Thursday, May 31, 2012

So Shockingly Sudden

Why of course... Instinct is neither logical nor scientific, but it's real.  There's only one word to describe what just occurred recently - SUDDEN.

Something's not right, but what?
I went to work as usual last Thursday, did my usual chores back home and went for a shower.  I didn't feel right, but I didn't know what's it.  I was not in pain, but I felt strange.  I saw some discharge (just a little and without blood), so I dismissed any morbid thought that came with it since there wasn't blood. 

I was initially supposed to see my ob/gyn on Saturday, but I thought I'd better go a day earlier.  An EL (emergency leave) sounds like a taboo on Friday and I was afraid if my boss gets the wrong idea that I was taking advantage of pregnancy to laze off until Monday, but I had a strange urge to rest.

I had my check-up and everything looked fine.  Fetal position was cephalic (head-down), but not engaged yet.  I was even overjoyed to have a clearer look at the fetus' face on the 4D scan for the first time ever. 

Still didn't feel right
On Saturday, I saw a lot of mucus coming out.  I wondered if it's the mucus plug - was it broken?  Or was it infection?  There's neither pain nor discomfort, also no itching, and I only saw a tinge of pinkness for a few moments before it disappeared.

The Bloody Show
After coming out of the washroom on Saturday night at about 8.30 pm, I suddenly felt a heavy flow of blood gushing out.  I knew something terrible was going on, I must not wait anymore and I went to hospital straight.

While waiting for Dr Norshida to arrive, the staff midwife examined me.  She did a CTG and told me I was having contraction.  The staff midwife asked if I felt anything, I said no.  Contraction?  But I didn't feel any discomfort, cramping, or sensation of contraction.

When Dr Norshida arrived, she confirmed that I was in labour.  As the fetus is only 29 weeks, I have to be admitted to a hospital with ventilator available at its NICU.

My worst nightmare has come true - a premature baby!  I was a former premature baby too (late preterm because I was 36 weeks already).  As I was "more matured" at birth, I did not require a ventilator.   My brother is a naturally full-term baby though.  So it's coincidence rather than anything genetic...

Under Observation
Only if I knew.....  I should have gone to ................... Basically, major Government hospitals are well-equipped in handling cases such as this.  And since I have the pink antenatal card (commonly called "buku merah") from Klinik Kesihatan, it would even be easier.

Alas, although I knew it's a "no-play-play" situation, I wasn't sure it was labour because I did not experience the typical symptoms of labour other than blood coming out, which was actually a show... and I did not feel any contraction at all.  Initially, I even imagined soon losing the kid inside for I thought my placenta was tearing away or something more serious, which gave rise to this bleeding episode. 

I was administered with Dexamethasone (steroid injection given to speed up fetal lungs maturation) and given nifedipine for tocolytic purpose.  I was referred to Gleneagles (don't ask me how did Gleneagles come into picture because it was a long story...), being one with proper NICU and such, as the Government hospitals like HKL, Ampang, Serdang, Putrajaya, etc that Dr Norshida had contacted told her that they had no ventilator. 

At Gleneagles, Dr Teresa Chow came and saw me on Sunday morning.  After checking on me, decision was made for admission to Government hospital.  Long-term NICU care will cost a mountain in a private hospital (this is not a late preterm baby who probably needs just a week in NICU, but a 29-weeker a.k.a. very preterm baby who will require a few months of care in hospital).  In this case, it turns out that the pink antenatal card from KKIA is useful for admission to Government hospital for delivery.  Dr Teresa then wrote a referral letter for me to get admitted to Hospital Ampang.

At Hospital Ampang
I was immediately sent to the admission ward - "Wad Bersalin Hospital Ampang".  I was checked on by a few doctors and the nurse told me to change to the pink hospital attire for maternity patients.  I gave the nurse my IC and pink card for registration.  Another dose of Dexamethasone was administered at 11.30 am.

View from my bed at the admission ward of Wad Bersalin Hospital Ampang

I was admitted to the labour ward at about 12.30 pm.  It's past lunch time, so my husband had to get me lunch from outside.  Thinking I might need a lot of energy for delivery later (which was actually not the case, because it was all too easy and speedy- the details are below...), I tried my best to finish my full lunch takeaway.   

I was bored in the ward, without anything interesting to read or look at.  I didn't walk around because I was fighting hard to buy time.  The only consolation was the opportunity to chat to a few other patients near my bed.  

Tea time. 

Dinner before delivery.  Rice with cabbage and spicy fish.    


A pain like no other, but briefly
I had no contraction pain from morning until the evening.  But starting at 8.20 pm, I began to feel some discomfort on my pelvic bone. From just once, the pelvic pain came once in every 30 minutes (8.50 pm), then once on 10 minutes (at 9.00 pm), once in 5 minutes (at 9.05 pm, and then every minute).

I pressed the call button each time the pain came.  Nurses came and checked if the pain was due to contraction.   After 5 minutes, the nurse told me that I didn't have contraction. The nurse then thought I was having UTI and had given me a specimen cup to obtain a sample for testing.  I told the nurse that I had no infection, and that I was also not in the urge to urinate at all. "Rasa meneran yang tersangat-sangat, tu je...", I told the nurse.  I couldn't lie down straight, but had to do it sideways.

9.10 pm
The nurses did not believe me.  At first, one of them told me "Dah check 5 minit, tak ada contraction. Kalau betul awak dah nak bersalin, mesti awak dah sakit sampai awak dah tak boleh bercakap.  Jangan risau, kesakitan ni pengalaman yang paling bermakna untuk setiap ibu, especially anak first".  Very consoling words indeed, still my instinct felt otherwise. 

Probably annoyed with my persistent complaint (I had to... because I really felt the urge to push), the nurse called the doctor.  The doctor came, did a VE and told the nurses to rush me to the Labour Room (LR) immediately because dilation was full.  I also heard her said "nampak kepala".  So fast!

I was pushed to the LR on the bed itself.  I was told "tahan dulu ye, try jangan push sehingga kita sampai labour room".  Looking back, I would have delivered in the ward itself had I ignored my intuition.  

I was in the LR with a few doctors and nurses ready.  The nurses guided me to lie down and hold myself. The doctor told me to push. 

Ideally, one should lie down still and not raise one's pelvis when pushing in order to minimise tearing to the perineum.  But in moments of pain, it's difficult to stick by what's ideal because the body's natural reaction is to defy it. 

Out to the world
And voila, all in all, it took just a few minutes and the baby's out in one push!  My baby is so tiny, just about the size of the adult cat at the backyard of my house.  Guess what's his weight?
My husband's at home when the nurse called him to come to the LR.  The kid came out so fast, which didn't even give his dad any opportunity to witness his birth.  So by the time my husband arrived, the baby's  already out although my husband took only a short time to reach on that quiet Sunday night.    

A little story on child delivery
How it feels to deliver a child?  I did not feel contraction although I was having it, but I only felt a brief, intense pelvic pain right before delivery.  It all lasted for just 30 minutes. I guess active labor came quickly right after the effects of nifedipine wore off.  Since my child is very tiny, I didn't have much trouble "expelling" him out.  

After delivering the child, the placenta was soon delivered.  The doctor and nurse then checked the placenta to make sure it's intact.  The nurse clenched her fingers into a fist and inserted it "inside" to contract the uterus.  A doctor massaged my abdomen a few times. It was a very, very bloody sight.  

I wish my husband was there to witness everything so that he knows how scary it is... hahaha, what an evil wife I am because I like to see people in fear.  Will he puke, get pale, faint, or appear indifferent at the sight of such bloodiness?

Due to my inability to do the ideal, suture was necessary.  The nurse would swab, stitch, swab, and stitch, ..... and the process went on until completion.  The swabbing part alone was painful enough, let alone stitching.  

I didn't cry because of pain, but some "uhh" and "ahh" were irresistable.   I was given a cup of Milo after everything's done.  

Post-delivery
After a proper cleaning up, I was taken to the post-delivery ward.  My husband went to the labour ward to collect my stuff.  Accordingly, my neighbours in the labour ward asked my husband if I've delivered, he told them "yes" and they said "wah, cepatnya...".  

It felt a lot more relaxing to be in the post-delivery ward.  Most mothers had their newborn babies beside them.  In Government hospitals, with the exception of those whose babies are admitted to the NICU, mothers are required to care for their own babies.  Only a few others were like me, all by ourselves.

I didn't really sleep that night because of the sheer attack of emotion at what just occurred - I was still shocked and almost in disbelief.  It was like a dream!

A random picture of my lunch at the post-delivery ward.  I forgot to take a picture of my breakfast because I was too hungry in the morning. 


First visit to the NICU
Since I've not bathed the whole day on Sunday, I went for a shower in the morning after breakfast. And followed by a brief walk from the ward to the NICU.

I wasn't surprised at what I saw.  After all, I also came out the same way as my child - premature and kept in an incubator.  His skin looked red but not wrinkled, unlike me as I was wrinkled when I was born (according to my father).  So tiny, so tiny!!!

I wasn't intimidated by the sight of intubation, the various lines and tubes because these are things that I used to see just a year ago - speaking of my nightmare at Hospital Ipoh last year which I've not really shared with anyone, well.....   Nonetheless, I was not without fear because I didn't know what to expect.  

The nurse told me "ok je ni... kalau nak tahu lebih lanjut, bolehlah tanya doktor".   I didn't bother asking the doctor, because if there's anything important enough that I need to know, I believe they'll inform me.  

How can I help? 
I went to the NICU again the next day.  I saw the doctor's note nearby... I didn't intentionally see it, but it's just there and I took a peep.  The final sentence said "Get EBM".  At least I felt a bit better that my child can be fed.

A nurse came and asked me for EBM.  On Day 3, the nurse told me to try expressing some milk.  She even took me to the "Bilik Penyusuan" and showed me how to do it manually by hand.  By hand because I was a bit too swollen over there and using a machine may hurt.  I took so long, 2 hours for less than 30 ml.  It was colostrum, I labelled my bottle and kept it in the fridge provided.
I wish I can do more for my child at the moment, but it isn't possible yet.  So the best that I can give is my own milk.  I wish I can have more milk in times to come so that I can play a greater part in helping my child's growth.  

Sometimes I feel bad that my body is unable to carry my child until he's fully term.  It looks a little mysterious and I do not have medical problems, except some PV bleeding during my first trimester and early second trimester (threatened abortion).

When I look back, I realise that's a telltale sign that my body is not quite fit to sustain a pregnancy for as long as most mothers out there.  On a drastic side, I'm seriously considering not to have anymore baby after this shocking event.

I contemplate a long journey in the NICU because my child is prematurely born.  God please give us the strength to overcome this present challenge...

Conclusion
Well, what else can I do but to pray for the best?   

The way he comes to the world somewhat reminds me of my child's grandmother a.k.a my own mother... the way she left the world.  Both went to hospital by ambulance (my child is in utero of course), my mom's intubated before she left, my child's intubated (for the first 19 hours of life) when I first saw him.  She left in May 2011, he comes in May 2012.  What a freaky coincidence, so I'm scared.   

The things I share in common with my child - we're born in the same month (our birthdays are just 5 days apart), we're born on Sunday, and we're Geminians!  I have nothing more to ask for, but to see him grow up like any other children out there, and do better than me in life.

Guess my note is going haywire as if I'm turning crappy, so I shall step down from my soapbox for now... and it's time to head back to EBM, no matter how little (not surprising, as there isn't any stimulation in the form of a baby's sucking).

Contrary to the myth that Government hospital is a scary place to be in, I'm glad for the generally pleasant experience that I had at Hospital Ampang for my child delivery, although there were some hiccups just before going to the LR.   

P/S: I delivered my second child at HUKM (or PPUKM) in March 2014.  This time, the pregnancy lasted more than 36 weeks, thanks to an emergency cerclage at 29 weeks, At last, I found out why I delivered preterm during the first time.  In short, an elective cerclage is mandatory for all my future pregnancies, if any.  The full stories are as follows:

Part 1: Eventful 3rd Trimester at HUKM

Part 2: -unfinished-

Part 3: Hello Brother of Alvin

Wednesday, May 16, 2012

Expect the Unknown

God... I have nothing more to ask for, but the well-being of the one whom I love and care from the bottom of my heart.  Please help us escape what we fear.

Will the sun ever rise once more, after so long a period of hibernation?   

Sunday, May 6, 2012

The "Green Tea and White Chocolate Chips Cookies" Project

Having inherited plenty of cooking materials, inter alia flour, green tea powder (matcha), and baking powder, I thought of making good use of them rather than allowing them to go to waste.  Baking came into mind, but being a total novice in baking, it took me some time before I decided that I was finally ready.

This is my debut project involving cookies. As a start, I've decided to try something humble, one that's easy to follow through.  

Thanks to the author of Da Washoku Kitchen, below is the result of what's adapted from her recipe (please click the link to be directed to her original recipe) - the Green Tea Matcha and White Chocolate Cookies.

With the necessary ingredients and tools from my brother's chef toolbox (my brother did chef training before, but is retired from the kitchen now), but not knowing what to expect since this is my first time, here's a pictorial summary of the preparation and baking processes:

Dry ingredients: 150 g flour, 1 tbsp matcha, a pinch of salt, and 1/4 tsp baking soda 

100 g butter, 50 g granulated sugar, and 100 g brown sugar in mixing bowl

Butter and sugar.  

Mixture of butter, sugar and eggs.

Approximately 1/2 cup white chocolate chips

Mixture of dry and wet ingredients

My first batch of hand-drop cookies prior to baking.  I made it into the size of a dime.

Cookies freshly out of the oven.

The original recipe intended these cookies to be chewy, and they should be baked at 330 deg F (about 166 deg C) for between 6-8 minutes.  

However, as I intended to bake ordinary cookies for this time, i.e. those that crunch as you chew on them, I've modified the baking temperature to 170 deg C for 20 minutes.  

Overall, I'm glad that the baking project went fine, except that I ended up with pain on my wrists during the night after I finished baking and cleaning up.   Speaking of pain, it's either due to not being used to doing small things one by one all by myself, or due the bodily change occurring within.  

The cookies here looked less green than I've expected, perhaps the matcha I used is more olive-green than green in colour.  Taste-wise, each bite gives rise to a hint of matcha aroma. Thus, these cookies make ideal treats for green tea lovers.

Kiddy's grandma would have been happy to try the cookies; I used to tell her I wanted to learn to bake cookies, but she'd just missed the chance to witness it by a year!  These cookies could have been good for  Mother's Day.          

Tuesday, April 17, 2012

The Beautiful & Ugly Truths

The ERL is one of the most comfortable trains of world class standard in Malaysia. But dishearteningly, many (though not all) of its passengers are "kiasu".

So familiar, yet so strange

Getting It
Try boarding the KLIA Transit during peak hours e.g. in the mornings and evenings when folks are busy commuting to work and back home, and you'll get what I mean.

No Better, Maybe the Worst
If you happen to be one of those in the needy category (e.g. being an elderly, or visibly pregnant, or a person carrying a child), you'll soon appreciate this "kiasu" factor more than ever. The chances of being offered a seat in the KLIA Transit because you happen to fall under the needy category is no better than when you take the LRT or KTM Komuter.

One in a Million
In general, meeting generous souls is quite a rare thing in our public transport scenario. Sad, but true. But from my personal experience, the chance of meeting kind folks who offer their seats to those in need is highest when you board the Kelana Jaya Line train (formerly known as PUTRA LRT), followed by Monorail, the Ampang/Sri Petaling Line (formerly called STAR LRT), KTM Komuter, and lastly, the ERL.

The Connexion
The ERL happens to be the most expensive amongst all the trains here. I wonder if higher purchasing power has any correlation with the higher level of "kiasu"ness among some (not all) ERL passengers - like maximising the money's worth of the ticket purchased. Or is it any other factor?

Far from Pleasant
My two cents here is that, the public transportations in our country is still far from passenger-friendly. The ERL may top others in terms of punctuality and arguably even comfort, but alas... the actual scenario is unfortunately tainted by "kiasu" attitudes among many of its passengers.

Thank You
However, having said that, I nevertheless highly appreciate those in the minority good Samaritan category who kindly offer their seats to folks in need of seats.

Those Days
Self-praise is no praise, but I used to offer my seat to others until I become needy of a seat myself. Do I expect anything in return of my small gesture? No, I don't and I shouldn't. There were even times when I felt discouraged to offer my seat, when I came across "recipients" who were either expressionless or thought there's no need to say "thank you".

Yes, I did get angry at times, being an imperfect human in the world. But I had to do it. It's either my conscience of making sure that a heavily-pregnany woman in front of me doesn't fall and cause harm to at least her innocent little one inside, or making an unfair generalisation that all passengers on board are "kiasu" and therefore deserve no help.

Nowadays
Pretty desperate for a seat nowadays, especially a long day out from morning until evening, I have little choice but to queue up on the platform to maximise my chances of securing a seat. I wish I can relax on the steel bench while waiting for the train, but I can't because so far, I've encountered only one precious occasion (after taking the train for how many times?) when a young lady was kind enough to ask me to sit.

Wednesday, April 4, 2012

For Every First Time

Being away for a long time, I wish I was having pleasant moments.

A breakfast served in front of my bed just as the sun began to rise... Isn't it awesome?

Toasted wholemeal bread with roasted tomato, scrambled egg and salad

The reality was far from being sweet. After all, being hospitalised means something's not right.

Unexpectedly So

It was my first time staying in hospital. It was the first time I was on IV drip. I was dehydrated, in pain, unwell, and down with infection. It's not related to pregnancy, but any neglect may have undesirable effects on it.

This moment was captured when I was still alert, right before the return of my dreadful fever that made me shiver and unable to sit or lie down still on the bed in the ward.

After about 24 hours, I gained some energy and appetite. Here are some of the food that I was served with:

Breakfast.
This is one of the lunches I had... grilled fish skewer with yogurt, boiled vegetables and whipped potato
Papaya and salad together with lunch

As these are food served in the hospital, they are prepared according to the healthy-version manner... low in salt, sugar and oil. The food are mostly grilled or boiled, and the "kuih" served during tea time is the low-sugar version, which I actually prefer because I'm a non-sweet-tooth person.

In front of my bed is a TV to keep myself occupied whenever I was awake. But then I was mostly asleep because I was tired, and lying down excessively had resulted in a little shoulder ache.


What Transpired That Day...

What a time to suffer from infection! The night before, I suddenly felt a strange chill all over. Suspecting a fever, I took my own temperature and voila, it's comfirmed. My stomach felt very unwell too.

I sought my brother for help to take me to the hospital in the middle of the night as I was by myself at my place that day. I went to Columbia Asia Hospital Cheras (in Balakong, near AEON Cheras Selatan) the nearest from home and also where I go for my antenatal check-up, apart from KKIA. I knew I had to be quick and yet be considerate towards my sleep-deprived brother, and thus Government hospital did not come into picture that night.

I only received outpatient treatment that night. Back home, I didn't think that my condition improved. I had a hard time falling asleep. The fever persisted despite taking Paracetamol twice.

The Next Day
Still not feeling right and based on instinct, I went back to Columbia Asia. This time around, I was referred to a physician, Dr Amir Ramli.

Blood and urine tests were done. I was diagnosed with AGE (acute gastroenteritis), and was dehydrated. That explains the extreme exhaustion I was experiencing. I was by myself, and was advised to be admitted.

And there I was, in the ward by noon, administered with IV drip after lunch, and having a fever. At that moment, all that came into my mind was the kid inside. I was afraid of any harm to it. After going through so many difficulties, why am I seem to be suffering misfortune after misfortune? Whatever it is, please spare my child...

Not Surprising
On the third day in hospital, I was taken to see my gynae for ultrasound scan. I was relieved that the kid appeared fine.

But what was that thing that I saw? My gynae, Dr Norshida asked if I'd like to know the sex of my baby. My reaction, just as expected was that I didn't want to know it.

But I saw it despite the blurry eyes, and I thought "uh oh, this is not surprising, but I'm sure my husband will be".

My Overall Comment on Columbia Asia
On the whole, I was happy with the service and facilities at Columbia Asia Hospital. I was in a double-bedded ward with attached shower and washroom. There's an LCD TV for each person with a few selected ASTRO channels. The staff were attentive, polite and prompt in their service.

Each patient who "checks-in" is given a set of toiletteries comprising toothbrush, toothpaste, 1 small-sized towel, 1 medium-sized towel, a comb, soap, shampoo, and a plastic cup.

The deposit (refundable) for each admission is RM300. If you are under any medical coverage, the customer care staff are very helpful in assisting you to secure your guarantee letter (GL). All you need to do is to show your medical card and they'll handle it properly for you... saves you from the headache of having to call here and there in times of distress during sickness.

Should the kid and I make it to the delivery stage, I'll definitely consider going back to Columbia Asia.

But being a patient in a hospital is definitely not a pleasant thing. Although properly attended to, being sick is never a good thing at all.

The Confirmation
What was a speculation for the rest of the night was finally confirmed the day after. When my husband came to pick me home, he asked if we could see our gynae because he's highly curious to know the baby's sex.

I prefer a degree of mystery, but my husband who's the opposite of me prefers things clear and straightforward. Despite the high number of patients awaiting their turns, Dr Norshida was kind enough to spare a few minutes with us. And so, my guess was confirmed. Anyway, it shouldn't even matter what my guess was, so let me just reserve it first.

I always tell myself
To have a child is to take a risk. At the end of the day, it's not up to me to design the fate of whoever that becomes my child. Even having the most perfect of genes doesn't guarantee that an offspring will be perfect, because the world is more than science alone. So, let's not worry unnecessarily, let's not allow my fear to ruin the moments of pregnancy.

Call me fatalistic, but as much as we'd like to deny it, fate does play a role in so many aspects of life. After all, we humans can only plan... but whether a plan materialises or otherwise, is beyond our control.

Conclusion
I have said in the past, I'm prepared for both weathers, rain as well as shine. The months to come will surely keep me waiting anxiously as if waiting for another major examination result in which I expect certain result, or else we'll be doomed.