Excess embyos

Long time no post. The twins are healthy. They are growing heavy each day. I received an unexpected email from the ivf center last week. They were asking for embryo storage payment. oops.

3 years ago around the same time in December, I was excitedly monitoring my eggs and anxiously praying for successful fertilization. The more embryo, the better! I got 7 embryos.

I have transfered 4 embryos. But only 3 were implanted. I was blessed with 3 kids. So, I have 3 more embryos left in the freezer. Oops... What is the fate of my excess embryos?

What should I do with my excess embryos: donate to childless couple, donate to research or destroy them. Storage is not an option. Storage is just prolonging the time to decide on what to do with the excess embryo? The maximum allowable storage time according to the Hong Kong law is 10 years.
Sooner or later, I have to decide. What is the difference if I decide now, and decide 7 years hence?

This question is definitely more difficult than the Miss Universe pagent question and answer portion. All my kids came from the freezer. I prayed for these embryos. question: Can we throw our blessings away? Karma! These embryos have the right to life. If I destroy them, I became a murderer.

If I donate them to research, it will be a lasting gift to humanity. Am I sure that the embryos want to be 'destroyed' for the sake of science? Again, the question is the right to life.

If I donate to childless couple, would they want to be adopted? There might be an endless quest for genealogy. Would they hate me? Would they be the undesirable person ( criminals, addicts) in the society in the future? (I dont want to think too much. Maybe I am undermining the parenthood of other people, but I am not the expert on the field.)

I believe that I must share my blessings. If I was granted with more than enough embryos, I need to share it. Should I donate my excess embryo to childless couple?

The more embryos the merrier. In the end, it just become my problem? Why I dont want to let go of my embryos? Why am I so attached to my genes?

Two days to go

I did not cry last night, but I kept on thinking what if I move the delivery date, I have my c-section in another hospital or I change my obgyne?

Can I still move the delivery date? My blood is getting thicker. I afraid the babies may die. I have stopped aspirin  8 days ago.

I have not find my anesthesiologist yet. The first prospect is going abroad. The second prospect had a prior engagement. Who shall I end up with? I hope I will not end up with Dr. Billy Ong. Where in the world have you seen an anesthesiologist who never ask for patient's allergies. I cannot forgot his infamous remarks: " no patient gets allergy from anesthesia, perhaps they Are only allergic to preservatives. I will not risk my career on you." Ouch ouch.... What is propofol? Is it a soy based anesthetics? If somebody is allergic to soy, will he not be allergic to Preservative-free Propofol?

I am allergic to dyes. Most of the dyes are aniline and azo based. Ai... I think i will be allergic to ester anesthestics. Because its hydrolysis produce P-aminobenzoic acid. Ouch... It has NH2 attached to be zene ring- its an aniline! I guess aniline allergy patients will be have allergic reaction to PABA, because its chemical structure are very similar.

My first born son is still young! ... Amen! I am freaking out.

I have another issue. I dont like morphine. I wish to propose fentanyl. Am I too nosy? I feels its my body and Its my life. 

placental antigen

Holy cow. What are the components of placental antigen? will it kill me? Is it true?
If placental antigen could leak into my blood stream, could it contain ABO antigen? I bet one of my baby is type O blood. Ehem... My blood type is O, while husband blood type is A. Hmmm... This led me to think his blood type is AO. Hahha... Dont want to think too much. I am still healthy and I dont seem like dying from hemolysis yet.

Target delivery date set

My target delivery date is set to June 30. 36w2d. Can I make it? I have dexamethasone shot starting yesterday. 4 doses 12 hours apart. Ouch... I forgot and missed the injection time today. I dont want to wake up in the middle of the night o have my final shot. I will just have it tomorrow morning. Hey, it feel I had contractions yah... But it is not as frequent as betamethasone. My babies are awake I guess. I will stop my aspirin on Monday. Wow! No blood transfusion if I can survive 10 days without contraction. My Blood test were perfect. Two weeks ago my KCT was 70, last week it was just 80.

Am I dreaming? I went to my immunologist tonight. I was shocked KCT went up to 100, drvvt 40. I need a smoflipid infusion. If I am going to give birth next week, no need for infusion. If I wish to deliver in two weeks I need Smoflipid. I cannot stop aspirin. My placenta is degradating, some of its antigen may have leaked to my blood stream causing my antibodies to be active once again.

1 to 2 weeks to go

When my obgyn comes back from her vacation, she will give me dexamethasone.  Is dexamethasone better than betamethasone? I guess both of them are the same. They can stimulate alpha receptors. I am anticipating for another episode of contraction. Will dexamethasone cause more water retention than betamethasone?

Whatever, This wednesday will mark my 34 th week of pregnancy. I guess my twins will be doing fine  when they come out of my womb. Nothing to worry about.

The operating table anxiety... Ehem. I dont want to think to much. I just hope my obgyn will be true to her promise： new anesthesiologist and neonatologist.

Levobupivacaine + fentayl...?

32w4d- no more contraction

Today marks my 32w4d. I was discharged from hospital yesterday. Whew! I survived bricanyl and magnesium sulfate this time. What strategy will my obgyne use for my next contraction? She said: I have one round of steroid to speed up my fetus lungs maturation. I doubt dexamethasone will not cause contraction. Ai... Life is... Ai... Why should I submit myself as a guinea pig to my obgyne? Btw, is my obgyne intelligent?

DFE predicts the lungs maturity of the fetus. If we can see the dfe on my 34th week ultrasound , is there a need for another round of steroid injection?

ehem... betamethasone

What are the side effects of steroids? water retention, potassium depletion, sodium accumulation and whatelse? After my discharge from hospital last week, I felt my tummy had increased in diameter. I gained 8 pounds in two weeks. I was keen to see if the babies tummy has increased in disprotortional rate. Thank god, they are normal that confirms that I dont have gestational diabetes this pregnancy. I did not see any remarks of polyhydronomus in my ultrasound report.
Anyway, I jumped into my conclusion betamethasone caused my tummy to suddenly grow big (water retention). This caused my uterine to stretch and contract. I blame my uterine contraction to betamethasone!

31w3d- contraction again

Can Betamethasone cause uterine contraction?  I see a common pattern ya. I had my second cycle of betamethasone injections on wednesday and thursday two weeks ago. I started to have uterine contractions on friday midnight. I had my third betamethasone cycle this wednesday and thursday. I felt uterine contraction again on friday midnight.

Is this a coincidence?  Oh my, my obgyn wants to put me on hospital arrest for three weeks. Do I deserve that sort of punishment? Am I a high risk patient of its just a transient phenomenon? 

Although I was able to haggle for bathroom privilege, I felt self-pity. I dont have my own bathroom. I have to bring my own bag of toiletries whenever I go to the bathroom. That is my life in maternal ICU. It is hot here. Magnesium sulfate had also contributed much heat. I used Bricanyl and Magnesium sulfate this time. Last time, we just used isoxilan.

I'm home

I was discharged from the hospital on monday. I went to see my obgyne today and I was told that the baby's head was engaged and my cervix funneled. She demanded a complete bed rest. I am not used to eating in my bedroom. I cant help but to get up and take a peek at my desktop computer also. Realvnc is good but it lacks mouse contol. My life is work integrated. Wahaha sounds like I am industrious ya! I cant help but to keep myself busy at home. I try my best not to move around.

My obgyne will be out of country for next next week. She will be on vacation for two weeks. Wow! Enjoying life ya! How about me... Can I sustain my pregnancy til she comes back? Who will be her reliever? Her dearest mentor or one of her students? Her mentor is my first obgyne... Yay! Is she still very rude? Her student- is she good enough? I dont want to think too much. I hope I can carry on my pregnancy for 5 more weeks.

What is the meaning of privilege?

What is a privilege? Is it a special right that is granted to a selected few? Anyway, I am proud to announce that I have regained my "bathroom privilege".

Can I have fine dining privilege? How about cinema privilege? I want to unwind a bit. Can I sneak out for few hours?

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30w5d- how many weeks to go?

Today is the 30w5d of my pregnancy. How long can I still carry on with my pregnancy? I have spent several sleepless nights in the hospital. I feel my eyes are puffy and have black eye bags. The other day my obgyn told me that she wished to let me stay for a month here in the hospital.

Is hospital the safest place to for me? I dont want to catch any nosocomial infection here. I really cant sleep much. I have requested fewer blood pressure monitoring, fewer fetal heart tone monitoring, fewer housekeeping, and i requested my food ration to be placed outside. My sleep had improved a little bit. Can i request for memory foam and bigger matress? Ehem... I start to have sore throat or dry throat? Is it because of poor sleep or poor humidity in  airconditioned room?

On the positive side, my isoxilan drip was removed just now. I feel I can be discharged this week. Let yus see what is next.

Btw, what caused my contraction? Does anxiety cause contraction? Am I feeble? I feel I am physically strong. Btw, I dont have urinary tract infection.

29 w 3 d- contraction

I had my second round of betamethasone on week 29. Perhaps, batamethasone caused me to be insomniac. I often get hungry whenever I am still awake at midnight. For a change, I put cayenne pepper and rosemary to my beef steak. Did it taste yummy? I forgot! The only thing I remember was an hour after eating the steak, my lower tummy felt heavy. I asked myself: Is this a contraction?
Then, I lay down on my bed and I felt my tummy had on and off stiffness and tenderness. I tried my best to sleep. Then, my instict kept on telling me that this was contraction. I reached for my ipad and started searching: " painless on and off tummy tenderness" , "can cayenne pepper and rosemary cause conteaction?"

Finally, I was convinced that I had contractions. I grabbed a cab and went to the hospital for nst. Bad news, I they had rushed me to the maternity icu. Tears suddenly rolled down my cheeks- where is my husband? who shall take care of my son?

What was the cause of ny contraction? not immune rejection, not uti.

6 weeks to go... operating table anxiety

Oops... Is it 6 weeks to go? Shall I deliver on week 34?

I had operating table anxiety last week. I was sleepless and I cried for few days. I admit I am a bit childish. If a stubborn child wants to have a red car, why not grant his wish? He will be paying anyway. Based on my belief, no other color shall please this stubborn child. He will not accept any compromise. I call this as the right to choose! Is there a patient rights in the Philippines? Sad to say, I think it never exist! 

Why am I still sticking with my obgyne with a very poor bedside manner? I hope my immunologist would refer me to a new obgyne. I was pondering whether to change obgyne or just change my obgyne's team (anesthesiologist and pedia).

Anyone wondering how bad is my obgyne? 

1. no empathy. One time a mom called in her clinic, she was in panic because her newborn baby did not have hole in the ass. She did not answer the phone (excused!) maybe because my obgyne thought she will visit her very soon. I will respect my obgyne more if she just keep her mouth shut while doing her ultrasound on me. Rather than uttering: "what can I do if the baby does not have an asshole blablabla."

2. Perhaps 15 years ago, I had a facial treatment. I got contact dermatitis with the topical anesthesia. For my record, I asked the dermatologist to write down the anesthesia used. Is it bad to request the anesthesiologist to avoid these three anesthesia? Its like dumb I do, dumb I dont. If I did not tell them my history, who is to be blamed? My point is there are many anesthesia there in the market. Let us say there are 20 products, why not just avoid these three? There are still 17 drugs available. Why quarrel with the patient? My anesthesiologist said: nobody gets allergy from the anesthesia. He will not risk his career on me. Perhaps, I am allergic to the preservatives only. His anesthesia is preservative free. Ouch... I wished to reply: what is perhaps? I cannot accept a guessing game here. I will not gamble my life on you. I dont want to entrust my life to you either. Can I request to kick out this anesthesiologist from the team while I am already in the operating table?

To an insult to the injury, my obgyne said: You know this patient has been bugging me since her first trimester about her allergies to anesthesia. She is very nosy, she even had researched biochemistry on that matter. Is this an over statement? I just asked her in my third trimester. So what if I have researched chemical structure of the anesthesia? Is there a law to prohibit patient to do so? I am allergic to azo and aniline also. Cant I have the right to take a look if the anesthesia has those in it?

3. nepotism. Her sister in law is a pulmonary pediatrician. I have so many complaints from my friends about that pediatrician- poor diagnostic skills. Prior to my caesarian section, I have requested my obgyne for a neonatologist twice. I thought she granted my wish. It was a consternation to see no pediatric consultant was present to catch my baby. She intentionally did not book the neonatologist. I was trapped by her smart maneuver ya. She thought I am stupid enough not to understand the scenario. She then said she will just book the regular pediatrician ah. Because my baby is healthy. Btw, was her sis-in-law around?

Issue: I had gestational diabetes last pregnancy, I remembered she told me to have insulin- dont diet. ( of course, it was with harsh tone.) I suddenly gained so much weight in my last week of pregnancy. My baby also gained so much weight during that period. I told the residents that I have gestational diabetes. I was so angry when I learned that they did not check the insulin level of my baby immediately after birth. I have another story on jaundice.... ouch.

Is the patient right respected?

As I write this letter, I wish to shop for another obgyne. :( Ai... I am indecisive. I love and trust my immunologist but I hate his partners. 

Ivig is not a miracle drug

I still keep distance from my obgyne. She asked me to have ivig on my 26th week, how can I refuse without offending her? I really dont feel the need for ivig. I feel she was playing medicine. Ivig is not a miracle drug. I just wrote her a letter. I told her that I will welcome ivig infusion if there is immune rejection. My globulin is high and my albumin/globulin ratio is less than 1. Grrr... I feel the proper authority to give ivig was my immunologist not obgyne. ^.^

Just a backgrounder. I have crp + , 3 days after ivig on my first pregnancy. I had uticaria, fever, chills on the eve of my first delivery after the plasma infusion. How can a forgetful person suggest ivig to me? She told me she had a patient who suffered hair loss because of Imuran. I asked her two times already... Is she 100% sure the hair loss was caused by imuran? I feel her patient had hair loss because of ivig. I believe in the theory of molecular mimicry. Anti- h. Pylori anitbody must be attacking a certain gene that resembles h. Pylori. (Or it triggers autoimmune response.) To me, alopecia is not so scary. I am scared of anti- klebsiella antibody. Some study shows that patients with active anterior uveitis have high titer of anti- klebsiella antibody. Klebsiella has six peptides (or few peptide sequence) that ressembles hla-b27. I am worried about the cross reactivity betweed hla-b27 and anti-klebsiella antibody. I dont want to get uveitis from ivig. My stubborn obgyne yielded. Hehe, shhh... I never discussed my theory with my immunologist. I will try next time.

26 w2d

I never thought I have come this far. So far so good. My congenital anomaly scan was perfect. It confirmed that I am carrying twin boys. Uterine doppler showed high left artery blood flow resistance. My albumin level is lower than the minimum range. It seems that fifteen pcs of amino acida day isnt enough. How many weeks to go ?

I had two bouts of diarrhea last month

I had two bouts of diarrhea last month. The first diarrhea was self limiting. Two soft and loose bowel movements  only but it resulted to systemic inflammation (CRP +). I was given antibiotics. Should I blame this to milk tea or the dimsum?

One or two weeks later, I had another bout of diarrhea. It was watery. I was worried of getting dehydrated. I cannot keep up with the fluid balance. It seems to me that the rate of liquid output was greater than my fluid intake. I was boweling like a toilet flush. Luckily, after seven times it stopped. My fecalysis showed that I had amoebiasis. There were rbc and pus cells in my stool. I was given metronidazole. Few days later, my stool culture had positive growth of citrobacter. Ouch! How can I be so unlucky?  Was it a lab error? Is Citrobacter very virulent? I refused to take another antibiotics.  I fear too much antibiotics will result in yeast infection - candidaiasis. I told my obgyne, I wanted to wait and see.

20w3d

My blood thickens on week 19. All the while, I thought my Kct was behaving well. Ai... Biology is biology. This confirmed that the peak immune response is really week 20-24 ya. I had a Smoflipid last week and I had my LIT last tuesday. Ooops, how much is my cholesterol... 280?

I am excited. But, I am scared to expect. Why am I so pessimistic?

I have back pains. I get tired easily these days. I did not experience these sort of complains in my first pregnancy.

I felt financial pressure as well: choosing school and investing real estate for them, ehem ehem...