I Flashed a Pharmacist

I flashed the woman behind the counter at Walgreens one warm spring day in 2002.

When I say I “flashed” her, I mean that I lifted my shirt and revealed my torso, bra and all. And when I say “the woman behind the counter at Walgreens,” I mean the pharmacist. And I remember that it was a spring day in 2002 because I was very pregnant with my first child, and I remember that it was warm because the heat was aggravating the very rash for which I was trying, desperately, to get a tube of prescription steroid ointment.

Earlier that month, I’d been having lunch with friends of mine when one of them asked me, “So, why are you rubbing your belly like that all the time? Is the baby kicking?”

I looked down and realized that I’d been rubbing steadily, absentmindedly, at a patch of my 7-months-pregnant belly. When I thought about it, that patch was kind of itchy, and I told him so.

“I bet it’s crazy when your skin gets stretched like that,” he said.

I went home that night and noticed that the stretch marks on my belly were looking strange. They were 3-D now, little valleys on the landscape of my body, and in the area I’d been scratching, a few of them were now home to tiny red dots. I rubbed some cocoa butter into them and went to bed.

Over the course of the next week or two, the red dots spread. I tried more cocoa butter, but it didn’t work. I made sure I moisturized my belly several times a day, but that didn’t help either. It kept getting worse. After a few weeks, I went to see my midwife. She took one look at my abdomen and bit her lower lip.

“I’m so sorry,” she said. “It’s PUPPPs.”

I hadn’t heard of it, so she broke it down for me. PUPPPs stands for Pruritic Urticarial Plaques and Papules of Pregnancy. “Pruritic” means “very itchy;” “urticarial” refers to hives; and “plaques and papules” are huge patches and smaller patches of hives. It’s something like an allergic reaction to a pregnancy. It happens usually in first-time mothers, begins in the stretch marks, and seldom ends until the baby is born.

“I had it when I was pregnant,” my midwife said. “It’s terrible. I’m not going to pretend otherwise. I’m sorry.”

Within a month, the rash had done exactly what all the web sites and pregnancy books predicted: it had spread to every inch of my body except for my breasts and my face. Intensely itchy didn’t even begin to cover the sensation: maddening, unrelenting feelings of crawling insects or tiny spiked hairs, relieved only by ice packs applied directly to my skin.

In fact, by then I had deep emotional connections to a menagerie of ice packs I kept in a rotation from my body to my freezer and back. I had one the size of a school notebook, firm and hard, that was perfect for sitting on or for resting on the top of my enormous stomach. Smaller, softer gel packs were best for draping over my hands and feet. A set of little cutesy brick-style packs made for lunch boxes could be tucked into my waistbands or clutched behind my knees or in the crooks of my elbows.

I barely slept. I moved from the bed I shared with my amazing, supportive, helpless husband so that my ice packs and whimpering wouldn’t keep him up all night, down to the futon in the room that would become the baby’s room. In the middle of the night, unable to sleep through the pinpricks of sensation that went skittering over my body every other moment, I sometimes sat up, rocked on my knees, and sobbed. Sometimes, I couldn’t help myself and screamed, “GET OUT OF ME! GET OUT OF ME RIGHT NOW! YOU’RE KILLING ME WITH THIS ITCHING! I CAN’T STAND HAVING YOU IN MY BODY ANY MORE! GET OUT!”

My husband came then and tried to help — to get me in another ineffective oatmeal bath or cold shower — and finally, he called my midwife and said we had to have more help.

She gave it her best. We tried Benadryl, a lotion called Sarna, hydrocortisone cream. We tried straight witch hazel. We tried baking soda. Finally, we tried a dermatologist. By then, I was over 8 months pregnant, and I asked if he could make this rash go away in a way that was safe for the baby.

“No,” he said. “But you’re almost done. You can make it a few more weeks.”

“I can’t,” I whispered.

“You can,” he said. “You can. We don’t induce labor early for PUPPPs. That’s ridiculous, and it’s dangerous for your baby, so stop asking me for that. Here,” he said, writing a prescription. “You can try this cream. It’s stronger than the stuff you get over the counter.”

We picked up the first tube of cream at the pharmacy and brought it home. My husband had to apply it to my back which, he said in a low voice, reminded him of photos he’d seen of the victims of Hiroshima.

I stood there, naked in my bathroom, and realized that this relationship was the most adult it had ever been. Sure, we loved each other fiercely, and sure, we’d committed to be together forever and we’d bought a house together — those are adult things. That span of ten minutes or so, though, during which I waited patiently while my husband dabbed ointment on the rash all over my behind — in the crook between my behind and my thighs, even — signified a level of vulnerability I’m not sure I’d displayed since I’d been a very small child.

What my husband did with that vulnerability is hard for me to explain. He was gentle and patient. He was matter-of-fact. He didn’t gag and he didn’t waver. He showed me what kind of parent he would be, and so I tried, as I stood there with tears running down my face, to gather the strands of my dignity and make myself into the kind of parent I would be.

The tube of ointment was small — smaller than a tube of toothpaste. The instructions to “apply ointment to the affected area(s) three times per day” meant that we ran out of it after 18 hours. I returned to the pharmacy to get a refill.

“Oh, I’m sorry, ma’am,” the pharmacist said. “You can’t refill this yet. The insurance won’t cover it.”

“OK,” I answered, slapping at the invisible ants crawling up my leg, “How much is it without insurance?”

She quoted me a number, and I said it was fine; I’d pay it out of pocket.

“But wait,” she said, looking again at the screen. “You just filled this yesterday. You shouldn’t need any more yet anyway!”

“I used it up,” I said, calmly, sweat trickling down my stomach.

“But, honey,” she said. “You can’t be using it right. You’re not supposed to put it EVERYWHERE. You’re only supposed to put it where the RASH is!”

I sighed. I looked inward. Somehow, I must have looked forward, to doctors’ offices and pediatricians who wouldn’t listen and another pregnancy that would lead to a baby who would need all my moxie.

I lifted my shirt: “This is what it looks like everywhere.” I said from behind the fabric.

“Oh. Oh my g-d. Oh…oh my. I’m going to make a few calls.” she said, scurrying away before I could get my shirt back down.

She came back a while later with what looked like a caulk-gun-sized tube of the ointment. “No charge,” she said, and told me to come back whenever I needed for more. She’d dealt with the insurance herself.

Three weeks later, my oldest daughter was born, after I’d finally gotten a round of steroids that calmed the itching down long enough for me to spend the last three nights before I went into labor in bed with my husband.

I gave birth as an adult partnered to an adult, and I felt ready.

The lovely Christine Wolf of Riding the Waves generously shared a writing exercise being undertaken by bloggers on ChicagoNow, and graciously agreed to let me join in. The topic for tonight was “Write about the first time you felt like you were a grown-up.” If you’d like to read some heartfelt, beautiful, inspiring writing, do check out Christine’s blog!

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4 thoughts on “I Flashed a Pharmacist

  1. Great piece. I loved this prompt from Christine. Becoming a medical advocate — for yourself, your child, or another loved one — is definitely an adult-making experience. As a veteran for traumatic pregnancy and babies who need “all my moxie”, I applaud your tenacity and strength.

  2. I had PUPPS. It was a NIGHTMARE, and I think was part of what sent me over the edge to postpartum depression/anxiety — as I was one of the unusual cases where it got WORSE after birth. I can’t imagine living with it for several months.

    • Oh Michelle, I can’t believe the hell that must have been, to have PUPPPs worsen AFTER the birth. I am so sorry! How long did that last? Even now, nearly 15 years later, I find itchiness to be the most uncomfortable sensation. I’d rather be in pain than be itchy. These things really leave lasting impressions on our consciousness.

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