Sunday, August 30, 2015

how many embryo left?

My obgyne asked: how many embryos do I  left in Hong Kong? She was pushing me to have another embryo transfer. I was speechless. I am worried about post partum flare- ankylosing spondylitis and uveitis. 

Ei, am I fertile? Is this pregnancy a result of pure luck? Will there be a lucky streak? should I be greedy? Can I opt not to use Ivig? I am afraid of antibodies. I had systemic inflammation before ( crp + ) two days after ivig.

I have not given birth yet. But my obgyne has asked how many embryo do I still have in Hong Kong for several times already.

one, two, three, push, push, push

one, two, three, push, push, push... I am not yet in labor. Was there an aerobics class ongoing in the obgyne complex? I used to hear one, two, three, push... push in the gym. 

My NST today was great. No contraction. But, I do feel contraction while sitting and walking. I need to have a little more patience  on my complete bed rest. Hmmm... can I really have a complete bed rest? I am experiencing acid reflux, if I lay on bed shortly after eating. My butt and shoulders are aching because of prolonged lying on the bed.

Monday, tuesday, wednesday, thursday... 4 days to go. Im scared.  By the way, I will be going to have c-section instead of vaginal delivery.  My immunologist would not allow me to contract as it will cut off the oxygen supply to the baby. Please wish me luck. 🙏

Friday, August 28, 2015

5 days to go

Estimated fetal weight: Week31- 1861 g, week32- 2536 g, week 33- 2168g week 34- 2233g, week35 tuesday 2363g and week35- 2913g

 Is the sharp fetal weight gain caused by my sweet tooth? But, i did not gain weight this month. Or was it ultrasound measurement error? I dont know why my obgyne had moved our c-section sched to its orignal date- sept 3. She just agreed on thursday to move the cs schedule earlier. Perhaps, she believes that the baby is continuosly growing. And there is no need for a rush c-section. The data are on her chart. I just dont know whether she analyses it or not.

Although the fetal weight appeared to be heavier. Its BPD and FL became shorter, compared to the measurment 3 days ago. Ai... I want to believe on my  immunologist comments. Im scared. Anyway, I will just trust my beloved obgyne. If she wants to delay so be it. But, i am afraid of brain damage and still birth.

5 days to go and it will be sept 3.

Thursday, August 27, 2015

3 days to go

We have to fast track to c-s delivery day. I have minor contraction last night. It was caught during my NST. But, I did not feel anything unusual.  The intern said he had touched by tummy during the spike in the tracings. My muscle had indeed contracted. Anyway, that was just a minor contraction. I was given a tocolytic for that matter. No worries.

This morning, I have received an email from my dearest immunologist.  He complains that there is a growth discrepancy between the head and abdomen of the fetus. The deceleration of growth is because of placental damage on top of placental ageing. ... The growth deceleration during the last 2-3 ultrasounds means the placenta is progressively deteriorating. ... Be prepared in case I have to deliver before wednesday next week.

Deteriorating? Early delivery? Oh my god. I need to take it out as soon as possible! I dont want the baby to die in my womb.

Sunday, August 23, 2015

10 days to go

Why I tend to stare at my calendar and do my countdown? Hey... I know it is just 10 days to go. I am still scared. Maybe I have an obsessive compulsive disorder! I am still afraid. To me, 10 days is too long. Many unexpected things may still happen.

Dear God, Please don't let me cry.
Hi baby, which name do you want? Alexander Gerard, Sean Alexander, Mark Alexander or none of the above?

My stress factors this pregnancy

1. Crp + while waiting for heartbeat (week 5-6)
2. Dim ultrasounds - low progesterone
3. Irregular shaped gestational sac week 6
4. Bluffed by obgyne regarding amniotic fluid level week 7
5. Kct, drvvt - i have soya and tofu quota. I detest its taste.
6. Low albumin- i eat like a vacuum cleaner. I may habe to shake my tummy to fill more food. My protein intake was never enough
7. Sleepless
8. Bloated stomach
9. Ultrasound measurements - gestational diabetes issue and intrauterine growth retardation issue

Overall, I feel a am lucky compared to those who suffers morning sickness. My main stress factor is food intake. I just feel like I am stucked in the opinions of my three doctors during my third trimester. I sometimes suspect on the accuracy of my obgyne's ultrasound measurements. Sometimes the abdominal circumference is lagging. One time the abdominal circumference was 4 weeks ahead. Too much amniotic fluid and low amniotic fluid. Do I really have gestational diabetes? Should i be really on insulin? Why sometimes I experience hypoglycemia? Obgyne told me not to diet, I should take insulin instead. Immunologist told me that my target albumin level is 39. It had dropped from 42 and My albumin was just around 36 even when I am on 42 tablets of amino acids. My target fetal weight gain is 150g per week. Unfortunately, I was not on track but I am always full. He adjusted the target week gain per week to 200g. I need to catch up. He added Heraclene in order to enhance my protein absorption and to boost my appetite even further. Because, the fetus should hit the target weight of 2.5kg by the end of week 35. Ouch, ouch intrauterine growth retardation?   I should eat more protein enriched foods. I remember one time during the consult my husband called me to ask what do I want for midnight snack? My immunologist smiled and replied: beef tenderloin. Ehem... Endocrinologist asked me not to over eat. Maximum weight gain 1 kg/ week for me. I am gaining about 2kg/week. My sugar is usually within normal range. My insulin resistance is particularly high in the morning. Sometimes I also experience some blood sugar spikes after meals. Is this the reason why I got more amniotic fluid and bigger AC of the fetus?

In one episode, I was shocked to learn that the fetus has gained 700g. A week prior to that my immunologist said: there was not much growth in fetal weight. My fetus has disproportionate growth of head, limbs and abdomen. I went crazy eating. Btw, Was it a measurement error? Is there an abnormality on my baby? Was it caused by too much amino acid?  i don't thnik amino acid is the culprit since my  albumin is on the low side. Oops, perhaps the amino acid has caused too much weight gain on the fetus. I feel one of the contributor of my stress is really the accuracy of my ultrasound measurements. Grrr... A week after the fetus has dropped 400g. Measurement error?

Crazy!  Finally, I dont want to over eat. Come what may. I will let amino acid dictate the outcome. I hope my fetus can  eventually reach 2.5 kg ( +/- 10%) by the end of week 35.

Saturday, August 22, 2015

How does it like on post partum?

How does it like being a mom? I just fired my new hired nanny and house maid. I have no luck. I fired six already. I am still searching. Can I do survive without any helpers around?

Is the c-section wound painful? I cant imagine myself not taking a bath for three weeks. Fried pigeon and black chicken will soon be my permanent staple. How will I look like a month from now? Is it fat, fatter or fattest?

Can I really do latching on breastfeeding? Will I have a post partum flare - uveitis and ankylosing spondylitis?

11 days to go and my holy bracelet

During this pregnancy, I got nightmares about ghosts trying to take away my baby from my womb. I dreamt of praying for safety. I remember last time when I had spotting, I also got that sort of nightmare. The ghost was trying to suck away the soul of my fetus from my womb. I also dreamt of robbers or bad guys kicking my womb.

When I woke up, I tend to remeber only a small fragment of my dreams. It is either: i am being chased by bad guys or ghosts and my bracelet was protecting me from evil. Are those warning signs for miscarriage? Perhaps, my dreams reflect my pessimism.

It is 11 days to go before my c-section. I cannot imagine how near I am to my delivery day. 11 days seems too long to me. I forgot the exact dream last night. I just remember when I prayed in my dream and I was not wearing a holy bracelet. Was it a coincidence? I dont wear that holy bracelet to sleep every night. Sometimes, I got those ghost dreams if I forgot to wear my bracelet.

I got that bracelet from my mom. She bought it for me when we went to China temple for pilgrim. Is this a psychologic thing or what? How can I comment? There is no scientific evidence to prove the efficacy of amulet. I cant imagine how my subconsciousness was programmed : wearing my bracelet confers protection against evil. Anyways, I hope I am really blessed by God on this pregnancy. I wish to go to the China temple again to offer my gratitude after giving birth.

Up to now, I cannot imagine myself carrying the baby, breastfeeding and the likes. I pray for smooth delivery and happy healthy baby.

Thursday, August 20, 2015

Sleepy baby

Last week, i had my betamethasone injection. That may also be the culprit for fewer fetal movements.  Whatever... Benadryl is safe for pregnancy. But, it can also sedate the baby. My conscience is clear.


Tuesday, August 18, 2015

Learn to say 'No' to nepotism

I realized I should make my own stand. I should say 'No' to nepotism. I thought of this several times already. It is my right to choose my own doctor.

I dont want to regret my decision of not insisting to have a neonatologist for my baby. I need to learn the art of saying 'no' to her sister-in-law, regular pediatrician.

Say 'No' to Benadryl

I went to have NST cardiotocograph last sunday. The internet had used the buzzer for nine times already but the baby just had a little response to the buzz. The I told the intern that the baby was moved a lot on friday. I seldom feel his movement on Saturday and Sunday. It seems that he barely kicked once. Actually, I am a little worried that is why I went to the hospital on Sunday afternoon instead of Sunday evening or Monday evening.

Good news: the baby's heart rate was good. But, it seems like the baby was sedated. Btw, was the baby sedated? Ehem, ehem I took Benadryl for two days already. So that was the culprit.

My immunologist said I have dry skin. But, I have applied body lotion for several times a day. I was lazy to buy his recommended brand of hypoallergenic lotion. Because it is only available in our nearby mall and drug stores.

My brother and mom laughed at my story. Then, I remembered Aveeno Oatmeal Lotion which I have used during my maiden days. Thank god, Aveeno helped! No exagerration... It was fast acting.

I thought Benadryl was my silver bullet. I can hit two birds with one stone. I could stop the itch and have a good sleep. Benadryl is FDA category B. But, it can cross placenta.

Saturday, August 15, 2015

Is benadryl addicting?

I feel intense itch all over. The itch is real, Im not acting! I love the side effect of benadryl - good sleep. It sounds like Im starting to get addicted to benadryl. I took benadryl couple of times already. It usually take it at 3:30 to 4 am, when I widely awake and itching all over.

My itch is real. I dont have cholestasis but i applied plenty of lotion all over my body for several times today. I just dont know why the itch is more intense in midnight.

DIY labor

I had three cycles of betamethasone injections. Usually, it was injected on two consecutive days- 24 hours apart. I thought I was scheduled to have my last betamethasone injection at 2 pm yesterday. To my surprise, when I arrived my obgyne's it was closed already. Ai, I had a DIY (do-it-yourself) injection. I injected it on my right butt. I thought that was easy but my left arms got cramps while positioning the syringe. Naughty me, I called my obgyne's secretary to bug their conscience. Finally, I cracked a joke. I said the most important thing is my obgyne should be available during my delivery. Otherwise, I may need to carefully study on how my neighbor's dog did her DIY labor. Why are the dogs more intelligent than me?

Ouch... That was really a bad joke. It reminded me of my monstrous obgyne ( my first obgyne .)  My first obgyne is my current obgyne's mentor. Chances are, she may act as reliever should my current obgyne not be available. Ouch ouch ouch. I am not playing a battle of pride. I can't explain my feelings. I just pray that I will be need her service again!

It is now 4:50 am, why am I still awake? Is it because of betamethasone? Or is it becausse I am emoting again? People with autoimmune disorder are belongs to the lowest class of the society. And I dont deserve to live in this world. Ouch! I should had requested her recite the Hyprocratic Oath in from of me ya! Somehow, I regret I did not take up medicine course before. I thought that was the least challenging profession. 

19 days to go- fingers crossed

19 days to go and It will be 36 weeks 2 days of my pregnancy. I will be having a c-section. I have mixed emotions: excited and scared.

Im scared of the following:
1. Bloods... I need 8 units of platelets 4 units of fresh frozen plasma and 2 units of standby whole blood
2. Anesthesia
3. Hemolytic disease of the newborn

I told my hdn concerns to my obgyne, it seems she doesnt care much. She just told me that her sister in law is very diligent. But, diligent does equate to intelligent. Ouch. I wish to have a neonatologist and not a regular pediatrician. I dont know how to request for one without offending my bratty obgyne. I wish I can consult my immunologist first before going into c-section. I dont know why I only trust my fairy godfather? Hmm... Perhaps he is an internist/ immunologist.

I dont want to give my obgyne a chance  to blame ghosts' month for any untowards incident that my happen to me and my baby. I am a believer of ghosts' month. But, I wish to be more practical for the sake of the baby. Premature baby and baby whose blood type is other than o (from blood type o mom) are at risk of jaundice.

I feel the mechanism of RH and ABO agglutination and hemolysis is the same. I feel there is no difference between B and A blood. Grr... Where did she get the excuse that type b blood is more strong? I dont know what is the proper translation for strong? Does she mean more potent? I just shut up and sent her an sms message explaining my side. I feel type o blood has antibody to A and B blood. Hi, obgyne... I feel if my antibodies accidentally goes into my son's blood stream it may cause hemolysis. I am still puzzled why my sister had exchange transfusion. My guess was my mom's antibody had breached into my sister's blood stream. That caused her red blood cells to rupture. And thereby causing her to have too much bilirubin- severe jaundice. But my sister was not breastfeed.

I miss fairy godfather.

Confused - fetal weight, AC and uterine growth restriction

Three weeks ago, my fairy godfather was suspecting an intrauterine growth restriction. He said in the span of 17 days, AC has just increased by two days wide. FL has just increased by 10 days, while bpd was on track. I was given Heraclene and my amino acids were increased to 42 tablets per day. The estimated fetal weight was 1.8kg.

A week after (two weeks ago), the estimated fetal weight was still 1.8 kg. Obgyne told me not to limit my food intake. I should take insulin shots instead. She said my immunologist was exaggerating. She considers iugr only when there is two weeks lag in the development.

Last week, the fetal weight was 2.5kg. How come the weight gain was above 700g in the span of 7 days? The estimated fetal age based on AC is 36weeks. Perhaps her previous measurement was wrong. It was supposed to weigh more. How to measure the abdominal circumference? Is the baby in slant view? How to estimate the fetal weight? Obgyne told me I need insulin! I became guilty on the food i ate. Maybe I have eaten high protein but too much calorie. My blood sugar was normal most of the time. I admit, sometimes my blood sugar tends to spike. Should I really take insulin? I handed my obgyne my home blood sugar monitoring record. Wow! Nice!

Is there abnormality with my baby? Why the baby gained too much? This week the fetus estimated age is just 32 weeks based on AC. Its weight has dropped by 300g. Now, it weighs just 2.2 kg. Why? Did i eat too few? Will the abdominal circumference measurement be affected by baby's movement or breathing?

I went to see my endocrinologist this week, I complained my blood sugar  why sometimes my blood sugar drops to 65 and 70?  Why sometimes my insulin resistance was high? I am still under observation til now. This means I have been pricking 4x60 for days= 240 times already.

I miss my immunologist. He is missing. What has happened to him? Thank god, my crp became negative on its own. Oopps, lab error last time?