#momlife

I haven’t been updating this site because life got busy since I took on the new role as a mummy.

My little one just turned two and my hands are even tighter than before. My time and attention is spread across all the to-dos and there is no little of both left at the end of each day.

I’ve not forgotten about the tears and the feeling of being lost, not knowing when I’ll see the light at the end of the tunnel.

However, I’m glad my boy is here with me. He reminded me of how hard I’ve tried to conceive and is now enjoying the fruit of my labour.

I’m fortunate to realise my dream of becoming mom.

If you are still trying, persevere.

Some of my previous posts includes the doctors I visited and treatments I sought.

Baby dust to you who is trying to conceive.

Subsidised vs Private

As a Singaporean, I qualified as a subsidised patient. To find out more, you may wish to visit the link below. It does detail comprehensively one’s eligibility: https://sg.theasianparent.com/kkh-gynae-charges

After the scare at KKH and much comforting words from a private clinician, we decided to also get a second opinion from a recommended gynae by our IVF doctor. To our surprise, instead of fretting over the nuchal thickness which KKH and both our IVF doctor had highlighted or recommend alternative treatment, he casually mentioned that we would just continue to observe baby’s growth and decide the next course of action. After all, in Singapore, the legal termination period of any pregnancy is before 24 weeks.

We decided to follow his words and in our following visit, the thickness remained. We were still worried but he reassured us that baby could just be an outlier, just like how some of us are tall or short, fat or thin! We felt a huge rock off our shoulders.

In my entire pursuit of having a child, I also came to realise that different doctors believe in different practice. My private gynae is pro-natural. That said, he is a man of few words. Ask him the questions you have and he’ll give you his most honest opinion in a concise manner. On the contrary, at KKH, they’ll be overly-cautious and provide you with all the worst case scenario, assumed all the worst of you and take extreme care to make sure all possibilities are eliminated. Because of this difference in practice, these are what I’ve gone through.

In KKH, things are a little chaotic. Subsidised patients see different doctors who are on duty at Clinic C. Upon arrival, one is required to register using a automated machine. After getting the queue number, proceed to room 18 (this is expected and not told to you though) to take the routine tests such as height and weight, blood pressure and pee test. I failed one of my pee test and was immediately scheduled for gestational diabetes test. I realised much later that as I mentioned, KKH was just being extra cautious. Typically, they test pregnant ladies at week 30-ish but I did my first around week 20 and another at week 32. I wasn’t even consulted or asked for an opinion. Also, upon reflection, I recalled I had an apple, a milk tea and a muesli bar before the pee test. All sweet stuff! Of course I failed the pee test!

At my private gynae, I also failed one of my pee test. But instead of getting panicky, they asked when was my last meal, what I had and brushed it off as I had a kueh (sweet pastry) and sweetened soya bean milk before my pee test.

Comparatively, the prices are rather affordable at KKH. Doctor’s fees, and ultrasound scans are charged at 50% off (~$60 and ~$35 respectively after discount) per visit whereas the professional fees at my private gynae costs me ~$120 and each scan costs me $65. Each pee test at KKH costs $13 so even after adding it to the doctor’s fee, it is still $50 cheaper than a private gynae visit.

The NIPT costs me $375, a huge difference from private clinics which easily charge $900 – $1200 for the test.

Ultrasounds are done at the Antenatal Diagnostic Centre in KKH by a trained/training sonagrapher whereas ultrasound scans are usually done by the private gynae themselves. The doctor that one see in KKH would usually only use the doppler to hear the baby’s heartbeat.

One other difference I noticed about the sonagraphy equipment in KKH is that it is unable to capture 3D images whereas my private gynae managed to capture my baby’s face shape and features. He could also tell me if there’s the umbilical cord around my baby’s neck although the sonagrapher at KKH told me tissues cannot be detected.

In KKH, if you hit your estimated due date, the doctor would recommend the patient to go for induced labour. As my private gynae is pro-natural, he does not even do cervix check (this basically requires the doctor to insert his finger to feel for the opening and estimate the size of the gap by centimetres) or a membrane sweep (which is inserting a device to stimulate the walls of the cervix so as to stimulate labour. He even mentioned that most induced labour ends up in emergency cesarean section surgery as the cervix is often not ready to allow the baby to be born naturally – This has some truth as I’ve known of mummies going through 4 different kinds of induction but ended up having to do a c-sec. In fact, he will just wait for me to enter spontaneous labour, even if I exceed 40 weeks. In the US, doctors wait up to 43 weeks. We’ve had a friend that was induced at 41 weeks.

Waiting, however, does have risks. 1. The placenta could age, malfunction and cease to provide nutrients to the baby. In that case, baby’s life could be endangered. 2. If baby passed meconium (poo), he could end up breathing them in and that might cause damage to his lungs. The reason why he breathe is because he can, and that he might, not that he will since he’s in the amniotic fluid which he does not need to and he could do it because he’s distressed. 3. Stillbirth. This could be unexplained or due to reasons 1 and 2. While there are 2 school of thoughts, I think it’s best to practice what you are most comfortable with.

In KKH, I rejected the offer by the doctor to perform the cervix check and membrane sweep at week 39 but I was rather keen on spontaneous labour as that would mean baby would arrive at his own time and I didn’t feel like rushing him. But on the hindsight now, I might just go for it if I exceed week 39 as I would rather have him in my arms and not know what’s going on in my womb. Afterall, as the doctor in KKH rightfully pointed out, it was so tough conceiving him that i would rather not risk losing him because of some oversight or personal preference by either myself or doctor.

The wait at the private gynae is comparable to the one at the KKH to a certain extent. The average waiting time is approximately one hour at both facility though sometimes stretched to 1.5 or 2 hours depending on the crowd. It’s best to arrive 30 minutes earlier to do all the routine tests in KKH so that you are on the dot to see the doctor at the time of the scheduled appointment. At my private gynae’s clinic, I prefer to be the last patient so that there’s no rush as there’s no patient after myself.

The cost of supplements are also different at both facilities as KKH subsidises the drugs prescribed and in the end, it boils down to individual’s preference, e.g. if you prefer to have the attention of one doctor or not (though it might not matter because some doctors don’t remember their patient anyway), depth of your pocket (how much you are willing to spend per visit and also, how comfortable are you with the facility’s staff (the nurses, the toilets, the waiting area, the cashier, receptionist etc.)

Past 36 weeks…

It’s amazing how time flies. My last post was written when I barely crossed the 20th week. Now I’m almost into my 37th week and I could only count my blessings.

So we were scheduled for an anomaly scan at KKH. There was either the option to take OSCAR (One-Stop Clinic for Assessment of Risk for Foetal Anomalies) and/or the NIPT (Non-Invasive Prenatal Testing). We opted for both as the OSCAR could detect any heart defects which the NIPT would not be able to. The OSCAR included a ultrasound scan that requires the foetus to be lying on his back in a flat position so that the thickness of a tissue/fluid at the back of his neck can be taken whereas the NIPT simply requires a draw of blood.

If the thickness exceeds 2.5mm, my baby could be at high risk of having down syndrome.

When we were due for the OSCAR, my baby was asleep in a position that was not ideal for measurement. The nurse then pounded the ultrasound stick on my abdomen repeatedly in an attempt to get my baby to lie flat. We were horrified.

The results for the test was bad. The doctors were really concerned because his NT thickness was 3.7mm. They even completely sidelined the NIPT completely which I did well in.

Devastated, we sought a second opinion at Mount Elizabeth Novena Diagnostics Centre. Similarly, my baby was asleep in a manner unfit for measurement. Instead of being rough on him, the nurse told me to return the following day so that she may get a better reading. I went back but he was again asleep. I headed for breakfast as advised and took kaya butter toast with eggs and tea. Perhaps due to the good food and sugar rush, during the scan, my baby was bouncing up and down while lying on his back. The nurse quickly got a few measurements and took the average: 3.2mm

How could there be such a huge difference?!

I was furious with what the nurse did at KKH but at the same time wasn’t too satisfied with a 3.2mm reading. I then consulted my regular doctor who advised us to go for CSV (Chorionic Villus Sampling). While it is relatively painless, it is an invasive test that requires extracting some placental tissues for analysis and therefore could possibly result in a miscarriage.

I was really caught in a dilemna then. While I want to proceed, I do not want to do it either. We had such a hard time conceiving him yet I wish for him to be healthy too. My doctor even told me the onus is much on the mother so I should know but I could not bear the thought of knowing he is healthy but risk losing him.

After much struggle and discussion with Poh, we decided not to proceed with the test and let nature takes its course. Poh said one thing that really stuck a chord,”We went through so much to have him. Do you really want to give up on him if he isn’t well? Even if he isn’t well, he got it from us. We have to take responsible for him.” That really hit me hard and I gave up the intent to pursue further. When we shared the decision with our doctor, she wishes us well, told us to think of nothing else any further and do my best to bake him to full term.

For those who are first time mum, you may find the list of tests available to mummies in Singapore here:
https://singaporemotherhood.com/articles/2017/10/pregnancy-scans-tests-prenatal/

I’ll share in my next post my experience with my chosen gynae and also the difference between being a subsidised patient and a private one. 🙂

Crossing the two-fifth mark

In the pursuit of becoming parents, we suffered plenty of heartaches, body aches and of course aches of knowing that we’ve exhausted our Medisave (thank god for that but no thanks that public hospitals are really rather incompetent and unable to tailor their treatment for special conditions) as well as possibly running into cash flow problems because of the huge amount of ka-ching we’re pumping into the bills we incur. 

Now that I’m finally pregnant, I constantly worry if my baby will be just fine and healthy. There are many possibilities that could happen and I can only constantly pray that all these will not happen to any children that are being conceived, especially mine.  

If you have read my past posts, you would have known that I’ve conceived via IVF, after many failed cycles of IUI, FET and fresh IVF cycles. The protocol I was given was different, and things were not any simpler with my existing hyperthyroid condition. 

The good thing is that my hyperthyroid has stabilised and now that I’ve crossed my 4th month, I’ve gone off all medications except health supplements. 

When I first conceived, I was still on the following medication:

Western Medicine:
(i) Fraxiparine x 1 daily, injection via tummy
(ii) Baby aspirin x 1 daily, oral
(iii) Progynova x 3 daily, oral
(iv) Utrogestan x 3 daily, oral
(v) Dhasalone x 1 daily, oral
(vi) Endometrin x 3 daily, vaginal insert
(vii) Proluton x 1 every alternate day, injection via bum

Chinese Medicine:
(i) AM – Ginseng powder with special formula to encourage healthy blood circulation and baby’s growth
(ii) PM – Physician’s prescribed pre-packaged medicine

Sounds like a lot of pills for some but this extensive support ensured my body was very well-supported to support the pregnancy and I’m very grateful to have Angela and Racheal (Angela’s nurse) looking after me. 

Besides the medication, I also had blood tests every 3 days to ensure that the hormonal levels – E2, Progesterone as well as beta-HCG were within the healthy range as a low level of progesterone may well suggest deficiency in the level of support and that a miscarriage could occur. 

This went on till 10 weeks where we had a scare. Though at this point in time, it’s not deterministic, we have made a decision not to pursue. We’ll keep our precious little one. I’ll talk more about this in another post. That’s a story on its own. 

Now I’m in my 16 weeks, going onto 17. I am due in another 3 weeks for the anomaly scan at 20th week. Please pray for me and my baby that we’ll be fine and healthy. God bless us. 

Finally!

I’m so pleased to share this news with you…

I’M PREGNANT!!!

I’m currently in my second trimester, feeling so blessed and grateful.

It has been a tough journey and the road ahead will be tougher but we (P, me and mini P) will pull through.

I’ll share more in greater details in another post. Till then! 😀

What to do/eat if you intend to start IVF?

As I had gone to many doctors, medical practitioners including traditional Chinese medicinal practitioners and also acupuncturists, I’ve had received plenty of advice on what to eat/do and not in order to have a successful egg transfer/implantation, be it fresh or frozen cycle. Believe or not, you may wish to refer to the list below as a reference on what to eat depending on which stage of conceiving you are at. I’ll share a post on what not to do/eat as it’s a long list below.

To improve egg quality

This needs to happen before the egg transfer i.e. during the oocyte retrieval stage, especially if you’ve got eggs but their grades, in the eyes of the embryologists are not ideal i.e. grade 2 or 3. It does not mean that you will not have a successful implantation that will eventually lead to a healthy pregnancy. However, after spending a bomb on the drugs and procedure, you would most likely want the chance of success to be as high as possible and having a grade 2 – 3 egg is just cutting your chances short. In my case, my doctor told me that my eggs were speckled under the microscope (think quail’s egg) and even recommended that I consider an egg donor (I was so disappointed in her but that’s another story for another post.). Luckily, I was recommend to another practitioner who recommended a different protocol.

  1. Saizen – This is a growth hormone which my doctor prescribed to me for 3 months before the oocyte retrieval. There are a few downsides to this treatment though:
    • Daily injections – Self-administered.
    • As it’s a growth hormone, my feet grew bigger – some of my shoes just became super tight and uncomfortable.
    • My complexion took a turn for the worst – My skin was a combination of oily and dry + sensitive to begin with. There were more oil secretion, leading to trapped sebum under the skin, more zits and also plenty or blackheads & whiteheads formed.

Be warned! But if it’s all aligned to your goal of achieving a little one you could cuddle and call your own, I guess it’s all negligible and secondary though I’m still trying to come to terms with my i-would-consider-terrible complexion. 😦

On a lighter note, the doctor did comment that my retrieved eggs looked clear and non-grainy which are of commendable quality and suitable for transfer. So all the zits-popping and pimples-squeezing were worth it!

2. Royal jelly – I took this as well although i’m not sure what’s the scientific rationale behind this supplement.

To remove lining completely

This is recommended so that one’s lining is shed completely during one’s menstrual cycle so that when the new one starts to build up, it’s nice and plump with little creases – ideal for implantation to occur.

  1. Drink Guinness Stout – Apparently it contains some substance that’ll will make you shed all remnants completely hence recommend to drink 1 can a day once spotting for menstruation starts. AVOID if pregnancy suspected!
  2. Eat pineapple – My friend swears by this! Apparently, pineapple is known to have the effect of clearing all lining and ensuring one have a clean shed. Start eating one slide of this fruit from day 1 of spotting to day 3. Do not eat too much as it might cause cramps.
  3. D&C – This is also recommended by some doctors to completely scrap off any possible remnants in order for a new fresh lining to build up. This may also be recommended when the doctor discovered kinks in your lining or polyps. I had both. The down side of this is that it’s possibly that one’s lining may take some time to recover i.e. the next time it starts to build up, it may not reach the ideal thickness for implantation hence bringing me to the next point.

To improve lining quality

For implantation to occur, some doctor requires their patients’ lining to be minimally 8mm and/or preferably 10 – 11mm. As such, the following methods have been believed to boost the growth/build-up of lining, especially if one’s lining is not thickening enough repeatedly for egg transfer.

  1. Drink red bean soup – On the 5th or 6th day of your menses, or once you noticed your menses is finishing, start to cook this dessert. If possible, cook the beans till it’s mashed and you can drink it together with the soup. If you are not a fan of beans, you may also just drink the soup but the most important thing about cooking this is to ensure all the flavours of the beans have been released i.e. the beans are boiled beyond recognition and the soup is filled with the essence of the bean. If you are too lazy to prepare this on your own, you may also buy those from the Chinese dessert stalls. They work well too.
  2. Drink minced beef broth – This is recommended for people who can take beef and very ok with just minced beef cooked in water and a little salt added. 5 days before my transfer, my lining was only 7mm ish… barely sufficient for implantation so I resorted to this. I drank the broth twice a day for 3 days and on the day prior to transfer, it went to 8.3mm – Just passed! Phew.
  3. Acupuncture – This is said to improve the blood circulation in that area hence I’ve been going for this since I started trying my 2nd or 3rd IVF cycle.

There’s this really famous and knowledgeable practitioner in Ang Mo Kio Ave 5, Zou Yu Min which everyone recommends on Singapore Motherhood but I prefer the other physician, Dr Qiu. Dr Qiu also practices at Dr Zou’s clinic on Tues and Thurs morning and has her own clinic at the other side of Ang Mo Kio on other days. I prefer to see her at her clinic for various reasons:

  • I could really feel her hitting the right spots with the needles.
  • She increases the number of needles when I told her that my lining was not as thick as expected.
  • She tries her best to do what she can for what you need, rather than make you feel like it’s a run of the mill.
  • It’s cleaner – The whole place is bright and uncluttered.
  • It’s less crowded – I’ll go at the time I arrange and there would be the no. of patients as there would be the no. of beds. No queues, no impatient faces.
  • She replies whatsapp messages so I would just text her when I’m going to check if she’s in and pop by at the time we agreed on.
  • I don’t feel the pressure that someone’s waiting for the bed that i’m on while I’m receiving treatment.
  • Dr Qiu does exactly what Dr Zou would, except she does everything herself. In Dr Zou’s clinic, Dr Zou will be the one who put in the needles but it’s her assistant who will remove them and her husband will the one collecting the fees.
  • There’s somewhat more privacy – In Dr Zou’s clinic, you can hear literally all conversations she have with everyone else.

If anyone of you are keen, here’s her contact.

Name of Clinic: Ci Yuan TCM Physician & Acupunturist
Name of Practitioner: Dr. Qiu Xiao Qian
Tel: 98625782
Address: Blk 128 Ang Mo Kio Ave 3 Street 12 #01-1843 Singapore 560128
Consultation Hours:
Mon, Wed, Fri – 10am – 1pm, 2 – 730pm
Sat, Sun 10am – 3pm
Closed on public holidays

4. Drinking ELO water – Again, this is touted as a good way to boost the oxygen intake which is believed to improve the quality of lining as well as the lining growing beautifully so I’m taking it. It’s not cheap though. Check out the prices at this website and good news! – There’s a upcoming sale on 9 – 11 Nov. 😀 Imma stocked up!

5. Take walks in parks with big trees during dawn and take deep breaths – This is a cheap and also effective way of increasing the supply of oxygen to your body and of course, your uterus but seriously, everyone’s rushing to go work in the morning – Who has time?! If you are a housewife, good for you. Do this and save some money. 😉

To improve implantation

  1. Acupuncture – After you’ve transferred, you are encouraged to head back for a poking. If it’s a day 3 eggie transfer, it’ll be a session on the day of transfer after the transfer and one more the following day. If it’s a day 5, then it’ll just be on the day of transfer after the transfer.
  2. Walking – Instead of lying on the bed the whole time during the two weeks wait, it is recommended to do light walking. Please don’t attempt a marathon or HIIT – That’s just plain stupidity because your body is already not able to sustain a pregnancy on its own and there you are thinking it’s alright to give it your all to do some exercise to keep fit and stay slim instead of focusing on what’s ideal for the little being you have endured so much to nurture within you – Sorry for the rant because I was also ticked off before and I’ve realised my mistake so lashing it out at any silly goons out there. :p

Light walking is good because it improves blood circulation and also encourages implantation to take place.

3.  Start on your support plan before the transfer – My body does very poorly in the area of progesterone production. In fact, I highly suspect that in addition to my eggs looking old, that’s also one of the reason why my previous cycles were not successful until I met my most recent doctor. She started me on progesterone and also other meds 2-3 days before I transfer – I was on a long cycle plus had a suppression injection so external support is extremely important, especially if the body is not going to start its engine once it receives signal that there’s implantation. Starting on the support meds i.e. estrogen and progesterone is also equivalent to sending signals to your body to prep it to receive a new life. Even though I started my support plan early, the production of progesterone had constantly remained at a bare minimum throughout my two weeks wait, much to my disappointment. According to the doctor, my body uses up the progesterone way faster than others. It’s also not helped by the fact that I’ve thyroid (this is strictly my own opinion) and that progesterone converts to cortisol when one’s stressed (and I feel I’m constantly stressed!) so the ample support was really helpful – alternate day proluton injection, daily endometrin vaginal pessaries x 3 and oral utrogestan intake x 3.

Disclaimer: Please note that all doctors have different practice – some don’t fancy you telling them what to do and different patients require different levels of support so the above are strictly for your reference, not for you to impose on your doctor. It’s also important that you find a doctor you are comfortable with and is willing to trust to do the right things for you – I changed doctors at least 4 or 5 times, especially when I realised that the protocol is very much the same or we don’t feel that we are well taken care of as much as they’ve promised.

4. Avoid taking barley water, chrysanthemum, green tea, unripe green papaya, pineapple, uncooked food (sashimi and medium well steak…), crabs (my favourite…) etc. anything that’s known to be cooling that might impede implantation.

To improve chances of conceiving

I left this portion till the end as it might rubbed some people the wrong way. I do not mean harm or harbour any evil intention, or even try to sway non-believers into doing what I did. I’m also not insinuating that by doing the following, you will definitely be successful. But as with all couple who are trying and have failed, I merely tried my best, be it any methods (as long as I feel they are acceptable and within my means) to try and have a kid. So, if you are uncomfortable reading on, feel free to skip it.

  1. Setting up an altar for previous failed IVF cycles/miscarriages/abortions – As I’ve started the post with believe it or not, it’s really up to your beliefs, religion etc. to decide if you want to do this. I did, for a piece of mind and for the fact that if my previous failure has resulted in wandering spirits, I want the best for them too – I hope they rest in peace. I did so in the recently passed 盂兰盆节超度法会 where they chant scriptures and prayers for a whole day as long as you’ve registered for whoever you’ll like the monks to pray for on the day.

The email i wrote to was sed@kmspks.org and below is just a message I typed:

您好。
我想提我的冤亲债主以及堕胎婴灵超度。请指点寺庙几时有举办超度法会。我想参加。谢谢。

Translation: Hi, I’ll like to invite the monks to chant scriptures for whoever I’ve offended in the past and present and also my lost children in order to free them for their sufferings and in hope that they may reincarnate. Please advise when is the ceremony and registration period. I would like to participate.
They’ll reply to you with the date of the next ceremony, and the date to register. You may go down to register during the period and you are also highly recommended to go down to the temple on the day of the ceremony to offer your respect.

2. Chant or write scriptures – There’re a few scriptures that’s recommended in one of forums in Singapore Motherhood. I managed to find the PDFs of some of these scriptures and did what was recommended. PM me to find out more.

3.Consult a medium – My mother-in-law is a believer so I am keen to know what’s going on in this arena as well and I did consult a shifu, not exactly a medium. Again, depending on everyone’s level of acceptance as well the level of sins committed, the characters of birth or also known as 八字,the shifu will recommend you do different things in order to redeem yourself in hope to be more successful in conceiving

4. Pray to 注生娘娘 – There’re different saying about this. You can pray to the gods after you give birth or if there’s a gender you would like to have or even before you conceive just when you intend to try. There’s also a few famous temples, well known to have blessed couples with children. You can easily google and there’s a couple of forums on singapore motherhood talking about this topic. I’ll be offering my respects if I have a smooth delivery. *Prays hard for one*

Ok, so that’s all that I’ve collated for your reference. All have been tried and tested so… you can be certain I’m not selling any one item or promoting any treatment because I’m endorsed or sponsored. :p

D&C in Malaysia

So, I mentioned in my previous post that I was recommended to do a D&C in JB, Malaysia.

Considering the costs and under the reassurance from Angela that I will be taken good care of, I went for it. By the way, Angela has also a clinic in JB, Malaysia housed in Johor Specialist Hospital. So, considering the fact that I’ve been to her clinic here in SG, and that she chose to have her clinic in that hospital, it can’t be that bad (although I was still very worried because there were just too many scare stories I’ve heard from people who visited public hospitals in Malaysia). Johor Specialist Hospital is not public, it’s private so as with all privatisation, it’s more expensive hence should provide better quality healthcare. I was really skeptical throughout but I chose to place my fears aside and trust in her.

Angela usually accompanies her patient but unfortunately in my case, she was unavailable on the day of my operation. Never mind, I thought. At the end of the day, her presence may add on reassurance but also pressure. There’s also nothing much she can do except for being there as she will not be the one carrying out the op. I arranged for my mum to go with me instead.

Once I decided to go for the op in the hospital in JB, I had to produce a copy of my passport as well as my blood test report – the one you would have to do anyway before you embarked on IVF. It was scanned over to the clinic and I had to go in one day before the operation to register. Angela’s staff have experience arranging for these trips so just do as you are told and everything should work out well. (Fingers crossed – You can’t really be sure about things being done in Malaysia…)

On the day prior to the operation, Mum and I took the bus in. The customs was packed as usual. We cleared it (after a 2-hour wait!) and checked in before we went to the hospital for registration. We stayed at KSL for the convenience – it was 5-minute taxi ride away from Johor Specialist Centre. The operation at Johor Specialist Centre actually included an overnight’s stay in the ward and you can even opt for a family member to stay with you through the night but we preferred to stay in a hotel instead. After all, I would not be able to choose who’s my neighbour in the ward and although it will be a all-woman’s ward, it’s not the maternity ward. On the day of registration, I was actually freaked out seeing 2 cockroaches in the room where I took my blood pressure, height and weight. The cockroach crawled out from nowhere and then crawled back under the wall. Mum joked that the cockroach came to see the doctor too. When I told this to Angela, she mentioned that we should have complained. I did, to the nurse who tended to me, and she gave me a weak smile. Maybe it was her pet.

On the day itself, I reported to the clinic at 7:30 am and they brought me to the bed that had been allocated for me. I changed into the surgical gown and waited for the doctor as well as the surgical theatre to be available. At about 9:00 am, Dr. Mohanraj Krishnasamy came to have a few words with me before he went off to get ready for the operation. At about 10:30 am, I was pushed in a wheelchair to the operating theatre. By the way, Dr Mohan does operations only on Thursday but I could only make it on Friday so special arrangement was made hence the long waiting time –  I was slotted in on the Friday schedule at 11:00 am.

When I reached the entrance of the operating theatre, I had to get on a surgical bed from my wheelcar instead and was pushed into a waiting area. The anesthetist came to check on me and not long after, I was pushed into the operating theatre. It’s pretty spacious and looked sterile (the typical whitewash walls and filled with equipment). I was pretty annoyed though, that the anesthetist did not do a good job putting in the IV line the first time that he had to take it out and do it once more, causing a major bruise on my hand.

Of course, I did not have the time to get angry or complained because before I knew it, I was knocked out.

When I woke up, it was already 12:30 pm and I was back at the waiting area. The nurse came over to check on my blood pressure twice and once she’s certain that it’s alright, I was pushed back to the ward.

As I woke up pretty early that morning, I went to sleep and woke up about at about 2:00 pm. The doctor came around that time to tell me that the operation went well but as the entrance to my uterus has been microscopic, he did all that he could in his means to carry out the op. It was my first time hearing that kind of description and honestly, it made me doubt the doctor’s ability. I haven’t had that kind of feedback before but as I mentioned previously, anything could possibly happened in Malaysia.

Thereafter, he mentioned once I’m fully awake, we can check out of the hospital. We had made arrangement with Angela’s recommended driver to leave the hospital at 5pm but the service after my operation has been nothing other than slow. At 3pm, my mum asked the nurse if we could leave, only to be greeted by puzzled faces. I changed and got ready to leave, whenever the nurses come back with a definite reply that I can go off. One of the nurses then came back to inform us that we need to make payment at level 1 before going off. We then went down to Level 1 make payment at the cashier, only to be told that they have not received any notice of payment from the wards or doctor.

Mum pressed on and insisted that they contact the ward for the notice of payment so that we could be in time for the vehicle. She even went over to the next room to collect the medication for me in the meanwhile though the nurse was pretty reluctant to release the drug without the receipt from the cashier. The whole chain of work flow is super inefficient. By the time the notice of payment was finally received, the cashier who was attending to me had a bad news for me – the operating system was down! She had to restart the system and get another of her colleague to attend to me. I was just dumbfounded at how slow and inefficient things can go… Finally, we paid and managed to get on the car just in time. In fact, we were told to hurry if we want to avoid the jam.

Johor Specialist Centre was only a 10-minute drive from the causeway but because we clashed with the crowd leaving JB, we only cleared customs at 6pm. It was not bad by the usual standards but if we had spent less time at the cashier waiting, we could have reached home earlier.

All in all, the experience was mediocre. Unimpressive but acceptable. At least the operation went well, there wasn’t haemorrhage post-operation and the cost is one-fifth of what it would have cost me in Singapore – The total sum that I paid was about RM 2,500  (~850SGD) but it would have been close to S$5,000 in Singapore.

Here’s a rough estimate of the amount of the procedure if it’s done in Singapore:

Doctor’s Fee: $1,000 – $1,800
Hospital Charges: $1,400 – $1,800
Anasthetist Charges: $350 – $450
Inpatient Fees: $200 – $300

These charges exclude the free one night stay that’s also included in the package price I paid.

Hope this post has been able to shed some light for people who are keen to go for a similar op in JB.

 

Unfazed…

Unknowingly, it’s almost a year since I last wrote. Since then, we’ve embarked yet again on another IVF cycle. This time, with Angela Ho from C.A.R.E.

When we first visited her, she was honest about how difficult our case looks – We failed multiple times and it does not help I’ve an existing condition that could possible complicate matters.

She recommended having me on daily injections of Saizen to “rejuvenate” the eggs for 3 months before retrieval and transfer. We went with it. Afterall, we would give any possible treatment a go if it could help us fulfill our dream of having our own child.

3 months went past and egg retrieval was performed. It was very unfortunate that my body gave wrong signals. Post-egg retrieval, Angela revealed that the bigger follicles shown in the scan were all empty and only 4 eggs were retrieved. As expected, I never had the opportunity to produce many anyway. She did, however, shared that the egg conditions were great and now we will just have to wait till I’m ready.

We forgo a fresh transfer also because I was on a long simulation cycle in a bid to get more eggs. Although I wasn’t successful, I was grateful at least 4 were retrieved and they were not bad.

After I had my menses, Angela recommended for me to go for a D&C, again in a bid to improve the chances of conceiving. A Dilation and curettage (D&C) is a brief surgical procedure in which the cervix is dilated and a special instrument is used to scrape the uterine lining. Previously, she did noticed that there was a kink in my lining and she is concerned about any thickened lining that did not shed properly from my uterus.

I was concerned about the costs as it’ll add another S$5K to the overall costs. So, Angela recommended me to go for the op in Malaysia which I did. On the hindsight, it’s something I would still consider though I might have just done it in Singapore if I have the money. I’ll cover this in a separate post.

So now, I’ve started on medication to prepare for the egg transfer. Despite still trying physically and trying to remain as positive as we can, I guess both Poh and I have almost exhausted our hope of becoming parents. I’ve turned to superstition and even tried being religious in my bid to become mum. Will that bear us fruits? I don’t know. I can’t see the future and I’m no God. All I can do is pray and continue with the medication I am prescribed, hoping that it will yield a positive result I believe we will be overwhelmed if we are really blessed with it.

P.S. Yes, the featured image has half of all the injections I took from my stimulation.

Exhausted

In every ways.

Financially, mentally, physically and emotionally.

While I’ve read that going through artificial child-bearing procedures are tough and draining, I didn’t know it could possibly empty me out in all aspects.

Financially

I went through a third fresh cycle with SGH but without success again. This time round, instead of Puregon or Gonal-F, I had Menopur injections instead. All seemed to progress well. There were 14 embryos retrieved, 7 fertilised, 5 made it to day 3 and 3 made it to day 5. While 1 of the Day 5 embryos did not survive, I transferred 2 of the better day 5 embryos with a endometrial lining of 11mm. It’s said that a 10-12mm lining is suitable for implantation. After which, there were twice daily vaginal inserts. All of these, with the last subsidy from the government and deduction of medisave (=$10K) will cost me approximately $5-6K out of the pocket.

But I did not succeed. That means if I were to embark on yet another cycle, the out of my (or rather his because he forks out more) pocket amounts easily to $15K minimally. It’s exorbitant. It’s easily equivalent to a trip for 2 to Iceland and back. Worst, supposedly we have that amount of cash and spend it and did not succeed again (The success rate for IVF IS only 30% for ladies below 35.), then what?

And the amount is excluding all the other treatments we’ve went for, including accupunture, intralipid transfusion, doctor visits to my endocrinologist to ensure my thyroid levels were in check, transportation costs to all these various clinics that’ll easily add up to another few grands…

Mentally

Going on repeated cycles can break down even the toughest or most resilient woman.

After the first cycle, we thought to ourselves, there’s always the 2nd.

After the 3rd, we were already close to wondering if it’s even possible at all. If it is, we would have had some glimpses of hope, especially after trying all sorts of treatment. But, no. We didn’t. Even though there were traces of hcg detected, the pregnancy is obviously not viable and had terminated in the early stages.

How many times must I go through the disappointment, frustration, only to have to pick myself up again? Never mind the negligible pricks and bruises from the daily, and sometimes multiple injections. The fear of going through the entire cycle, and the possible outcome of a negative pregnancy blood test result is enough to turn my world upside down. Let’s not even begin with the tormenting thoughts that’ll bang themselves hard against my head, telling me what a failure I am for not being able to do what a woman is supposed to naturally, blaming myself for not taking enough care of myself and for ignoring his want to have children earlier. I blame myself, also, for giving up the one pregnancy I had a shot at, when I was given an opportunity to, all because I wasn’t ready. He blames himself for not getting me to try for children earlier and for allowing me to have my ways and insisting of wanting kids at a later stage in life.

All these thoughts just made us accumulate bitterness gradually.

While I could easily take up a sport or join a community to distract myself, all these gathering and sports need money which I would rather save for the next cycle. I also began to be extremely watchful of what I spend on because of the impending hefty cost. All these carefulness and watchfulness eats up the positivity in me.

Physically

Travelling to and fro the various clinics where I receive the assortment of treatments is extremely tiring. The unpardoning weather just makes it worst.

Besides that, when you are going through a cycle, the swollen ovaries were enough to drive you nuts.

During the 2-week wait, the stuffing of progesterone up the vagina caused me 2 bouts of yeast infection.

When the pregnancy blood test is negative and the progesterone is cut, the plunge in the hormones caused huge amount of hairfall. Locks choked the gutter and made him gawked. We were in disbelief and could only pray it’s temporary. Boy, we were glad it was.

The subsequent menstruation is also nowhere near comfortable as large amount of blood would literally gushed out periodically. I had to change pads at leas 4 times a day to ensure I was dry and prevent leak.

Emotionally

No words would suffice. Each cycle is a rollercoaster ride that starts with being hopeful, then anxious of the outcome, trying to stay calm and stress-free but only to be greeted with disappointing result that would break my heart apart. With every cycle, abit of me died. So did him. So did the love between my husband and I. Both of us hurt so much we couldn’t talk. Sometimes, it even hurt to get intimate because the act simply reminds us of how inadequate we are. On our last try, the atmosphere between us was so tense conversations became heated quarrels, finger-pointing and a lot of resentment, bitterness and tears. There were so much pent-up frustration that’ll snowball and surface after each failed cycle.

On top that, announcements of pregnancies of friends and family members around us just add salt to the wound.

Feeling isolated and lonely became a norm. No one could really understand (not that I would want anyone to since that would probably mean that the person has been through all that I had to and I definitely would not want any of my close ones to.) and no matter who you confide in, you’ll feel it’s pretty pointless at the end of the conversation because it’s either they feel sorry for you, which is not helpful, or they’ll give you weird advice which you’ve probably tried and also does not find helpful.

It has gotten to a point that talking about it would just bring tears to my eyes.

So here I am, pretty emptied in all aspects.

I begin seeking solace in reading the bible and immersing myself more in work whenever possible. Beside numbing my wounds, they distract me and allow me to focus on other aspect in life.

Yet despite all these pain, I would continue to try. Why?

Solely because we desire, that one day, we can have children we call our own. To hold and to love. To cuddle and to kiss.

Perhaps the one day would come.

And even if it doesn’t, at least we know we’ve tried, as hard as we could and as much as our shallow pockets have allowed us to.

Acupuncture

So the session on saturday concludes my acupuncture treatments (for the time being).

After a conversation with an an ex-colleague, I learnt about how she conceived successfully with the help of acupuncture. She has failed her first IVF with KKH, switched to a private practitioner, and underwent Lucrin injections before she began another cycle of IVF. For her 2nd cycle, she added acupuncture as part of her infertility treatments. Miraculously, she succeeded hence highly recommended me to give a try.

The TCM practitioner is none other than Zou Yu Min who practices acupuncture at a small TCM hall with her name at Blk 505 Ang Mo Kio Ave 8. I too, decided to give it a shot,  hoping that it will also help me succeed in my attempt to conceive.

While I will still stick to SGH (because I’m still eligible for government subsidy and I have 1 more shot with my 2nd and also last embryo which is frozen and kept with SGH), I hope this additional treatment will improve the environment aka my womb for my egg to implant. Apparently, this treatment does that, improves the quality of eggs and reduce undesirable side effects that comes along with the monthly affair such as aches, bloatedness e.t.c.

Each session lasts 40 minutes – 20 minutes for the abdomen and calves, and 20 minutes for the back. If you are worried about the pain, you should be comforted to know that the needles are so thin that the prick is hardly felt and if felt, gone in a split second. When I’m distracted, I would not have noticed the prick too.

However, being the nervy me, plus the insertion is done one by one, and there’re about 10 for the front and 6 on the rear (not concurrently but first front first then back), I tend to be uptight, no matter during which session, and stayed exceptionally still so that she don’t miss the acupoint.

Please don’t get me wrong. She’s definitely experienced and has helped many, even those in their forties conceived. While there may be more than one success factor, she definitely does her best for each patient.

The waiting time is abhorrent though. It could stretch between half at hour at its shortest to 1.5 or even 2 hours at its longest. Most of the time, it’s waiting for a vacant bed for the acupuncture to take place. An appointment is necessary, although you may not always get through the line. Try to book at least 3 days in advance as her slots are filled up very quickly with both existing, repeating and new patients. She’s often packed to the brim, seeing up to 8 patients an hour. There’re only 5 beds in that puny space she owns so waiting is inevitable.

Ladies who wish to get pregnant typically do not undergo acupuncture when they visit her the first time as they are often having their menstruation. The practitioner usually recommends commencing treatment on the 4th or 5th day of menses, where the flow has lessened significantly. The effect of each treatment typically last 2 – 3 days so she usually encourages female patients to undergo the treatment twice, or even thrice, a week if time permits.

I started in May and went for my FET last week. On the day of FET, I went back after my procedure to have acupuncture done. As undergoing acupuncture post FET is said to help the egg implant, I took no chances and returned every alternate day for the same treatment that week.

Now, all that I could have done is done.

Today’s the 2nd week of my two-weeks wait. We shall know the outcome by the end of this week.