6th & Final Consultation with Obstetrician & Gynaecologist - Dr Tan Ee Ping

I am now 39 weeks pregnant! No sign of baby coming anytime soon yet but I am feeling more and more whale-like everyday. Walking is strenuous , getting up from bed or a chair is a herculean effort, standing ardous...ok I guess you all get the picture...

It was just supposed to be the standard weekly check up with Dr Tan but because I went to see her the last time and was in a lot of pain, she asked me to come back two weeks later. So essentially it was either I would already have given birth or be at 39 weeks pregnant.

Hubby and I were extremely surprised that when we arrived there the clinic was less than half full. Considering all our other visits, where the clinic was so crowded, you literally had to fight for a place to sit or stand. We only waited around half an hour to 45 minutes after all the necessary urine test and ultrasound. Baby #2 is now estimated at 3.2 kgs! I really thank God my weight did not change from the last visit 2 weeks ago, so I am still at 70 kgs give or take 200-300 grams more.  But no significant weight gain.

Hubby hadn't eaten lunch yet and I told him that I would be ok to see the doctor on my own so he could go next door to the middle eastern sandwich restaurant and get something to eat. I got called in and started chatting with the doctor. I had a few questions pertaining to what I wanted during my delivery such as delayed cord clamping, delayed bath and I wanted to room in with my baby so that I could breastfeed him exclusively. I also asked her about whether my SPD condition as per my previous posting here would have any effect during the delivery process. She explained that I might experience pain after the delivery rather than during the delivery. We chatted a little more and then I mentioned, I should be alright since you are going to be there and are aware of all the complications that I have had so far.

It was at this point that she dropped a BOMBSHELL on me! I can't remember what her exact answer was, but it was along the lines of "most probably not". Chances are she would not be able to deliver my baby because she herself was going in for surgery and was going to be on medical leave from 1st of February onwards for the next 3 months! I was shocked and dismayed when I heard this as I am only one week from my due date of 3rd February! I was on the verge of tears and then got a little angry and told her how come I was not informed at all?  According to her all her patients were told as she had made a decision somewhere mid January, because I was in so much pain the last time I saw her, this little very important information had slipped her mind! She said that I was probably her only patient that didn't know!! I felt like crying really...after all these months, the main reason that I started seeing her was because I felt comfortable that she would be the doctor who would deliver my baby and also provide me with a different birth experience from Chapati!! She then recommended another doctor called Dr Eee and said that I should probably make an appointment to see him as soon as possible. I got really angry then...why in the world would I take the time to go see her and go through all the rigmarole of tests, ultrasound and discuss what I wanted during delivery? Why didn't anyone say anything to me?? I was so so so mad I tell you...

I took the recommended doctor's information and expeditiously left the room. The best part was, they had the gall to charge me the normal fees for the ultrasound and consultation!!

I understand that we are all humans and our bodies do break down and need to be looked after...even for doctors but I felt that they didn't even bother to make sure that something so important was communicated to ALL their current patients. Especially those who are so near their due dates. Malaysian "tidak apa" (couldn't care less) attitude at its best??!! I really hope not. I realised that with Dr Tan, you really have to make the effort to ask, check up on things...whilst she is pro-natural and is an experienced specialist, she has somewhat forgotten that personal touch and connection with her patients. Can you imagine that something so important they can forget to inform ALL their patients? I hardly have time to make other arrangements! It was a case of, if you deliver now, great!She can still be my doctor, a few days later I get some unknown doctor that I have not even met and doesn't know the first thing about me! What's the point of seeing a private specialist and spending thousands of ringgit (I mean literally 5 to 10 thousand ringgit) when I can get the same kind of treatment at the government hospital for maybe a few hundred ringgit all in for the 9 months including delivery? Yes, I was really upset.

Anyway, I hastily paid the bill and left to look for Hubby. I am now half wondering if I should have just walked out and refused to pay the bill...I think that I would be less angry...I can't even believe that I was so nice to the nurses there when all I wanted to do was give them a piece of my mind.

Consultation        = RM80
Ultrasound          = RM40
Total                    = RM120

I lamented and cried all the way home whilst Hubby was surprisingly calm, caring and utterly at peace. He assured me that whilst it was upsetting, he was sure that everything will work out for our good and that God is always looking out for us and will not let anything go wrong or allow us to experience anything less than the best. He told me to quickly arrange an appointment to see the other doctor the next day and leave all my anxiety in God's hands. 

I felt much better after that, and proceeded to make the appointment to see Dr Eee...but I was still worried and decided to do a little more research and to reach out to members of the The Gentle Birthing Group Malaysia from whom I got the recommendation for Dr Tan. However, I didn't get any responses with regards to any reviews or experiences with Dr Eee and the only thing that I could find was Dr Eee's Women Specialist Clinic FB page with reviews in it. Now I am praying and hoping that he will be the right doctor for me.

December 2015 Expenditures

I finally completed our December 2015 household expenditure report and we had already anticipated that we would be spending more due to our plans for home improvement and Christmas. I believe that we were already quite prudent with our spending and didn't go overboard with the presents and food. In fact, thanks to brother-in-law and sis who was home visiting from Qatar actually paid for our enjoyable and yummy Christmas Lunch at Gobo Chit Chat at the Traders Hotel. I got my turkey and other Christmas food! Love you guys.

Our eating out expenditure went up tremendously because of meet ups and gatherings for the Christmas season. One of hubby's school mate is actually moving his whole family down to Johor and this was the last few times to meet in KL. 

Fuel expenditure also went up as we made a short trip to Ipoh as Hubby's uncle finally lost his battle with cancer. We went there to be with his Aunt and other family members. Hubby's car was also involved in a dreadful pile up and until today, is still being repaired. He also sends and picks me from work and Chapati to his grandparents everyday. I think he averages over 120 km everyday. Not including time in traffic...etc. coupled with work. Love you heaps dear and thank you for doing this! I am now about 38 weeks pregnant and he doesn't want me to drive in case something happens. I am on my last two weeks before baby#2 arrives. 

I am still not very good at organising the categories and missed out some expenditures so it took quite a while to reconcile them. Here you go! 

Item/Vendor	Amount (RM)	Notes
Haircut	$65.00	Went to see Junn and gave her a little tip
Doggies	$492.20	Supply of food for 3!
Kids MISC	$247.00	Jungle Gym activity tickets bought in a group buy and Christmas Merry Go Round rides
Formula Milk	$120.00	Chapati’s Stage 3 Milk
Diapers	$65.98	2 bags of diapers to put in Grandma’s house
Kids Toys	$79.00	Hubby decided to buy in a number of trucks for the boys as he found them cheap in MR DIY. Slowly give as gifts over the year.
Baking Ingredients	$119.70	I planned to do some baking for Christmas but it didn’t happen. Must use up the ingredients this two months.
Toothbrush	$10.59	Hubby’s and Chapati’s toothbrush looked a little blackish/greenish.
Groceries	$456.59	Didn’t eat much at home in December but we still spent money on groceries???
Eating Out	$1,351.70	Sigh…Christmas dinners…outings with friends…drinks…nearly tripled this expenditure from last month. NOT GOOD! But Fun!
Home maintenance	$1,471.80	We bought new storage solutions from Ikea as we are doing up our home DIY. Will show some before and after photos.
Home Cleaning	$355.00	Cut grass and weekly cleaner 5X
Car maintenance	$413.00	X-Trail major service and a tyre puncture repair.
Fuel	$938.67	We are using the gas guzzling 4 wheel drive as Hubby’s more fuel efficient car got into an accident. As of today still not back yet.
Travel/parking	$57.00	I used Grab Car quite a bit as we are down to 1 car. Mum was also hospitalized.
Gifts	$685.42	Weddings, Christmas presents for family, office gift exchange, children.
Medical/Medicines	$396.29	2 baby checkups and misc meds for Chapati and myself. I have bad acid reflux lately.
GRAND TOTAL	$7,324.94

How did you do on your Christmas month? Did you overspend? 

The Pain of Symphysis Pubis Dysfunction (SPD)

I am now on my last few weeks before the arrival of baby#2. Suffice to say that I am still so not ready...

Anyway, something else to share is that last Saturday night I just could not walk without crying as the pain was so bad. I didn't know what I did or didn't do  and where was the pain was actually. The minute I tried to stand and put one foot in front of the other, the stabbing excruciating pain in my back, groin and panty line area would come. Coupled with the really heavy feeling of baby pressing downwards on my vaginal area. I could not lie down comfortably either and the only position that offered a little relief was sitting upright on a chair.

Slept really badly on Saturday night and come Sunday morning, it was even worse! I literally cried and cried every time I moved and finally decided to go see Dr Tan. I really thank God that she has clinic hours everyday of the week including Sunday and when I called, the nurses there asked me to come in as soon as possible.

So we quickly got ready, packed Chapati in the car and drove straight there. It was torture to climb the stairs to her clinic and by the time I got to the front door, I was in tears again. I couldn't move to the toilet to pee for the urine test, much less walk to the back of her clinic for an ultrasound. I was crying from the pain and the nurses quickly bumped me up the line (I think) to see Dr Tan soonest. I explained to her what I was feeling and after hearing me out, she put her hand just below my belly where your pubic hair grows and pressed. It HURT! Badly! She then explained to me in simple English, that my pelvic bones seem to have separated more than it is supposed to at the stage of pregnancy that I am at. This normally happens closer to the time that baby is due to come out but I was only 36 weeks plus. Because of that, my pelvic bones move too much and thus the pain. Which she said could be excruciatingly painful (which was really bad in my case) She also explained that some times, mothers experience this pain as well after birth. In any case, she prescribed rest for two whole weeks or until I deliver.

I was of course horrified! This is the beginning of our new financial year at work and the first month! Appraisals were due this week and so was our quarterly workshop! I still had so many things going on at work that I took it for granted I had another two weeks to clear stuff up.

The nurses then brought me a wheelchair and we found out that her clinic area has lift access and they kindly arranged for an access card to allow Hubby to drive to the basement where I could be picked up. If only I knew, I would NOT have attempted the stairs in the first place.

On the way home, I called Doc sis in the USA and explained to her what happened and she explained my condition in a little more detail. She also gave me the name of this condition to look up so that I could understand what was happening to me. Symphysis Pubis Dysfunction...yeah a real mouthful.

This picture explains it a little better.

I like how this What To Expect website explains Symphysis Pubis Dysfunction.

"Symphysis pubis dysfunction, or SPD, means the ligaments that normally keep your pelvic bone aligned during pregnancy become too relaxed and stretchy too soon before birth (as delivery nears, things are supposed to start loosening up). This, in turn, can make the pelvic joint — aka the symphysis pubis — unstable, causing some pretty strange sensations and sometimes pelvic pain."

In my case it was acute and piercing pain when I stand and try to walk.

There is a bit more material on Wikipedia and another website called Birthsource.com. The article in Birthsource touched a little bit on delivery which was helpful to know.

"Birthing vaginally is certainly attainable and preferable even with SPD. Spreading of the legs, however, should not be extreme. Perhaps the best positions for pushing when you have SPD is either "all-fours" (hands and knees) or side-lying. Squatting may be painful as well as the most common birthing position, the sitting position with legs wide apart. Be sure that you explain to the nurses and other caregivers that you have symphysis pubis separation and need to minimize spreading your legs widely. One of the drawbacks of receiving an epidural during the birth is the pain of separation may be masked and therefore you may be put into positions that are only making the problem worse. Unfortunately, you wouldn't find this out until the anesthesia wears off and you have the extreme pelvic pain. Therefore, it is imperative that the caregivers know of your condition and do not suggest positions that could exacerbate the situation."

So now, it's for me to "enjoy" this time off to myself, though I reckon that it will be a little difficult due to the fact that I am working from home. (Thanks to technology...NOT!) But the last few days of limiting movements, because I am at home, has really helped to reduce the pain and discomfort tremendously. Now just a little more research to do on delivery positions, I really don't want to suffer post delivery.

Mummies! Please do share experiences and resources if you suffer from SPD too. 

Update: 17th January 2016

My bill for this emergency visit.

Consultation    = RM80.00
Pharmacy        = RM20.00 (10 tabs of Ultracet (tramadol + paracetamol)


Though I am wondering why she prescribed me Ultracet as I did some research on the drugs and they are category C. Lots of recommendations that it should not be taken during pregnancy & breast feeding. Thank God, I only took 1 tab the other day as I really wanted to lie down without pain. I don't plan to take anymore unless I am really in a lot of pain.

5th Consultation Appt. with Obstetrician & Gynaecologist - Dr Tan Ee Ping

I am now 36 weeks preggy! I am so not ready to do this. I need more time! A friend of mine shared that her second pregnancy was also very different from her first. By the time she had come to terms with the actual pregnancy, it was already time for her to give birth. Seems like I am going through the same thing.

Anyway, I got to Dr Tan's Clinic at about 12.30 again and found the clinic full of people! The last time I pulled this stunt, there was only 2 other couples there. Anyway I registered and the nurse commented that Dr Tan only arrived at the clinic about 11 am at she was busy at the hospital delivering a baby. (Thank God, I didn't go earlier as I had my KKIA check up in the morning)

As usual, I took my weight and am now at 70 kgs. Then went to take my urine sample. I handed my cup to the nurse and then proceeded to sit down and wait. A little less than 5 minutes, the nurse called me and she didn't seem to happy. I went into the room and she said..."did you just eat?" I of course asked her why and she frowned and said that I had a positive result for sugar in urine! (Arrgh! No!...not a this late stage...) Anyway, I told her that I did just have an early lunch of kueh teow soup with meatballs just before coming here. She keep quite and looked a little unsure what to do. She said that during my last check up, my urine also had borderline trace sugar results. I told her that I didn't know that and she asked if anything was done the last time and I said no. So she told me just wait to see what doctor says when my turn comes.

Was I worried? Of course I was! I didn't want to develop gestational diabetes at this stage! This is when baby packs on the pounds and mummies with this condition tend to have bigger babies! I already feel like a little whale...

Anyway, I got called to go for the ultrasound and Hubby managed to turn up in time to see the scan. He is getting so big now that the scans were not so clear and he is now 2.5 kgs. Bump has really grown. They also took a vaginal swab to check for GBS (Group B Streptococcus) I seem to have a lot of more stuff this time around compared to my first pregnancy with Chapati. Tetanus jabs, GBS testing..etc. Praying that it will be negative.  

I didn't really have to wait that long to see doctor as the nurses were joking that Dr Tan was seeing patients at lighting speed due to her being late. I told her about my swollen vaginal area and when she checked, she said that I had a swollen blood vessel which might rupture during delivery. Casually she said that she would just have to patch me up. I gave her a look of horror and she then assured me that it was pretty common. Just bloody...extremely bloody but common. Her advice was to ice my vaginal area to bring down the swelling. (Told hubby about it and he asked if he could put ice cream! Naughty fella...) Then she also told me to be a little more careful with what I eat as my urine test was positive for sugar and I have to monitor my blood sugar levels for the next two weeks.

The clinic offered to loan me the glucose meter for free which I thought was wonderful until I asked them how much the test strips cost if I were to buy it from them. RM190! I got a bit of a shock. I don't know the first thing about glucose meters and their test strips but there was no way the glucose test strips would be that expensive right? When I commented that it was expensive, one of the nurses who was processing my bill, quietly said that it was expensive. So I decided to try and buy them on my own.

This is the free glucose meter that the clinic loaned me

So here is my bill for this visit. Once again, I did not buy vitamins from them.

Consultation Fee             = RM80
Laboratory                       = RM70
Radiology (Ultrasound)   = RM40
Total Bill                          = RM190 (ouch! payback for my previous cheap bill)

Not much longer now before Bump arrives!

I went to look for the test strips in quite a few different pharmacies and what do you know? None of them carry the strips that go with the meter that they loaned me. (Why am I not surprised?) So instead, my in-laws loaned me theirs, since they only have to check themselves once a week. They have a cool, portable, easy to use one and the strips only cost about RM40 per box of 25!

 ACCU-CHECK Performa

 Thanks heaps Mum & Dad!

Pregnancy Support Bands aka Maternity Support Belts

This posting is so overdue! I finally manage to sit down and finish it. After seeing Dr Tan the last round in November, I decided to hunt around for some pregnancy support bands as she mentioned that it might help me to feel better when moving around.

I first saw the Carriwell Adjustable Velcro Support Belt in a maternity dress shop somewhere in Festival City Shopping Center in Setapak. It looked like this (I am using all the photos from the internet as I am a little shy to show my bulging tummy. Somehow doesn't look as good as these preggy women...)

I thought that the price of RM 79.00 was a little pricey for some bit of elastic band! 

I didn't buy it and instead decided to go home and do some research online. I typed in maternity support belts and then pregnancy support bands and the prices range from as cheap at RM 21 to nearly RM 300! How do you decide on what to buy? After a short discussion with Hubby I decided to narrow it down to something that is not too bulky and therefore would be more comfortable when wearing underneath my normal day to day clothes. You got to remember that with our weather here in Malaysia, a little extra bit of clothing can cause real discomfort and a lot of sweating when moving around. So after looking through all the pictures, I thought that the Carriwell Adjustable Velcro Support Belt and the Carriwell Seamless Maternity Support Band would serve my needs pretty well. So begin the hunt for a good bargain to buy both. 

This is what the Maternity Support Band looks like. (I thought it looked really comfortable)

After spending sometime on the internet, I think I managed to get a pretty good deal on Lazada which gave me a 20% discount on the total price for both types as it was my very first purchase from Lazada. Total price = RM 127.84 and it arrived within one week from ordering!

I found the Maternity Support Band to be extremely comfortable to use because the material breathes well and when worn under blouses and dresses doesn't show through. The support however I felt was of medium level only.

The belt on the other hand seems to provide a more firm support as it literally holds up your belly (like a belt that holds up your pants) but a little uncomfortable as it sits just between your growing belly and groin/pelvic area. So sitting down can be a pain as the belt pinches the area. My experience is never wear the belt on bare skin! I normally wear the belt on top of a pair of maternity pants or if I am wearing a dress, I will wear the band then the belt over the band.

Overall, it has definitely helped me to feel better when walking. It gives you the feeling of being "held in" instead of "all out" (Hahaha!) Just a little bit more work when you want to go to the toilet.

I would definitely recommend maternity support bands/belts for Mummies like me who's baby is bearing down and it feels like your "bottom" is about to drop out at anytime. It also helps to alleviate some of the round ligament and sacroiliac joint pain that I was experiencing. It also helped me with the lower back pain though the pain is still there, walking is not so unbearable.Not long now...36 weeks and counting...

Mummies do you use any maternity support? Which ones?