JOURNEY 7 : Admitted to UMSC for Delivery

Assalamuaikum and Hi All, 

My wife was admitted to Universiti Malaya Specialist Center (UMSC) in her 37weeks 4 days of pregnancy.

Prior to that, we realize our fetal movement is not as usual. So we went twice to the hospital to check and do CTG. Alhamdullillah, the fetal looks good. 

37w4d

We actually came for a check-up at public PPUM clinic and was entertained by our doctor, Dr Rajeev. He communicated with Prof Siti and was advised to be admitted by today. 

Then, we went straight to Wad Dahlia. It is located at Level 3 of Kompleks Kesihatan Wanita dan Kanak-kanak PPUM. The first question asked by the staff nurse was "Prof Siti ask to admit today?"

And yes!

They immediately ushered us to the nice pinkish Labour Room. The room in Wad Dahlia UMSC is where you will stay for delivery and if it is normal delivery, you will deliver your baby in the same room. 

It is a nice room, but a little bit small as compared to other private hospital. Nonetheless, we have nothing to complain as everything was good for us. 

So the journey begun. We first was advised to wait for Dr Rajeev to come for the Balloon insertion procedures. Hence we took our own sweet time, and my wife did not even change her attires yet. Out of sudden around 12pm, Prof Siti came down and requested to the procedure immediately. 

It was very intense procedure, with full of pain. I could not bear to see my wife in pain, and wish if only i could take away all the pain with me. The main objective of having this balloon is to open up the cervix.

The journey started for the next 24 hours. 

To be continued............ 

JOURNEY 6 : 35weeks Pregnancy at UMSC

Hi All, 

During 35 weeks pregnancy, we went for a visit at UMSC. Prof Siti seems happy with the baby size and sees there is no urgency to deliver the baby at this point of time. 

However, we were asked to be admitted at 36weeks for monitoring and early delivery. 

Since the baby will be delivered early, the plan is to inject DEXA. Main objective is to make sure the baby's lung is matured enough once the baby is delivered. 

Glucose Reading Spike
The plan to inject Dexa had causing our Endo team worry. Based on their advise, Dexa injection would cause the glucose reading to go really high. Therefore, strict monitoring shall be done during the exercise. 

Our Endo Hospital Putrajaya team then wrote a referral letter to UMSC and UMMC Endo team for next course of action. We were referred to PROF. DR. SHIREENE RATNA. She is really good and motherly as well. 

Admitted at 36weeks
On 36weeks, my wife was admitted for Dexa injection and prepare for early delivery. Instead of being admitted to UMSC, she was admitted at PPUM (UMMC). The reason being is because Prof Siti would her team to closely monitor her. 

On the 3rd day of admission, she was brought to another scan done by one of the consultant. The Prof recommended there is no urgency for early delivery. 

Discharge from UMMC
Since we have got a new recommendation, Prof Siti came by and advise my wife to return home and wait until 38weeks. 

:)

JOURNEY 5 : UMSC Prof Datuk Dr Siti Zawiah Omar

Hi All, 

Since we had "not so good" experience with FPP Hospital Putrajaya, we have then decided to look for other possible option. 

We googled multiples hospitals and found out one of the best specialist / consultant / Doctor who can manage High Risk Pregnancy is Prof Datuk Dr Siti Zawiah Omar from Universiti Malaya Specialist Centre.

Visit her Profile here: https://umsc.my/?umsc_doctor=siti-zawiah-omar

She is very motherly, indeed. 

We first met her back in 2018 when we lost our first. We sought for treatment and opinion to plan for our next pregnancy.  

30weeks
We managed to see her after 32weeks, that was after we were released from FPP Hospital Putrajaya. 

When we met her, one of our first question was whether she could accept my wife or not. And SHE SAID YES!

We were so happy that time and since them we follow up both at Hospital Putrajaya (Public Clinic) and UMSC under Prof Siti Zawiah. 

34weeks
At 34weeks, we went for visit at Hospital Putrajaya public clinic. The doctor scan the baby and found the size is slightly big at 3.4kg. Therefore, they advise us to be admitted immediately for monitoring and early delivery. 

We then inform the Doctor that we would like to deliver at UMSC, and a referral was given. We immediately consulted with Prof Siti and was advised to only see her the following week. 

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

To be continued...

JOURNEY 4 : Experience with FPP Hospital Putrajaya

Hi All, 

This episode, i would like to talk about our experience with FPP Hospital Putrajaya. 

Insurance
Since my company covers maternity cost, we have opted to go for FPP - O&G. 

First Visit
We have registered an appointment to meet with the one and only women Doctor for FPP at Hospital Putrajaya, for now we will call her The Doctor. Well known for her kindness and specialties, we unfortunately had a bad experience with her. 

During our first visit, she was accompanied by another MO, i would name her as Dr S. 

Dr S had mistakenly advise The Doctor that my wife had DKA during pregnancy. After a minute only she realize that the DKA happened long back when my wife was first diagnosed with diabetic type1 (20 years ago!). 

The whole thing changed. "The Doctor" then review my wife glucose monitoring logbook and she started to mumbling about the glucose reading without even trying to understand her condition and recommendation provided by Endo team. She immediately tell my wife to be admitted for strict control. 

When we discussed this with our endo doctors, they are not surprise with it considering there are not many doctors whom aware of insulin pump. 

Since then, we realize that she might not be the best for our case. It seems, this is her first time to seeing Type1 Diabetic patient with Insulin Pump. 

I remember she said, "Owh, this is how the insulin pump looks like. Come Dr S, look at this" 
p/s: Dr S ignore her. 

Lastly, we agreed with "The Doctor" to release my wife to normal clinic. The reason is because of the cost which we feels nothing about it as we both know that we can afford it. 

My wife cried so badly after leaving the room. We both understand her concern on both baby and mother health, but jumping into conclusion without trying to understand the background, that was wrong. 

After all, we both happy with our decision to be released into normal clinic instead of FPP. Probably, they are best in normal case but not for special case like ours. 

Nonetheless, i hope this experience would not hinder you from seeing them. Their services are still the best, indeed. 

:) 

JOURNEY 3 : Glucose Continuous Monitoring - Freestyle Libre

Hi All, 

This episode, i would like to talk about Freestyle Libre. 

It is a glucose continuous monitoring (GCM) and very useful for type1 diabetic as well as patient with insulin pump. When we were with Hospital Putrajaya, the doctor requested my wife to use Libre for 2 weeks. 

Unfortunately in Malaysia, this product is not yet released. Hence, it is only available at Hospital Putrajaya, prescribe by the doctor. Othrewise, you would not be able to purchase this anywhere in Malaysia. 

The nearest available country selling this product is at Singapore. Sadly, we tried to communicate with the agent in Malaysia, they unable to sell it to us. 

Nevertheless, if you have extra budget, you may request your friend to purchase this for you from Singapore. 

Please visit this link for more info. 

https://www.freestylelibre.us/

:)

JOURNEY 2 : Appointment at Hospital Putrajaya

Hi All, 

We were scheduled to meet both specialist at Hospital Putrajaya through combine clinic. However, since my wife is Type 1 Diabetic and using insulin pump, therefore it is very difficult for the O&G to do their monitoring. 

Further discussion, we decided to separate the clinic into, Endocrine and O&G. 

Insulin Pump
Insulin pump is one of the method to manage Type1 Diabetic Patient. It works by providing continuous insulin injection. 

In my wife case, she is using NovoRapid (prescribed by the doctor). 

During early pregnancy, the glucose reading were haywire. Up and Down. It was so difficult for us to monitor. My wife have to take the glucose reading manually at least 8 times a day.

Fasting Sugar (wake up), Pre-Breakfast, Post-Breakfast, Pre-Lunch, Post-Lunch, Pre-Dinner, Post-Dinner, Before Sleep

Its tedious work but worth it. Throughout the pregnancy, my wife HbA1c was 6% which really good!

Dawn Phenomenon 
We always encountered high glucose reading for fasting sugar due to dawn phenomenon. Because of that, we have to increase the basal insulin rate to almost 2.0unit/hr. 

And during pregnancy, my wife insulin utilization is quite high as well, around 130unit per day. This mainly due to insulin resistance resulted from hormonal change during pregnancy. 

Assurance 
Rest assured, the support and commitment given by specialist and consultant at Hospital Putrajaya was really great. They supported my wife since day1 we got to know she is pregnant. 

:)

JOURNEY 1: 1st July 2019 - 0445hrs, Positive Pregnancy Test

Hi All, 

On the 1st July 2019, very early in the morning at 0445hours, my wife woke me up to show the pregnancy test result. 

Both of us were surprised by the result and wonder what should we do next? 

2017
Back in 2017, we lost our first baby at 11weeks digestion. We take a deep breath and the first thing we did early in the morning was to call our healthcare provider, Klinik Kesihatan to set for earliest appointment as possible. 

Appointment
And we managed to get the appointment set on the following week. During the appointment, we mentioned on the high risk status and then was requested to follow up with the Doctor for every single week. Mainly the purpose of us seeing Doctor at Klinik Kesihatan is because we would like to open / register "Buku Pink".

After detail discussion with the Doctor, we decided to do the follow up with combine clinic at Hospital Putrajaya instead. Both endocrinologist and O&G expert would be available at this hospital therefore it will be easier to monitor. 

Next, Appointment at Hospital Putrajaya

:) 

This Blog is About...

Hi All, 

First of all, welcome to my blog. This blog is about my wife pregnancy journey, who was diagnosed with Type1 Diabetic since 9 years old. 

Considering it is a High Risk Pregnancy, there are a lot of thing that we would like to share, up and down of our experience which we hope it would be beneficial for my readers. 

Nevertheless, please bear in mind that whatever is shared here, is not a medical advise. Please do seek professional medical advise from your respective Doctor. 

Happy Reading!