Post delivery care for your vagina wound

If you deliver by natural birth and if there is tear or the doctor made incision or cut for you, then the doctor will also made stitches for you.

Since there are stitches then you have to take care of the wound so that it will heal properly.

FIRST IS TO PREVENT FURTHER DAMAGE

Take stool softening medication like Duphalac (from Abbott) or Lactul (from Y.S.P.) because you would not want any further damage whenever you pass motion.

Personally I prefer Duphalac because Lactul is sweeter than Duphalac.

Also bear in mind if you plan to breastfeed that your body tends to be more dehydrated which translate to "harder"stools :(

So Dupholac is a must. In fact I consume a total of 3 plus bottles for about 3 months because during my confinement, I did not consume much fruit thus aggravating the situation.

Note the different prices. Cheapest @ AA Pharmacy RM17.80

Also during post delivery, you may be prone to having piles or hermorrhoids because of the dehydration. So to prevent, try passing motion frequently like twice a day (ideally) and drink more fluids.

One symptoms I had of hermorrhoids is itchiness in the bottom after passing motion. Really an annoying post delivery symptom.

Plus there were numerous times where I suffered "cuts" from passing hard motions where it bled momentarily as well.

TREATMENT
So to prevent major cut to the anus, I read that to help pass out hard stool, use a finger and apply pressure near the opening of the anus.

And if you suffer from piles or hermorrhoids, do Kegel Exercise throughout the day and even night.

When taking hot showers, use a finger to GENTLY push the protruding part into the anus. It also helps to do Kegel exercise simultaneously as you push the part in as it help to suck that part in.

APART FROM STOOL SOFTENING

Initially I was afraid to take a mirror to look at my "bottom" because of the stitches and all but when I finally found the courage to do so, I noticed I had "yellow" spots in certain parts.

Yellow spots (enlarged) in the vagina area

My KKIA nurse and  my gynae nurse said these are normal. I just need to keep the vagina area:-

1) clean 

2) dry

3) aired

4) sizt bath

5) kegel exercise

How to do this?

Clean is obviously with water.

Dry means tissue follow by blow drying with hair dryer with cool air

Aired means do not use thick sanitary pads. Use panty liners if there's no more blood discharge etc. And if possible do not use even panty liners.

Sizt bath for me means soaking with hot salt water for 15 minutes. Initially 2 times a day but increased to 3 times a day when I saw the yellow spots.

Use "garam halus" as it is easier to dissolve and I used about 3 handful each time. That's a lot of salt.

In addition I keep a pot of warm to hot water nearby to add when the bath water (I used normal heater water set to highest temperature) is not longer hot.

Apparently when the water is not hot, the bacteria which came out can go in again. So it's important to keep the water temperature hot during the 15 mins.

Normally by 10 mins the water in no longer hot, so I'll add hot and salty water.

I will use a timer and during the 15 mins, I do some simple arm exercises (for sample click tracy-anderson-arms-exercise) as well as Kegel exercise because Kegel along with Sitz Bath can really speed up the healing process.

Also getting a bigger pail is great if you have bigger hips like me.

Initially I used the blue official Sitz Bath pail but later I changed to the red pail cos I find the water level in the blue pot too low to reach those yellow spots.

So now after 4 months of delivery, I am glad to say that proper care, Kegel exercise and Sitz bath, there were no permanent damage and I have complete healing from the initial cut and tear as well as post delivery cuts from passing motion.

Also thankfully whatever piles or hermorrhoids which I suffered during the first 2 months are also gone! :D

Baby jaundice emergency - what to do in Malaysia

If you have read my previous entry you would have known that my newborn baby was admitted to hospital on Day 6.

I would like to share on the chain of events in the hope that it would prevent others from making the same mistakes as me.

First you must understand that if you are breastfeeding, then do not consume any herbal medication. Read my post breastfeeding-and-eu-yang-sang-products-jaundice.

Secondly to check for jaundice, press on baby skin with your finger. It should NOT be yellow after you release the finger. The most yellow part would start from the head, follow by the chest, arm and getting less at the feet.

Also jaundiced baby are very lethargic. Will only sleep and not wake even for milk.

Medically there are a few ways to check jaundice level but the most accurate method is by blood test.

And by Malaysian standard, the type of treatment is determined by the level of jaundice.
Above 400 - blood exchange
399 - 300 - phototherapy with 2 lights
Below 200 - phototherapy with 1 light

For my case on Day 6 at night, when I went to a pediatric for checkup, the doctor using a light sensor obtained a reading of 28mg/dL approximately 490umol/l.

He immediately recommended hospital admission but did mentioned that with high jaundice level, the light sensor's reading may not be accurate. I requested for a letter. My 1st mistake.

Referral letter from the pediatric to Pantai Cheras

With the letter, I rushed to Pantai Cheras because I delivered there.

I thought with the letter, baby can be admitted immediately. I was wrong!

I was told to wait for my turn to see a general doctor before he can direct me to the proper department.

I was shocked because there were a lot of patients waiting.

The right thing I did was:-
I stood in front of the nurse and refused to take a seat even though she kept telling me to sit.

The 2nd thing I did right was IMMEDIATELY ask if there are any phototherapy light available.

The answer was None!

Imagine if I had waited!!

Having learned this, I then googled for hospitals contact and called the hospitals first to know which have available light.

Results:-
Pantai Ampang and Sunway have but Sunway will only accept the baby and not me as there's no bed for adult available. Plus priorities are given to those who delivered at Sunway.

So I rushed to Pantai Ampang. Again I have to wait at the emergency room.. And it's no surprise that there's a crowd. But the nurses fast tracked me and I got to see a doctor soon.

When she saw the report and the high reading of 490, she gave us 2 options.

First - get a blood test to confirm the level.

a) If the reading is confirmed higher than 400 then baby will need blood exchange which Pantai Ampang does not have facility.

b) If the reading is lower than 400 then we can be admitted.

It is really not an option because it takes time to do the blood test and we would have wasted precious time if the reading is indeed more than 400.

So we chose to go to a government hospital in case the reading is really that high.

Again we made a MISTAKE of asking for Pantai Ampang doctor's referral letter.

Anyway with the letter we went to HUKM as only government hospitals have the proper facility for blood exchange.

AT HUKM

Once in HUKM we waited, yes waited to see the medical officer to take the blood, then wait even more (total of 5 long hours to be exact) in HUKM for the blood test.

The level was confirmed as 361.

Good news that baby don't need blood exchange.

Bad news - HUKM do not have bed available for us.

The medical officer told us to try HKL. I immediately broke down and cried.

By God's grace the medical officer took pity on us and helped us to get a place in the maternity ward instead of the NICU (Neonatal ICU).

By 3am, Baby was finally admitted and had to go through phototherapy with 2 lights and blood test every 6 hours (taken from the wrist) to monitor the jaundice level.

So my ordeal to get him admitted began 7pm and ended at 3am (8hours) that night and through all these hours all I did was keep feeding him breast milk.

In the ward, I set alarm every 2 hours and even carried him on my chest as he sleep under the light.

Thanks to all the prayers, breast milk and the fact that both me and baby are of same blood group, the level drop from 361 on admission date on to 273 in 43 hours.

Also a big thank you to all the doctors, nurses and staffs at HUKM for saving my baby's life!!

In addition, upon discharge, HUKM recommended a follow up audio test because high jaundice besides affecting the brain could also damage a baby hearing. Will blog on this experience in the future.

UPDATES:- click audio-test-for-baby to know more about this test.

* * * * * * * * * * * * * *

So what have I learnt:-

1) Always know which hospitals are the nearest to you and which have the best emergency service.

Knowing your options will save you time.

- - - - - - - - - - - - - -

2) If you decide to go to emergency government hospital, never ask for referral letters from other hospitals.

Having letters gave the impression that government hospitals are your last minute options. You only went to them because the private hospital rejected you or do not have the facility to treat you.

If you just go there with any medical emergency, like for my case, baby high jaundice, you have better chance of being accepted without any letters.

That is because throughout the conversation between the medical officer (MO) and the pediatric doctor in HUKM on the phone, I kept hearing the MO saying that we went to KPJ (which is govt staff lingo for private hospital) and they did not accept our case for a good 3 minutes before the doctor on the other end rejected us by saying there is no bed available.

This is my personal opinion because I feel that if they are really full, they would have rejected us outright instead of having that long conversation.

- - - - - - - - - - - - - - - -

3) Referral letters cost money $$. My bill at the pediatric was RM70 and RM102.15 at Pantai Ampang.

RM102.15 for medical advice only. There were no medical tests done at all except taking of body temperature. I suspect the amount is for the referral letter which is now in HUKM's record.

RM70 bill from the pediatric

RM102.15 bill from Pantai Ampang

Baby's bedding - IKEA fitted sheet for cot can fit other sizes?

I find prices in Malaysia for bedding for babies rather expensive compare with adult's bedding.

I mean a SMALL latex dimple pillow by Bumble Bee costs RM49 and a fitted sheet for playpen mattress of same brand costs RM34.30.

I can't say about the quality of the latex pillow but for the fitted sheet, it's a bit too expensive for a single piece of cotton textile the size of 41" x 28" x 1" (104cm x 71cm x 2.54cm) because:-

1) the quality of the cotton is not there.. It's not even thick nor soft

2) the motif / print may not be to your liking.

So instead of spending this amount for the fitted sheet, I opted for IKEA's fitted sheet which retails for RM39.90 for 2 pieces (at a much cheaper price of RM19.95 apiece).

The only problem is IKEA's sheet are stated to be 120 x 60cm. Not exactly a perfect fit for a normal playpen mattress of 41" x 28" x 1" (104 x 71 x 2.5cm).

But I took the risk because I prefer plain colour bedding (can choose from white, blue or pink) and the material is stretchable like t-shirt materials.

VERDICT:-
fits perfectly!

Breastfeeding + Eu Yang Sang "So Hup" Pills = JAUNDICE

If you plan to breastfeed your baby, then don't take any herbal pills like 'SO HUP' pills, regardless of what the salesperson said.

Take it from me.. I paid a heavy price for trusting a saleslady from Mid Valley Eu Yang Sang branch.

Through breastfeeding my baby was indirectly consuming those herbs and his small-yet-to-fully-develop liver was unable to process it and it became toxic to his body.

It was these toxic which caused him to have high *jaundice or skin appearing yellow.

*[granted that having assisted vacuum during natural delivery will also contribute to higher risk of jaundice.. Yes you read correctly, babies which were delivered through natural birth using vacuum to suck the baby out will also tend to have jaundice].

But consuming more than 1 1/2 boxes of 'so hup' pills push the jaundice reading higher.

By Day 6 when I sent my baby for check up, his jaundice reading was 361 umol/l approximately 20.63mg/dL.

Apparently in Malaysia once the level reach 400 umol/l the baby will have to go for a blood exchange with possible risk of brain and ear damage.

Since it was 361, my baby went through hospital admission for 2 days 1 night with photo therapy with 2 lights.

While he was in hospital, the jaundice level had to be monitored every 6 hours through blood test. It was really heart wrenching to hear his loud cries as the doctors try to find the correct tiny veins on his tiny hands. Imagine doing this every 6 hours  T.T

After checking out of the hospital, we have to continue to monitor the level at local government clinic by drawing blood too but thankfully this time from his heel.

The whole ordeal took 2 weeks to end and all because of the simple mistake of taking herbal concoctions while breastfeeding!

So if you plan to breastfeed, please steer clear of ALL herbal potions. Just consume normal chicken soup etc for nourishment.

Because apparently most emergency wards are not as effective as it should be, especially when your emergencies happen at night!

It can really SAVE LIVES if you know what to do and where to go for medical help. I hope what I learnt the hard way can help you avoid the same mistake and HEARTBREAK which I went through with Hospital Pantai Cheras and Ampang services, so CLICK baby-jaundice-emergency-what-to-do.

Pre-Seed Fertility Friendly Lubricant - if you are trying to conceive

After trying to conceive to no avail for about 3 - 4 months, I realised that something must have been off somewhere because:-
1) I know exactly how to calculate my ovulation period since I have a very regular cycle of 28 days and
2) I know that it is God's intention for all woman to be fruitful and multiply,

I suspect it's because of my dryness during intercourse so I googled on lubricants and the Durex lubricant which I have can potentially kills the sperm.. Oops!!

NOT GOOD for sperm

So after searching, I found PRE-SEED which claims to be safe for use during intercourse as it acts like kind of a safe conduit for the sperm to swim in and reach the egg.. interesting!

GOOD for sperm

But is it available for sale in Malaysia?

Since my sister will be going to USA in September 2013, I asked them to buy for me but apparently this brand is not available on the shelves in USA... and them being virgins are too shy to inquire for me.. Darn it!!

So after their trip and more googling and I found the local distributor in Malaysia and they supply to none other than my favorite pharmacy, AA Pharmacy!!

You do have to call in advance to check because they sometimes have it in limited stock, which explains why you might not see it on AA Pharmacy's shelves (yes, it's on the shelf and you do not need to ask at the counter).

It retails for RM92.90 and I am very pleased to say that I used it once in October 2013 and was confirmed pregnant by November 2013 =D

You are supposed to use it with the enclosed applicator but for me, my hubby basically used his finger and and applied around my vagina. Works the same.

So if you have been unsuccessfully trying to conceive for some time now, you can consider investing in this lubricant, cos even though it's on a pricier side, you don't need a lot and it can double as a normal lubricant in the future (unless you want to avoid pregnancy) =D

(below are more photos of the insert and box)

How to treat Vaginal Yeast Infection - Lactacyd vs Candazole V Feminine Wash

Even before I conceive, I was having vaginal yeast infection which I suspect was caused by the dosage of antibody given by the gynae or sexual intercourse because I never had this problem before or you can just blame on hormonal changes.

How do you know it's yeast infection and not something worse? Well your vagina area is itchy and gives out a yellow but odourless discharge. Looks kind of like cheese.. Other website describe it as cottage cheese.. well it just look and feel like cheese to me.

Anyhow, before I was pregnant, I tried Lactacyd pH3.5 Feminine Wash

Verdict:- don't bother buying it. It doesnt work at all!!

DO NOT BUY THIS!!

The thing which work for me was:-

1) stop using panty liner

2) bring a change of panty (100% cotton pls) to work and change it when it's soiled

3) CANDAZOLE V feminine wash by Hoe Pharma. Click hoepharma.com.my/products
Now this is a feminine wash which works!!

BUY THIS

But too bad, it was not recommended by my gynae once I got pregnant.

My email to Hoe Pharma on the safety of the wash for pregnant women goes unanswered since 28 November 2013.

So basically I just stick to method 1 and 2 and used the prescribed YSP anti-fungal cream by my gynae but since that ran out, I changed to Decozol cream by Hoe Pharma.

Click hoepharma.com.my/products for Decozol cream.

Trying to Conceive - what I have learnt

If you follow my blog you will know:-
a) I'll be turning 40 this year
b) I just got married in 2012

Hence starting a family is very much on my agenda.

But I also believe in giving a one year time to settle down in my marriage before I conceive even though my age factor was always niggling me.

Anyhow after 7 months of marriage, we decided it's time to try to conceive. Well suffice to say, the process is not as simple as I thought it would be.

Because the first time we let the sperm in, I suffered from stomach cramps as well as wind or abdominal bloating which led me to a mistaken belief that I was pregnant.

So off to a visit to a gynae after I cleared my period for an explanation of the cramps and discomfort.

My gynae explained that sometimes there could be bacteria or etc in the sperm which did not agree with my body and hence prescribed 2 dosage of antibiotics for myself and one dosage to hubby. She said that this will solve the cramp problem in the future.

Zithromax 250mg to be taken 4 tabs in one go

Metronidazole 400mg 1tab twice daily until finish

So I was back to square one.

In trying to conceive, I discovered:-

1) the more expensive the PREGNANCY TEST KIT, not only is it more accurate because it is more sensitive to hCG level, it will be able to test conception even before your period is due.

Assuming you have a regular 28 days cycle, the first day of period is counted as Day 1, then you should ovulate sometime on the Day 14. So your period will come after Day 28.

So if you are pregnant, meaning around Day 14 your egg was fertilised but the kit wont be able to tell you that immediately as your hCG level is too low.

The earliest would be like Day 24 (meaning 4 days before your period is due) but First Response kit claimed it can detect pregnancy 6 days before period is due but then many of these results are inaccurate and you will have to do a second test.

So if a person say that she is positive like just 1 week after her wedding, then you know that she conceived before her marriage because there is no way a home pregnancy kit can tell you that. Hehe.. this is just extra gossipy info.

* * * * * * * * * * * *

2) besides pregnancy test kit, there is the OVULATION KIT.

This is especially helpful for those whose monthly cycle is not regular and therefore need this kit to let them know when they are OVULATING (in rough terms it means when the eggs has come out, ready to meet the sperm).

If you are not ovulating, then there's no egg to be fertilised.

So this is a great kit to let you know in advance when you are likely to ovulate. This kit usually comes in more than 1 piece cos hey you'll need to test you urine every few days to help pinpoint the date.

* * * * * * * * * * * * *

3) in trying to conceive, there is only a small window each month during which you can conceive, typically no longer than about 6 days, but since sperm can survive inside the body for about 5 days, it's good sense to have intercourse a few days earlier than before you ovulate.

* * * * * * * * * * * * * *

4) they always say to have more sex in order to increase your chance.. BUT having more sex at nearly 40 years old is not easy when it's sometimes not wet down there.. so you reach for your Durex lubricant.. BUT NO.. turn out normal lubricant can potentially kill the sperm.. but no lubricant means no easy sex..

Stuck in this problem I googled and came across lubricants which are sperm friendly. It may cost more, but it's definitely worth it.

I read that K-Y Jelly by Johnson and Johnson might also harm the sperm so I bought Pre-seed Fertility Friendly Lubricant instead.

Read my next blog on Pre-Seed Lubricant for more information (click pre-seed-fertility-friendly-lubricant).

* * * * * * * * * * * *

5) fertilisation in itself is not the end, as the seed must implant itself to the uterus before it's good to go.

Not only that, the position which it implants is also very important..

Because some embryo plants itself outside the uterus (a.k.a. ECTOPIC PREGNANCY) which can be very risky for the mother as the fetus grows it can damage mother's surrounding internal organs.

* * * * * * * * * * * *

6) so what do you do when you get a positive reading from the pregnancy test kit?

Well the instruction on the pregnancy kit says to make an appointment with the doctor asap.

I realised this advice was WRONG as I went to see the gynae a day after the kit showed positive.

But I was only 4 weeks + 3 days *gestational age pregnant, so the doctor couldn't see anything on the ultrascan. Just saw gas. Bummer!!

The earliest to see the positioning of the embryo is when you are 5 weeks pregnant.. Hence I wasted RM80 on the consultation and ultrascan fee :(

* * * * * * * * * * * * *

Side note:-
* gestational age vs fetal age
gestational age is age of fetus counting from the first day of your last period
fetal age is actual age of the fetus, meaning counting from day of fertisation

Doctors prefer gestational age because most women know when they had their last period but who knows when the fertilisation actually happen, right?

That is why doctors prefer gestational age. Also partly because it's easier to track the pregnancy based on 40weeks gestational period (9months cycle).

* * * * * * * * * * 

7) I realised that conception is pretty much a miracle by itself and should not be underestimated as we are involved in a delicate process of creation.

So it's important to stay healthy before you get pregnant, meaning if you have weight problem, blood pressure problem, vaginal infection problem, etc - SOLVE IT before you conceive because once you are pregnant, there are a lot of medications, creams etc which are off limits to you, including flu medicine.

Last but not least, whatever faith you profess, always commit your plans to God and He will see it through for you.

Tracy Anderson - Arms exercise

Watched Fashion Police on 4 June 2013 with Tracy Anderson as the guest celebrity.

In the show she taught one simple step to firm up your arms.

So the next day, I found this video on YouTube and challenged my colleagues to a 2 weeks exercise program at 530pm daily in the office.

We have been doing it for 3 weeks and I can see results in my arms =D

Before and After 3 weeks

Picture on Left was taken on 11 June 2013 and Right on 26 June 2013 (15 days). Notice how the arm is firmer at the bottom and you can see a more prominent curve at the top.

TONED ARMS BABY!! Yay!!

I must say I am very impressed by Tracy Anderson's method and hopefully in time I'll get the "ballet arms" which she promised! >.<

Oral B Interdental Brush

If you hate going to the dentist, then you should do this at home on a DAILY basis - floss in between ALL your teeth.

And if you find it difficult to floss the teeth at the back of your mouth, then you should get an INTERDENTAL BRUSH.

I especially like the Oral B one as the handle is long and the brush is tilted at 90 degree angle, making it easier to reach the teeth at the back.

I have purchased disposable types in Taiwan but the handle is shorter and the brush is straight and not tilted. Hence not as convenient as the Oral B ones.

NOTE that your gums will most likely bleed A LOT, during the initial week of use. I bled like crazy and the gums were sore but I persisted and now I experience cleaner teeth.

PROS:- NO BAD BREATH, which is very good! A dentist even remarked that when you sleep with clean teeth, you will have better and healthier digestive system cos the germs in the mouth inadvertently travel to your tummy.

CONS:- you might see unsightly gaps between teeth, especially the teeth in front, but if you ask me, I prefer gaps than cavities/ holes anytime!!


VERDICT:- if you are not afraid of seeing blood, give this brush a try. You'll see less of the dentist this way.

Cleansing net

If you are ever in Daiso, do look for this item as it's very very useful. It retails at RM5 for 2 pieces. It is so useful that I even travel with one.

You use it with your foaming facial cleanser. It will cut down the time and effort needed to build bigger, stronger and firmer lather.

The Japanese believe that such fine foam will translate to more effective cleansing as the cleanser can now penetrate and clean the pores of your face.

Try it and see. You can even use it with a bar of soap - works like a charm! ^.^

Traditional remedy for heatiness

As we are living in tropical Malaysia, the weather can sometimes be too hot for our body.. coupled with lack of rest, stress and poor diet which can lead to "heatiness" in our body.

A tell-tale sign of heatiness - bad breath or heaty breath and possible body rashes or pimples.

To combat it, try boiling some chinese herbs such as barley, crysehthemum (or kekwa in malay).

Alternatively for extreme heatiness especially in cases of CHICKEN POX, I boil a pack of concoctions purchase from chinese drug store.

You can drink 100 Plus, Pocari Sweat, Livita or even coconut but these herbs worked for me besides I find coconut gives my stomach wind.

The key ingredient in those packs are the shavings of animal horns.. Any animal horns will do but of course horns from exotic animals like antelope, gazelle or water buffalo are more effective and pricier.

The ones in the picture below, even though stated as antelope, I highly suspect are just plain cow or goat horns cos the pack only cost me RM10.

So next time you feel heaty, why not give traditional remedy a try! Just buy a pack, boil it in water! Easy peasy!!

When boiling there's a slight smell.. hard to describe it. The boiled water is almost colourless and tasteless just like normal drinking water.