Thursday, November 22, 2012

GDM - Monitoring My Blood Sugar

Somehow, just weeks before I'm due, my gynae is convinced that I have gestational diabetes mellitus (GDM). After admitting me last weekend to monitor my blood glucose level, I was referred to endocrinology specialist, Dr Dato' Faridah.

As a result, I have to monitor my blood glucose daily at home. I'm not so pleased with it, but I am not one who dare to go against doctor's order because I know they have my best interest at heart. So I had no choice but to purchase the blood glucose monitor device:

The hospital recommended Accu-Chek Performa as it is the most accurate

This device can be bought at any reputable pharmacy. It comes with 25 test strips (where you deposit the blood sample in order for the device to read your blood glucose level), a pen device which is the pricker (you can set the prick level - the pharmacist recommended that I used the lowest level which is '1' as it is less painful), 10 refillable needles (I have to change the needles after 3 times due to hygiene and since the needle may not be as sharp as before after prolonged use) and of course the device itself. I bought mine at RM199 at a pharmacy in Prima Gombak, nearby my house. I also have to buy the alcohol swabs (RM6.90) to sterilise my finger before I prick it (it seemed scary the first time I have to use it).

At the point of purchase, the pharmacist helped to set the device and explained to me on how to use the device even though the nurses at the hospital have explained to me before I was discharged (after all, it is the same equipment). Somehow, I find the explanation useful as at the hospital, the nurses helped to change the test strip and the needle pricker used was different from the pen device in this set.

Initially I did not dare to prick myself so I asked Suami Terchenta to prick me. To my surprise, it did not hurt (unlike when the nurses did it at the hospital). I guess it has to do with the prick level set by the nurses. Since level '1' already draws sufficient blood from my finger without pain, I stick to that level until now.

So, now we come to the blood glucose reading.

Although I am not fond of doing the tests every day, it is interesting to read the test results. I have to do the test 6 times a day - before/after breakfast, lunch and dinner. My pre-breakfast readings (fasting) normally hover between 5.4 - 5.5 (my doctor claims this is borderline), while my pre-lunch readings are lower at 4.2- 4.7 (maybe because I don't snack in between breakfast and lunch, and I walk to the food court to buy lunch). My pre-dinner readings are higher - between 4.8 - 5.4. I guess because by night, my metabolism slows down even though I'll be busy in the kitchen preparing dinner.

My post-breakfast readings tend to be consistent if I only have a bowl of oat for breakfast. But if I add muesli, nuts and fruits to my breakfast (as recommended by the dietitian), the reading will be above 5 and even reach 7 (but still within the targets for control for non-fasting condition). Post-lunch and dinner are even higher - average is 8.6.

So during doc's visit to my room today, she took a look at my blood glucose journal and noted that at above 8, she should be prescribing me with insulin shots to manage the blood glucose level. Luckily, I also jotted down my food intake in the journal so she agreed that maybe this week the insulin shots can be postponed if I reduce my rice to half portion instead of one portion and reduce anything cooked with soy sauce.

She also asked me to continue with the oat breakfast and incorporate a bit of walking (around 10 times going back and forth at home) but not to overdo it in case I start my early contractions again. I immediately like Dr Dato' Faridah again because unlike the dietitian, she gave me a more practical advice that I can easily follow.

Some mothers can enjoy food to their heart's content before they deliver but unfortunately, that's not the case for me. Apa nak buat, for the sake of the baby and to avoid being stuck with diabetes at a later stage of my life, I have to control what I eat and become vegetarian (huhu...). Caiyok Carneyz! Only 3 more weeks to go (plus 60 days of confinement food!) \O/

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Wednesday, November 21, 2012

False Alarm!

This morning I was woken up by a strange sensation on my lower back, tummy and pelvic. Before that, I had gone to the toilet 3 times where else normally I take only one nightly trip to the toilet (I usually empty my bladder before going to bed).

After going to the toilet for the third time and feeling somewhat uncomfortable by the strange pressure on those areas (the lower back started to throb and ache constantly), I sat on the edge of the bed massaging my back and tummy.

To be honest, I've never felt this discomfort before. My first baby was delivered 3 weeks before her due date due to placenta praevia and via c-section. And my miscarriage incident that had me induced happened more than 3 years ago I forgot how it felt like.

The discomfort somewhat felt like menstrual cramp minus the pressure on my cervix during those heavy period flow. It felt so surreal that I could not decide whether the pain was real or I was just over-analysing the feelings.

I almost smiled when I remembered the hilarious conversation that took place in my head as I was internalising the whole situation:

Optimistic self: Oh come on, if it's real labour, you don't have to think too much about it. Just go with the flow! If a horse can do it without all these natural birth plan and hypnobirthing and whatnots, why can't you?
Desperate self: We don't know what the horse is thinking during labour! Probably it would ask for pain-reliever if it could talk!

Somehow even though I was just quietly sitting and massaging my tummy and lower back, Suami Terchenta woke up and asked, 'Why? What's wrong?' I hesitated before replying, 'Umm. I just feel somewhat uncomfortable around my tummy and back area.'

He immediately woke up and asked,

'Is it contraction?'
'I don't know. It doesn't feel like it.'
'Is it symptoms of labour?'
'I don't really know.' Which was an honest reply.

He got up, touched my tummy and then decided to find one of my pregnancy reference books to find out (time2 macam ni baru la dia nak baca buku2 tu!). After leafing through the pages, he concluded,'I think it could be it. Shall we go to the hospital now?' By then, I detected a hint of worry and concern bordering panic in his voice.

I crawled on the bed and lay down on my right where my lower back was not painful. 'Not yet. But can you massage my back? It hurts.'

He was on his feet and emptying the luggage from our last trip to the hospital on Saturday. He stopped and helped to massage the affected area, which brought relief to me. I started to fall back asleep when Khayla woke up and cried for milk. Then I had to turn to my left so she could snuggle against me.

By 7.30am, I started to notice the contractions. I was walking down the hallway and immediately felt a pulling sensation on my lower abdomen as it tightened. The pressure was so intense I held on to the wall and clutched my tummy. Suami Terchenta looked at me with a frown on his face.

'It's contraction right? Time to go to the hospital?'
'Um. I don't think so. It doesn't appear frequent.' I was still reluctant to rush to the hospital over a few tinges because I was scared that my doctor will ask me to be induced. Ouch!

I continued to the back area to get my work dress when I was stopped mid-way by the same intense pulling sensation. This time it made me moan.

'That's it. Let's go to the hospital.' Suami Terchenta made the decision.

In between the contractions (which started to appear at regular intervals), I managed to iron my cloth and tudung, laughed at the absurdity of the painless pressure yet so intense it made me pause while I was walking, and get ready. I texted my boss to inform that not to worry, but I need to get checked out because I'm having unexplainable discomfort which is getting persistent.

We dropped Khayla at her nursery and then drove to the hospital. I started the contraction timer. Everytime I suspected it was contraction, I pressed the button and then endured the uncomfortable sensation. Some of the contractions were mild, but some made me clutched Suami Terchenta's arm in agony. Each lasted between 30 - 50 seconds with 10 minutes apart:

My contraction timer apps

When we reached the emergency entrance, the hospital staff seeing me tottering in awkwardly, greeted me at the door.

'Are you feeling labour pains already?'
'I'm not sure...' I explained where the pains were and informed that this was my first experience of 'labour pains' (if it was what it was).

She immediately brought me to the labour ward at 6th floor using a wheelchair (because I started to groan and almost double over whenever the contractions hit me).

When we reached there, the labour ward staff took over and had me settled on the bed to strap on the CTG scan. Then Suami Terchenta appeared and sat next to me watching my every expressions. Occasionally he held my hands when the discomfort was so intense.

The CTG scan displayed the fetal heartbeats (which was steady between 130 - 170+) and the contractions (true enough, it appeared every 10 minutes, averaging at 68 which is already moderate and the more intense ones reached 104, which is already considered as strong contraction).

After half an hour, the lower back pain on my left transferred to my right. When the nurse staff took the CTG scan output, she asked me to remove my pants as she wanted to check whether I'm dilating. At that point, a very intense and stinging pain overcame me on my upper right tummy that I had trouble breathing. I gasped, grunted and stared incredulously at Suami Terchenta as I was suddenly reminded of the same pain I felt when I was induced during my miscarriage 3 years ago!

Mine was between 4 - 9, I think

Nurse asked me to take a few deep breaths (and boy, it was hard to breathe properly when the intense pain was overcoming me!) but I managed to control my breathing and finally sat up. Then I lay down again for the exam and although I read and heard many people said the exam was painful, it was not that painful to me.

Nurse then proceeded to give me injection to help the baby's lung mature in case I really go into labour. She cautioned me that the injection will STING. This time I agreed with her.

Then my gynae popped in and confirmed my worst fear - yes, I'm in real labour and those are regular contractions. If I continue to be having those contractions and already dilating by tomorrow, she will start the birthing process even though my baby is still 2 weeks shy from being considered as full-term! That certainly got me alarmed, thinking that I am not prepared at the prospect of looking after a preemie.

Suami Terchenta had to leave my side to register my admission and I paced the room and swayed my hips to relieve the contraction pains. I also decided to update my FB status just so I could distract my mind from the pain. After a while Suami Terchenta reappeared and we waited to be transferred to a normal ward to wait out the labour.

I even received a call from work,

'Hi. Are you on leave today?'
'Um. I'm in the hospital, having contractions.'
'I just need to check something. Blablabla...'
'The latest status is, blablabla... Urghhhh....' Contraction hit me and I grunted in pain.
'Err... Never mind. I'll just call your boss. Take care!' My colleague sensing my discomfort immediately ended the call.

After we were in the normal ward, I continued to pace the room and sitting on the sofa to ride out the pain. Lunch was delivered. I ate half-heartedly but finished my meal thinking that I might need the energy later should I ever required to be induced today (although I was still praying that it's not time yet and the whole thing will stop).

After lunch and exhausted from enduring the pain and endless pacing, I decided to try take a nap. I slept for 2 hours clutching my tummy.

Then my prayers were granted.

I woke up when a nurse came in to check my blood pressure. The first thing I noticed was I wasn't in pain anymore. Sure, it still throbbed where the pains were, but it was just a faint and mild sensation. Even the contractions were very mild it felt only like Braxton-Hicks!

The pain gradually went away and by night I wasn't feeling them anymore. This was confirmed when the nurse took my CTG scan again - I occasionally had tightening due to BH but the rest was normal. Alhamdulillah! :)

CTG scan showed that contractions have gone away for the moment!

So now I'm hoping to be discharged tomorrow after my gynae and specialist who is monitoring my GDM give the clearance.

Until now I'm wondering what could have triggered the early contractions - maybe because the night before I had pineapple soup for dinner, or because I let Khayla have the boobs to calm and settle her down (although she only suckled for maximum 20 minutes before she dozed off). Or work is driving me crazy. There are a lot of possible reasons but none really makes sense.

Hmm. Anyway, now that I know how labour pains feel like, I HAVE to make some changes to my routine and definitely need to catch up on exercise to prepare me physically for the labour when the time comes. And practice the whole breathing and positions to cope with labour pains. Lots of things caught us unprepared during this short experience, and I need to read and practice more. So does Suami Terchenta. Well, I hope he'll take it seriously as well! :p

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Sunday, November 18, 2012

Firstly, I must say Alhamdulillah this pregnancy has been pretty much smooth-sailing and stress-free most of the time compared to my first full-term pregnancy experience.

I did not suffer from swollen and achy feet, nor constant backache. I'm also mercifully spared from the internal heat and eczema that made me most of the time miserable and irritable during my first pregnancy. I still remember how I often broke down in tears because my feet and tummy were so itchy when I'm hot and back then, we didn't even have an aircond to relieve my heat! The eczema problem was equally distressing because the cream and soap the hospital prescribed did little to help.

Except for the episode of non-stop vomiting during my first trimester that had me admitted in the hospital due to dehydration, my 2nd trimester and half of my third trimester has been trouble-free.

So I was not expecting to be admitted to the hospital again before delivery until I had had the OGTT. A week later, my doctor called to inform that my result was not so good - my reading was 11.1 mmol/L. Okaay.... Since I already expected that my blood sugar will be on the high scale, I did not really take serious notice when she asked me to see the dietician. Furthermore, I was on MC, I had a sick little girl to look after and also I had to work even during public holiday this week. So, making an appointment with a dietician who is going to ask me to eat brown rice instead of white rice (I'd seen dietician during my first pregnancy) was definitely not one of my top priorities.

Finally last Friday, I had an appointment with my gynae. As expected, she was not happy that I had not make the effort to go see the dietician immediately despite my reasons. She told me that she had a patient who lost her baby at 38 weeks because of uncontrolled GDM (gestational diabetes mellitus) and she is not taking that risk again. Before I can say, '...but!' she had written a note to have me admitted immediately that night so the hospital can monitor my blood sugar (or known as the 7-point test).

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Friday, November 16, 2012

Salam Maal Hijrah

Just wanna say... Salam Maal Hijrah 1434H to all Muslims all over the world. May Allah SWT bless us all this year :)

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Thursday, November 15, 2012

Those weeks everyone was not feeling well...

It's the time of the year again. The season full of the nasty flu bug.

Remember when I told that I had accidentally detoxed myself two weeks ago? Turned out that I actually caught the flu virus from someone and all those headache, muscle pain, blocked nose and severe coughing were NOT because of detox whatsoever.

These couple of weeks turned to be very rough and challenging for all of us in the family. As soon as I caught the flu, my whole family became infected with it as well. Hubby had it too, but he recovered fast, which is within 2 days. It's the pregnant lady and a fragile baby who struggled to fight against the virus.

Let me tell you, coughing non-stop while being heavily pregnant was a very unpleasant experience. Every time I was having cough attack, I had to clutch my lower tummy because it hurt like hell!

My medicines

But what's more horrible is being pregnant and having to care for a sick baby.

Khayla couldn't sleep well because she was having high fever (38.8 degrees Celcius people!) and because she couldn't breathe properly due to runny nose. Since she had to breathe through her mouth, several times she woke up with dry mouth and throat, so she became cranky again. My poor little girl!

Her fever lasted more than 6 days despite her taking antibiotics. When her temperature rose too high, we gave her the suppository that has to be inserted through her rectum.

It brought her relief for a few hours but after that the stubborn fever returned and we had to give her paracetamol again. And cold med. Cough mixture. Something to relief the phlegm. There. So many medicines that she hates but had to swallow.

Night time was a nightmare for us parents. In the middle of the night she woke up crying and kicking up a fuss because she only wanted to sleep on my arm. Most of the time I had to refuse because in the morning I'd wake up with backache from leaning too far on my side. Another reason I had to let her down is because she got annoyed with my growing tummy that gets in the way. She'll kick my tummy so much so that I have to wake hubby to pass her to him.

To sum up the past few weeks we had little sleep taking care of Khayla. Both of us were jaded and weary.

Daytime was no better. Her runny nose was worse, and she cried a lot. She only wanted to be cuddled up and became upset when we wanted to do something else like prepare lunch or do laundry. However after giving her meds, she settled down on her rocking chair and slept. She looked so tired with black shadows under her eyes. It just breaks my heart!

The sick little girl

Another thing that made us so miserable during her sickness was her lack of appetite. She ate one or two spoonfuls of rice with chicken soup and then she was done. She refused her milk and balked at the idea of taking plain water (usually she doesn't mind drinking plain water). So it's no wonder that her body took a long time to get well because she was not getting enough nourishment.

I tried giving vitamin C tablet. She was only interested in them for a couple of days, and after that she refused that too. Then I have to force her to eat Scott's Emulsion to boost her immune system. So far she is still taking that supplement.

I'm thankful that now we are feeling generally better, although all of us still haven't fully recover from coughing. Hoping that we'll be in good health by the time the baby arrives - dear germs, please go away!

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