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