The "Candies" Before Bed ...

As you can see, my daily 'candies' as I call them.

 

These are the night ones I take before bed. Two powerful purple tablets that suppressed the immune system and the little one with 'heart' is for blood pressure.

 

I am back on CellCept since two months (or so ago..) - My kidney biopsy results showed that I am now Class 4, I've upgraded from the previous Class 3. I am also a Class 5 holder. Class 5? Now, don't be confused,

 

Class 1-4 (I-IV) and 6 (VI) are related, means, the higher the no., higher severity.

While, Class 5 (V) its by its own, membranous lupus nephritis.

Class I	Minimal mesangial lupus nephritis
Class II	Mesangial proliferative lupus nephritis
Class III	Focal lupus nephritisa
Class IV	Diffuse segmental (IV-S) or global (IV-G) lupus nephritisb
Class V	Membranous lupus nephritisc
Class VI	Advanced sclerosing lupus nephritis

Treatment wise, I am back on CellCept, rather than the usual "Cyclophosphamide" treatment for LN. I consider myself "lucky" to get on to CellCept again - as it is the less prescribed treatment due to the cost involved. Being in public healthcare, I can only pray and hope to get the best or better alternative.

 

(Cyclophosphamide is a type of chemo drug, while CellCept is an immunosuppressant)

 

The problem with Cyclophosphamide is that it can cause infertility - permanent, and possible early menopause. Although doctors did explain that the dosage used now is much lower and infertility is more towards the 'male' gender. I was not convinced and ended up getting all emotional (first round) and was given CellCept instead. I responded well on CellCept, went into remission, got pregnant and during pregnancy, the proteinuria, blood all started leaking from my kidneys - prayed a lot during pregnancy and with the The Power of Prayers ...

 

.... talah .... I now have Sophia who loves to pull my hair!!!

 

 

 

That's me, with my moonface features.

Thanks to the 30mg of Prednisolone I take, on top of CellCept on a daily basis.

 

Prednisolone is a type of steroid that suppresses the immune system.

It has many side-effects if taken long term.

I've been on it since 2004!!! YIKESSS!!!!

 

Side Effects? Me? So far, weak bones, easily bruised and mild cataract!

Sometimes, on high dose - elevated BP and MOONFACE plus a camel hump and sometimes, weird craving for food, like now, I've been eating chocolate non-stop. NOT GOOD!

 

I must tame my appetite!!

 

 

P:S: Thank you to all my wonderful bloggie friends who still visits despite the lack of 'action' from me!! Love you all a lot!!

 

 

FPP Hospital Selayang Review - "The Cost & Verdict"

The Cost

It cost us around RM 4,000 under FPP in Hospital Selayang for delivery via ELCS - Cesarean, 7 nights stay in a single room (as Little Sophia was still in NICU and I had to wait to 'room-in'), medications, blood tests.

This time, upon discharge, the credit card machine works!

Discharge process was slow but bearable. I wasn't going far anyway, just to NICU to room-in with Little Sophia. :)


The Verdict

Honestly and truthfully, I am pleased with the medical team.

Although rather unhappy with the room's condition and food provided. I didn't complain. Only once I told the cleaner to clean under the bed because I couldn't stand looking at the dusts and spots. I even wiped it myself!

In short, Hospital Selayang must improve in hospital support services, particularly cleanliness and also quality of food provided to patients. If the current contractors are lax and not up to mark - change!

FPP Hospital Selayang Review - "The Procedure - Cesarean"

The Procedure - Cesarean (26/2/2013)

Booked for a Cesarean, morning the next day, 26/2/2013.

Meaning, I've fasted, on drips, shaved (ahem!) and gone through all those pre-ops preparation in view of Cesarean which will proceed as planned provided :-
- A ventilator is available at NICU (as I am expecting a preterm baby)
and, - there's no other emergency cases.

In the morning, a nurse came to fix the urine bag. (Ok, what urine bag!!) - It is also known as urine catheter, to make sure you don't pee and wet yourself before, during and after surgery! Yes, a tube inserted to catch pee into a bag. I declined, because I know it will be uncomfortable. I requested for it to be done in the OT, after they numb me! :)

At around 7 am, a nurse 'unofficially' informed me that ventilator is not available and procedure may be postponed to the next day, or another 'next day' until available. I didn't like the sound of it! This mean I had to fast again? and again? and shaved again? ... okay, maybe not the 'shaving' part.

Around 8 am, as I was reaching for my cuppa of oats drink (to break fast, 'unofficially'), Dr. Yu came and said can proceed as NICU can make arrangements if needed. Oh yes!

Off I go to the OT!

Never been to an OT before. Oh my - it is so bright!

First, I had this whole group of aliens (people in green) surrounding me, freaking me out. Then, suddenly, someone said "FPP" and many green people had to leave (I guess they were there to observe and learn) - so, take note, perks under FPP - Not so many green people.

Then, the very nice Dr. Anesthesia started numbing me. I had to sit up, bend a little while she administers the 'numb' drug. (By the way, I love the song "Numb"!) - believe me, she's so good that I felt nothing during the numbing procedure.

However, I did have a 'not-so-nice' (wouldn't want to call it 'bad') experience with the IV line. The first IV line they did became 'blocked', removed - they tried to do a new one at the OT. First attempt unsuccessful as it was painful after, then second attempt, my hand swelled up as they started the drip ... third attempt they did it inside bend of my elbow, which was successful but I didn't like it as it restricts my movement, in case I needed to protect myself against green people.

I had two IV lines, both hands. Feeling very cold. Very, very cold, freezing cold, shivering - they had this blower with hot air to keep me warm... still, I was shivering. I've never felt so cold before.

After I am all numb ... okay, half numb - lower body - Dr. Yu (I think ... everyone looks the same in the OT) started the procedure. I can feel 'something' but not pain. Pain had been blocked.

When I felt doctor pulling, I knew he was trying to get Little Binny out ... soon after, I heard my Little Binny crying.

My Little Binny is finally here.

The nurse showed me my Little Binny, asked if I know the gender. I said yes, girl.

Me, still drowsy. Should have taken a picture of the urine bag!

My precious little girl.

God, please protect her from all harm. She's just too precious. I love her.

Little Binny weigh-in at 1.84 kg. She was then transferred to NICU.

Little Binny @ NICU

FPP Hospital Selayang Review - "The Admission"

"Review" on Government Hospital, now that's weird.

Anyway, I am not very normal.

I did end up taking FPP (Full Paying Patient) for my ELCS (Elective Cesarean) at Hospital Selayang under Dr. Yu. My ELCS was for medical reasons. The Nephro thinks my Lupus is screwing with me kidneys! (i.e. Leaking protein, blood, leukocytes ...)

The Admission - 25/2/2013

At Level 5 - Labour Ward, Hospital Selayang - 8.00 am.
I Waited. And Waited.
FPP or not, I still have to Wait .. and Wait ..

Then,  I was directed to go to  'observation unit'
- CTG to monitor baby's heartbeat.
- Ultrasound (estimated my Little Binny weighs 2.2kg)
- Blood Test
- Dexa Injection on my butt (to help Littly Binny's lung make surfactant so that Binny can breath easily)
- Inserting a very biggie IV line! (ouch!!!!)

(Level 5, Observation Bay are shared by FPP, non-FPP - so, do not expect much privacy!)

Oh ya, remember RM 3,000 is required as deposit under FPP - cash or credit card.
Do bring along your ATM card, as the credit card machine may refuse to work, like on the day I was admitted!! Worry not, there's an ATM on the Ground Floor, just make sure your daily limit is sufficient! (In my case, it wasn't and I ended up paying half first, and half in the evening when my hubby came)

I waited till 12 pm before a room was available!
A Single Room - means hubby can bunk in!

Next - The Room

22-Feb-2013 : Missy Binny @ 34wk 1day

EFW : 2015 g 

Grow Binny Grow!

21-Feb-2013 : Bag Is All Packed

4 More Days to being warded ....

Bag packed.... 

Green, green bag - according to Feng Shui of the Water Snake 2013, very lucky colour la...

Not knowing what to pack - I had to google.

And, hopefully I've packed more essential and less 'nonsense'. :)

Good thing is - I've managed to stuff everything into ONE bag. :)

Earlier, I had TWO bags, then... almost had the THIRD bag .... looked as if I am going for a holiday.

20-Feb-2013 : To go FPP or NOT?

5 More Days to hotel hospital admission day (25/2)

What is FPP?

FPP stands for Full Paying Patient Scheme at selected Government Hospital in Malaysia.

Sort of like a private section, where patient gets to select their own specialist, comes with priority in-patient facilities but do not expect to be treated like a 'diva' in 'real' private hospitals.

Below is the estimated cost, obtained from Hospital Selayang.
The other hospital offering the same scheme is Hospital Putrajaya.

I am posting this because I remember google'ing' like mad for cost estimates.
So hopefully, it will help others who are now google'ing' like mad.
"Estimated Cost of Delivery under FPP in Selayang Hospital"

Am I going for FPP?
Very likely, with much support Aunt LL :)

My only worry is, should there be complications and I'm needed to stay much longer ... the hospital bill will creep-up... and up....
Then again, I've been told that I can exit from FPP, at any time upon settling all outstanding.

Why am I going for FPP?
A specialist will be sure to perform the c-sec and stitch me up after ... without FPP, I may end up with a trainee - I've heard of horror stories.
A little privacy, with a single room - fingers crossed rooms are available upon admission.
And, should Little Binny ends up in NICU - it will be under government rates, not FPP.

Please pray, purr that all will be well, smooth and safe for little Binny and I! :)

19-Feb-2013 : Anesthesia Clinic

6 More Days before being admitted (25/2)

19-Feb-2013 : Klinik Anaestesia or Klinik Bius @ Hospital Selayang for a Pre-Ops Evaluation.

Given this blue form, to be attached to my 'pink pregnancy' book.

BP : 116/81

PR : 104 bpm

Considered high-risk due to my pre-existing Lupus condition.

ICU backup.

Hmmm...

Footnote :- 

Cried. 

Auntie J lectured me for not telling her things.

Must not cry. 

Love you Auntie LL.

Shopping for Missy Binny : IKEA Baby Cot & Etc...

We went shopping for Missy Binny at IKEA today!

A Baby Cot, Mattress, Chest Drawer & etc!

Our pockets end up lighter by RM 787.50

We bought the most economical baby cot available at IKEA - RM 165.00, almost bought the cheapest Cot Mattress, which was less than RM 30.00. Then decided not to be so cheapskate and bought a decent (we think) mattress which was RM 179.00.

IKEA Baby Cot + Mattress + Mattress Protector + Mattress Cover + Blanket = RM 430.70.

Week 33 : Off Aspirin

Week 33 : Off Aspirin - that's what Dr. Y said.
So, today I'm officially "Off Aspirin".

I've been having sleepless night ... very anxious, afraid, excited - ever since knowing that I'll be warded on 25/2 for a planned early delivery at Hospital Selayang.

Things moved so fast, with the Nephro referring me to a specialist in OBGYN ... and talah ... a date was set!

Missy Binny will be 34wks ++ by the time of planned delivery - not sure of the exact date yet as they would have to make sure baby ventilator is available prior to surgery.

Wish us lots of good vibes & luck !!!

Possibility of Early Delivery ...

Just when I thought no doctor cares ....

Ring, ring goes my phone and it is Dr. E !!!
Yes, Dr. E - I've only met him once, last week ...

Now, Dr. E is referring me to see an OBGYN specialist - Dr. Y.
Finally, seeing an OBGYN specialist!!
Prior to this, I've only been seeing the MOs ... and trust me, they can be pain in the ass ... leaving you blur and blur'rer' after each appointments....

So, tomorrow - I am getting a referral letter from Dr. E to see Dr. Y.
Dr. E mentioned possibility of early delivery as my lupus is ain't that 'quiet' ....

Wish me luck!
Hope I get good, compassionate, kind doctors who know what they are doing!

Today Is a Good Day to Pee!!!

Another 24 hours urine collection!

My last 24 H results showed I'm leaking 1.0g protein in a day - not good!

Hoping for better results this time.

Pregnancy Weight Gain Guidelines

Recommended Pregnancy Weight Gain 

Pre-pregnancy Weight 

• Underweight (BMI less than 18.5)- 28 to 40 pounds (about 13 to 18 kilograms) 

• Normal weight (BMI 18.5 to 24.9)- 25 to 35 pounds (about 11 to 16 kilograms) 

• Overweight (BMI 25 to 29.9)- 15 to 25 pounds (about 7 to 11 kilograms) 

• Obese (BMI 30 or more)- 11 to 20 pounds (about 5 to 9 kilograms)

How to calculate BMI (Body Mass Index)?

Use a calculator :-

Or to an online tool like :- http://nhlbisupport.com/bmi/bmi-m.htm

My Pre-Pregnancy BMI is ....

Hehehe - "Overweight" it says...

So, I must aim to gain in between 7-11 kg.

At 28 weeks, I am about 70kg ... thus my weight gain so far is 3.4 kg.

(Maybe that's why Missy Binny is measuring a week smaller...)

Must gain a little bit more! More Tandoori Chicken, please!

Missy Binny : 28 weeks 0 days (3D 4D Scan)

Missy Binny at 28 weeks + 0 days!

Today, we went for a 3D 4D scan at a clinic nearby.

Must say, we are very happy with the service - Jezzlyn is wonderful!

For RM100, you get a 3D 4D, plus a 2D growth ultrasound!

Online booking available at :- http://bayi-ibu.com/3d-4d-scan-malaysia/

Missy Binny is measuring a bit small, about a week behind.

Estimate to weigh about 1057 grams!

Technology is simply amazing!

And, this is Missy Binny .... with her legs up by her head, also known as "breech".

No worries though, many babies will re-position themselves by 35 / 36 weeks!

Little Missy Binny : Echogenic Focii

The arrow points to "Echogenic Focus" / "Echogenic Foci" / "Bright Spot" on her heart (left ventricle) discovered during a Little Binny's private scan at 22 weeks.

Yesterday I had another detailed fetal scan. This time, it was at PPUM (Pusat Perubatan Universiti Malaya) - similar to the private scan I had, they found the bright spot on Missy Binny's heart. Rest appear normal and she's growing well. :)

What is Echogenic Focus?

An echogenic focus is a “bright spot” in the heart that can be seen on an ultrasound. Most of the time an echogenic focus is seen in the left ventricle of the heart. This is NOT a heart defect, it does NOT change the function of the heart, and it does NOT cause heart disease. Usually the bright spot is a small calcium deposit and is a normal finding.

Refer to :- http://www.med.unc.edu/nursing/programs/women/womens.ed/english/Echogenic%20Focus.pdf
(A very good reference.)

However, it can be a soft marker for chromosome changes, like Downs.

Meaning, it can be nothing or something.

In my case, it is a relief to know that EF is an isolated finding as rest appears normal BUT, as I am 35 years old, it puts risks for chromosome change higher.

Bloggie friends, please pray that all be well and healthy for Missy Binny and I.

Little Missy Binny : 21 weeks 6 days

Presenting ... Little Missy Binny!!!

Three White Lines =  Girl!

(that's what the Sonographer told us!)

I've been pretty much freaking out and worrying after the detailed scan last Wednesday.

That's because they found a bright spot on Little Missy Binny's heart.

I am still very much worried.

I have another detailed scan this Thursday - I hope it is all clear.

Little Binny : 20 weeks 4 days

Little Binny says "Hi" to everyone!
We have reached the halfway mark of pregnancy! 20 weeks!!

Little Binny is estimated to weigh 322g ... and the Little (maybe not so little) Mommy weighs, ahem... 66.6kg today .. Hmmm.........

Little Binny looks well on the scan and the doctor can't see any indication of 'birdie' (ahem,) so, maybe it will be a "Hello Kitty" theme for Little Binny.
However, Daddee still thinks "Doraemon" theme and 'birdie' will somehow 'pop-out' next ultrasound.
Hahaha.... Daddee oh Daddee... He sure wants a little helper with his DIY projects.

Next ultrasound will be the detailed scan at PPUM (Pusat Perubatan Universiti Malaysia) - a different hospital (university hospital) as they don't do it in Hospital Selayang ... :(

Urine - Protein +3, Blood +3, Leukocytes +2

Dear Krazy Kidneys,

I know there's Little Binny's waste that you need to process too.
It can be a little overwhelming.

Please be good?
I promise to drink lots of water ... barley water...

Your fairy god-mother (the Nephrologist) wants to see us after New Year, second day of 2013 to be exact.

And, we have a date on Christmas day to collect 24H urine, to submit on 26/12.

Be good and strong Kidneys! Love ya lots too!!

We need to be strong for Little Binny!


Yours Truly,

Krazy-Ma

Today 19 weeks, 1 day

Yay!

I am now 19 weeks, 1 day pregnant!

Although I must say that I look rather 'flabby'.

And, I need a haircut badly - looking very much like a 'time-escaped' cave-woman from centuries ago.

Went for my check-up / follow-up at the hospital on Wednesday.

Thing is ... my blood & urine lab works came back 'abnormal', but didn't worsen ..

(detected + protein, +++ blood, ++ leukocytes in my urine...)

(hemoglobin 7.8!!!)

My kidney function seems okay,

My blood pressure is normal,

I have no pedal edema,

I do not have Beta Thalassemia,

And,

Little Binny is estimated at 236g! Growing correspondingly...

I guess it is all good?

Still can't tell if Little Binny is a Boy or a Girl!

(the doc who did the scan didn't really try, sigh... after all it is a public hospital, can't really demand much!)

Oh My Meds ....

Meds Oh Meds...

Let see what I have....

75mg Azathioprine

75mg Aspirin

15mg Prednisolone

600mg Ferrous Fumarate

and....

Obimin, Calcium and Folic Acid...

Next doc review on 7 & 15...

Please let me have some good news!