Due to constrain of time, this post is almost half a year overdue by now. Instead of discussing on my 2-months experience as a patient of ward 2B, today I would like to jump into Part 3 first - my delivery experience at HUKM, the arrival of Alvin's brother:
Removal of cerclage
For first-timers who wonder how does the removal of cerclage feels like, it is painless, done without having to go to OT, and takes only a few minutes (note: speaking of cerclage done via the " v ", not abdominal cerclage).
A cerclage is normally removed from the 36th week onwards. In typical cases where contraction is absent or when the os is otherwise still closed, these patients will be discharged... and will only return when it's time to deliver.
On Monday, 31/3/2014 at 9 am, I was sent from ward 2B to the labour room - Room No. 1 (LR) for removal of cerclage, and possibly delivery on the same day. Prior to that, I was told not to eat after breakfast - a precaution just in case if a c-section is required... you'll never know until the time comes. And prior to the removal, a CTG was done in the LR.
Labour Room no. 1, 1st floor, HUKM
But I was in the middle of nowhere...
In Part 1, I had mentioned about an opening of 2 cm prior to admission into the HDU where I was tocolysed before undergoing an emergency cerclage.
Upon removal of cerclage, the os was already 4 cm. However, there was no contraction at all. To induce, or to return to the ward and risk everyone getting "kelam-kabut" if suddenly I felt like delivering?
Epidural vs. no epidural
At HUKM, the doctor readily asked if I would like to have epidural. Cost-wise, I did not see it being included in my bill - I wonder if it's free, or only at a very minimal charge? :)
My initial principle was to have everything as natural as possible with minimal intervention (I later betrayed that so-called principle but arguably it's for good). The devil in me suddenly changed my mind when I heard someone screaming in pain from a neighboring room . Thinking of it now, my fear might not be unfounded for after all, I was already distressed by the long stay in ward, and did not want to aggravate what's already there by undergoing tremendous pain... One may or may not agree with this, so it's entirely a personal and subjective decision.
"Hot soup" and epidural is not 100% pain-free
Induction of labour: This is my first experience going through an induction. The membrane was first artificially broken. I felt a gush of warm fluid slowly flowing out. It felt so much like hot soup. From the CTG, I could see a rise in fetal heart rate, which went back to normal 15 minutes later. Adik must have been irritated by the sudden 'disturbance'.. haha. The pitocin drip was administered 30 minutes later.
Epidural analgesia: A little similar to spinal anaesthesia, but they are not the same. With epidural analgesia, contraction, VE and suturing were all pain-free... but not when the baby started crowning where sakit bersalin tetap ada... despite having it.
A brand new experience
With epidural on and half a pint of pitocin left, I was relaxing myself when I suddenly felt a very sharp pain as if something was poking my pelvic real-hard.
I'm by nature a person who does not scream easily, yet it wasn't easy restraining myself from uttering some "uhh" and "ahh" every now and then. This was definitely nothing like what I went through with Alvin... this was a totally new experience for me.
I called the nurse, and 2 of them came in. One of them did a VE and told me "wah, cepatnya sudah 7 cm.... awak akan bersalin ni". The nurses had helpfully guided me until the baby came out. The whole process didn't take long.
If I remember correctly, the baby took 5 minutes from when I began to push to be out. The reason why it's fast is not because I'm strong, but an incompetent cervix probably makes it easy to get the baby out.
Deep breath in, hold the breath, push... then breath out. I do not remember how many times I repeated that, but beneath the pain, I was filled with gratitude for the brand new opportunity to share similar experience as what typical mothers who carry their pregnancies up to 9 months go through. If a baby of 2.51 kg is enough to give rise to so much pain, imagine moms of truly full-term babies whose little ones are 3 kg and above.
The first touching moment was when I heard adik's first cry... It was very loud, very loud indeed (to me as one who delivered a near-term baby for the first time ever).
NB: It's still fresh in my mind that I all heard of Alvin at Hospital Ampang some 22 months ago was some faint "weeeee"-sounding cry, which is expected in the case of a very preterm baby due to immature lungs.
Another moment that felt touching to me was when the nurse put adik onto my body for about 10 minutes before cleaning him up. All these, were my first experience although I was by no means a new mother when adik came along.
As soon as the epidural was off, I felt a little dizzy and had no appetite to eat the sandwiches served at the labour room. Gosh, while I felt generally well with spinal anaesthesia except for urticaria on both legs, I felt sick after the epidural was off. Fortunately I did not eat anything in between meals, or else imagine the possibility of puking... something which I fear very much.
The 1st few days post-delivery
Due to an unforeseen reason, both adik and I did not get to go home on the next day although moms of typical SVD cases are usually discharged the next day.
Conclusion
I was advised that if I get pregnant in the future, I must come in for early booking. An elective cerclage will be necessary, and should be done early at 16 weeks. Which means a cerclage is a must each time I am pregnant. And hopefully will not have to be on long stay in ward. If God lets both Alvin and Aaron grow up smoothly, I should preferably not be pregnant anymore in view of some realities that seriously require me to stop playing with risk.
Although unplanned, I am nevertheless grateful for the arrival of Aaron despite the close age gap with Alvin. It will be an uphill task upon the family to simultaneously take care of 2 very young children at home but I believe there is a reason behind everything that occurs in life, why at this time and so on.
The next challenge will be a test upon my skill and patience in maintaining a balance between my existing routine, caring for and teaching them what they ought to learn... oh God, please guide me to the correct path in order to carry out my responsibilities with strength, fairness and patience towards them both. Right now I am still far from doing enough for the brothers, let alone feeling like a good parent.
P/S:
I appreciate and would like to express my gratitude to the following persons, including those whom I saw earlier before going to HUKM:
- My first ob-gyn Dr Norshida of Columbia Asia Cheras who did my antenatal check-ups during my first and early second trimesters;
- Prof Jamil who did all the detailed scan and very thorough check-ups during my second trimester;
- The good doctor and nurses at KKIA SK... I've gone there a couple of times for the sake of getting the 'buku merah';
- Dr Aqmar Suraya for promptly referring me for admission into ward 2B and doing my difficult cerclage which in turn had saved Aaron from being born at 29 weeks;
- The soft-spoken Prof Azurah for giving me the green light to go for the emergency cerclage;
- The registrar and all the medical officer whom I've met either at the ward or HDU ... I was under "team hijau";
- All the good HO and kind nurses who had worked very hard in monitoring and providing care... am thankful to the nurses for their patience in guiding and encouraging me when breastfeeding was initially a major headache + heartache - Despite frequent latching, I had zero milk for the first 3 days (will talk about that topic one day);
- The medical students, nonetheless. All of them were very professional and in my heart I wish them the best;
- My ward-mates cum friends. We had great times together, and I was happy to join a recent reunion with them at Iera's home recently; and
- My husband for coming in every evening after work, my parents-in-law and sister-in-law for coming over whenever they're free although Seri Kembangan is not very near to HUKM... cousin Vernon for texting in to ask how I was doing, and friends who either came in physically to visit or gave me words of encouragements online.... Thank you Azies and family, Paul, Moganah & husband, Lidia, Maliz, Aimi, Fahmi and Ahmad for coming over to HUKM for a visit / my home /delivering the gift to me at home. Thank you to my dear colleagues for the cute hamper from Chomel Store. :)
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