KKIA Kuchai (Klinik Kesihatan Ibu dan Anak)

These are my experience and opinion of KKIA Kuchai which serves Sri Petaling and Bukit Jalil:-

The contact number for KKIA Kuchai is 03-79801178. The number listed in the website is wrong.

1) the clinic is NOT on the ground floor. You press for your number on the ground floor but you will need to go one floor up to wait for your turn.

2) be there early because it covers a wide area therefore there's a crowd by 10am. I arrived at 8:06am and got number 35.

3) for new cases, it's best to go on Wednesdays as the nurse takes blood every Wednesday. Also note that they handle new cases from 8am to 10am only.

UPDATE:-
They handle new cases on Tuesday and Wednesday but they require you to make an appointment through phone before going.

4) the best time to go is when you are 12 to 13 weeks into your pregnancy.

5) as with all government clinics, expect to wait. Then again even with good private gynae, the wait is the same.

6) do not be alarmed if the numbers being called jumped from 20 to 50. This is because in this clinic, every patient is automatically assigned a nurse. This will be the same nurse that will attend to you from Day 1 until you deliver (unless she is on leave that day).

So the numbering progresses according to that particular nurse's list of patients and the tests (blood, urine, blood pressure etc) which the patients have to take.

7) the clinic is very organized with rooms assigned for taking blood, checking heart beat, opening account and explaining the do's and don't of pregnancy (but I personally think that by filling in your highest education in the pink book, the nurse know the level of information they need to impart).

Anyhow many important information can be found from the pink book itself.

8) lastly, there are a lot of foreign nationals moms to be there.. possibly from the influx of foreign workers in Kuala Lumpur, thus adding to the crowd but all the nurses are very patient even when they have to write the same information twice (once in your pink book and then another time in the clinic's pink book which they keep as a record).

9) there is NO ultrascan machine in KKIA Kuchai :(
That is why you are requested to bring your own ultrascan printout at the time of registration.

Not many KKIA have the machine but I know KKIA Puchong has one.

So basically in this KKIA the nurse will feel for the baby with their bare hands and use the doppler to listen for the heart beat.

I commented to the nurse on this and she recommends that I write to Kementerian Kesihatan to complain, which I did.

The Kementerian was very efficient in replying through an acknowledgment email and a phone call follow by an official reply:-

Basically they are saying that since March 2013 they have requested for the machines but reiterates that for every acquisition by the government will take time and there's a process which they have to follow.

So let's see if my baby will enjoy this machine and if not, I hope other moms to be will not have to wait too long for this one important piece of equipment.

UPDATE @ 4 December 2014:
Yahoo!! KKIA Kuchai just received their spanking new ultrasound machine last week!! Yeah.. but it's not up and running yet as the doctors need to go for training first on how to use it.

Still it's great news! :D

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

Breast pumps - manual or electric?

Since I have tried both, my verdict are as follow:-

Manual pump
Pro
1) Less parts to wash and assemble (depending on model)
2) Cheaper
3) Total control on speed and suction

4) More natural suction like babies'

Con
1) Tiring for the hand
2) Might not be able to empty breast cos your hands are tired from the pumping

Electric pump
Pro
1) Not tiring. With practice, you can even be hands free without using the hands free bra
2) Can empty the breasts

3) Adjustable speed and suction power (depending on model)

Con
1) Price price price.. With Medela Freestyle going for RM1,499 (this is the cheapest price for this model in the market), it's no wonder people think twice before buying an electric double pump.

But fret not as there are many cheaper and affordable brands out there.

2) More parts to wash and there are more parts to be carried - the pump, tube and power adaptor.

VERDICT
The choice of pump will depend on how often you intend to pump.

If occasional pumping (once or twice a day), then manual will do. But if you are full time working mother, then do yourself a favour and get double electric pump!

See the guideline chart below on choosing the type of Medela's range of breast pump:-

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.

What happens if failed glucose test during pregnancy

Apparently many pregnant women failed their second glucose test.

Blame it on the urge to binge or the sudden cravings for fast food and carbonated drinks.

Anyway so what happens next?

Well for me, my nurse at KKIA (Klink Kesihatan Ibu dan Anak) immediately rang me up for a next day appointment for BSP (short for Blood Sugar Profile).

I suspect this is the same standard test for diabetic.

Basically it's a test done for sugar level AFTER 2 hours of every meal (breakfast, lunch and dinner) which inadvertently mean you'll be spending the whole day in the KKIA.

Bummer!!

Double bummer for me because my nurse did not explain properly the procedure so I ended up starving until 230pm before my lunch because I was under the mistaken belief that I must take a before-eating-blood-sample for each meal.

Why 230pm? Cos the KKIA closes from 1 to 2pm. No one explained that I just eat at 1230pm and come back at 230pm to draw blood :(

SO BASICALLY WHAT HAPPENS IS:-

1) You fast 10 hours (last meal was before 10pm the night before), then at 8am you take a control blood test (TEST 1).

2) Go for your breakfast, then wait 2 hours then go back for TEST 2.

3) Go for your lunch at 1230pm or 1pm then go back for TEST 3 after 2 hours.

4) Go for your dinner at 6pm then go back for TEST 4 after 2 hours.

Sounds simple right?

Still I managed to mess up my BSP test.. haha.. Well at least it's good news that they will not be drawing blood for 6 times but only 4 times.

Note the results are immediate because they use the same device which diabetics use to monitor their sugar level.

So since my mother have the device, I did all future tests at home because I have to control my diet and monitor the glucose level with BSP (blood sugar level) every 2 weeks until I deliver my baby.

Not only that, I have to do MGTT test (click this link for more info on MGTT glucose-test-during-pregnancy-mgtt) after 6 weeks of delivery.. Hmm... Guess monitoring glucose level is pretty serious business during and after pregnancy!

UPDATE:- my result for the glucose test AFTER delivery came back normal!! So means I'm not diabetic! So failing the test during pregnancy does not mean you are diabetic.

Just have to control your food intake during pregnancy so that you do not pass a high glucose level to your baby during delivery.

Glucose Test during pregnancy (MGTT)

SUGAR WATER

Glucose or meal glucose intolerence test (MGTT) is usually done once by pregnant woman during their 2nd trimester but for me since:-

1) I'll be 40 years old when I deliver
2) I gained a lot of weight during my first trimester

I have to do 2 times (once in 2nd and another in 3rd trimester).

It's mandatorily done by Malaysian government clinics but not private clinics. Not sure the reason but possibly because Malaysia is trying to control the number of diabetics in the country.

Cos if the mom is diabetic during her pregnancy, chances are high that the fetus will also be diabetic. By doing this screening, if it's true that the mom is diabetic, then the government can immediately step in, either through education on proper diet or medication.

Also diabetic fetus will also be bigger in size thus making it harder for the woman to deliver later.

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

WHAT IS THE TEST?
In summary, compare 2 blood samples of before and after drinking a glass of sugar water.

TO BE PRECISED, IT'S:-
Basically the test is done by taking a blood sample first thing in the morning after a 10 hour fast.
Usually the fast begins at 10pm the night before for a test at 8am in the morning.

Then you'll be asked to drink a cup of warm sugar water (very sweet).

You'll be ask to rest / sit for 2 hours. During this 2 hours, try not to move too much and if you feel uncomfortable, you may even lie down.

This is especially a problem for pregnant woman who have morning sickness. That is why the test is usually done in the 2nd trimester.

Important note:-

a) not to vomit during this 2 hours, you'll have to ABORT the test and schedule another day for the test.

b) during these 2 hours, you cannot eat or drink anything.

c) If you can successfully hold in the sugar water, then another blood sample must be taken within the 2 hours. If longer, again the result is not that accurate.

Basically a comparison of glucose level in these 2 blood samples will show if your body can successfully process the glucose or not.

* * * * * * * * * * * * * 

SIDE NOTE - can you drink water during the fast?
I have obtained differing views from the websites.

My nurse say I can have sips but the UK sites states that drinking water is not a problem.

VERDICT on drinking water:-

You can drink all you want before 10pm but by next morning, just have enough to quench your thirst.

* * * * * * * * * * * * * * * 

So what happens if the result is NOT NORMAL?

I will be blogging on it, cos I failed my second test :(

So to all pregnant women out there, it's always good to watch the amount of carbohydrate that we eat and the sweet drinks that we drink.. specifically white rice, milo and carbonated drinks.

UPDATE:- since I failed the test, I have to do BSP (blood sugar profile). Click what-happens-if-failed-glucose-test for more info.

DHA for pregnancy - Neurogain PB vs GNC

Only realised the importance of DHA supplement after attending an antenatal class during my 25 week of pregnancy. It's vital for brain or neurological development of the fetus.

Fortunately, many websites say that the importance of DHA intake peak during the third trimester.

Anyhow if possible, do take DHA latest by week 18 so I was 7 weeks late. Still I believe it's better late than never.

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

My first DHA was Neurogain PB

Got mine from AA Pharmacy @ RM44 for 30 capsule. I saw the same thing being sold at Caring pharmacy for RM51. Guardian around RM49.

NOTICEABLE DIFFERENCES

1) First thing I noticed after taking the DHA is the soreness or dryness on my lips was gone.

Before I had to apply and reapply lip balm in the morning, afternoon and night to prevent Angelina Jolie's lips.

I called it Jolie's lips cos the cracked lips / soreness and redness was so bad that my upper lips lines expanded and look thicker.

2) Second thing I noticed I do not need to apply Cetaphil cream on my legs anymore as they are no longer dry.

I thought that's great.. but the price was a bit of a put off.. at about RM1.50 per capsule it's quite costly since I have to take it everyday and I have to take other supplements as well.

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

So to cut costs, I tried GNC's DHA instead.

It's only *RM47.40 for 60 capsule (*if purchased as GNC VIP during birthday month but normal retail price is RM72.90).

Comparison between Neurogain PB vs GNC DHA

VERDICT
I personally prefer Neurogain PB simply because I tend to burp fishy smell after consuming GNC's.

I did not have this problem with Neurogain PB. Also with Neurogain PB my lips were completely ok but with GNC's I occasionally (like once a week) still have to apply lip balm.

* * * * * * * * * * * * * 

Note:-
a) the lower the EPA, the better it is for pregnant woman but 100mg is still ok but lower is better cos something to do with EPA can dilute cholesterol in the body and too much of it (more than 3gram) will thin the blood and increase risk for bleeding for normal person. So pregnant woman better avoid if possible.

b) the best time to consume DHA is after meals (any meals).

* * * * * * * * * * * * 

More photos on NeuroGain PB

Size of the capsule

Anakku vs Pigeon Baby Cloth Napkin Review UPDATED

PRICE

Anakku is RM35.90 for 12pcs in Sogo

Pigeon is RM35.90 for 10pcs in Parkson

QUALITY

Anakku is slightly thicker than Pigeon

I try to capture the difference with camera but it may not show in the photos but definitely with the naked eye, when you try to see a ceiling light with the napkins, you can clearly see that Anakku is thicker.

SOFTNESS

This is not so clear cut because since Pigeon being slightly thinner (really slight), tends to be slightly softer.

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

VERDICT

Since both brands are almost same, the only factor would be price for me. So if you can find any of these brands at cheaper price, you can go ahead and buy it.

BUT NOW THAT I have washed them with washing machine, PIGEON is definitely the choice for me as they are easier to fold because they do not crumple as much as Anakku.

GO FOR PIGEON!!

Pregnancy and cough - what do you do?

Many friends told me to be careful during pregnancy not to fall ill as many medicine are a
no-no for me.

Well somehow my boss was having a terrible cold one day and before you know it, I had sore throat the following next day.

Normally with the sore throat it will take like a day or two before it develops to flu, fever and cough but somehow during pregnancy my immune system was lower so I had all these symptoms within the same day.

To make matters worst, every time I cough, I pee..

So there I was changing panties until I ran out of them before it occurred to me that I should have use panty liners. I changed like 6 - 7 panty liners that night because I coughed badly throughout the night until 6am.

Being apprehensive of taking any medication, I decided to let the cough fester and hopefully go off on its own on Day 2.

But by Day 3 since I had yellow sometimes green phlegm, I decided to see my gynecologist because I google on it and some pharmacist mentioned that if you have:-

- no phlegm
It means it's viral infection and will go off on its own.

- if there's phlegm then it depends if it's colour or clear.
Clear is better as colour phlegm means there's bacteria infection.

* * * * * * * * * * *

After my visit to Dr Tan Ee Ping I was given 3 medicine:-

1) cough syrup - IRIDIN LINCTUS by Axcel
2) antibiotics tabs - CO-AMOXICLAV 625 by Axcel
3) tabs for allergic rhinitis or urticaria - XYCAL TAB 5mg by GSK

The syrup was to be taken if there's cough but I must finish the rest of the tabs within 5 days.

The syrup was supposed to cause drowsiness but it did not have much affect possibly because of the small dosage of 5ml. But I must admit that the syrup is rather nice tasting with no bad after taste like certain syrup.. Yummy!!

Apparently the medicines prescribed was of good quality cos I showed the same medicine to the KKIA nurse because I was due for an anti-tetanus jab on Day 4 and the nurse said that these are good medicines which are pregnancy-safe which will not affect the jab.

So ladies, if you are having cough with colour phlegm, dont wait it out but see your gynecologist or any GP because seriously who knows how long you'll be coughing before it clears.

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

More photos of the medicine:-

IRIDIN LINCTUS cough syrup - 5ml each time

Merino Lanolin Cream for dry eczema skin and pregnancy rashes

Fantastic cream from New Zealand!

Being pregnant seems to open up a floodgate of physical disorders in the body such as sudden surge in vaginal discharge, rashes and even pimples. Blame it on hormonal changes :(

Rashes on the foot

So to counter some of these problems, I found it rather useful to:-

1) change my shampoo and conditioner to Ma Cherie's Airy Feel range cos it keeps my scalp less oily and thus less pimples on the head.

2) apply Lanolin Cream on my tummy, breast and back to prevent itchiness - after all my skin being stretched all day.

I find this cream particularly effective because even though when compared with Cetaphil Moisturizing Cream, this lanolin cream leave a more STICKY feeling, it washes off with just plain water and keeps my skin moisturized until my next shower. How cool is that?

It also helps to counter the skin rashes to a certain extent because it does not completely rid me of the rashes but at least keep the itchiness at bay.

So this is a better long term solution for me rather than relying on hydrocortisone cream during my pregnancy.

For more product info on Merino Lanolin Creme, see packaging and product information below:-