Priceless moments..

4th Ramadhan..

I started to have contraction from that morning it self and went to see Dr Idora for check up (refer to prev post). Balik je from Pantai Bangsar, my husband dah tanya "Tak nak bukak puasa? You are starting to have contraction pain. I'm sure Mxx hilang selera makan once the pain becomes more frequent. Abang rasa berdebar2, I have a feeling that we are having a baby tonite." But then, I wasn't keen to break my fast but what my husband said was true. So we headed to Burger King drive thru for a bite of Swiss Mushroom burger before going back to our house in Bukit Jelutong.

I lied in bed the whole afternoon as the pain was increasing in frequency and intensity. I was supposed to be admitted at night for induction of labour but looking at how the contraction was progressing, I was sure that I did not require prostin after all.

My dad called few times and advised us to go to PMC ASAP. After much deliberation, my hubby and I decided to make a move around 6pm. To avoid the traffic along the Federal Highway and the congestion of cars heading to Bazar Ramadhan @ Stadium Shah Alam, we opt for NKVE and NPE instead. Labour room, here i come!



Arriving sharp at 6.15pm, I was immediately wheeled to the labour room and vaginal examination revealed that I was 3cm dilated! Mak aii.. at that time sakitnya contraction mmg tak terkata!!!! Sebab tak tahan sgt, I told the staff nurse that I need epidural immediately. But the nurse said, my contraction was only 2 in 10 minutes, not strong and I should give myself another hour. Fine, I tried to walk around in my room, in and out of toilet and baring kiri dan kanan to distract myself but seriously, the pain became too unbearable! Rasanya nak terpatah tulang my hubby sbb I squeezed his hands too hard.
I finally gave in, called the nurse again and requested for epidural STAT. Unfortunately, the anaesthesiologist only came 2 hours after and this particular staff nurse told the dr (in front of me!) that my contraction was not that intense and it was just me who could not stand the pain! What the heck? I was so pissed off with her and it's me who is paying for it, not you!!! Bengang betul la....

Luckily the anaes was nice. The medication worked like magic. I felt numb from my waist down and cuoldn't even feel any flinch of pain at all except for on and off hardening of abdomen during contraction. Shortly after that, all my family members arrived (after iftar at Museum Islam) and only mommy was allowed in to see me. The first thing that I asked her, " Sedap tak bukak puasa kat Muzium Islam?" I felt touched coz my mom said this year was not as meriah as last year coz me and hubby plus few of my siblings (Eida and Rasheeq) couldn't come. So makanan pun rasa lain macam aje...

Dr Idora finally came around 11.30pm. CTG so far was reactive (means baby's heart beat is okay) and my contraction was good (tell that to the nurse just now!). VE showed that my os was already 4cm dilated and she decided to do artificial rupture of membrane (ARM). She showed me her glove and told me with a serious face, " Maryam, it's thick meconium la." I was post date and the stress of contraction would've caused my baby to poo poo. I kept quiet and being a Paeditaric Dr, that was my biggest fear, that my baby has passed meconium (not light, but THICK!) in utero. Should the meconium entered the lungs, it can cause meconium aspiration syndrome (MAS) and from my limited 4 years experience, I've witnessed few newborn babies died of this illness in my NICU. Nauzubillah.... I wish my friends and my boss were there to stand by for my baby. So, I told Dr Idora, " that means kena caeser la ye?" and she said yes and the only reassurance that I had was that my baby's heart beat was still okay.
I was preped and wheeled to the OT immediately for emergency LSCS. It was really cold and I was shivering thru out the operation. Luckily, my hubby was there to keep me company. I pray to Allah and hope that my baby come out well. After much anticipation, I finally heard the OT staff announced loudly, " Baby is out at 12:29am!" Few seconds after that, I heard the best sound in the world, my baby cried! Alhamdulillah.... Not long after that, the nurse showed my baby to me and as I first layed my eyes on her, I immediately fell in love.

My god, after 9 months of being pregnant, with all the misery, the back pain and swollen leg and skin rash, it all comes to this precious moment...

Hana Khadeeja, so alert even on day 1 of life!

My shout to the world: my baby girl was safely delivered on August 15th, 2010 at 12:29am!

To Dr Idora and the team.. baby Hana says tq very much!!!

My 1st debut to the world

Birth Announcements by WiddlyTinks.com

Labour suite, here I come!!

I'm blogging in between my contraction!

As usual, I was having insomnia these days especially since my unlucky encounter with PUPP but last night was different. I was having lower back pain quite similar to dysmenorrhea (sakit senggugut) and I noticed that my painless hard rock abdomen was getting frequent up to every 30 minutes. But there was no other signs of labour including leaking or show. So I waited till this morning to see Dr Idora as we happened to have our appointment scheduled today.

In the labour room, awaiting CTG recording

Hubby, always by my side

She was worried as USG showed that my liquor volume is very little and the baby can easily get distressed. Vaginal examination revealed that the os was still closed but the baby's head was already well engaged. Luckily the fetal heart is still okay thus, she suggested for me to get admitted tonight for induction of labour and KIV emergency section tomorrow if the labour doesn't progress or the baby is not doing well .

Baby's heart beat is steady (upper graph)

See? I'm already having irregular contraction (lower graph)

Currently, I'm having contraction once in every 10 to 20 minutes. It felt exactly like sakit senggugut tapi x100, started from my lower abdomen and extended to the back. My dear husband tak sampai hati tgk I menangis tahan sakit and tried his mighty might massaging my back to ease the pain. If the contraction is getting regular, I might not need prostin after all.

My dilemma at the moment is whether I should get epidural for pain relieve.. My elder sister who was blessed with easy labour for all her 3 kids was really adamant for natural analgesia "Pethidine should suffice," she said.. Huhuh.. My pain threshold is very low! I'm the kind of person who will pop ponstan for any kind of headache or PCM even for low grade fever! So, takpelah, thanks for the advice but if the pain becomes too unbearable, I will still opt for epidural anyway!

Lagi 1 yg I terkilan sgt is I'll be missing tonight's iftar with my family at Museum Islam KL!! It is an annual event for all of us and I was the one who was planning for this in the first place! Sedihnya.. terbayang2 all the nice desserts like muhallabiah, baklava and their main courses like lamb and nasi bukhari.. My husband told me, " Ala, bila2 boleh makan, maybe our baby wants to tag along, so this year dia tak bagi mama dia pegi lagi.." Alrite, whatever u say, baby!



Okaylah.. have to sign off now.
I'm trying to prepare myself mentally and physically for the gruelling stress of labour.
Wish me luck and doakan I berjaya push my baby out ya.
Doakan jugak dipermudahkan segalanya and that both mommy and baby sihat walafiat.

I'll make a birth announcement as soon as the baby arrived ya! See ya'll after the labour k.

P/s I'm worried about my yummy peanut butter cuppies that I baked last night (blowing my own trumpet, here :p). Tak sempat nak letak cream cheese icing lagi. But they are still tasty when eaten plain anyway.

Confirmed. It's PUPPs!!!!

Thanks to my friend, KC, he diagnosed me of having this rare condition called PUPP. This is my first time hearing about this condition as I've never encounter any of my previous pts with PUPP. I searched the net and found several websites that discussed on this skin problem.

Basically, PUPP stands for Pruritic Urticarial Papules and also known as Polymorphous Eruption in Pegnancy. These fancy skin lesion is actually one of the commonest skin dermatoses (condition) in pregnancy but actually statistically it not that common pun as it only affects less than 1% of pregnant women (and I'm one of the UNlucky few!).

It is normally found in the first pregnancies during the third trimester (tho it doesn't tend to recur in the subsequent pregancy, THANK GOD!), women who carry twins/baby boy (as in 70% of cases, they found male fetal DNA in skin biopsy). Why it happen? The underlying cause us unknown but basically blame it on the hormonal changes and the overtly stretched skin! Most importantly, it is harmless to both the mommy and the baby.

Just like me, it started of as a small red bumps (papules) around and on the stretch mark such as the tummy but always spare the belly button area. The small skin lesions starts to become bigger and later on spreads to the thighs, legs, buttocks, breasts and arms. It can be in a form of redness, tiny bumps or urticaria (macam kena gigit gegata). As for me, rashes ni only made their ugly appearance on my overtly stretched belly and swollen legs and it let me tell u, they itched like CRAZY especially at nite that I have become sleep deprived!!!!! Ive also bacame very irritable, cranky and felt like killing everyone..LOL!

Unfortunately there is no cure for it. Treatment is just symptomatic relieve including high strength steroid cream (i.e betometasone / clobetasol) applied 5-6 times a day to reduce the itchiness and prevent further spread (no wonder mine did not improve that fast as I only use em 3 times a day!). After that, u can change to lower strength steroid cream and use it sparingly once the symptom has improved. Oral steroid is reserved to those with severe itchiness. Oral antiistamine such as zyrtex, benadryl and antarax are less effective in control the itchiness but helps u to doze off when used at night. From personal experience, frequent warm (not HOT) baths do help and please avoid the sun as sweats will make the itchiness worse!

For those who wonder, this condition usually resolved after 1 week of delivery but s mall number of pt have the symptoms up to 6 weeks post partum (Nauzubillah).

Hopefully this answers your curiosity.Doakan that I get well soon ya!

Diagnosis please..

Today, I'm a doctor, a staff nurse as well as a patient. I mentioned in the previous post that I was having a dermatologic crisis for the last 1 week and unfortunately it got worse last nite. The skin rash (uticaria + papules) initially started on my stretch mark but now spreading on both my leg and few on my arms. It appears like an allergic reaction but towards what, I still have to figure it out.

Memang sgt2 gatal tahap gaban! I couldn't sleep at all last nite due to the itch and did not have a heart to wake my husband to help me scracth. Takpelah, biarlah I jadi zombie sorang2...

FYI, I've tried all sorts of cream and lotion from steroids to crotamiton but the condition seemed getting worse.So, this morning, mmg dah sgt tak tahan, I went to the hospital and zoomed directly to the clinic where I worked.

As a last resort, my dear colleague poked me and injected me with hydrocortisone (anti-inflammatory). I left the branula in place at my left wrist for a 6 hourly jab (which I have to do myself at home!).

I intentionally wore an extra long sleeve today just to cover the ugly branula. Coz u now why, kalau orang lain perasan, they must have thought that I'm a lunatic patient who just absconded from hospital!!

Since I entered 40 weeks, banyaknye ujian Allah nak bagi. Please pray that this problem goes off quickly ya!!

And to my dearest medical colleagues, can you be like Dr House and give me a diagnosis? Thanks!!!!

Project Mega..

I'm planning to take the next 2 days off before my 41 weeks check up with Dr Idora. Since today is my sister in law's birthday, what I have in mind is to bake her a chocolate cupcakes with cream cheese icing (u can never go wrong with chocs and cheese). I'll be seeing her for our annual buka puasa at Islamic Arts Museum KL this coming Saturday and I shall give her the cuppies as a present. It is not an expensive gift but at least it is the thots and efforts that count, rite?!!

Before I start my Projek Memasak, I have to buy few baking items: the main ingredients, cupcake trays and cases and not to forget a MIXER! I'm ashamed to admit this but I do not own a mixer. Someone must have forgot to buy me one as a wedding present 2 years ago..hahah. The only baking that I did these past few years was only bread and butter pudding as well as blueberry muffins (i did once after I bought a 'how to bake muffins' book from MPH) and that only requires manual (hand) mixing!

A very cute pink kithen aid

Hmm.. I will definitely post the picture later of how my cupcakes look like (if it turned out okay just like in the recipe book) :p

If I just keep quiet, please assume that something went awfully wrong with the cuppies while I was baking (such as I broke my water bag and went into labour) and NOT that the cuppies burnt in the oven :P

Wish me luck!!

On weaning..

I don't have kids of my own yet (very very soon, insyaAllah) but I do deal with kids and parents a lot since pediatric is my field of interest.

One of the problems that I faced or shall I say my kiddo patients have are anemia (low hemoglobin) due to delay in weaning to solid food. Majority of these children was found to have Hb as low as 7gm/dL and the main cause of it is that they are iron deficient. Infants beyond 6 months of age should not receive their main source of nutrition from breast milk or formula milk alone as the iron content is not sufficient. That's why WHO recommend that weaning diet is introduced by 6months of age.

When I asked the parents (unfortunately many of them are not that well educated) they cried in despair saying that they have tried different kinds of baby cereal/porridge and the baby just refused or could probably take 1 -2 spoonful before he starts screaming or closing his mouth shut. I'll start sighing coz that means I have to spend extra time taking a detail dietary history. What surprised me was that some of these parents don't even know that there are rules to follow with soooo many ways in preparing baby's food from fruit puree to finger food!

I believe u lovelies out there knows that in these days and age, u can almost get everything online, including baby's food recipes.

What I always say to these parents are:

1) When introducing solids, make sure that u offer same new food and wait for 2-3 days to look for symptoms of food allergies. Do not introduce more than 1 new food at one meal.

2) Experiment.. experiment.. experiment.. Different babies have different reaction to the taste and texture. Offer them different foods and use different ways of preparation.

3) Be patient.

Foods for different age:

6 months:

cereals & grains, fruits (banana, avocado, mango, pears), vegetables (sweet potato, carrots, peas)

7 to 8 months:

you might add on proteins (chicken and tofu), dairy (plain yoghurt)

8 to 10 months:

you can be add more variety to the above food e.g fruits (dates, papaya, kiwi), vegetables (broccoli, white potato), proteins (meat, egg yolk) and dairy (cream cheese)

10 to 12 months:

carbs (pasta), vegetables (tomatoes -> introduced late due to its acidic nature), protein (whole eggs after 12m.o)

What I've discussed here are all based on my readings on these issue (I don't have any first hand experience) . I'm planning to compile a simple handouts s on baby food recipes to give to my troubled patients and parents which I have yet to add in my TO-DO LIST!

I'm sure you parents out there are very creative and experts when it comes to this matter. Do share with me your opinion on this ya..

Thank you!!!!

Gatal!

Gosh, tak sangka tomorrow dah start posa and tonight dah kena Tarawikh. I told Ahmad that he should go ahead for jemaah prayer at the mosque and I'm gonna stay at home tonight. It's not that I don't want to go, solat beramai2 and dengar tazkirah, but then both my feet itch like h***. I don't know why, but since I got back from work, the skin on my feet suddenly turned red with few bintik2 spots probably due to allergic reaction. Did I terpijak ulat bulu just now or did some evil insect bite me (tapi takkan dua2 belah kaki kot?)

So I have been scratching and scratching non stop and mind you it's not easy to reach both my feet with my belly so BIG, obstructng my way and view. So in order to garu at all the odd spots, I have to sit in an akward and uncomfortable position macam acrobats and start Projek Menggaru. Arghhh.. merananye! If it doesn't subside by tonight, I might have to pay my hospital a visit for a hydrocortisone injection. .. huhu.. Ujian pertama bulan Ramadhan.

Wokeh.. have to sign off now.. nak solat Isyak and Terawikh jap..

Happy beribadat dear friends..

(p/s I wish it was my palm yang gatal, at least maksudnya nak dpt duit :P)

Best place for Iftar..

Last year's Iftar with family

I love Ramadhan month for many reasons. Apart from what it meant for us Muslims, I feel that this holy month brings families and friends closer especially for a planned Iftar get together.

I'm deeply in a sad mood as most probably I won't be able to fast this year and join the iftar gatherings .. and... on top of that, I will definitely have to ganti posa SEBULAN! huhuhuhu..

Anyways, one of the best place that me and my family love to go every year for buka puasa is Museum of Islamic Arts restaurant. We really enjoy middle eastern cuisines especially their main dish like lamb kebab and traditional sweets like baklava and etc... The price is quite acceptable as Middle Eastern Food mmg expensive: RM 77 for adult and 45 for kids less than 12 y.o

.

The seats are of limited number, so tak la ramai sangat orang. No need to berebut2 ambik makanan or worry that they run out of food. The surau is nearby to perform your Maghrib prayer and for Tarawikh, Masjid Negara is just across the street!

I'm sure you have your own favourite place for Iftar with your loved ones (our parents house not included ya). Do share with me coz I might balas dendam and pay a visit next year..heheh..

Last but not least, to family, friends and fellow bloggers: Selamat Berpuasa!

Big foot..

I've mentioned few times in the previous posts that both my feet are really swollen like an elephant which forced me to wear sandals 1 size bigger. What me and my hubby noticed today was that my feet are a little bit less edematous, from elephant size to panda bear's.. heheh..

Old ppl say that once your swelling lessen that means you are approaching labour. Are there any truth in it coz if it is.. I would be the happiest person on earth! You know why? I'll be 40 weeks on the dot tomorrow!!

I just went to see Dr Idora 2 days ago and vaginal examination (which btw was quite painful, sorry to mommies whom I did VE before when I was a naive houseman) revealed that my cervix was thick, posterior and closed, and the baby's station was high. So my Bishop score was not favourable, therefore I can't go for induction of labour (IOL) that day. Since the USG showed that the baby is still doing well, she suggested to me to wait for another one whole week for spontaneous delivery. Should the baby decide to still hibernate inside her momma's womb, then I have to be induced by 41 weeks. Errk!

Bishop scoring

Being a paeds Dr, I do receive a lot of calls from neighbouring friends in labour room for failed IOL or fetal distress after prostin insertion. Obviously, for us, paeds team to stand by in operating room for emergency LSCS in case the newborns are not doing well. Thus, it is a bit scary to go for IOL as the risk for section is higher and on top of that emergency section as any kind of major operation does come with it's own complications (not to mention extra charges).

I guess God knows what's best for me. Most importantly, easy and safe delivery and the baby come out well and healthy.

Do pray for me, ya!

Hmm.. heavenly..

dessert— n
1. the sweet, usually last course of a meal
2. chiefly ( Brit ) (esp formerly) fruit, dates, nuts, etc, served at the end of a meal

Treasure box from Paddington House of Pancake: yummy!

Molten Larva from Chilli's: to die for!

Cuppies from delicious: heavenly..

New gastronomical discovery, Whoopie pie!!! a very sinful chocolaty pleasure!

http://shoppingqueen78.blogspot.com/search/label/Whoopie%20Pies
(p/s Thanks KS, noticed that 2 whoppies already disappeared? They were gone even before we left Putrajaya..heheh)

I have a confession to make. I have the biggest sweet tooth that when it comes to desserts, I can never say NO! I noticed that since I'm pregnant, most of my cravings are in the form of cakes, cuppies, ice cream, choccies, puddings, triffles, fruits and even traditional Malay (lompat tikam) / Indian (ghulab jamun)/ Middle Eastern kuehs. I can't help myself and thank god that I don't have gestational diebetes for eating too much of these rich offerings. Not guilty though, alasan yg paling munasabah-> pregnant.. hhahahah.

Unfortunately, I'm not born with a skill (or kerajinan) of a baker. I love to eat but I'm too lazy to cook and clean up the mess. The only thing that I make (time and time again) are triffle and bread & butter pudding coz my hubby loves em soo much.

I just browsed through few cupcake blogs and just can't help myself but be amazed with these bloggers passion and creativity in baking (my friend, Dr Ezura included). I got so excited looking at all the yummy cuppies and cakes that I even ordered 2 blueberry cheese brownies for raya from Chomel Cupcakes at http://chomelcupcakes.blogspot.com/! (Dah boleh makan ke sumer2 nih at 21 days postpartum??)

Bestnya kalau rajin and pandai memasak. I went thru few cupcake recipes and find em not that difficult to make except for the decoration which I think requires certain acquired skills.

My azams after I deliver are:

1) Raise my baby well

2) Produce enough breast milk for BF

3) Learn on baby sleep routine

4) Study for my part 2A paediatric exam in December 2010

- that means a lot of books to read and questions to do.. huhuhuh

5) And finally, belajar buat cuppies, or better, attend class buat cuppies!

Banyaknye nak kena buat and I'm a bit scared as I'm a poor multitasker.

Wish me luck yer.. wink wink..!

Yum.. yum.. it's fruity time!

My husband just emailed me this poster.

I don't care about any warehouse sale happening this weekend coz this all-you-can-eat promotion means a gastronomical heaven for me. For those who do not know me personally, my other name would be Durian Queen! I can eat this king of fruit not by ulas but by bijik... SERIOUSLY!

Some people cannot stand the adverse effect of eating too much of it.. panas la.. demam la.. etc.. I never faced any problem before until recently when I went back to parents' house and ate like setengah bijik? My goodness, I was already sweating like a dog on a rainy day! I'm sure it was because of the pregnancy thingy that I cannot stand the heat anymore.

My main worry now would be:

1) Can I eat as much as I used to? With a limited gatric size, I don't think I can gobble up durian, manggis, dokong, rambutan and all other yummilicious tropical fruits in one session.

2) Some of my nurses said that if you eat durian and you go into labour, the liquor will have a foul smell. Izzit true? It would definitely be an embarassing moment when Dr Idora rupture my membrane and the whole labour suite smells like Durian Eau De Parfume.

ERRRKKK?!!?!

I know what you did last weekend.. mwwwaaahah..

I have officially reached 39 weeks today and I’m on long MC until my due date courtesy to my dear friend (u know who u r). I never had so much time in hand, thus, I’m spending it very wisely: catching up on sleep, surfing the net, blogging and reading up Dr Spock’s Baby & Child Care particularly on the topic of feeding and napping. I’m also trying to settle some matters before I deliver including servicing my way over due Honda car and going to the bank to pay up for my MRCPCH 2A exam in December which will cost me 500 UK pounds!

Last weekend, I went for my weekly antenatal check up with Dr Idora. I was a bit anxious sebab my baby ni agaklah besar sizenya and true enough, she has now reached 3.7kg +/- 300gm!!! OMG, I hope berat dia minus 300gm sebab kalau 3.7kg + 300gm (u do the math..) maknanya her estimated weight would be 4.0kg!!

Macamana nak push ni??? Will my pelvis be wide enough for her to go through?? I looked at Dr Idora with my panicking face and I guess those who know her would have guessed.. she just gave me a reassuring smile and said, “ It’s okay, we will still try for SVD ya..Your baby is fine, her heart beat is steady and the blood flow through the umbilical artery is good. I’ll see you in another week, okay?” My goodness, Dr Idora (and my husband) had so much faith in me. I shall not let my loved ones down and especially to my baby who is counting on me, “Mama akan cuba buat yang terbaik ya.”

Anyways, last week was my sister, Eida’s and my nephew Umar’s birthday. Since Eida is in Kota Kinabalu, so last Saturday my family only celebrated Umar’s 11th birthday at San Francisco Pizza, Bangi. I’m clueless when it comes to buying gift for boys, particularly of Umar’s age so me and my mom finally gave him an angpau and let him buy his own present.

Ahmad and I did not plan to spend the night at my parents house but my mom lured us with her Nasi Lemak Sambal Udang that she planned to make the next morning. Okaylah, when it comes to mommy’s cooking, memang terpaksa mengalah and surrender awal2 .. hehhe..

(dalam hati, mana la baby tak besar, mama nya pun makan byk.. wink wink).

Abang and me at San Francisco's Pizza: waiting for others to arrive

Animatedly chatting and eating..

Umar, the birthday boy and Rasheeq, my youngest bro enjoying their meal