cholestasis?

[LiLStar]

The last couple days I've been feeling like I'm getting a yeast infection (any relation?) so i tried taking a bath with salt and vinegar, something I'd seen recommended on a bunch of natural remedies sites. In that bath, the bottom of my feet started itching and starting behind my knees and working up my thighs it *burned*! I was thinking maybe my skin was not agreeing with the vinegar, drained the tub, refilled with fresh water, that didn't feel any better so I just got out and dried off.. then I felt fine. This morning I wake up to go to the bathroom and couldn't fall back asleep because of that dang yeast infection, but now also my back, tummy, and breasts are pretty itchy too, and probably the least of which the palms of my hands. I've read other cholestasis threads here, and now I'm just paranoid I'm SO close to the end and the thought of being forced to deliver in the hospital or worse, hospital plus induction really just makes me want to bury my head in the sand and forget I ever heard the word.

The seriousness of it that is portrayed here makes me think I should run out and get tested just in case.. but.. I'm only seeing a homebirth midwife. Is this something I could ask for in a walk-in clinic? Does it have to be an OB?

Does a little itching for less than a day even mean anything anyway? I would LOVE for someone to tell me I'm just being a hypochondriac

[umami_mommy]

your midwife should be able to order a liver panel.

or you can just start taking for herbs to support your liver... like milk thistle and blessed thistle and if that helps the itching well, then you know.

i believe the site most people have been referencing is itchymoms.com

you're so close i'm not sure it's soething to get in a lather about, but i know most medicos do....

[LiLStar]

I live in a homebirth-illegal state. my midwife can't order any tests. It does seem pretty ridiculous since the test everyone says is most important takes about a week to get results, I'd be 39.5 weeks before getting any results! I will definitely pick up those herbs though, just in case! They can't hurt. what form are they in? Just tablets? Dosage recommendations?

[umami_mommy]

are you getting shadow care? the DEM i started out with suggested shadow care. if it gets bad you might need a blood test... it can get serious and put baby at risk.

i would just get some maybe nature's way herbs... good company and just go by the recommended dose on the back.

i would for sure look at your diet too. dark greens twice a day would be best. like a salad of baby greens at lunch and cooked greens at dinner.

i found this online:

General Tips for Foods that are Especially Good for the Liver

http://www.gmhc.org/health/nutrition/liver/food.html


Eat plenty of fresh fruits and lightly cooked vegetables especially dark green, leafy vegetables and orange, yellow, purple, and red colored fruits and vegetables—they contain living enzymes, fiber, vitamin C, natural antibiotic substances, and anti-cancer phytonutrients.


Eat foods that are rich in glutathione or help to produce glutathione in the body. Asparagus, watermelon, broccoli and boldo are good sources of glutathione while papayas and avocados are foods that help the body to produce glutathione.


Bitter foods like dandelion greens, mustard greens, bitter melon, Romaine lettuce and broccoli raabe can help in cleansing the liver.


Herbs like dill, caraway seeds, garlic, onions, boldo, turmeric and cayenne are easy to use in cooking and can help protect the liver.


Green tea has immune-boosting properties and contains less caffeine than coffee.


Drink lots of water (6–12 cups per day) because it helps the kidneys to get rid of the toxins that the liver has broken down.

Omega-3 fats are very helpful. These fats are found in cold water fish such as salmon, tuna, mackerel, sardines and halibut. Other good sources are ground flaxseeds, flaxseed oil and walnuts.


Nuts, seeds, and avocados are good food sources of polyunsaturated fats and monounsaturated fats that are less harmful to the liver than saturated fats.


Foods that can Make the Liver Work Harder


Saturated fats are harder for the liver to process. Limit high fat meats like sausage, bacon, salami, hot dogs and high fat dairy products like whole milk, ice cream and cheese, which contain saturated fats.


Other foods to limit that have a lot of saturated fat are french fries and high fat snack foods like potato chips, Doritos and Cheese Doodles.


Limit processed foods like white bread, white rice, cakes, cookies, donuts and candy. Add whole grains like whole grain breads and cereals, brown rice, quinoa and barley to your diet.


Limit caffeine to 2-3 cups/day. Caffeine is broken down by the liver and may make it more difficult to cleanse the liver. Coffee, tea and most sodas contain a lot of caffeine.


Eat light meals more frequently. Eating a light evening meal can help to reduce the liver’s work during the healing hours of sleep.


Things to Avoid


Avoid alcohol. Alcohol is known to be a powerful toxin that will damage the liver. Recreational drugs can also be stressful to the liver.


Limit, as much as possible, chemicals such as food colorings, flavorings and preservatives as well as toxins such as insecticides and pesticides because these substances make the liver work harder.


Avoid multi-vitamins that contain iron. Iron is stored in the liver and supplementing with iron may increase the risk of iron toxicity.

[sarahmck]

Tread very carefully. Your story sounds awfully familiar, and mine came extremely close to making me lose my homebirth and did manage to destroy the last eight weeks of my pregnancy.

I will try hard to keep this short, but probably won't succeed.

I had slightly itchy hands and feet, and also a bit of itching elsewhere. Nothing terribly notable. I looked around on-line for creams and came across a reference to itchy hands and feet being a sign of cholestasis. So busybody me goes off to my regular appointment with my backup OB (I saw him every few months) and mentions this and gets tested. This started a snowballing medical drama. I had slightly elevated bile acids (that's what is elevated when you have cholestasis). My OB wanted me to take the drug that cholestasis people take (ursodeoxycholic acid, if memory serves). I didn't fill the prescription. In the meantime, I was having semi-weekly blood draws which showed my liver enzymes going up and up and up. My bile acids stayed only mildly elevated, though. I felt fine. A bit itchy, but not bad. Not the unbearable tear-off-your-skin itching that you read about on itchymoms.com. If I had never read about the hands and feet thing, I never would have been "diagnosed" and would never have even mentioned the problem to my midwife or OB.

In the interests of the length of this post, I'll cut out tons of details. I tried everything to get my blood tests looking better -- diet, acupuncture, etc. -- and did get them moving back in the right direction. But my liver enzymes were still very elevated despite the improvement. My bile acids were back down to normal though. So now I didn't have cholestasis after all. But my OB was freaked out because there is no disease that is characterized by elevated liver enzymes and nothing else. So a week before my due date, he said that he couldn't sign off on my home birth and intimidated my MW into agreeing that I should deliver at 39 weeks in the hospital. Before this (when I officially had cholestasis), he wanted to deliver me at 36 or 37 weeks.

I was subjected to a ton of monitoring, and that monitoring caused me tons and tons and tons of stress and nothing good came of it. I was told that my baby was in danger of dying in the next 6 hours due to my low fluid levels (which tested normal the next morning). And on and on.

In the end, I fired my OB on a Monday, saw a new OB 40 miles away on Wednesday while in early labor (he said that my liver enzymes were "obstetrically insignificant," and delivered at home on Thursday. I had to see the second OB to get him to say I was okay so that I could get my MW to feel comfortable delivering me at home.

It was all a NIGHTMARE, even though it turned out fine in the end and I had my homebirth like a wanted. But that was against all odds. If my husband and I weren't 100% committed to having a homebirth, we wouldn't have had one. Even as committed as we were, we came extremely close to losing our midwife at the very last minute. It was only due to help from some others that we were able to get her back to being willing to take the risk to deliver me at home.

By the way, this was in California and my OB was the local fabulous OB who every loved (and still loves) -- supportive of homebirth, willing to be the backup for MWs, all natural everything, etc.

So....my advice to you is to follow your gut. If you are itching horribly and feel like something is wrong, by all means go get tested. Cholestasis is a dangerous disease and if you do have it, you may decide that the risk of stillbirth is more significant to you than your desire to have a natural full-term homebirth. However, if you just have a bit of itching and are like me and can't keep yourself from looking everything up on the computer and diagnosing it yourself, do yourself a favor and leave it alone. I found that the calendula itching lotion that they sell at Whole Foods was very helpful. I can look up the exact name if you like, but it is in the first aid section.

I'll be glad to give you more details if you like. Just PM me or respond here. Also, if you do decide to test, read the research about cholestasis. There is a very interesting study that found that the risk of stillbirth doesn't go up at all until the mother's bile acid levels get beyond a certain level. So there's a range between the top of normal and that number where you have it, but your baby isn't at risk. The OBs will all want to get you on the drug and deliver you by 37 weeks, though, regardless of how elevated your bile acids are.

Oh, and one other thing. Bile acid tests are done on two different scales. So depending on which lab does the test, you can get numbers back in totally different range with different normal reference ranges. That makes tracking your progress extremely difficult. And the test takes a week to get back, even STAT. And sometimes you have to fast and sometimes you don't. And the doctor doesn't always know. So be sure to ask to lab tech.

Good luck.

[umami_mommy]

i have heard of this going both ways... women that end up getting tested to high heaven and then forced into an early induction and women who treat themselves and the itching gets better and baby is fine.

i think it depends of how bad it is when you first get it and how far along you are when it starts too.

[LiLStar]

Originally Posted by honeybeedreams

i found this online:

General Tips for Foods that are Especially Good for the Liver

Wow lots of great info, thanks! And I'll look for that brand of herbs, we have a couple awesome HFS around here. I take NCD zeolite drops too, basically when I remember.. which is like, once a week instead of 3x a day like I should. I'm sure that'd be good for this. I'll try and remember better, heh!

[LiLStar]

Originally Posted by sarahmck

However, if you just have a bit of itching and are like me and can't keep yourself from looking everything up on the computer and diagnosing it yourself, do yourself a favor and leave it alone.

heh heh, I think I'm exactly like you! Unless the itching gets worse (because it feels pretty minor now) I think I'll go with the herbs for peace of mind, and focusing on eating well! Can't hurt anything and the diet suggestions in honeybeedreams' post would be good for anyone

[umami_mommy]

Originally Posted by LiLStar

Can't hurt anything and the diet suggestions in honeybeedreams' post would be good for anyone

yeah, i honestly think that all the iron in prenatals cause a lot of problems for pregnant women.

[LiLStar]

Originally Posted by honeybeedreams

yeah, i honestly think that all the iron in prenatals cause a lot of problems for pregnant women.

I'm taking floradix...

[umami_mommy]

i'd stop it. in addition to the food extracts in there it also has just regular old supplemental iron like any prental.

i use food to make sure i am getting enough iron.

iron can be very detrimental to both the liver and general health.

do you know for sure you are anemic?

[LiLStar]

My hemoglobin was 11.25 at my 36 week check, which isn't really bad. my midwife recommended either floradix or liquid chlorophyl because she prefers it to be at least 12 during labor.

[umami_mommy]

aviva romm recommends in "the natural pregnancy book," (to treat and prevent anemia)

dark green leafy vegetables
sunflower and pumpkin seeds
organic unsulfured dried fruits (raisins, prunes, figs, apricots and cherries)
blackstrap molasses
beets
red beans
dark turkey meat
eggs
seaweeds (kelp and dusle)

eat vitamin C rich foods, and limit dairy consumption when you are eating iron containing foods.... (black cherry extract is great, since it's high in C and iron!... tastes yucky though)

i would add clams and mussels... as they are very high in iron and of course organic red meat... i had a 6 ounce bison steak the other day. it was yummy and just what i needed.

also, the single most important herb is NETTLES... i can't stress this enough. i drink nettle tea every single day. also alfalfa and RRL.

you can aslo use yellow dock and dandelion root... but yellow dock can be harsh, as it's a liver cleanser... mayeb just a few times when pregnant.

aviva romm says not to worry unless your level goes below 11, but it can't hurt to have it right on the money at 12 for the birth...

i would just skip the iron supplemets, as i think it's stressing your liver.

i found this last year when i was anemic... it's a cool website:

http://tinyurl.com/2vrqfb

[Gray's Mommy]

Originally Posted by LiLStar

My hemoglobin was 11.25 at my 36 week check, which isn't really bad. my midwife recommended either floradix or liquid chlorophyl because she prefers it to be at least 12 during labor.

My m/w said that anything over 10 is fine in the 3rd trimester...
something you may want to check out.