Week 22 - Down with Sinusitis

It has been more than a week that I am down with sinusitis. Recurrent fever, blocked nose, thick nasal discharge, post-nasal drip, sore throat and headache have been my loyal companions since then.

Sinusitis, has been part of my life since a few years ago. Just 3 years ago, I have gone through quite a painful FESS (Functional Endoscopic Sinus Surgery) at Damansara Specialist Centre to cure my chronic sinusitis problem. However, sinusitis still comes back after that, the only different is it occurs less frequent, cut down to once or twice a year, as compared to last time when it hit me every 2-3 months.

I went to my company's panel clinic to get some 'medical advice'. In fact, the main purpose of my visit was just to get a few days of MC so I can rest or work from home. For the ultimate welfare of my precious baby, I know I could not afford to take any medicine, even though I'm prescribed. The doctor seemed to read my mind. There was no mediccation prescribed, except some paracetamol to mitigate my fever and headache and some lozenge to sooth my sore throat.

Back at home, I have been applying the following methods to clear my nasal passage and to boost up my immune system:

• Inhaling vapour rub steam
• gargle diluted organic charcoal bamboo salt water
• eating plenty of fruits
• drinking sufficient fluid
• rest, rest, rest.....
• keep a positive mindset

As per today, my condition has improved, slowly but steadily. Each day, I wake up feeling a bit better than the previous.  Christmas is just a round a corner, I want to be able to enjoy the joy of this beautiful celebration as everyone else does.

Maybe I should also seriously consider to save up some money so I can buy a little cottage in the suburbance area of New Zealand in the near future. Why is it so? Read this...

Last year May, I was down with sinusitus, just 2 days before my husband and I departed to New Zealand for our 1-month backpacking trip. Cancelling the trip, which had been long anticipated was totally not a choice for me. I insisted to fly, even though accompanied by full blown sinus symptoms. Miraculously, all the symtomps disappeared when I began to immerse myself in the pure air of New Zealand. 

So I guess flying to New Zealand whenever sinusitis hit me again is a good idea, don't you think so? Hahhaha....May my dream come true.

Merry X'mas to you who drop by to read my writing.

May you and your family have a joyful and peaceful holiday!

Week 20 - Meeting The New Gynae

Today is my 1st appointment with Dr. Paul Ng Hock Oon. My husband and I arrived at Pantai Hospital Kuala Lumpur (Bangsar) at 10:45am for our 11:00am appointment.

We were told by the receptionist that today's queue will be slightly longer because Dr. Paul was still in the labour room. Well, it would be worthwhile to wait as long as the baby came to the world safely:)

At 11:45am it was my turn to meet the doctor. Pleasant looking Dr. Paul greeted us politely before he explored more about my medical history.

Before long, came the moment that we had eagerly looked forward to, seeing our baby! At the ultrasound room, there were 2 screens, one placed next to the patient for the doctor's viewing; while the other placed above the patient's bed  for the patient and her visitors' convenient viewing.

Our baby is growing well with the weight of 350gm at week 20.  The Doctor carefully showed us the baby's eyes, nose, lips, heart, bowel, hands and legs. Even though the images were only shown in 2D, but I already knew that the baby's has his/her father's signature chubby cheeks:). Well, here comes the most important feature, is the baby a boy or a girl? Let me do some recap before we proceed further.

Week 11(Nuchal Scan at FMGC) - Dr. Patrick told us that the baby was most likely a boy.

Week 16 (Damansara Specialist Centre) - Dr. Guna said that the baby was very likely a girl.

Week 20 (Pantai Hospital KL) - Dr. Paul said that the baby is a .............

I will only reveal the baby's gender next month when we do the 3D scan, just to be accurate. Both my husband and I have no special preference for boy or girl. In fact, we are very happy to have this unexpected miracle baby. Either boy or girl is a blessing to us. However, my mum prefers a boy while my mother-in-law favours a girl. Either way, I will not be able to fulfill both parties at the same time because I only carry one baby at a time, haha!. After all, regardless what the gender is, this baby will be our jewel.

After the whole consultation which took about 30 minutes, the nurse took my urine sample (for protein test), measure my weight and blood pressure. 

We are very comfortable with Dr. Paul and have decided to see him for the rest of the trimesters.

The total cost for today's visit is RM104:

Consultation  RM 50

Ultrasound    RM 50

Admin Fee    RM   4

We then proceed to the admission counter to find out more about the delivery packages offered by the hospital. There are 2 options:

Option 1 (4-bedded room) RM2688

Option 2 (2-bedded room) RM2788

(Price inclusive for mother and baby)

The above options are inclusive of the following items:

• Normal spontaneous vertex delivery conducted by Consultant Obstetrician
• Care for the newborn in the nursery by Consultant Paediatrician
• 3 days, 2 nights stay

The packages are only available for patients under the hospital's resident Consultant Obstetrician, Dr. Idris Ahmad and Dr. Paul Ng Hock Oon.

However, the above price only covers the basics of the basic. The usage of epidural, forceps/vacuum delivery, accelerated and induced labour, phototherapy for baby and any additional item will incur additional charges.

Well, we expect that we shall pay more than the figure shown, but at least it provides us a guideline for budgeting. Everyone prays for a smooth delivery, but it is always wise to allocate a back-up fund for unforseen emergency. 

My Bible

This is my 'bible' during my pregnancy. I discovered it when I was in week-7, in Kinokuniya when I followed my husband for his business trip to Singapore. However, I didn't buy it with Singapore dollar. A week later, I got it from Popular at The Curve, Mutiara Damansara. Its price was RM49.95 and Popular card holder entitled additional 10% discount.

It is full of details, explains your body changes from week to week, easy to read and most importantly FUN to read. I highly recommend this book to all expecting mothers.   

The Little Red Book

Some of my friends told me if you get yourself registered with the government health centre (Pusat Kesihatan) at your area , you will be entitled free monthly maternity check-up and more importantly, your baby will enjoy free injection throughout his/her childhood in the future. You just need to flag the 'red book' at the registration counter every time you do your check-up. The red book is a book that recorded all your medical records about your previous visits.

Many of us hold negative perception about the services offered by government hospitals and clinics.We think that the nurses are rude, the doctors are inexperience, the hygiene level is low and the queue is long.  The only good point is the charges is low.  Thus, many of us, especially those who can afford above middle class lifestyle, don't even bother to consider visiting government health care institutions when in need, even though that is one of the basic citizen welfares that the government invested millions of dollars to maintain annually. All Malaysian that hold a valid identity card are entitled to enjoy this welfare. However, most of the tax payers choose to let go their right. Instead, they spend more money to visit private clinics or hospitals for better treatment. Sorry to say that, I was one of them.

I decided to apply for the 'red book' after I had a conversation with one of my friends, whose husband is an eye specialist in a government hospital. According to her, both her son enjoy free injections by the government. They never paid a cent to get the jabs. However, she honestly told me that she delivered both her sons in the private hospitals. The reason being if you choose to deliver in the government hospital you will never know which doctor will deliver your baby as it depends on which doctor is on duty during your delivery date. Also, in most cases labour is done by experienced nurses instead of certified doctors. I do not know how true is this. I just know that all my family members objected when I 'tested' them by saying:" How about having me deliver the baby in the government hospital?"

When I was in week 17, I visited Pusat Kesihatan Taman Ehsan to apply for the red book. This is the nearest government health care centre from my house even though it is really not that near. Bringing along our marriage certificate, electric and water bill (to prove that we stay in the right district in order for me to visit this particular health care centre), my husband and I arrived at the health centre at 8am on a Wednesday (new registration only opens every Wednesday).

Pusat Kesihatan Taman Ehsan

Upon arrival, I was shocked by the number of the crowd. There were so many pregnant ladies, infants and their family members of all races.

The waiting hall

After submitted my details to a nurse at the reception counter, I was ordered to weigh myself and measure my height at the weighing corner. Yes, this is completely a D.I.Y system, either you weigh yourself and remember all the readings or you can ask your companion to help you.

After that, I was directed to provide urine sample for glucose test. So how to do this by yourself?   Firstly, go to the rack in the toilet, pick up an empty bottle with number written on it, provide your own sample, put the bottle back into the rack and then remember the number on the bottle. Honestly, I was quite amuzed by the system as it reminded me my secondary school time where we got the chance to organize all kind of science experiments in the lab.

What I did next was waiting, waiting and waiting. My husband had to leave me alone by 10:00am as he had a meeting to attend. I didn't dare to leave my seat because I knew that I would lose it immediately I stood up. I was given a queue number, but at the same time names were being called by nurse too. The waiting hall was crowded and noisy, filled with the chattering sound of the patients, the cries and giggling sound of the kids....And in the midst, we have to pay attention to the nurse whenever they call a patient's name. There was no public announcement system, you had to open your ears and pay attention. I was confused. Should I just look at the number showed on the electronic display board or listen to the names being called?

By 10:30am, I heard my name being called. I woke up from day dreaming and quickly walked to the nurse, who was stationed at a table. I was welcomed with a smile, a very sincere one. She asked about my medical background and jotted down my weight and height before measuring my blood pressure. Next, she asked if anyone had tested my urine earlier that morning? I said no.

It gave me a shock when she suddenly stood up and raised her voice at the crowd:" Siapa yang belum uji kencing, sekarang ikut saya pergi toilet!( Whoever has not tested her urine now follow me to the toilet!)" 

Upon her announcement, about 10 pregnant ladies made their way to the toilet to take their own urine specimen and began to queue up in front of that nurse. I was so worried if someone had mistakenly took my bottle. Luckily this did not happen. One by one, the nurse put in the diabetes test strip into our bottles to observe if there was any colour changes on the strip.

After that, I was asked to wait for my turn to do the blood test. It was another 30 minutes aimless wait before my name was called again. I was led to a room where my blood specimen was taken. Then, the nurse passed me the test tube filled with my blood sample. I learned that I had to bring my own blood sample to the laboratory, which was housed at the same building. I only waited for less than 10 minutes, before the lab assistant passed me my blood test report. That was a test for HIV, STD and hemoglobin level.



The counter of the blood test laboratory



With the blood test report, I went back to the nurse at the blood test station. She explained the result to me and asked me to wait for my turn to see the doctor. By then, I knew that when the electronic board showed my number, that would be my turn to see the doctor in the consultation room. 

Finally, I was in the doctor's room after 30 minutes. She was very young, but friendly and caring. After reading the report in my red book, she performed an ultrasound to check the condition on my baby. The ultrasound image was printed out on the spot and then stapled in my red book. 

I felt relieved after seeing the doctor and thought I can go to work finally. However, I was told that I had to go back to the waiting hall to wait for my turn to see the nurse. It took another 15 minutes before my turn. The nurse set the date and time of my next check-up in the system. Sje also convinced me that the next check-up would not take so long as they already have all my details. The date and time of a compulsory dental check-up session was also set as this was one of the requirement that I need to fulfilled if I chose to give birth in the government hospital in the later stage. Another requirement was to attend at least 2 sessions of breast feeding training, organized by the same health care centre. 

I was also given one month supply of multi vitamin, floic acid, vitamin C, and iron supplement. I asked how much and where should I make the payment before I leave. The nurse smiled and told me that I do not need to pay anything, just remember to take my supplement accordingly.

A week later, I came back to the same place for my dental check-up. The waiting time was 30 minutes. I got my tooth filled (it was painless!) and again it was free of charge.

Despite the toilets are not sparking clean and the place is a bit crowded, overall, the nursing staffs were very friendly and informative. If you do not mind to spend a morning or an afternoon each month for your routine pre-natal check-up, government health care centre is actually not a bad choice, if your pregnancy is not a complicated one. At least get a red book, leave a record in the system, so that you can send your kid for free jabs in the future, if you want to. 

My red book (personal details has been deleted for privacy purposes)

P/S: I have not decided if I will be going for my next appointment at the government health care centre as I will be seeing my doctor in the private hospital too. The purpose of my first visit is to get the red book and leave a record in the system. I have decided to deliver my baby in the private hospital.    

My new gynae, where and who?

I have to bid farewell with Dr. Prashant after I 'graduated' from my 1st trimester.  If given a choice, I would like to continue to be under his care, but since he does not deliver baby anymore ( he has chosen to concentrate solely on treating infertility since the past few years), I have to be 'deported' to another gynae.

Where to go and who to choose? After a few round of discussion with my husband, we chose to seek a gynae in Damansara Specialist Centre (DSC) due to its proximity from where we stay. Hence, after seeking Dr. Prashant's opinion, he wrote me a referral letter so I can start to visit Dr. Gunasegaran begining from week 16.

After gathered some information from the internet, I found Dr. Guna was a highly sought after gynae, even celebrity like Erra Fazira delivered her baby under Dr. Guna. Due to this, I was a bit worried about the long queue and probably his pricey consultation fees. But, why worry? Let's find out first.

In week-16, I made an appointment with Dr. Guna's clinic. I was told by the nurse to be there by 10am, but she also reminded me that it did not mean that I can see the doctor at 10am. Waiting is a norm in Dr. Guna's clinic.

My husband and my mother accompanied me for that visit. We reached DSC at 9:30am. The clinic was very crowded, easily there were 15 patients plus their family members were waiting for their turn. The nurse told me to wait (but couldn't estimate how long) because the doctor was in the labour room.

By 10:15am, the doctor was not back yet, so we decided to go to a nearby shopping mall to kill some time. The nurse looked relieved when I told her so and informed me to come back at 12pm.

By 11:20am, I received a call from the nurse who asked me to come back immediately because according to her I would be the last patient and the doctor was waiting for me before he went up to the OT room to attend a caesarean case.

By 11:30am, my mother and I rushed back to the clinic, while my husband went round to search for a parking space at the crowded hospital. I was panting as we ran all the way from the hospital lobby to the clinic. The nurse was glad to see me and told me that it would be my turn soon after the patient in the room came out.

2 minutes later, my mum and I were ushered into the consultation room to meet Dr. Guna. He was kind and patient, that kind of doctor that can give you confidence. After a brief chat about my medical history, we proceeded to perform the ultrasound without my husband. I prayed hard, hoping that my husband would rush in in time to see the baby as I knew how much he had looked forward to each session of ultrasound.

The scan was already half way through when my husband finally joint us. Luckily, the baby welcomed the father by showing some amazing stretching of his/her legs. Both my mum and husband couldn't stop laughing when they saw the baby's naugthy gesture. I enjoyed the session too but was having some hard time turning my head 90 degree to the left at all time to look at the monitor, that was placed just next to the bed. I missed the monitor in Dr. Prashant's clinic as the monitor was placed on top of the patient, we just need to look up straight.

Dr. Guna confirmed that the baby was doing good and my pregnancy was stable. We were relieved by his comment. However, the gender of the baby still couldn't be confirmed due to his/her position. We were totally ok with either boy or girl, looking at how long we have waited for his/her arrival.
The whole consultation session took less than 10 minutes. We proceeded to the cashier counter after that. The total fees was RM335, with the breakdown as listed below.

Medical Record Service          RM     5
Consultation                                 RM 180
Ultrasound (no picture given)   RM  150

Honestly, I was a bit shocked by the charges as it was a bit at the high side to us. There was no medication prescribed nor ultrasound picture given. My husband jokingly said that I was 'spoilt' by Dr. Prashant because we were given the ultrasound pictures everytime, without us asking for it. In fact, I went back to Dr. Guna's clinic after the payment to ask for the ultrasound picture (even though both my mum and husband told me not to sweat the small stuff ). Unfortunately the nurse said they will not give the picture if the patient did not request. Thus, the picture was not even saved in the computer hard disk. She reminded me to remember to express my request to the doctor before the ultrasoud next time.

No doubt, Dr. Guna is a good doctor and his vast experience could not be measured by money. However, we reckon that we should start saving some money for the baby's future. Decision was made to look for another gynae and for this we went back to Dr. Prashant for another referral letter.

This time, we were recommended to see Dr. Paul Ng in Pantai Hospital Bangsar. According to some reviews, his queue is shorter (hence very suitable for working woman like me) and his charges is 1/3 of Dr. Guna's.

I will find out more and update my experience when I see Dr. Paul Ng for the first time in week-20. If you have any experience with him, please share it with me. Thank you!

Weird Early Pregnancy Symptoms

Morning sickness? No, I do not have it. 

I have evening sickness instead.

From week 6 (when my baby 1st heart beat was detected) to the end of week 7, I still did not quite believe that I was pregnant. Other than having more vaginal discharge and having extremely tender breasts, I did not vomit nor experiencing other usual pregnancy symptoms as what have been illustrated in the pregnancy books. While I thought I inherited the good genes from my mother, who claimed that she did not vomit even once when she bore all her 3 daughters, the 'never say never' curse began.  

Starting from week 8, I began to vomit almost everyday, after sunset. So, I have evening sickness instead of morning sickness. In fact, on weekends, I would vomit throughout the day.

The good thing of having evening sickness during the weekdays was my colleagues did not know that I was pregnant. So, I effortlessly kept my promise to my mother and mother-in-law of not to break the news before I successfully sailed through my 1st trimester. Instead, due to the symptoms of vomiting, extremely lack of appetite and having difficulty sleeping at night,  I had lost 2 kg in 2 weeks. Some of my colleagues even asked me tips on losing weight. This was the answer that I wished I could answer them. ' Be pregnant, that is the best way to slim down'.

Every meal time was a tortura session. I wanted to throw up whenever I saw food, especially meat and seafood. I hate food, but I have to eat something. I survived by taking frequent small meals of Jacob cream cracker, materna milk, corn, tofu, veggie and a bit of white rice. I also stopped cooking our own dinner (which I used to enjoy very much) for 3 months because I couldn't stand the smell of oil. Unfortunately, the auntie staying 2 stories below my apartment prepared fried dishes everyday, without fail.  I suffered so much and had to close all the windows in my house whenever the smell of oil began to sip into my unit. 

I even stopped reading printed newspaper because I would vomit everytime I opened the pages and the smell of printing ink hit me. Thus, I rely heavily on online-news and TV to know what was going on in the world. The only plus point about this was I saved some money and help saving the Earth for not buying printed newspaper until today.

Also, I constantly smelt gas in the kitchen, so forcing my husband to check on the gas tank and the stove to see if there is any gas leakage. He checked several times and found everything was in order. He finally gave up and officially labelled me as 'Dog Nose' . Yes, my nose became so sensitive to an extent that I could smell cigarettes if there was someone smoking within 50-meter radius from me. My husband was also forced to shower extra frequently ( up to 3 times a day), so that I will not reject his hugs. Of course, he was also prohibited to use his usual perfume.

Another changes was my scalp became extremly oily. I couldn't even bear with myself if I do not wash my hair on daily basis. To make my life easier, I cut my thick waist-length hair to shoulder-length shortly after.

I was patiently waiting for week-12, because most of the pregnancy books say that nausea and vomiting will normally ease when the pregnancy reaches week-12.

Week-12 finally arrived but I wasn't that lucky, I continued vomiting until week-15. Before that, I went through all the vomiting session with a sense of gratitude. I knew the arrival of this baby was a miracle, so I am willing to endure all kinds of early pregnancy symptoms.

But on a night in week-15, I couldn't cope anymore and burst into tears while both my arms were still hugging the toilet bowl. Negative feelings flooded in. Why I have to suffer so much? When can it stop? Why baby you tortures mummy like that?.....My poor husband, who squatted next to me looked so helpless. There was nothing he could do to mitigate my sufferings except quietly patting my back.  Luckily, after a few seconds, I calmed myself down, wiped off my tears and told myself that I am a strong lady, nothing could put me down!

That night, for the 1st time, my husband took his 1st attempt to talk to our baby. He softly rub my stomach and told the baby to be a good kid, do not make mummy vomit anymore. I did not know was this an effective method or not, but miracuously I really stopped vomiting a few days later. Touch wood!

Today is week-17, I have been ' vomit-free' for almost 2 weeks. My appetite is also starting to recover. I can finish a proper meal without much struggle now. In fact, the usual sense of 'hunger' that have been missing for almost 4 months is back now.

Thank you baby, for being so considerate. You are a good kid!



Picture source: http://www.coompax.com/



An Angel knocks my door?!

Dear friends,

I am finally back. Sorry for keeping you guys waiting for so long. As what I have mentioned in my earlier post, much had happened in my life in the past few months, but I have sailed through safely, by having huge sense of gratitude to everything that comes to my life.

Since the last post about my treatment progress was written on Aug 18, if you have time to follow my story I shall continue to recap my jouuney from Aug 19.

Aug 19 was a of day miracle. It was a normal afternoon, when I visited Dr. Prashant's clinic to request for some Duphaston to stimulate my mentrual cycle, having said that I was experiencing severe PMS symtoms for already more than 2 weeks.

Dr. Prashant suggested a UPT test before prescribed me with the medication. I complied although I told him I have done one a week ago at home and the result was as usual, negative. I then went to the toilet to provide some specimen while the doctor continue to see other patients.

After 20 mins, my name was called again and I went in to see the Doctor, with nurse W standing beside him.

The doctor passed me the UPT kit and said:"Take this home and frame it up."

I didn't get what he mean, but took over the UPT kit to have a look. OMG, that was the first 2-line diagram that I have ever seen in so many previous UPT since I got married almost 5 years ago!

I couldn't believe my own eyes and started to ask stupid questions: "How come? What does this mean?"

Dr. Prashant:" The urine test shows that you are pregnant, but to confirm further I will send you to do a blood test at level 4."

"OK, but when and how does this happen?" I was still stunned.

" Well, we never know but miracles happen everyday, you don't know when it will come to you." The doctor tried to calm me down.

"However, let's wait for the blood test, if it is positive, we also have to wait for the 1st heart beat, probably in 2 weeks time, to confirm that you are really pregnant. If that is the case, we will take care of you until you pass your 1st trimester before we send you to the gynae of your choice......." Doctor continued to explain the details to me and for what I could remember, nurses congratulated me, but I was like floating in the sky, couldn't believe the news. I got pregnant, naturally! This was certainly too far out from my expectation. I was waiting for the post-IUI cyst to ease and cracking my head to schedule the 2nd IUI amidst of my hectic schedule.

Next, I proceeded to 'float' to level 4 for the blood test. The nurse had a hard time to find my vein even though they had to spend like 20 minutes to 'bend' and 'pat' my arms. I ended up giving way to a patient who came shortly after me. But nothing matters anymore, I was on the cloud nine!

After my blood sample was taken, I went for a meeting at a client's office. Half way through the meeting, I received a call from nurse H who confirmed the blood test result as positive. I thanked her and ended the call without saying much. My heart was fluorishing, my mind was filled with the most beautiful thoughts in life.

After the meeting, one of my co-worker come to me, wanted to know what brand of skin care that I was using because she said my skin was glowing. I wanted to answer her 'baby dust' , but instead I held back and told her I was just using some normal moisturiser that she can easily purchase from the open shelves of many personal stores in the market.

On my way home, I called my mum to tell her the news, she was shocked too but quickly warned me to stay calm and take things easy until the heart beat of the embryo was detected. She also warned me not to tell anyone about the pregnancy until  after I have sailed through the 1st trimester.

In the evening, when my husband was home I did not have a clue on how to reveal the news to him. As usual, we chatted on some other matters and he suddenly remembered that I went to see Doctor Prashant on that day. As I myself was still in the state of shock, I murmured when I answered him. I told him that doctor needed to check the heart beat after 2 weeks.......He was confused and asked if I have any problem with my heart. I finally stammered out the details and he managed to get what I meant. He was overwhelmed and I could almost see his head hitting the ceiling as he jumped up with joy.

The news reached my in-laws after 2 weeks when the baby's heart beat was detected (the embryo was 6 weeks old by then). As per my mother-in-law's order, we have to keep the news in secret until after I am in 12 weeks. So, other than my husband and me, only my mum and my in-laws knew that I am pregnant. Now, I am in week 16. So, I guess I am given the 'permit' to make this public to you, my dear readers.

I was wishing for an angel and out of the blue, an angel knocked my door. I opened the door and welcomed him/her with gratitude. Thank you everyone and everything in this universe that had made my dream of becoming a mother come true.

If you are challenged by PCOS like me, do not ever give up hope on having baby. Be positive, love yourself, take good care of your physical and mental health and most importantly, have regular intimate sex with your spouse. You never know when you will hit the jackpot. In addition, it is always a good suggestion to have an experienced and patient infertility expert like Dr. Prashant to guide you through the journey.

Update......pending

The past few weeks were hysteric. There were a few outstation assignments; a few unreasonable job datelines; an 'companionship" trip which I followed my husband to attend a job training in Singapore; my cousin's wedding back in Kota Bharu; relative's visit to KL and sadly, my father-in-law's funeral back in Sungai Petani.

So, all these explain why I have neglected my blog for so long. I am so sorry to all my readers who wanted to know the latest update of my treatment. Thanks to all of you who had sent me emails to check on my status. I truly appreciate that.

With the hectic schedule as mentioned above, there was no progress since the BFN of my first IUI. I promise to write more about my journey next month, after everything has settled down and when I have more time to myself.

Till then, see you soon and stay tuned!

Another long wait......

I have not been updating my blog for a month, solely because there is just nothing happening here. A little recap here, today is Day 48 of my cycle, my period is not here yet. I was told by Dr. Prashant that my cycle will be longer than normal ( assuming 28-35 days for normal woman, so mine will maybe take a week more than this) this month, but I just don't know how long is 'long enough'. Should I continue to wait in uncertainty or to get some Duphaston from the clinic to stimulate the arrival of my period?

Well, as a PCOS patient, I am so used to irregular cycle, and most of my cycle are basically longer than 48 days. So, actually there is nothing  unusual for me this month, isn't it? To a certain degree, the answer is yes. But, the problem is I have been experiencing quite a severe PMS (Premenstrual Syndrome) since the last 2.5 weeks. The symptoms includes lower abdominal pain, very sore breasts, extremely lethargic, frequent urination, feeling cold in a 30 degree Celcius room and feeling hungry in the middle of the night (even though I already gushed down milk or milo as prevention before sleeping ). Well, does all these sound like early pregnancy symptoms? Haha, I did a test at home a week ago, and as usual there was only one line appeared. So, the odd of pregnancy is totally out.

To fight the feeling of lethargic, I brisk walked and cycled for an hour in the gym at least 4 times a week, regarless how unwilling my heart was. At least, exercise made me feel fresh for half a day, and I also wanted to shed away all the fat that accumulated from all the mid night nibbling.

Everyday, I wish my period will come in order to chase away the PMS. I also experienced a lot of thick discharge. 4 days ago, I was happy when I saw there were some blood strings among the thick discharge as I thought this was the indication of the arrival of my period. But, nothing happen until now.

Yesterday, there was a sudden sharp pain on my right ovary, that lasted for maybe 1 to 2 seconds. Well, I am afraid that this is the sign of the return of ovary cyst. 

Will make an appointment to see Dr. Prashant soon, at least to get some Duphaston, so I can 'jump out' from this grey phase! Also, if possible, to discuss the best timing to begin my 2nd IUI as I have to travel very frequent next month. So, timing is also a concern here. Finger crossed.

Update on My Post-IUI Cyst

Yesterday was day 18 of my cycle.  I have an appointment with Dr. Prashant in the morning to check the condition of my 'post-IUI cyct'.

The finding of the transvaginal ultrasound was the cyst has shrunk by itself from 30mm to 10mm. Confidently, Doctor Prashant said that it will disappear by itself soon. Also, I was told that my period will come by itself, just that the cycle will be abit longer this time, probably 5 weeks. Yeah, no need to take Duphaston for this cycle!

I might not be able to understand the logic behind Dr. Prashant's prediction but somehow, I was relieved, as I have just gone back to my original shape (though not very shapely lah) after taking care of my diet and deligently visited the gym everyday after the 1st unsuccessful IUI. 'Drug free' means I do not need to face the awful bloating and lethargic feeling again, at least for this month.

To a certain extend, I still wish that I have the opportunity to become a mother. But there is really nothing much that I can do to guarantee the realization of my wish. Many say 'take it easy, it will come by itself if it meant to be'; many also say 'you have to keep thinking about it as per the theory of The Law of Attraction'.

So, what do I say? I have nothing to say. But I can tell you how I feel. As a woman, if you are sub fertility challenged, you should not confine yourself too much to the mindset of 'I must have baby, I must!'. You will push yourself to the brink of insanity if baby luck is not with you, and worst still, your neurotic expression will impose tremendous stress to the people around you. Be aware while you are treating subfertility, there are also beautiful worlds around you. Your career, you love ones, your hobbies, your current existing life! Savour them while you patiently wait for a miracle!

Total Expenses: No Charge.

2nd IUI......On Hold

4 July 2011 (Mon)

Today marks the 3rd day of my period.

It was a beautiful Saturday when my period visited. However, it was awfully unbearable. I attended an event in the morning and the pain swarmed in when I went back home in the afternoon. I had a very bad stomach cramp until I could not even keep my body straight. I turned, rolled, curled on the bed, but there is no posture that could mitigate the pain. I remembered one of my friends told me that labour pain is a thousand times more painful than menstrual pain. If it really is, giving birth is truly an act of insanity! There was even a point that I wished that I could just pass out, just to escape from the pain. In fact, I did. With my palms holding my lower abdomen while I was still searching for the best posture, I fell asleep. The pain was all gone after 2 hours of deep sleep.

Well, with the arrival of my period, I went to Dr. Prashant’s clinic to see if it is possible to have my 2^nd IUI today. Unfortunately, he found a big cyst ( I did not bother to know how big is it anymore) on my right ovary, the side that produced 2 big follicles last month.  Due to this, I was told to take a break this month.

Having ovary cysts after IUI is pretty common. According to the doctor, ovaries always response by showing cysts after they were forcefully stimulated to produce eggs. All the extra follicles that one gets will increase the chance of getting cyst. When this happens, we let the ovaries rest and hopefully when we leave them alone, the cyst(s) will subside naturally too. Of course, the patient can be prescribed with medication to force the cysts to regress, but my doctor prefer to go with the natural way. I agreed with him. When someone is angry, leave him alone. This is simple theory.

So, am I upset to sit a month out? I thought I would. But, surprisingly, I am doing fine. I  know that my ovaries have been working very hard. They deserve a good rest. My mind too. Keep thinking of all the treatments and forecasting the outcome is killing. This month, I am going to enjoy my work, my personal time and the quality time with my love ones.  

You should not treat your life as incomplete, just because you are reproductive challenged. In fact, imperfection is part of the perfection of this universe. You own your life, you are responsible to make it beautiful and meaningful no matter what obstacle comes along.

Total Expenses: No charge

1st IUI - BFN

A picture paints a thousand words.

This is the result of my 1st IUI, photo was taken this morning, 15 days after the IUI.

Well,  I sort of knew that the result will be BFN (Big Fat Negative) as I am experiencing a very bad PMS. Not only my stomach is growling, I am also swarmed with fatigue and feeling very bloated. I also have to constantly observe and remind myself to stay positive as negative feelings will just flood in whenever there is a slight grey feeling coming to mind. I guess I have to endure these for a few more days until my period comes. My period would not come until I finish the Duphaston supply, another 3 days to go.

Other than the weigh gain, the ovary pain and the PMS, IUI makes you a stronger person.
Looking forward to the next IUI cycle.

1st IUI - 11th Day Post IUI

Not yet, I have not done any pregnancy test yet. My doctor told me to perform the home pregnancy test next Monday, so I decided to be an obedient patient. Indeed, I guess it is my subconcious mind that want  me to be patient. At least I still have a few more days to remain hopeful if the end result is not desirable.

The pain, mainly on my right ovary that started 3 days after the IUI and reaches its peak 6 days after the pain started, finally subsided yesterday (10 days post IUI). Technically, I cannot categorize it as 'pain'. The feeling is more like a sense of constant tension and tightness, that causes discomfort when you move your body. It is very different from the pain that caused by PMS (Prementrual Syndrome).

Although the findings from the Internet shows that it is not unusual for women to experience ovary pain after IUI,  I still called up the clinic to check if this is really normal and most importantly how long will it take to subside. The nurse replied that it is normal to feel some pain due to the enlarged ovaries and the pain usually subsides after 2 days since the pain begins. So, I suspected my ovaries were really very swollen since the pain took more than 2 days to subside. Due to the discomfort, I have since stopped my regular exercise routine. I also noticed that I have gained quite a bit around the waisteline. Trousers that used to be loose can now be nicely fitted. This is definitely not a good news if I am not pregnant.

Well, after the ovary pain subsided, I started to have the familiar PMS feeling. On and off, there will be some abdominal cramp. My left calf also have the 'wanting to cramp' feeling, just I do not know when it will cramp for real. Of course, if you ask me, I definitely do not want to take these as the indications of the period is coming. But this is really something that beyond my control.

Maybe I should be more relax and not to be so neurotic in observing every changes in my body.

Well, if the period comes, welcome it!
If I hit the jackpot next Monday, celebrate it!
Either way, life goes on!

1st IUI - 6th Day Post IUI

2011.06.18 (Saturday)

Today is the 6th day after the IUI (procedure was done on Monday 13 June). I have been feeling some pain on my right ovary since Wednesday (2 days after my IUI). It started as a mild pinch that occur occasionally.  I didn't bother about it as I have been busy at work.

The doctor said there is no 'pantang' after IUI. I can eat, exercise and work as usual. The only thing that I have to avoid is caffeine. I am fine with this as I don't drink coffee due to pulpilation after drinking it. Well, I did take a short distance flight to Alor Star for a job assignment on Wednesday. I have also conducted an interview that took place in the forest of FRIM (Forest Reserve Institute of Malaysia) where the shooting team have to do a bit of hiking to reach the shooting point. Since I exercise quite regularly, I don't think that the discomfort was caused by the hike. However, the painful twinges has become more and more obvious since this morning. I felt it more whenever I laugh. I even began to suspect if it was a sign of ectopic pregnancy. But this is far too early to happen! Touch wood!

Having done some survey on the Internet, I felt more relieved because I am not the only one who experience ovary pain after the procedure of IUI. Some even experienced more severe symptoms like sore and sensitive breasts.  Phew! What I have been experiencing was considered mild.

So what is the cause of the pain I am feeling? It is the side effect of overstimulating your ovaries to produce eggs. The pain happens mostly after the ovulation.  If the ovulation is triggered by HCG injection, the pain might be more serious.

Well, how can I treat it like nothing happen after taking medication and injection to stimulate my ovaries? There is a lot of activities happening inside there. So, ovaries have the right to show their trantrum too!

Ist IUI - The Procedure

My husband and I reached the clinic at 8:30 am, after driving for an hour. The traffic was heavy as today is the day the school starts after the 3 week break. Heavy traffic was the main reason my husband chose to produce the semen in the clinic rather than at home. He wanted to make sure his 'supply' contributed for the IUI was as fresh as possible.

Semen produced will go through a 'washing' process. Sperm washing allows sperm a higher chance of survival and hence, a higher rate for fertilization. The washing separates sperm cells from semen, which helps to get rid of dead or slow-moving sperm and chemicals that may impair the fertilization.

Since the process of sperm washing will take about 2 hours, we decided to pass our time at the Starbuck in a nearby shopping mall. I was told to keep a full bladder for the procedure, so I did not visit the ladies since 10 am.

By 11:30, we were back at the clinic. My bladder was very full but the nurse said that the semen washing process was yet to be completed. I was given the 'permission' to release half of my bladder. My husband was skeptical that I could release just half. This was actually my 1st time to do so. Yes, we can control how much volume we want to release.

At 12pm, finally we were called into the procedure room for IUI. The nurse showed us a semen container labelled with my name,  to confirm that the sperm belong to my husband. After that we were left in the room to wait for the doctor. The room was very quiet. I could hear my empty stomach growling. I kept looking at my watch. The time seemed to crawl.  I did not know what to expect from the procedure. I read that it was an almost painless procedure; but there were also quite a number of people who complained about muscle cramping and severe discomfort. Besides, I was also worried that I could not make it to a meeting that had been scheduled at 2pm. In fact, I knew that my husband who showed his support by accompanying me today also had an important presentation at 2:30pm. I felt more and more anxious. Suddenly, my husband miraculously received a call from his colleague, who informed him that the presentation was postponed to a later date. I could tell that the phone call had lifted a tremendous amount of stress off his shoulder.

I am ready for the procedure!

At 12:15, Dr. Prashant confidently walked into the room. Holding the result of the semen analysis, he told us my husband had produce some good sperm, 50 million sperms with the motility of 3 (1 being the poorest and 4 being the best). We knew that the success rate of IUI depends on many factors, with some of them unexplained. But, at least this was a good indicator.

After that, Dr. Prashant began the procedure by inserting a speculum into me. I felt very minimal discomfort, but this was considered painless compared to menstrual pain. Next, a very thin and flexible catheter was inserted into the cervix. Washed sperm  is then injected through that catheter.

"Done!" The procedure just took like less than a minute when I heard the doctor said so.

"Really? I hardly felt it." I could not believe that eveything was over.

"Yup, did you think that I was going to put in a knife?" Dr. Prashant replied with a smile.

I told the doctor that I doubt that I was going to ovulate because I did not have a vivid positive result from the ovulation test. He said he was aware about my test results and asked me not to worry as he noticed that I have thick mucus which was normally a sign of ovulation.

I lay for another 10 minutes before we left the room. I made a bee line to the loo to empty the already filled up bladder.

I was given 15 days supply of Duphaston, which I will start taking from Wednesday onwards. The Doctor said I can do a pregnancy test after 2 weeks.

Finger crossed, we hope an angel will be sent to us. But if it is not meant to be, we will try again.

Total Expenses  RM 980

• IUI Procedure
• Duphaston 10 mg x 30 tablets

All in all,  we have spent RM 2320 for this cycle of IUI.

1st IUI - Catching the LH Surge!

The past weekend was somehow very stressful for me. As per instructed, I tested my urine every morning, hoping for a positive result from the ovulation test.

2011.06.11 (Sat)
I did the ovulation test first thing in the morning. As there was no instruction on the packaging ( I was given loose packets without the box), I dip the absorbent sampler into the urine container  for 10 secs, then let it lie on a flat surface. I kept staring at the result window. After about 1 minute, I saw 2 lines appeared, 1 clear and 1 faint.

Hmmm? So how do I interpret it? Positive or negative? Never mind, let's ask Google. The answer I got from the Internet showed that other than 2 clear blue lines, the rest of the variants are considered negative. I also found out that I should dip the absorbent sampler in the urine for 20 secs.

To be honest, I had never used an ovulation test kit before. My previous doctor asked me to monitor my basal body temperature to detect an ovulation, where I was requested to take my temperature every morning, preferably at the same timing before I stepped down from the bed. A sudden drop of the body temperature indicates ovulation. In fact, due to my irregular working hour in TV production line, it was hard for me to measure my temperature at the same hour every morning. Sometimes I woke up as early as 3am for a morning assignment; sometimes I slept as late as 4am after a round-the-clock assignment. But, believe it or not, I still deligently recorded my temperature for one and a half year, not knowing that I was a PCOS patient; and a PCOS patient who does not have regular period is unable to detect her ovulation point because she does not ovulate in most of her cycles! Whenever I recall that period of time where I innocently waited for a sudden drop of temperature on my basal body temperature chart, I have nothing to say except meeting a good doctor is very crucial in the process of treating infertility. Well, sorry for swaying away from the original topic, let's get back on track.

Feeling a bit insecure, I rang the clinic during lunch time to explain my test result to the nurse. The nurse told me the same answer as what I found from the Internet. I was told to continue to do the test tomorrow morning and inform them the result.

2011.06.12 (Sunday)
Excitedly, I did the ovulation test first thing after I woke up. This time the result was clearly negative because I can only see 1 control line. I was confused because at least yesterday there were 2 lines, although 1 was faint. Does that mean things are going backwards?

I texted the nurse to tell her the result of the test and she called me after 10 minutes. I was shocked when she said that she would try to arrange my IUI in the afternoon and asked me to stay at home and wait for her call.

"Why IUI is arranged when I have a negative result?" I eagerly needed an answer. She explained that since the day before there were 1 clear line and 1 faint line, that indicated that the level of LH was picking up. After that, the LH surge might have already happened (as early as12 hours after my previous test) without me knowing. The level of LH will drop after the surge. This explains why I only see 1 contol line (negative) this morning. So, I should be ovulating within the next 36 hours.

Well, now I totally understand the science behind the test, but the point is how do I catch the LH surge if I only do 1 test a day? Well, that is the reason why there are some people who choose to do 2 tests a day (1 in the morning, 1 in the evening) because they just don't want to miss the surge.  But this practice can only be applied to those who have regular period, where they can roughly estimate when their ovulations will take place. They just need to do the test during that few days. For those who have irregular period, it definitely will burn a lot of money just to buy the ovulation test kits.

The nurse then called back to inform me that she was unable to arrange the IUI on that afternoon, so it would be carried out on Monday morning. She reminded us to do our own 'home work' before Monday, just to increase the chance of pregnancy. Well, trust me, making love as per instructed by a third party is indeed very stressful for both the husband and wife!

Ist IUI - Ultrasound #02

2011.06.10 (Fri) - DAY 13
My day seemed to slightly run behind schedule this morning. As I didn't want to be late for my 10:30 am appointment, I drove faster than normal (but still in the safe zone!) and managed to step into the clinic at 10:25 am. I thought I was on time until I found out from the nurse that my appointment was actually at 10:15 am. Anyway, I shall just patiently wait for my turn.

At the waiting area, there were three couples with one couple having their 2 cute little girls with them. Each of the girl were holding an ipad on their palms, quietly soaking themselves into the world of cyber games. Looking at the two beautiful little girls, I could not think of any reason for their parents to visit the infertility clinic. Maybe they wanted more kids or were under pressure to get a boy. Well, I should respect any reason to bring a child to this world, as long as that child will be showered with love and care.

At 11am,  it was finally my turn to see Doctor Prashant. Before performing the ultrasound, he asked if I wanted to empty my bladder before the transvaginal scan. Since my bladder was half full, I proceeded to do so. Well, the result of the ultrasound was encouraging, there were 2 big follicles on my right ovary, the biggest one was 18.4 mm, the other one was smaller at the size of 14.6 mm. On my left side, there was 1 big one (which I forgot to take note of its size).

Dr. Prashant decided to see if I can ovulate naturally in the next 3 days (Sat, Sun and Mon). I will be given 3 Clearblue ovulation test kits, which I am supposed to use to test my first urine every morning, starting from tomorrow.  If by next Monday, the test result is still negative, I am expected to have induced ovulation by taking an HCG jab. Hmmm...I did not expect the arrangement of the natural ovulation to take place. I thought that I would be given the HCG jab today and subsequently followed by the IUI procedure tomorrow (Saturday). However, if things can happen naturally, why use external force? Also, who in their right mind would ask for a jab if it is absolutely not necessary yet? Let's see how it goes. Asking about when would be the estimated date of my IUI as I have an outstation assignment this coming Wednesday, Dr. Prashant said he will arrange the IUI to take place latest by Tuesday. Phew!

Before I left the room, the doctor instructed the nurse to perform an ovulation test on my urine. I was a bit surprised because I just emptied my bladder 5 minutes ago, I truly did not have any more specimen to provide for the test! The nurse smiled and jokingly said she just needed a few drops. I politely apologised and told her that I couldn't even give her a single drop. I asked to be given some time to 'refill' my bladder.

So, I spent the next 15 minutes practically hugging the water dispenser at the waiting area. Forcing myself, I gushed down 5 cups of water.

By then, I caught the attention of 2 little Indian boys who kept looking at me, wondering why this 'aunty' was so thirsty. My constant action of 'demonstrating how to dispense the water' really aroused their curiosity. Before long, the elder one took the gut to come near and tried to dispense some water for himself and his younger brother. They seemed to have a lot of fun trying out this new 'game'. I saw two happy boys giggling and running around with the their paper cups. This infertility clinic somehow looked more like a paediatric clinic today.

Finally, I managed to produce some specimen for the ovulation test. The test result was negative. So, I shall continue to do my own test at home and text one of the nurses (yup, I was given her handphone number) if there is a positive result within the next few days. An IUI will be arranged 24 hours after the ovulation. The Doctor jokingly said neither himself nor his nurses liked to work on Sunday, but if that was meant to be, they will still perform their duty base on the needs of their patients.



I was provided with 3 ovulation kits and 2 containers, one for the urine test and one to store hubby's sperm if he prefers to produce it at home or cannot make it to the clinic on the day of IUI.



So, the only thing that I shall do is to relax and patiently wait for 2 clear blue lines to appear on the ovulation test kits.

Total Expenses  RM 240

• Consultation               RM 80
• Ultrasound                 RM 80
• Ovulation Test Kit     RM 80

1st IUI - Ultrasound #01

Below is the little recap of what I have gone through prior to today's ultrasound (Day 9)

Day 3 - Day 7   Letrozole 2.5mg (twice a day, 2 tablets each time)

Day 6               Injection Folliova 150 iu

My appointment was set at 2pm and I arrived 10 minutes earlier.

The clinic was crowded, but quiet, as usual. There were 4 couples at the waiting area, 1 lady in working suites and an Indian young man, falling asleep on the couch.

I grabbed the latest issue of 'Nu You' Chinese magazine and started to dwell into the world of fashionista, thinking that it would take some time before my name was called.

Before long, my name was called. It was 2pm sharp.

Dr. Prashant was in his OT robe, maybe he just finished performing some procedures.  Smiling, the doctor asked how did I feel. I told him that overall, I am emotionally ok, but physically not that optimum.I felt that I have lost my appetite lately and I felt really bloated and nausea if I eat the normal portion of food that I used to. My tummy has bulged and I have put on 1 kg.  He was surprised that I was already experiencing all these symptoms at such an early stage of the treatment. He said maybe I have developed many eggs. Anyway, the ultrasound will tell the truth.

The result of the transviginal ultrasound showed that there were 1 big and 1 above medium size follicles on my left ovary, while on my righ ovary, there were 2 big follicles.

Dr. Prashant said that my condition is classified as 'reasonably fast'. I think that means my body responded to the medicine faster than normal, but overall it is still considered as acceptable aka. NORMAL. However, he told me he normally does not want too many eggs for IUI and I was told that the big follicles most likely will shrink by themselves after a few days. So, he will give me another shot of folliova (at a lower dosage this time) to 'maintain' the growth of some of the 'meant to be' follicle(s).

I understand that I should not be thrilled to have almost 4 big follicles because they might shrink and disappear (back to nothing?!) OR contrary, they might all grow and if I conceived, I am exposed to multiple pregnancies, which always carry higher risk than normal pregnancy, especially for woman at my age ( I was born in 1977 :p, you do the math).

The nurse then proceeded to 'jab' a shot of Folliova 75 iu to the left of my belly button area.

I am expected to come back for my 2nd ultrasound on Day 13 (10 June, Friday) and most likely the IUI procedure will be performed on 11 June (Saturday).

After payment, I left the clinic at 2:30pm.

One thing I like about Dr. Prashant is he is a friendly no-nonsense guy. If you throw him questions, he will answer you patiently. If you do not have any question, he will give you clear and precise instruction for your next step. My session with him is always short (not longer than 7 minutes for consultation plus ultrasound), but you will not feel neglected or 'rushed' through. There is always eye contact and 'just enough' information for you to carry on with your treatment. 

Total Expenses  RM 260

• Consultation   RM   80
• Ultrasound     RM   80
• Folliova 75iu   RM 100

Ist IUI - Folliova Jab

Today is Day 6 of my cycle. I went to the clinic to have my 1st jab of Folliova (which is actually FSH to stimulate the maturity of eggs).

I arrived at 10:15 am. The nurse who was at the reception counter mentioned my name aloud " XXX is here for her jab!" to another nurse in another room upon seeing me entering the clinic. The atmostphere of the clinic looked more relax than usual. To my surprise, the clinic was not crowded at all, and the lights of the other corner of the waiting area were turned off. There were only 2 nurses (normally there were more) and 2 patients, who seemed to come for jab or some other small procedure. It looked like Dr. Prashant was not in. Anyway, my jab was meant to be done by a nurse.

After 2 minutes, I was in the 'jab' room. The nurse asked me to lift up my shirt, revealing my belly button. She asked me which area that I wanted her to poke the jab. Haha....I asked her which area will be less painful? She shrugged and smiled. Immediately, I knew that wherever I pick, I will still fell the pain. Good thing, able to feel the pain means that I am still alive. She finally picked a 'site', which was about an inch away to the right of my belly button.

If I said it was not painful at all, then I am lying. But, it was really something bearable for a mature adult. This little pain was not a big deal at all.  When I asked is there any side effect should I expect? The nurse told me it would be lethargic. Well, since I have 'survived' from fatigue with Duphaston, bloated and nausea with Letrozole; I don't think I cannot survive from lethargy with Falliova. Just that I need to constantly remind myself to be mindful while I am driving and doing my work.

After setting my next appointment, I left the clinic.

My next appointment with Dr. Prashant is on 6 June (Monday). Looking forward to see the progress of my eggs. In fact, I don't know what to expect. It has been quite a long time that I do not have regular period naturally ( most of the time, I have induced period by taking hormone pills prescribed by doctors). The nurses said it might takes a few cycles of IUI to see how my body response to the treatment. I agreed with them, I am now on an experimental journey to explore my body. Other than being an obedient experiment subject, there is really nothing more that I can do to 'control' the outcome.

Do my best, accept whatever the outcome is and keep trying (well, I know I can only say this if there is still positive balance in my bank account).

1st IUI - Let's begin

I arrived at Dr. Prashant's clinic at 3pm, for my 3:15pm appointment. There were 3 patients ahead of me, all accompanied by their husbands. I was alone since Bernard is conducting a training today, thus impossible for him to come out from the office in the middle of the day.

I went in to see Dr. Prashant at 3:30pm. Initially, he intended to do a abdominal ultrasound on me to make sure there is no cycst or any unusual imagery before the IUI takes place. Well, after a few attempts, the Dr. couldn't figure out the images on the screen  as my bladder was not full enough for the scan. So, a pelvic scan (transvaginal scan) was done instead to check my uterus and ovaries. Well, things were in order, other than plenty of immature follicles were seen in the ovaries of PCOS patient like me.

I was given Letrozole 2.5mg to stimulate the maturity of my eggs. The consumption will be 2 tablets, twice a day for the next 5 days (Day 3-Day 7).

On Day 6, I am required to go to the clinic again to take an injection of Folliova 150iu.

This will then be followed by the doctor's consultation on Day 9 to monitor the progress of the eggs.

The nurses guided me through the steps, things are actually not that complicated. Since today is my Day 3 and it was already afternoon, the nurse asked me to swallow 2 tablets of Letrozole on the spot.

When I walked out from the clinic, I felt a bit light headed, couldn't believe that I was already on the 1st attempt of IUI.

Total Expenses RM 840 

• Consultation         RM   80
• Ultrasound           RM   80
• Letrozole 2.5mg  RM  500
• Folliova 150iu     RM  180

Making appointment for my first IUI

My period came yesterday, which was after 4 days I finished my Duphaston course. Hmm...I was attending a book launch and seminar by one of my favourite author, Liu Xuan (刘轩), when I felt a little bit of warm discharge flowing out. Wow, lucky that I already have a sanitary pad prepared in my handbag:)

During the last few days, Despite feeling slight premenstrual cramp on the tummy, I was feeling more energetic compared to when I was under Duphaston. So, I guess the fatigue that I experienced earlier was indeed the side effect of Duphaston.

On my last visit, I was told to call the clinic on the 1st day of my next period, in order for me to begin the IUI procedure on Day 2. Since yesterday was a Sunday, I called up Dr. Prashant's office today to make an appointment. The nurse schedule me to see the Doctor at 4:15pm, but shortly after she called to change the time to tomorrow after lunch.  Well, I guess as a patient there is not much space for you to bargain when it come to fixing an appointment with a well-sought-after doctor. Once, I was also told by the receptionists that the doctor and the nurses do not go out for lunch.  

As a working woman, one should be extra patient when it comes to this kind of situation. Be objective and be calm, adjust your time flexibily, so you can follow through your treatment. It it never been easy, but what choice do we have? Just do it.

Hit by Unusual Fatigue

As per Dr. Prashant's prescription, today is the 9th day of me taking Duphaston. After tomorrow, my period is expected to come within the next 5 days.

I have been feeling very lethargic lately, especially in the afternoon. My eye lids are so heavy and my whole body feels like wanting to shut down.

When the night comes,  (normally I am able to stay up to 11 plus), my brain starts to feel numb and my eyes become so dry and tired even before the clock hit 10:30 pm. I have no choice but go to bed early and I will doze off in just a few minutes. This seems to be unusual as most of the time I am a light sleeper as by default it will take up to an hour for me to fall asleep. The weight shown on my scale has also gone up 1kg, I do not notice I have been eating more than usual. Will it be the water retention?

Despite conquered by sleepiness and fatigue, I still force myself to do an hour of exercise at least 4 days a week. I either brisk walk and slow jog on the treadmill or practise yoga in the morning. The endorphine from exercising will keep me energetic for 2-3 hours, after that I feel fatigue again.

Last Sunday, Bernard and I went walk up to Kiara Hill. We used to do this once a week. In fact, the 45-minute journey of walking up and down hill is not something very challenging. But guess what? My right ankle and tibia ached the next day. I have to walk very slowly as my right feet feels so painful when pressure is imposed on it . I still cannot understand why this can happen since I exercise regularly and it is a routine activity for us to walk up Kiara Hill. Since then, it has been 2 days I skip my daily exercise, hope that my feet will recover soon.

I also feel some pain on my right ovary occasionally, especially after I carry something heavy. So, not only I cannot walk properly, I also cannot carry heavy things now. One thing good about this is now I have excuses not to do many things at home. Hahah, poor Bernard has to do all the house work.

Well, would all this 'weird' things be the side effects of consuming Duphaston? Will see how I feel after tomorrow, when I finish this course of Duphaston.

Decision Made for IUI

13 May 2011 (Fri)

Friday the thirteen marked my 2nd consultation with Dr. Prashant, after I underwent my HSG procedure 2 days ago at Pantai Hospital Kuala Lumpur.

To avoid driving 2 cars and to pay the rather expensive car park rate at Wisma Perintis  (RM 6 per hour, with 1st hour complementary by KL Fertility Centre), I picked up Bernard from his office at KL and headed back to Damansara for our appointment.   We arrived at the clinic at 11:40 am, it was crowded. After registering ourselves, the waiting routine began.

Unlike many other clinics that provide outdated worn out magazines, this clinic has the latest issue of popular magazines in English, Chinese and Malay. These magazine certainly makes the waiting easier.

We also bumped into a well known Malaysian Singer, the talented and cheerful Mr. R ( name to remain anonymous) in the clinic. As far as we know, he and his wife already have 2 lovely sons. However, since he did mention that he wanted to build a soccer team in a newsspaper interview some times ago, I guess that is the reason he and his wife appeared in Dr. Prahsant's office.

Not too long after that, Bernard's name was called, but not by the nurse. It was his ex-colleague. She and her husband were there to have their 2nd IVF. Prior to this, RM15K was spent to remove her endometriosis at Tropicana Medical Centre. Then, she completed one cycle of IVF, which costed her another RM20K ++.  Unfortunately, luck was not on their side. She was calm and peaceful while telling us her experience. I guess this is how infertility patients feel after they have gone through many turns and corners in their journey of attempting for a child.  Well, which couple in this waiting room did not have their unique experience in the path of treating infertility? There is nothing you can do, except continue to look at the bright side and keep trying.

Half way through sharing her experinece, my name was called by the nurse. It was 12:20 pm.

After looking at my HSG report, Dr. Prashant was certain that both my Fallopian tubes were in normal condition. Thus, my only problem now is PCOS. He suggested IUI first. If the result remains unsuccessful after 2 to 3 cycles, then IVF comes along. Well, since IUI is less complex and will cost less, Bernard and I agreed to the suggestion without further consideration.

To end the consultation, Dr. Prashant delightfully told me to call the clinic on my next menstrual cycle in order for us to begin my 1st IUI. Well, teasefully I told him that I wouldn't know when I can see him again because I am clueless when my next menstrual cycle is (since I am a PCOS patient!).  Caught off guard, he graciously smile and quickly prescribed me with 10 days of Duphaston. So now I am able to forecast when is my next menstrual, which is after 2 weeks.

After staying under the dark clouds of hormonal imbalance (which caused aovulation) and having both blocked tubes for nealrly a year, I started to see the sun beaming through the cloud.

At least now I am moving forward with my 1st attempt to meet my angel. No one will know or guarantee the end result. But you have to believe that good things will happen if you have good thoughts and do good deeds. This is what life is.

Total Expenses RM140

• Consultation
• Duphaston x 20 tablets (10-day course)

HSG, the 2nd time!

11 May 2011 (Wed)

Today I went for a HSG procedure to check the condition of my Fallopian Tube.

Technically, this is already my 2nd HSG. The 1st one was done July last year at Damansara Specialist Centre. The report conclusion was both my tubes were 'invisible', despite 2 doses of contrast was injected . Honestly, I was not very happy with the result of 'invisible'. Did that mean I don't have a Fallopian tube or my tubes were blocked? According to my doctor at that time, Dr. Abdul Ghafar at LPPKN (Jalan Raja Laut, Kuala Lumpur), 'invisible' is directly interpreted as 'blocked'. I was told that If I am not convinced with the result, I have a choice to do another HSG after 3 months or proceed for a Laparoscopy to confirm the condition of my tubes. Chose to live in denial, I did not do anything to find out the truth until last week.

This time, my HSG was scheduled at 10 am at Pantai Hospital Kuala Lumpur. Bernard decided to accompany me this time. We arrived at the imaging department at 9:50am.

Pantai Hospital Kuala Lumpur (The picture was taken from inside of the car, so there was a reflection at the bottom right corner)

The Imaging Department

After submitted the referral letter from KL Fertility & Gynaecology Centre (which specially requested for Dr. Vimalah to perform the procedure), I got myself registered and was soon instructed to make the payment at the cashier counter. The charges was RM436.60. Pantai was obviously dearer than Damansara Specialist, which costed me only RM250.

At 10:30 am, my name was called. The procedure began after I changed into the OT robe.

Well, was it painful? I guess it all depends on the endurance level of an individual. To me, the pain was bearable. It felt like a slight cramp at the ovary area when the contrast was injected into the uterus. Dr. Vimalah directed me to make slight turn to the left and the right to assist the contrast to flow better. The whole process took about 20 minutes. I couldn't wait any longer for the outcome of the X-ray, thus decided to ask Dr. Vimalah immediately after the procedure. She told me both my tubes were clearly seen and they were both patent! The only negative side was the free spill was very small in amount. This could due to my tubes were very fine. Honestly, I was delighted to get a different result from the 1st HSG but at the same time, I tried to keep myself calm as nothing is confirmed until I receive the film and the final report which will only be ready an hour later.

As per instructed by Dr. Prashant' nurse last week,  I made a call to Dr. Prashant's office after the procedure to make a consultation appointment on the same day. Unfortunately, Dr. Prashant was not available for the next 2 days. So, the earliest appointment available was made at 11:45 am on this coming Friday (13 May). I am aware that it will be a black Friday, but to me, if things are progressing forward, everyday is a good day!

Total Expenses:

HSG RM436.60