size of asparagus! She’s close to four pounds and around 16 inches long. All five senses are fully functioning and this week she’s going through further brain and nerve development. Her irises react to light, and she’s strong enough to both grasp a finger and move her head from side to side. Best update of all? The number of weeks remaining before she gets here is in the single digits!
– I thought I had swollen ankles before this week. Oh no. If I’m on my feet too long with this heat I get serious kankles, y’all. I have to put them up ASAP and chug water when that happens.
– Always. Hungry.
– I’m dizzy and winded all the time. She’s crowding my lungs now which makes it hard to breathe and a little frustrating when I’m trying to get things done and can’t stand for more than a few minutes at a time.
– Back aches!
Things to remember:
– She is moving around like crazy! She does this thing now where in addition to kicking, she’ll just push things around in there, hard.
– Next Monday we’re taking our maternity pictures! I’m excited, although I may or may not have had to go buy a new dress since the one I got last month doesn’t fit anymore. 😬
– I have another doctor’s appointment next week, after which my doctor wants to see me every two weeks until I hit 37 weeks. Then he wants to see me every single week until he gets the phone call that I’m in labor. 37 weeks is full term, which means while ideally I go to 40 weeks, baby could come any time after 37.
– I am slowly wrapping up my volunteer work so I can focus on growing my business before she gets here and, you know, getting the nursery and the rest of the house ready for her. I didn’t realize how much there was to do and how long it was going to take me to do everything since I’m exhausted what feels like all the time.
Nine more weeks. I just want her here already! 💗
July 16, 2019 § Leave a comment
Week 30 Bumpdate
Baby is the size of a zucchini! 🥒 (By the way, y’all, the fruit/veggies are a reference to how *long* she is, approximately.) Both her brain and body fat are beginning to regulate her body temperature and her immune system is getting stronger. She’s packing on the fat – she has at least three or four pounds to go before she’s born! And she’s a pro at opening and closing her eyes now.
– It’s definitely getting harder to move. My balance is way off, I’ve perfected the preggo waddle, and it’s a struggle to get off the floor if I’ve been sitting on the ground. I can juuust bend over still but that’s about to be a thing of the past.
– I’ve outgrown a lot of my maternity clothes and have upgraded to the next size up. 😞 Trying not to be upset about it.
– I’m winded walking anywhere, especially outside in the heat – baby is starting to push on my lungs.
Things to remember
– Our first childbirth class was last week and I sat riveted the entire time. Our instructor is a hilarious, older labor and delivery nurse it was really nice to get a perspective from someone who has been delivering babies for 40 years. I’ve read everything I can get my hands on about childbirth yet I learned a ton like apparently, dehydration is the number one cause of preterm labor. And baby’s brain is still only two thirds of the way developed by week 35 (or 37, can’t remember) so those final weeks are so important if it’s possible for baby to stay in there! Not that you want to go too long over 40 weeks. Our instructor told us in the 70s, she gave birth at 46 weeks (!!!) and she nearly lost her baby since the placenta was just about dead at that point!
– I’ve meant to mention this in other bumpdates – baby girl LOVES salt! If I have salty foods she does a little happy wiggle which is so different from her other movements. Her absolute favorite thing is soft pretzels. 🥨
– After lots of research I chose baby’s pediatrician and will be making an intro appointment soon. Apparently the doctor comes to the hospital within 24 hours of birth for the first check up.
I can’t believe we hit 30 weeks. 3/4 of the way there. I hope these next ten weeks fly by!
July 9, 2019 § Leave a comment
Week 29 Bumpdate
Baby is the size of an acorn squash! She’s around three pounds at this point, and she’s only going to get chunkier as white fat deposits grow under her skin. She has dream cycles already, she’s moving her diaphragm regularly to practice breathing, and she’s starting to run out of room! I can feel her kicking pretty hard now and I know she’s probably saying, “Let me out!” 😂
– Back aches, leg aches, feeling winded all the time, heartburn, hunger… I’m gonna stop there but I have to admit, it’s like someone flipped a switch and suddenly pregnancy got a little more difficult. Wouldn’t trade this for anything, but you know…hurry up, September!
Things to remember
– Ho boy. We had an epic situation with our 15-year-old AC giving out on Saturday evening and us having to pack up two people, a dog, and two cats to go stay with my mom in Anthem until we could get it replaced. Over a few days we got a taste of (human) parenthood what with being up all night with unhappy animals and having to think of ways to keep them comfortable and happy outside our home. (Let’s just say, our doggo does NOT like going potty in a strange place.) Thankfully the AC company we chose could install a temporary AC unit yesterday so we could all go home and they will be here Friday to install our new one.
– I had a scare Sunday when one company came out to give us a quote. Long story short, Alex and I drove to the house with Lucy to meet him and when he knocked on the door I took Lucy upstairs by the collar to put her in our room. But in her protective mode she fought me, slipped out of her collar and bolted back downstairs and her quick movement caused me to fall forward, hard. I landed on my knees and instinctively threw my hands out so I wouldn’t fall on my stomach and everything was all right (besides some skinned knees) but we were scared by the near miss of something awful happening. Alex said he wanted to handle Lucy from now on when she gets that excited.
– On another note, we start our childbirth classes tomorrow at the hospital, and I’m really looking forward to them! I want to learn as much as I possibly can.
11 more weeks. Hurry up, September!