Monday, December 31, 2012

Prof Dr Raman Subramaniam; FMGC

Early 2011, we were introduced to Dr. Raman. His clinic (FMGC) is at Jaya One. We knew our search for a gynea was over when we met him. Yeap, right from the first visit. Both hubby and myself were very comfortable and satisfied. Or should I say, relieved even - that we found our doctor!

He took his time to run various investigations. He started from the very beginning to the very end. He never gave up even after 3 failed IUIs. It was after the laparoscopy that he told us, IVF is the only thing left to try now and he recommended an excellent reproductive specialist, Dr Eeson.

During my laparoscopy surgery, he got Dr Eeson to come in as well, since Dr Raman foresaw that we may have to go in for IVF. This is so that when we do actually go in for IVF, Dr Eeson would have already known my insides, so to speak. Now tell me, how many doctors you know that think ahead and be pro active? This was all done in goodwill. Dr Eeson was not paid to come in to the OT to have a look. From there you can know what kind of character Dr Eeson has as well.

Dr Raman is very fatherly. Oh no, I don't mean the fatherly kind who would be nosy, over caring etc... He was caring, never nosy, always ready to listen to what we have to say, took his time to answer any questions we had, always made sure we were comfortable. Even at times when we wanted to discuss something private, he never hesitated to ask his nurse to leave the room. 

Despite being extremely experienced, he never once generalized me. I definitely needed a doctor who would understand that I am just different from the other women out there. My body, my health and my hormones especially can't be put in the same boat with others. 

I will never forget the day of my laparoscopy, he held my hand in the OT while I was about to be knocked out.

The only drawback is that the appointment to see him is first come first serve basis. You still have to come in the morning to register, but be prepared to wait 2 to 3 hours to see him. After a few visits, we got the hang of it. We went in the morning to register, and we would either come home (since our home isn't that far), or go have breakfast and waste some time and then go back up. Consultation charges are between RM90-RM100.

The nurses are nice too. There are two senior nurses, Ms Sona, and Ms Josephine. They are really very helpful. Sona is a person who is super positive all the time. She's always smiling too despite being so busy. Josephine is a person who is outspoken, but is very helpful. Be nice to them because they go through a lot in a day at the centre. 
 
Disclaimer: All comments & thoughts stated above regarding the doctor & the centre are solely of my own. Hence, judge the doctor for yourself before blindly deciding. What you look for in a doctor is not the same with me. Make an appointment to see a doctor, go for it, have a chat, and then decide.

Sunday, December 30, 2012

Dr. T. P. Baskaran; HKL

Now, if you know or heard about Dr. Baskaran, you must be wondering why on earth I went to see him @_@  Well, simple - my parents knew him. They said he was a very good OBGYN at HKL. Hubby of course didn't follow me for any of the appointment because he wasn't happy with me going to HKL.

Anyway, first of all, he isn't an OBGYN. He is a specialist for maternal-fetal condition. Clearly, my folks aren't aware of the many clinical focus that is available. Or perhaps it wasn't all complicated during their time eh? 

He did some blood tests and scans for me, and asked for hubby to take a SA as well (which of course he didn't do it there) - after a couple of times of seeing him, he just said to me that we have to do IVF. Without even checking on my tubes etc. Yes, I admit, we are doing IVF now. He referred me to a reproductive specialist in HKL itself, which of course I didn't go. Hubby was never going to agree for us to go to HKL anyway. 

What can I say about our general hospital? Bad. If you are prepared to wait for half a day, or maybe more, then go ahead. Of course, all you gotta pay is a mere RM5 or RM10 - with a referral letter from a government clinic - but the service, the wait, the environment - not worth it. Oh, not to forget, all the trainees who will be there watching your scan etc. 

Oh, the doctor also has a clinic of his own somewhere in Sg Buloh and he also has clinic days at SDMC.

Disclaimer: All comments & thoughts stated above regarding the doctor & the hospital are solely of my own. Hence, judge the doctor for yourself before blindly deciding. What you look for in a doctor is not the same with me. Make an appointment to see a doctor, go for it, have a chat, and then decide.

Saturday, December 29, 2012

Egg pick-up / Ovum Pick Up / Oocyte pick-up (OPU)

We reached KL Fertility Centre at 6.50am today. The nurse took my weight and height and showed us to our room. Honestly, we had no idea what to expect or what to do. When we walked in to our room, we just looked at each other. The room was like a hotel room. Well, what were we thinking - RM10,000 just for the OPU and embryo transfer; of course the environment would be the same standard. 

About 5 minutes later, I was asked to change into the surgery gown, and then I had to fill up some forms. Since I am not a patient here, so yeah, there was quite a bit of info to fill up and of course the many consent forms to be signed.



At approximately 7.30am, our doctor came to say hello. Again another consent form to be signed ;)  Anyway, he was happy to see us calm and collected. I was actually sitting in my gown next to hubby on the sofa, chatting and watching TV. 
 
A little while later, the anesthetist walked in. Very friendly. She explained that I will not be under full GA. Instead I would be under very heavy sedation. This is because it's an OPU, and the embryo transfer will be in 3 days, so they would not recommend me to take any heavy drugs. I did get a bit worried then and immediately asked her, would I feel anything. She confidently told me no, but I may be able to hear those in the OT talking. I suddenly had recalled my HSG Xray experience and didn't want that to repeat again. 

I was taken to the OT at 8.05am and was back in the room by 8.45am. Of course I didn't know anything until about 9.10am - the pain woke me up. The pain was really very bad and hubby told me later that I  had a tear roll down my eye. Since my threshold for pain is high, hubby knows when I say it's painful, it is really painful. I was immediately given a pain injection on my buttocks. 

I drifted off to sleep off and on. And during this time, someone informed hubby that it's time for him to produce his soldiers. By 10.30am, we were done with everything. I had a fruit and a few bites of cornflakes that was given to me, and a glass of orange juice. We then went upstairs to get the payment done. I was still in a daze all along. 

Then we waited for the doctor to meet us. He was delayed quite a bit. We only saw him around 1.20pm. Anyway, the surprising discovery is that my left ovary which was lagging, had 5 eggs sucked out. And the right that was responding so well, only had 2. Hahah The doctor kept trying to get more since the right had really good eggs previously, but none other than that 2. Hence, the reason why I had more pain than I should have. Yes, in total, we have 7 eggs. We know nothing about it for now, but we can only keep our fingers crossed and hope for the best. May there be at least 5 to 6 embryos as well. 

Now my meds are:
1. Zinnat antibiotics - twice daily for 5 days
4. Daily supplements - most importantly Folic Acid

and:
1 tab twice daily at 12 hourly, taken orally
2 tab three daily at 8 hourly, taken vaginally

Friday, December 28, 2012

Dr. Fatima Najla; Kelana Jaya Medical Centre

In 2010, we decided to see a doctor to ask on how do I stop my OCP. Whether I would need to slowly ween off it or take any supplement to reduce any side effects I may have. Since we didn't want to return to Dr. Siva, I searched / asked around for a lady doctor. We thought let's try a lady doctor : Dr. Fatima Najla.

The hospital itself is okay. In comparison to Damansara Specialist Centre, the difference was almost nothing. Now you must have thought I'd say DSC was much better eh? The waiting time is no difference - can get quite long despite having an appointment made. She has evening clinics as well, which is a plus point. Consultation is between RM50 - RM70

The doctor is very nice. She doesn't rush you and she takes the time to explain things to you. We went to her a couple of times, but didn't continue again since she or the hospital do not do infertility investigations. We'd rather see a doctor at a hospital with the whole works. And yes, she gave me a prescription of Clomid without doing any sort of investigation. Perhaps it was common for some doctors to give patients who are already 30 to go on Clomid and say, okay, now you guys try this cycle with it.

Disclaimer: All comments & thoughts stated above regarding the doctor & the hospital are solely of my own. Hence, judge the doctor for yourself before blindly deciding. What you look for in a doctor is not the same with me. Make an appointment to see a doctor, go for it, have a chat, and then decide.

Thursday, December 27, 2012

Dato' Dr. Sivamohan; Damansara Specialist Centre

I've decided to blog about the hospitals we've been to, and our experience with the doctors we've met. Let me start with the first doctor we've ever seen in 2005 - Dato' Dr. Sivamohan who is a consultant OBGYN at Damansara Specialist Centre. 

He was the doctor who put me on Mercilon, the OCP. We went to him a few times, but then we didn't follow up thereafter. For some reason, I was not so comfortable with him. Yes, he may be very experience, but I was not too sure if he would take us seriously. Sometimes a doctor who is too experienced would think that they know your health very well just by talking to you and asking a couple of general questions. 

We didn't go to him for any main issues. We definitely were not planning to get pregnant then, hence the OCP. But now that I look back, I suppose I would have thought twice about going on OCP for almost 6 years if the doctor would have taken the initiative to explain and give us some knowledge on it. 

I have heard a lot of great things about this doctor. No doubt, he is very experienced, but he just couldn't be our doctor. 

As for the hospital, nothing much to say since he has a clinic / waiting area of his own. Yes, the wait at times can be long, but isn't that a norm anywhere? As for charges, consultation only is anything between RM90 - RM120.

Disclaimer: All comments & thoughts stated above regarding the doctor & the hospital are solely of my own. Hence, judge the doctor for yourself before blindly deciding. What you look for in a doctor is not the same with me. Make an appointment to see a doctor, go for it, have a chat, and then decide.

Wednesday, December 26, 2012

IVF - Lost count of the appts

Today was our last appointment before the egg retrieval a.k.a OPU (Ovum Pick Up). My estrogen levels are reaching 5000 plus. But my progesterone is ok - nothing alarming. Ah, you know the reason for testing the progesterone levels? To check if your uterine lining is doing good or not - not getting too matured. 

Anyway, I was given a higher dose of FSH today - a total of 450iu. Eggs on my left ovary are beginning to wake up, but not good enough. Can't delay the OPU either because the doctor can't put you on FSH for too long. Plus my right ovary is doing good and the time is right. 


OPU will be this Saturday at KL Fertility Centre. I will be admitted from 7am & discharged about 1pm, if all is ok. I will be on GA (thank God for that!). Hubby has been to the centre a few times now for sperm count and also for the sperm collection for our IUIs. I have yet to see the place myself.

Anyway, after the OPU, hubby will have to produce his soldiers on the spot when asked  :) 

The embryo transfer will be on New Year's day - yeap yeap, 1st January 2013  :) 
What a way to start our New Year eh? Well, a year we will move on - either with or without a baby. 

We would have to purchase some antibiotics and other meds as well. Tomorrow will be my last day for the Suprefact injection and at night (8pm precisely), I will have to take the trigger shot i.e. Ovidrel (hCG). Friday will be free of injections, but the start of the antibiotics at night. 

It will be exactly 22 days of daily injections tomorrow. And it doesn't end here. There will be more meds (tablets) - to be taken orally, and vaginally.  Yes, you read that right - vaginally. 

Good luck to us!

Tuesday, December 25, 2012

Supplements

Both hubby and I are on supplements. Most of it were already a part of our daily supplements - well, I must admit that it's definitely not a daily thing. But ever since we started IVF, I've made sure that we take our supplements as recommended by the doctor daily. No skipping. 

Hubby's supplements - yeap, I am not the only one taking Folic Acid.

Mine

Monday, December 24, 2012

IVF - 9th Appointment: FSH increased more: 375iu

22nd Dec - Yes, the very next day. The eggs on my right ovaries are doing good. They have passed the required size i.e. 10mm in average. The eggs on my left are still slow. Only 1 has reached the required size. The other 3 are still lagging. So the doctor has increased my total FSH for today & tomorrow. 24th Dec we will be going in to check the progress and also my blood work results that was done today. 


Before
After :)

Sunday, December 23, 2012

IVF - 8th Appointment: Increase of FSH: 300iu

21st Dec again a trip to the hospital. Well, it's a norm now. The doctor did mention that once we start the second phase, we will have to go in alternate days. Since the follicles in my left ovary is still lagging behind, the doctor has decided to increase my dosages. So today was 3 boxes of Foliculin and 1 box of HuMog. Oh, I forgot to mention, that Suprefact has to be continued daily. Suprefact is the one that ensures the doctor has full control over my hormones. 


I was a bit upset that my ovaries were not responding well. But the doctor kept saying it's okay, because all we need is one good egg. But it's a number game. The more the eggs, the chances of more embryos. Of course I was hoping for the minimum - 10.

I was depressed the whole day. But thank God I came out of it by night when hubby got home from work. 

Saturday, December 22, 2012

IVF - 7th Appointment: HuMog + Foliculin

19th Dec was our follow up - to check on the progress of my follicles. Right ovaries had 5 follicles but my left, only 4. Anyway, the doctor added HuMog now to my injections. So now, it's 2 boxes of Foliculin and 1 box of HuMog. The total of FSH is still 225 iu. 


Tuesday, December 18, 2012

IVF - 6th Appointment: Second phase

Day 2 period i.e. 13th Dec I gave blood & 14th Dec was our appointment. My blood work and TVS was all good and we are game for the second phase. The cyst that was seen in the last appointment, wasn't a cyst after all. The second phase is the complicated phase as the injections are not as straight forward. I am on Foliculin 225i.u and the continuation of Suprefact but only once a day. So now I take both the injections at the same time in the morning. The doctor explained that in the long protocol, the meds are mixed on our own based on my body's reaction. I will soon be adding another med into the injection. Tomorrow is our appointment to see if my ovaries are responding well - not too well either. It has to be balanced. 

The Foluculin injection is more than just an ant bite. This, I feel the pain. During and after injecting. The pain subsides after about 15 to 20 minutes. I was bleeding fresh blood the day before and also yesterday. As worried as I was in getting OHSS, but what hubby said came out true - it must have been just the stress, plus my period must have been not over entirely.



The daily dose for now
What do I feel? At times agitated, hot flush, my right pelvic area aches - nagging sort of ache, headaches.

Lets see what tomorrow's appointment unfolds.

Saturday, December 8, 2012

IVF - 5th Appointment: The start of the injections

Day 21 was on December 6th. I was very prepared for the injections but not for the side effects. Menopausal side effects can be scary. And with my history of PMDD, I was all the more freaked out. Funny isn't it? Most are scared of the injections....

I don't know if I've mentioned before - I am being put on the long protocol. This has been the way for IVF since ages ago, and is a better way to control my hormones compared to a short protocol. Based on my history, the doctor preferred that I go on the long protocol. 

Anyway, we went in for our appointment at Pantai. The doctor first of all did a TVS scan - to check on any possibility of cyst, or unusual happening with my insides. Lo and behold, I was shocked when he said I had a 4cm cyst. But then he also just as immediately added that it is most likely a corpus luteum since it was my Day 21 of my cycle.

Then we were sent to do the payment and to collect our meds for the whole cycle. It took us almost an hour to get our meds cuz the pharmacy had some issues regarding authorization to give out IVF meds. Finally our doctor spoke to the CEO and got the meds released for us on the package price. I will share the total package breakdown once all this is done. 

We had brought along our own cooler box, but to our surprise, it wasn't big enough! So the pharmacy gave us a polystyrene cooler box with all the meds in it. 

We then went back to the doctor's clinic and we were taught on how to do the injections. It has to be done twice a day and precisely at the same time - starting from the 2nd injection. Since we did it at 7.10pm, we had to do it everyday at 7.10am & 7.10pm. Yes, we have to plan our days wisely as I can never miss the timing to the injections. Yes, never. For the first 2 weeks - it will be only 1 med - Suprefact - 0.1ml twice a day.

In total it would be 28 injections - exactly 2 weeks. Hubby has given me once so far, and I've been doing on my own. It isn't a big deal. Just a pin prick. Yes, seriously. Probably my threshold for pain is different than others.

All the meds kept in the fridge the moment we got home. It took up the first shelf entirely!

The syringes
Excuse the photo. I can't seem to upload it the right way despite rotating it.
Anyway, this is the prep daily - Suprefact to be taken out 5 min before, 1 syringe & 2 alcohol swabs - 1 for the bottle, and another for the tummy.
 
The needle
The injection is done 2 fingers side of the navel, and 2 fingers below. The reason for this is because there are no major veins here. This is not an IV injection.

Next appointment is on Day 2 of my period. Yes, I will bleed as per normal. 

So far the side effects I have felt:
Day 1 & 2 - floaty feeling. It's like I am high on alcohol. 
Day 3 - was a bit edgy.

Hope it doesn't get any worse.