Melanie’s Four Pregnancies With Obstretic Cholestasis

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by Melanie Weltin

My First Pregnancy

My experience with ICP started in 1997. Four months after I was married to my wonderful husband Chris, we were thrilled to find out we were expecting our first child!
Things started out rough for me, as it was my first baby and I had constant morning sickness. The morning sickness became so severe that I became anemic and had to be placed on nutritional supplements. I believe that this was all normal, as my body was just not used to the “new” hormones of pregnancy. I thought this was bad, but I had no idea what I was headed for in the months to come.

Being a military wife, I was often home alone while Chris flew all around the world. I was in a new town, with no friends, no family and no idea how to get anywhere on the base! This only added to my pregnancy “woes”.

At approximately 4 months into my pregnancy, I began to experience itching that was quite bothersome. This being my first pregnancy, I was not quite sure whether it was normal or not. After some time, the itching became so bothersome that I decided something must not be right. I was losing sleep and my husband had become the “robotic scratching machine”.

I decided at this point, that is was time to place a call to my OB. Although we were in the military at the time, they were contracting all pregnant patients out to civilian OB’s (thank the Lord). Dr. Kolkas immediately ordered a whole slew of blood testing to be done to rule out Hepatitis and other diseases. (Just for background info – at this time my husband was in ICU at the Medical University of South Carolina, seemingly dying from malaria he picked up while in Africa on a mission with the Clinton clan) Dr. Kolkas did not feel that it had anything to do with that, but just in precaution felt it necessary to rule it out. Not a whole lot is known about malaria in the USA.

After ruling out all disease, she still did not feel like my blood tests showed ICP because of some things that did not seem to match up with a “normal case” (bilirubin levels have since been proven to not be a factor when determining ICP – they may or may not be elevated).

Still itching and with no diagnosis, she decided to refer me out to a civilian liver doctor. In order to be seen by this civilian “specialist”, the military doctors first had to evaluate me to make sure I was “worthy” of a visit. This is basically the governments way of telling you nothing is wrong with you, and that’s exactly what they did!

I was seen by a military doctor, who ran NO blood tests, and instead patted me on the back and told me itching was completely normal during pregnancy.

At this point, I was totally bewildered and literally on the brink of suicide. My husband was deeply distraught, and the itching was seemingly taking over our entire lives. The bile acids had built up in my system to the point that my teeth even itched! I would roll around on pavement, scratch my feet with gravel, freeze myself in ice, or do anything just to get a moment of relief! I became a recluse who never got dressed and had trouble doing any housework whatsoever. My husband did not only have to take care of the house and a lunatic wife, but hold his demanding job down at the same time.

After relating the military doctor experience to Dr. Kolkas, she started doing more research on her own. She contacted the liver doctor and he agreed to see me and set up a payment plan with me if the Air Force would not cover the bills (to this day they haven’t paid a lot of them).

The liver specialist evaluated me and ran blood tests. He contacted doctors who deal with ICP regularly in high incident countries, and diagnosed me with ICP. He also started me on Actigall. For three weeks I felt hopeless as it did not seem to do anything, but then it started slowly relieving some of the itching!

From about 6 months, I was constantly being monitored with non-stress tests. This was a sense of relief to know that my baby was alright, but at the same time I knew that the babies who die of stillbirth from this disease often give no apparent or immediate sign before dying.

The itching would come and go off and on through my whole pregnancy. Benjamin was due on September 5th, but tried to come on July 28th. They stopped him from coming with IV meds.

A week later, the itching had begun again to the point where I was ready to die. My mother-in-law took it upon herself to place a call to Dr. Kolkas and tell her how bad off I was.

Dr. Kolkas called me and the same day did an amniocentesis to document fetal lung maturity. 3 hours later, on August 6th, Benjamin Micah was born by caesarian section due to breech presentation.

His first few days were rough, as they placed him in ICU at the time because of his color. He looked like a Jamaican baby! I have since seen this in my other son, and believe it to be due to the bile salts. I do not think it is necessary to have them in ICU, but if it calms the mother, than it can’t hurt.

At the writing of this article, Benjamin is a healthy little active toddler. He was slower in motor skills, and talking ability, but I do not think it had anything to do with ICP. It’s just Ben. :o)

My Second Pregnancy

My second pregnancy came only 4 months after Benjamin was born. At about 3 months, I lost this baby. I went through a time of depression and feeling at fault, but felt comfort in the fact that one day I would be able to see my baby in Heaven.

My Third Pregnancy

In August of 1999, I found out that we were expecting again! I started out a nervous wreck! Dr. Kolkas had become a great source of comfort to me, and during the year that passed she had left her practice. We were no longer in the military, but I choose to keep with the office and try the new doctor that replaced her.

Only 6 weeks into this pregnancy I began itching! I was very afraid that this new doctor would deny me medication, as I was so early in my pregnancy. Much to my surprise, she didn’t and had actually worked with one other patient before with ICP. (surprise, surprise – she had been an Air Force doctor) She ended up being an excellent doctor who kept very on top of my pregnancy.

At one point during the non-stress test, Joseph’s heart showed a decline. Dr. Zozulin did not feel that this was normal, and sent me over the hospital for more monitoring. He came through that fine, so they sent me home.

I still felt something was wrong, and even though I was only at 8 months I decided to try to help him along. I started taking Castor Oil (don’t do this unless you talk to your doctor – it has it’s own risks including meconium staining). The castor oil did the job, as my water broke on April 20th, 2000. Joey was born healthy, but might not have made it had we not have delivered when we did. He was as blue as a smurf from a double wrapped cord around his neck. When the blue wore off, then of course he took on that , oh so cute, Jamaican baby look. He did not require any special treatment, and just as Benjamin, is a healthy little boy. The Lord blessed me with two healthy children in the midst of the sometimes horrible effects of this disease.

My Fourth Pregnancy

As I sit here and type, I am now pregnant with our third child. I had my gall bladder removed in between Joey and this baby, and was hoping that that may aid in this disease, but it did not. The itching started right up as soon as I realized I was pregnant. So far, it has been bearable. I will update with new info. as my pregnancy progresses.

A Note About My Faith

I wish to take this opportunity to give credit to the Lord Jesus Christ for bringing me through each of these situations. It was through my first pregnancy, that I had a lot of time on my hands, and was eventually came to the knowledge that I was a sinner who needed to be saved by studying the King James Bible. I see how the Lord used this disease in my life to turn around and save me! I pray that now I can be a blessing to others through the Lord’s gift of ability to publish a web page. God Bless all the ladies suffering through this. May you seek peace through the Lord Jesus Christ, as HE is the ONLY one who can bring peace.

Article Reprinted with permission.

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