Where its all begin...

15/06/2010
First visit to KMC – Dr. Kamarulzaman (O&G Specialist)
Scan showed AFI of 29cm + glucose in urine.
Dr. Kamal mentioned his concern on the high liquor level.
Polyhydramnios
Could be due to few possibilities, and since glucose level sedikit tinggi, he ordered 2 hr Glucose Tolerent Test for the next day.


16/06/2010
2 hrs MGTT. Been fasting from the midnight. (Throw up a bit during the test)
Test result come back normal – so Gestational Diabetic is not the reason for the high amniotic level.
Next appointment in 2 weeks time.

27/06/2010
First visit to KK Kubur Panjang – Dr Jayasree
Scan showed AFI level increase to 33cm.
Dr. Jaya advice to follow up at Hospital Sultanah Bahiyah for Anomaly Scan (detailed anatomy scan)
Request to follow up from KMC instead since Dr. Kamal pun ada mentioned nk buat another test if the Glucose Test come back normal.


30/06/2010
Follow up with Dr. Kamal @ KMC
Performed Anomaly Scan.
AFI level increase to 35cm.
Scan showed baby’s distended bowel with ‘Double-Bubble’ sign.
Possibilities of Duodenal Atresia.
Dr. Kamal advice to follow up for 2nd opinion with Dr. Bavanathan – Perinatologist/Feto Maternal at Hospital Sultanah Bahiyah (High Risk Pregnancy specialist for Northern Region).
He personally rang Dr. Bava (who happened to be his student ages ago) to discuss my conditions.
Appointment was set for the next day.


01/07/2010
First appointment with Dr. Bava @ Hospital Sultanah Bahiyah.
Dr. Bava & his team (2 other Registrar) performed another Anomaly Scan
Confirmed Double-Bubble sign.
Cardio Chogenic focus scan – Heart.
(dinding baby’s lung sedikit tipis, might be due to pressure from excessive liquid.)
Ask about any chromosome abnormalities – based on the scan, they don’t find any soft marker or abnormalities (yet).

Result
- Possible diagnosis of Duodenal Atresia
- Baby will need urgent surgery after delivery
- Dr. Bava suggest to deliver here in HSB since the specialist Paed Surgeon only available here.
- high risk of preterm labour
- suggest to induce early (36 weeks GA)
- ordered mummy to have steroid injections to help mature baby’s lung.
- Dr. Bava to contact Surgical team (paed)
- next appointment 21/07/10.

02/07/10
Hospital Sultanah Bahiyah- Labour room
2 steroid injections within 12 hrs interval.
8.00am – mummy got the first steroid shot (ouch!)
8.00pm – the second n last shot.

Current management
Continue follow up with KK for weekly antenatal check up
Home visits by senior nurses weekly
(so, bi-weekly monitored)

Note for tomorrow appointment (21/07/10)
Anxious to wait for tomorrow’s appointment...
Hopefully Dr. Bava could decide when to induce sbb daddy need to confirm the date so he can be with us.
Method of delivery: normal or c-sect? (baby still not engaged and might not be since too much liquid), hubby suggest to opt for elective c-sect to reduce stress on mummy n baby. Will consult with Dr. Bava.
To be introduced to the Neonatal team.
Possible for early admission?
To ask doctor on how severe baby’s condition? (mummy need to study more on DA today)


Ya Allah ya Tuhanku..permudahkanlah perjalanan kami.. semoga kami tidak diuji dengan penyakit2 yg tak mampu kami ubati.. amin..