day 5 of life

26/12/14

The Maternal and child health nurse came visiting today. Chips is again jaundiced up to his chest. Cafu has to bring him to the buntong clinic to check his jaundice level. Thank god that it is under photo level again.

Eric and Sheao Loei came for visit today. Chips opens his eyes wider and said hmm when he was given his very first ang pao. We felt much better after chips was examined by sheao loei. Moro's was complete. We had a good laughter on how many times cafu did moro's per day.

Milk is starting to kick in but still insufficient for chipsmore. medela has became my good friend.
We then discussed chip's chinese name with eric. eric's mandarin is just superb. there is a list of name given by the astrologer mak sing loong. father in law is very keen on naming him ming feng. But i find it so 'kolot'.

In the end, we came up with the name
Darren Lau Kai Jye ( which means armour and able to protect himself)

the confinement lady came today. i felt very anxious when she started handling chipsmore.
when she bathes chipsmore, i am afraid that she will trip and fall. when she washes the hair first instead of the face, i got upset. Im just not willing to trust anybody to take care of chipsmore. So, i spent most of the time scrutinising the confinement lady. I made her wash chipsmore's face first. I asked her how many babies she has taken care of. I just don't want my baby to be her experiment.

Anyway, we were both less exhausted with the arrival of the confinement lady. Just going to ignore the unhygienic part of her. Dr Oh said old ladies are like that.

day 4 of life

25/12/14

It is finally christmas day. I really miss the christmas buffet that hubby usually planned for both of us. I miss seeing the christmas deco in the shopping malls. I made cafu to promise that he will bring me and chips for christmas buffet next year.

We have been giving formula milk to chips. I tried using the medela breast pump today. Woah.. finally some milk is there. I just love my medela pump. 

After consulting Hng for the amount that we should feed, chips is more active. He opens his eyes and smile.

My in laws have decided to get us a confinement lady. Of course, mom is not happy about it. But she doesn't understand that we have been so tired. Cafu just couldn't wake up in the morning. I guessed that it was worst that doing medical call. I donno how kupo will feel. I hope she doesn't mind.

Chips was dressed up nicely for photo shooting today

He is trying his best to turn over ...................... Another awesome development. Thanks to DHA

day 3 of life

24/12/14

It is chip's day 3 of life. I find it very disturbing at times with the frequent vital signs monitoring and antibiotic administration. Just couldn't sleep well. Chips has his BCG today and was noted to have slight jaundice. he was put under photo while waiting for his bilirubin level.  It felt so hurtful to see him under the photo naked because he was cold. Both of us were discharged the very same day. His jaundice is below photo level. Mom bought a cake for the 1st mat staff as a token of appreciation. 

Boss and the staff from skin department came today. they gave me a bag to put baby items. Of course, brother Ang TS came and gave me more moral support. 

The rain finally stopped on the day of discharge.

We went to manjaku mall to get a pillow for breast feeding. Sister Leong has made a very good recommendation. At least, my muscles no longer ache while feeding chipsmore.

To initiate breast feeding is not at all simple. I do not know how much milk chips is taking. As a result, he went into another episode of hypo. Sugar was just 1.7. Cafu and I were both so worried that he might end up having cerebral palsy. He wasn't crying for hunger. He just kept sleeping. The new daddy kept doing moro's reflex just to make sure that he is fine.

Mom told me to stay in cafu's house during confinement. She said cafu is not comfortable in my house. True as it is but we were both dead tired taking care of chipsmore. We just can't handle him without the help of a confinement lady.

day 2 of life

23/12/14

It is post op day 1. I am doing fine. Ambulating in the ward the next morning and sitting up to try breast feeding. it felt weird when chipsmore started sucking on the nipple. I know that his stomach is still very small and i do not need to feed him much. But i have GDM and he is at risk of hypoglycaemia. During his stay in the hospital, he had one episode of hypoglycaemia. paediatric has seen him and planned for discharge once the sugar is stable. 

Family members and colleagues came visiting. Ang TS has been very supportive. It is very rare to get a male colleague who knows so much about breast feeding. He shared his papaya soup with pork recipe with me. He even gave his wife's number so that i can consult her when i have difficulty to breast feed. Getting chipsmore to latch has not been easy. my muscles ache when i carry him. I just can't put my areola inside his mouth. Nurses has been helping me occasionally. It seems so simple when they are around. But when i am alone, i just can't feed chipsmore. We had to give him frequent formula milk.

Cafu has been staying with me in the hospital the whole time. Chipsmore laughed at day 1 of life. It was really scary to both of us. Probably DHA has done its wonders.

The room 1 that i was staying must have been haunted. I could hear another baby crying beside my bed. I don't dare to look at that side and kept waking cafu up to on the lights. 

day 1 of life

22/12/14

It was a rainy day. The sun was no where to be seen. I woke up earlier than usual, feeling anxious most of the time. I was terrified of the operative procedure and pain. I wore my favourite pink preggie dress and had a last picture with baby chipsmore inside me. I am seriously going to miss his kicking.

We registered at the labour room and got my room in the first maternity block. A nurse came and took my vital signs. Had my very first CTG done while chipsmore was sleeping. He was doing fine. CTG was reactive. Of course, houseman came and took consent. He looked really blur cos he gave me the wrong consent form. Instead of LSCS, he gave me a consent for laparoscopy. Then, he offered to set my iv cannula. Gosh!!! I was already terrified with him. So, requested for the hubby to set my iv cannula. He must have been anxious too because he took three attempts , kept telling me to trust his skills. But it was to avail. He failed to set my line and had to request for GA to help me. Thank god Dr N was on call that day. I got to know her while we had indian food in Tandoor Grill with thiru and kai ma Vny. I  again felt comfortable with her. One attempt and yay!! got my IV line. Out of all the procedures that i need to go through, Cafu's branula insertion was the most painful.

My op was scheduled to be at 2pm. I had these profuse sweating episodes with abdominal pain prior to op. Silly me. I was actually in labor but i tot i was having panic attack. The diligent nurse put her hand on my abdomen and told me that i was having contractions. But, i refused to trust her. I got more scared while listening to ladies screaming out of delivery pain in the labour suite.

Soon, it was time for my op. The maternal OT was super duper cold. I was practically shivering non stop. Everything was blur because i was not allowed to wear my spectacles. Mom came in to accompany me. Hubby was there too. I felt relaxed almost instantaneously once i saw Dr T. Dr N gave me my spinal. I could feel the numbness creeping up slowly from the distal end of my toes to my abdomen. Of course i could still feel the gauze when Dr T was rubbing the povidone over my abdomen. Then i remembered what rani told me. Its ok. you will still feel them touching you and you will feel the pushing force. She actually enjoyed her LSCS. 

Dr T said there was no fat in my abdomen but it was very vascular. So, he asked whether i took traditional medication. he had to cauterized quite a bit. He tried to make a small incision for me cos it will be less painful. Chips was just 2.7 kg during his last scan at 36 weeks. We never expected him to be so big. The O&G team couldn't pull chipsmore out and had to use a forceps. Chips cried vigorously and i was relieved. Paeds team stand by for my baby too. I gave a quick peck on the chip's cheek before they took him away to the nursing room. I could see the reflection of my exposed abdomen via the gigantic OT lights which illuminates the whole operation theatre. I had always wanted to see my own uterus. Chips was delivered at 2.45 pm with a good weight. Mummy gave him his first spoon feeding.

Dr T told me that i was already in labour because my os was opened. So, somehow i feel that i chose the right day, the right time, the right mode of delivery for chips. I couldn't expressed how grateful i am to have Dr T as my O&G dr during the entire pregnancy. 

It has been raining the whole day. It stopped raining a lil while when chips was delivered. Chips, Kelantan had the worst flood disaster on the day when you were born. The rain never stopped till the 3rd day when you finally got discharged. 

Cafu and chips were both by my side in the first mat block. Ku po cooked a lot of nice food for me as well. we still donno what to name chips.

pregnancy diary

it has been quite a while since the last time i blogged. I have now become mummy to the most adorable lil angel. We have been calling him baby chipsmore. Baby Chips was conceived in Paris during our honeymoon. His EDD was supposed to be on 1st January 2015 but he had to say hello to this world earlier on 22/12/14 via elective LSCS. Just a recap on what had happened during the entire pregnancy.

At 5 weeks of POA, i had threatened abortion. Went to see this particular malignant O&G MO Dr S. A TVS was done and was told that the sac is good. As usual, it is extremely difficult for a medical officer to get MC. She told us that no matter what, whether i work or i don't, whether i rest or not, baby chips will only have 50% of survival rate. She even scolded me for not filling up the details in my pink book. I went to work as usual. 

Being a new MO in Ipoh has some disadvantages as well. I do not know any doctors from O&G. Thank god mom has been working in the labour room for pain service and she suggested me to follow up with the fertility specialist Dr T. I remembered vividly that i called Dr T for an appointment during the PV bleed and he was visiting Cameron Highlands GH.

Me : Dr T, I am having PV bleed. I think its threatened abortion. Can i see you today?
Dr T : Sure, come to Cameron Highlands GH

That was my first encounter with Dr T. Somehow i felt very comfortable with him. We had a few serial scans done. He assured me that chipsmore is fine and prescribed me some duphaston tablets to strengthen the pregnancy . Sorry chipsmore. Mummy didn't take duphaston because it caused severe migraine.

Anxious hubby is always pestering me to rest. He has been telling me that the hospital will not collapse without me. Boss wants me to rest as well and he proudly said that he has enough MO to run the department. 

At 6 weeks of POA, Chipsmore went missing. We could not locate his fetal pole from the TVS. Sac was still in good shape. Dr T told us that i might have a missed abortion. Since the sac is still nice, he told us to wait for a week. I will have to go for dilatation and curettage if the sac remains empty during the next scan. Cafu and I were both so devastated with the bad news. I thought  that I was strong. I believe that Chipsmore must have been abnormal or maybe God doesn't think that i will be a good mother. That was why he had to take him back. I cried for few days at home. I kept wondering why God had to take Chipsmore away without even letting me see her ( ** well, i used to think that chipsmore is a girl ). I started blaming myself for working too hard.

We couldn't wait for a week. It was a mental torture. So, we requested for another scan. Finally, Dr T showed us chipsmore and his fetal heart sounds. It was a relieved for the both of us. That is why we call him chipsmore. Asha named him that.

I was diagnosed to have GDM at 11 weeks of POA. I was very strict with my diet until there was not much of weight gain during the initial part of pregnancy. Since i was always hungry, Dr L told me to eat. Worst is inject insulin. BSP has been stable all the while. I do get my monthly treats of haagen dazz, stickies and secret recipe cakes.

chipsmore had a choroid plexus cyst in his brain during the next scan at about 12 weeks. Dr T claims that choroid plexus cyst usually resolves by 25 weeks and its normal in most pregnancies. In view of my family history of edward syndrome, i was then referred to Dr J for a detail scan . Detail scan showed choroid plexus cyst but no ventriculomegaly. we were then counselled for amniocentesis. There is no point keeping a child with trisomy 18 because he is not compatible with life. amniocentesis was then done and it was a relief to know that chipsmore has normal chromosomes 46 XY.

when i first felt his quickening,  it was like little butterflies fluttering inside me. then i could appreciate his kicks better. sometimes he would be wriggling inside like a worm. i can grab his elbows and knees at times. 3rd trimester was the most uneventful. i was basically enjoying every moment of it. i tired easily. i no longer walk up the hospital tower block and no longer on call.

it was finally the time to decide on the mode of delivery. Dr T asked me to think about elective LSCS vs SVD. there is high rate of fetal distress. I was very scared with delivery pain despite epidural. after all that we have gone thru, i don't want to risk my baby anymore. I have finally decide for elective LSCS even thou cafu was against it. Everybody gave me the funny smirk when they know that i opt for elective caesar. I got tired of explaining. So when i got irritated, i will tell them that..... Look, Chipsmore is my baby. I will sign the operative consent. I decide on the mode of delivery.

My in laws are very superstitious. They had to choose a good date after consulting an astrologer. I don't know what good dates meant. But i chose 22/12/14 because that is the day mom is around, Dr T is on call and it is a monday ( ** I want to enjoy the weekend after eating tong yuen ). 

being the M&HO in KKIA

Time really flies...  It has almost been a year as a medical & health officer in PKD . To begin with, i had never requested for a placement in the health side. I prefer the busy settings and the adrenaline rush in the hospital. I strongly believed that i will not gain any knowledge and my hands on skills will be gone once i serve my duty in the health side. When Dr U decided to put me in KKIA, i begged her to put me in the OPD. My passion has always been in medical. To deal with preggies is definately a NO - NO. Needless to say, my attempt to escape from KKIA fell on deaf ears. I was hopeless and speechless. I started weeping almost instantaneously in the sedan. Then there I was praying wistfully for a miracle.

Cafu showed me the way to the clinic on the very same day. We were both outside the clinic. The clinic is a two storey building, looked really old with its coat of beige painting. I was still sobbing when he asked me to have a look inside the KKIA. I refused to do so. The nurses would have just giggled and laughed at this lil crying baby who is going to be a doctor there.  Cafu told me the staffs are very helpful and he surveyed the parking. Damn! Then i realized, the next problem will be...... driving to work and how to park the car in the clinic. There are no side parkings. What to do when there is a maternal mortality? What if i just missed something and that simple mistake lead to the death of the mother? Do I have to go to the JKN? What if i missed a placenta previa and the mother just bleeds and die at home? What to do if a preggy just decided to fit in the clinic and i am alone?

The beginning has always been the most difficult. Thank god my YM Dr S has been very kind to me. She has never scolded me before. She taught me how to use the scan machine. It was indeed a culture shock when i first saw that scan machine. You have to really squint your eyes in order to get a clear view of the CRL. Then she taught me how to kiao the cha cha ( vagina ) and also to put things inside the cha cha.

Holding the antenatal cards alone caused some amount of stress. I must be good enough to identify the maternal problems, picked them up and refer them to hsah. I had to ask JM June what to document in the antenatal cards. She has taught me well. Dr, just document properly. Cover your ass

There are a lot of problematic patients in the KKIA. I can still remember them vividly

1) my very first patient had PIH on treatment and came with proteinuria. uric acid was increasing trend. Case was admitted immediately and her baby was delivered the same day.

2) A patient with PIH on labetalol has been complaining of headache for 2 days came to KD. BP was 160/100, proteinuric. I accompanied this IE patient to the hospital. BP upon arrival was 180/120. She was initiated on MgSO4. Due to some unfortunate anaesthetic complications, she succumbed to her death. She developed sepsis post operatively. Had a very bad hospital acquired pneumonia and was started on tazocin. We were so afraid that she might be our first maternal mortality case. She finally knocked on heaven's gate 3 months post delivery.

3) Being a M&HO is different from a medical officer. we are expected to go down to the field. There is a baby who developed severe NNJ at day 4 of life. both parents refuses admission despite explaining the complications of SNNJ. I had to go to their house, called the husband in langkawi just to explained to them why is SNNJ so dangerous to the baby. I was really scared to talk to them. Finally, i understood why their refuses admission. They were in a state of poverty. they could not afford the hospital bills. isn't it sad?

4) Nothing good happens on a thursday when Dr S is not around. I will received funny calls exactly at 11 am. one of it was pregnant lady fitted near the mosque. My JM and i rushed to the scene. Thank god, it was not eclampsia but it was merely chills and rigor. the mummy to be was admitted for pneumonia

5) Not to forget the notorious M. M has very poor controlled of her type 1 DM. she is a G2P1 and she made all of us promise not the tell her boyfriend that she had a baby b4. How could a man not know that her wife had deliver a baby earlier? wouldn't the episiotomy scar be visible? wouldn't it be loose when they had SI? we had to provide transport for her to go for antenatal follow up in the hospital. Once she is there, she sat outside the clinic and will never go for her follow up. She is never compliant to her diabetic diet and hematinics. God has been kind enough to her. Her baby is well and she is proud of her baby. The nurses had to go to her house just to make sure that she japs her insulin correctly. Her DXT was 23 after delivery. Haiz... she defaulted her NCD follow ups as usual.

there are many more manjalitis patients... a lot of them refuses IM imferon. even if they do agree for imferon, they will still buat muka manja

will be missing every single bit of my days in KKIA SP, Dr S, Dr C, Dr L, and also the awesome lunch gossip moments with the bakar arang team :p

there.... no more under 5 mortalites or matermal mortalies

i will be going to the eye department on 15/1/13