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PREGNANCY 怀孕笔录

Delivering Triplets by Cesarean

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Delivering Triplets by Cesarean

Many people asked : “So… is it by natural birth or cesarean?”

 And many are still ignorant that multiples will be born preterm. Hmm…since it’s preterm and x3 preemies, natural birth is definitely mission impossible.

So how “pre” term is it? Well, that depends on individuals. The national gestation period for twin is 36 weeks and triplets is 32-33 weeks. We were slightly more “ambitious” and aimed for 35th week from the very beginning. Well… our OBGYN told us 34th week is already a big success and as the pregnancy moved into the 3rd trimester, she was even prepared to deliver the babies at 32th week if my frequent contractions worsen. (Yes, I have contraction from the mid of 2nd trimester onwards, read more about my winding pregnancy journey here)

Most winding street in the world - Lombard St (San Francisco, USA)

Most winding street in the world - Lombard St (San Francisco, USA)

So it must be by Cesarean – a delivery method which is popular among celebrity moms and over showered by pretty misconceptions such as it’s painless, fast, easier than natural birth, leaves your vagina uncut, able to choose an auspicious delivery date.  *Grin* Wrong wrong wrong.

I really regret not reading the book which Roger borrowed from the library “Everything you need to know about Cesarean”, prior to my delivery. I always tossed it aside, sign… should have read the details instead of merely browsing through the summary pages on the eve of delivery. As a result of my ignorant, I was completely caught off guard. Other than feeling excited by my OBGYN’s comments that there would be a big team of nurses, OBGYN and pediatricians in the operation room, so much so that Roger was not allowed to tag along since the room would be very crowded, I wasn’t prepared for the post-op difficulties at all. Sign…

Thus I will like to “warn” you of the facts you should know about Cesarean so that you will be mentally prepared.

No, it’s not done in a cosy lovely room.

Most of the hospital will decorate and furnish the delivery room so as to reduce the distress during labor. However, for Cesarean due to multiples delivery (e.g triplets) or complications, it has to be conducted in a big operation theater. Thus be prepared to celebrate your commencement of motherhood (which is the most touching moment in most women’s lives) lying on a small and cold operating bed, in a scary and mechanically filled theater.


Yes, you still need epidural.

You may have heard of moms who went through natural birth complaining about how scary epidural injection was as it’s injected at the back of your spine (refer to image), and thought that it’s not required for Cesarean. Hehehe, wrong. You’ll still need that couple with other anesthetics measures, so that you will feel painless from the chest downwards. Thus be prepared for this scary injection. Well, at least this is what attribute to the gem of Cesarean – being painless. Although you’ll still feel a slight “pulling pressure” when they pull out the baby, trust me, the whole delivery process is painless, “senseless”. In fact, you can only “hear” the delivery process, when the nurse/doctor narrates the process to you.


No, you can’t see the baby immediately.

Unlike natural birth, whereby the mom can see and feel the baby “coming out” and in most circumstances, nurses will pass the baby to the mom immediately after birth, you won’t experience this for Cesarean. A cloth screen will be placed above your chest so that you won’t be terrified by the bloody process, but that also means you won’t see the baby coming out. And once the baby is out, he/she will be hurried off for a whole lots of inspection. If the baby is ok, and there’s time, the nurses may show you the baby. But for my case, beside hearing their cries and seeing 1 baby from the corner of my eye (which happen to lie on the inspection station near to me), Roger – who wasn’t even in the operation theater, was the 1st one to see and touch them while they’re on their way to the special care units and nursery.


Be prepared to be “bedridden”.

Firstly, you got to wait for the anesthetics effects to go off completely. That will take around 1 day. Alas once the sensation comes back, be prepared to take lots of pain killers for the tummy cramps, leg cramps, and sickening backache (due to epidural injection). And you are supposed to get out of bed and try walking on the 2nd/3rd day so that recovery will be faster, even though you would have wish that you can lie on the bed forever. Whoever said Cesarean is painless, please line up so that I can give you a slap on the face.


Yes, you’re indeed 80 years old.

Why do I say that? Well, firstly, you’re attached with a urination bag initially, and secondly you are “forced” to wear XXXL granny panty (not to pressurize your stitches). Nurses will then check with you “Have you urinate or pass motion? Is it soft or hard?” And if you’re not doing it, they will encourage you to do it.

There’s nothing more embarrassing then using bed pan for urination and passing motion. Well, guess that’s the only “motivation” to kick me off the bed and start walking to the loo, despite in severe pain.


You can’t get your tummy back in shape that fast.

Ok, there’s this post-natal tummy binder to squeeze it back to shape, and in Asia, we will also go for the Malay post-natal tummy tuck massage. Alas for Cesarean…sign…thanks to the binder, my wound was pressurized and bleed. I was re-admitted again 3 days after discharge. It took me more than 1 month to heal. As for the Malay massage, got to wait till the wound heal. So while waiting for the wound to heal, I can’t do much other than continue wearing baggy maternity clothing to hide it and hoping it will shrink miraculously.

Thus, please please please, read more about Cesarean prior to the operation so that you can be mentally prepared. Click here for more details.


DELIVERY

We are so so so lucky that the pregnancy journey came to an end and along this winding road, with so many odds and possibilities that the pregnancy will end up in disaster, we keep to our faith that God will lead us and bless our babies with a smooth delivery. So on 11 April 2011, in week 35, 3 healthy babies are born by C-section: Asher 李宇恒 2kg, Brayden 李宇哲 2.2kg, Charlotte 李宇心 2.2kg! Praise the Lord for the miracles!

Brayden and Charlotte had slightly low blood sugar so they spent their first night in “special care unit” for close monitoring and feeding. Thereafter, they were fine and returned to the normal nursery. On day 5 of my admission, all 3 were fit and healthy to go home with me. What we thought is mission impossible (deliver beyond the national gestation period for triplets and 3 babies are able to go home with mom) and see it as a fairy tale which will only happen to others, occur right in our lives!!!

Here are the video and photos of this blessed delivery!

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My Encounter with Baby Blues

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My Encounter with Baby Blues

If you think that pregnancy and delivery of multiples are tough, wait till the babies are born and the REAL challenge begins! The first wave of siren is BABY BLUES. If you think that it won’t hit you, (well… e.g. maybe you’re a singleton mom, etc), please be alert. It can hit anyone, anywhere, under any circumstances. With the huge physical changes, hormones changes and taking up of new role in life, one can never take things for granted. Why do I say that? Cos, I nearly cross the line of sanity. I saw 3 psychiatrists and a sleep specialist, fortunately the conditions went away miraculously within a week without developing into postpartum depression (Thank God!), and this is the story!


Shortly after a grand discharge from hospital (imagine having our parents and sibling over, carrying the 3 babies out of the ward, video taking and all), upon returning home, we decided to let all 3 babies slept in the same cot and relocated the cot from the nursery into our bedroom so that we can monitor them closely. Little did we realize that, this is the beginning of our nightmare.


Cons of C-Section delivery are longer period of recovery, post-natal cramps and pain, and possibility ofbleeding from the wound. With no anticipations of these and the immediate taken of roles in looking after the 3 preemies,  plus the torment of taking lots of medication, and distress over low breast milk supply (feeling of “failure” and guilt), I soon found myself in constant “alert and panic mode”, and always pushing my limits to get out of bed to attend to the crying babies.


Every morning and night I’ve to take Antibiotics pills x 2, iron tablets x 2, vitamin C x 3, fenugreek supplement x 1 & pills x 2 to boost milk supply…burpppp…

The feeding, burping, nappy changing, bathing, seems non-stop. While the 3rd baby is done, the 1st baby cry again shortly after that. Even though my mother-in-law stay in to help us, we were all overwhelmed.


I wasn’t able to rest well and soon, 2 days later, prior to bed time, I found blood oozing out of the gauze dressing covering the C-section wound. Roger rushed me to KKH A&E, it was past midnight and by 5am in the morning, I was pushed to a ward for hospitalization. Bad timing, I thought, as our triplets had high jaundice level and Roger rushed back home, fetching them to Polyclinic for jaundice testing soon after I settled down in the ward.


I was left alone in the cold ward when Roger left in a hurry upon day break. The A&E doctors were very worried for me as it’s uncommon for bleeding. They arranged for detailed ultrasound scan and it’s certainly the cause of a nervous breakdown subsequently. What happen was, the Sonographer scanned for an abnormally long period of time and even had to consult a senior Sonographer for advice. The Senior entered the room and took over the scan job, she looked so distress that I thought I had some terminal illness or what. Then both of them consulted a doctor’s advice. I was so worried, what happen??! They refused to tell me and simply said “it’s all in the report and we’ll submit this report to your doctor, she’ll explain to you later”.


However, nobody updated me on what’s really wrong, the nurses refused to say, they simply said “the doctor will explain to you later”. So I waited and waited, till Roger arrived after lunch and still no news from the doctor. We started to panic. What’s exactly wrong with me? We asked around but the nurses only said “the doctor will explain to you later…she’s coming in the evening after her clinic session…she might be very late…” So we waited till after dinner and still no news. I started to cry, non-stop. Then they told me the doctor will phone me and tell me what’s wrong with me. But we waited and the phone didn’t ring. Soon, it’s 7pm and Roger is still stuck with me in the ward, waiting for the doctor. We are already worried for the 3 preemies and now this?! The clock is ticking and soon it’s 8pm. Roger started to demand for help… “any doctor please, any doctor will do. Can any doctor read the report and explain to us in layman term what’s wrong with my wife?”


Finally at 8pm plus, a male doctor rushed over and explained it’s only bleeding from a blood clog which is quite common and nothing serious for us to worry about. It may be due to over-stretched of the wound area and I need to be on antibiotic drip plus 1-2 days of stay in the ward. However by then, I was already on the verge of break down. Soon after, my doctor finally called and explained the same thing to me, I was instructed to rest well overnight and she’ll visit me in the ward the next day. Upon hearing this, Roger was so relief and left at 9pm. 3 preemies were still at home and we were so worried that his mother couldn’t cope taking care of them alone.


Alas after the ridiculous episode in the ward, something triggered me and I couldn’t explain the sudden increase in heart beat, feeling of anxiety, and INSOMNIA. I couldn’t sleep and I mean it, I was soooo worried for the babies, missed them soooo much, I couldn’t sleep. Soon, I found myself in a near to break down/panic mode, couldn’t rest and sleep in peace, and started walking up and down the ward anxiously. I asked for sleeping pills but waited for hrs before I was given a flu tablet with a sedative side effect. It couldn’t bring me to sleep, and I became more alert after that. It’s 2am in the morning. I panicked and wondered what’s wrong with me.


Fortunately my dear friend Sarah, is a counselor in IMH (Institute of Mental Health) and I called her immediately. She advised me to inform the nurse of my condition and asked for a stronger dosage sleeping pill. She also consoled me and assured me she’ll informed her colleague working in the KKH Mental Wellness Service to attend to me on the next day. “It might be baby blues or postpartum depression which is very common for mothers”…after hearing that, I finally realize I might be on the verge of crossing the line of sanity.


I followed my friend’s advice and after 2 hrs, around 4am, the nurse gave me another drug (not sleeping pill) with sedative side effect. It couldn’t work as well. I found myself dropping in and out of the sleep in very short duration (a few seconds or minutes) and upon falling asleep, I would wake up in panic. I had experienced chronic insomnia and anxiety problem in my uni days before, thus the feeling of getting “out of my mind” again is very frightening. Thus when the day break and my doctor finally came to my ward, I immediately asked for discharge. I assumed that the “mental block” will go away once I return home. She was surprised at my emotional out burst and assured me the bleeding condition is nothing serious. On hearing my persistence request to return home, she agreed on 1 condition, I must see the psychiatrist from the KKH Mental Wellness team first.


Fortunately my mom came and she could tell I’m on the verge of break down. She knew how I suffered from insomnia and anxiety problem in my uni days so she was quick in picking up the tell-tale signs even though I didn’t tell her what happen the night before. She consoled me and encouraged me to be brave. The psychiatrist came around lunch time and upon hearing my episode last night, she prescribed the flu tablets (yes, with sedative side effect, so it’s not a sleeping pill) for my insomnia and anxiety, and schedule to see me again weeks later. I was discharged after lunch and upon returning home…


…the problem worsen. The baby cot is still in my bedroom. I still couldn’t sleep, even with medication. And worse, I had suicidal thoughts and irrational thoughts of throwing my babies away. I couldn’t believe what I was thinking and how could I have such thoughts when I went through 8 painful mths to conceive them? Now that they are healthy and miraculously able to return home with me after discharge, how can I have such irresponsible and inhumane thoughts? That night, after midnight, I decided to take action before I really harm myself or my babies. I woke Roger up and told him about my irrational thoughts and anxiety problems, and my decision to seek immediate help from IMH. Roger was with me during the uni days when I had the anxiety problem and he totally understands the seriousness of the problem if no proper help is administered. Thus he respected my decision and fetched me to IMH A&E straight away.


Fortunately IMH is just minutes away and before I might collapse with a panic attack (emotionally melt down or break down), we saw the psychiatrist and he advised me to stay in for the night at their Sayang Wellness Centre… to be away from the babies for awhile, have better sleep and recuperate well before returning home. Surprisingly (refer to the photos), the wellness centre is a spa-like sanctuary, with rooms well-decorated like a small boutique hotel (cool!), and after popping a Hydroxyzine pill (a type of medication for itch, with sedative side effect but it’s not a sleeping pill), I went into deep sleep. I had well uninterrupted sleep for 4 hrs and the next morning, they greeted me “morning” and serve sumptuous American breakfast. It was like a holiday retreat for me, just what I needed! The nurses were very friendly and caring and I loved the aunties nurses who consoled and encouraged me this condition would go away very soon. They shared with me their baby blues problems when they just had newborn babies and I started to realize I’m not alone.


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After breakfast, another lady psychiatrist attended to me and advised me to stay longer. Sarah (my friend who worked in IMH) came by too, with a bouquet of lilies. Roger arrived shortly after that and we even played table tennis in the centre. It was like back to courtship and it’s so recuperating! We realized that we need a break from time to time, just the 2 of us, to get away from the babies, in order to survive the long journey down the road.


So Roger suggested to move the baby cot out of our bedroom and use dog therapy on me by letting Cola (our cute doggy) resume sleeping in our bedroom. He’s trying to resume back to the setting before babies arrive and let me take over the motherhood role gradually. And best of all, he would arrange short break to the beach or cafe or even playing badminton in the evening. I was sooooo relief that he’s with me in this battle and I felt half the battle won.

The psychiatrist was happy with our intervention plans and family support, she prescribed Hydroxyzine pills for my discharge that day so I could take it if the insomnia problem persists. That was the prettiest morning. I stepped out of the wellness centre, ready to face the challenge ahead. I held Sarah’s lilies in my arms, and let the slight drizzling rain refresh my face. Yes, with family and friends’ support, nothing is impossible, I told myself repeatedly.


Upon reaching home, my mom was there, my mother-in-law was there. It was the day for babies to go Polyclinic for their jaundice blood tests. Both mummies were very good, they suggested to go after lunch instead so I could have sufficient rest. My mom still sense my tension and uneasiness in taking over the mother role so she sit on my bed and started chatting with me. She shared with me her anxiety and depressive thoughts when she had us (me and my brothers) and how she overcame them. 1 thing which she said that really impacted me was 儿孙自有儿孙福,莫为儿孙作远忧 which means “your children will have their own destiny and fortune, thus do not worry excessively for them”. If we are constantly worrying for them, then there would be endless things in life for us to fear for them ~ whether they’ll fall ill, whether they’ll meet an accident, whether they’ll… …endless.


That night, I couldn’t sleep again. I was having hallucinations of hearing babies crying even though the cot is no longer in my room. We were totally drained after looking after the babies for the whole day, my body is shaking with exhaustion and yet I couldn’t sleep. The Hydroxyzine pills didn’t work this time. Thus I decided to consult a sleep specialist’s advice. It was after midnight, I can’t remember if it was 1am or 2am. I google frantically and took down the numbers of whatever pop up. The next morning, I called them and finally manage to secure a morning appointment with Asia Sleep Centre at Paragon. Roger was worried for me too, so he fetched me there, hoping that he would not lose his wife to postpartum depression.


Little did we realize, what Dr Kenny Pang said is gonna change our life. His words are more powerful than any medication or psychiatrists’ consultation. While hearing my story, he completed my sentence before I finished it, and he fully understood what we were going through, the insomnia, panicky mode, hallucinations. Surprisingly, his diagnosis is…“you’re completely normal Winnie, it’s what all human beings are going through when they have babies, it’s a natural instinct to be sensitive and alert to babies’ crying at night” I was so shocked, while I thought I’m on the verge of sanity, this doctor said I’m alright ???

“I’ve 3 kids and they are over ten yrs old, but till now I still have lack of sleep…about 3-4 hrs of sleep per day”…and this is what a sleep specialist said. “But it’s alright, as long as you can catch some naps during the day time, even if it’s 30 minutes, even if it’s on the sofa, it’s still considered sleep”…I’m still very shocked and he continued…“we are adults already, and it’s not necessary to have 8 hrs of uninterrupted sleep at night, we are no longer children you know?”


But I’m still very worried about my “abnormal” insomnia condition, so I asked him when would I recover…“well, it depends on you, some people recover within a few days, some take weeks or months, some take a few yrs”… A few yrs!!! What if I’m the unfortunate one who never recover? Oh NO! So I asked for sleeping pills, REAL sleeping pills, but he won’t prescribe…“Winnie, sleeping pill is addictive and I don’t want to move you from a problem to another bigger problem, I don’t want to cultivate a drug addict!”

“I will prescribe none addictive drugs which are not sleeping pills, but how well it works will depend on your mentality. If you can change your perspective and accept the parenting role, even if I give you M&M, it’ll work.” My mind is in a daze, I’m very exhausted physically and all I care about is whether I can sleep…so why is this doctor talking about parenting? “You’re a Christian right? Just leave it to God, He’ll guide you.” With a big confident smile and strong hand shake from him, the consultation ended…I couldn’t understand back then…we collected the pills and left.


After leaving the sleep clinic, Roger suggested to go for lunch at one of our favorite coffee shop. We discussed about what Dr Pang said over lunch and I finally realized having insomnia, being panicky and anxious are all natural parts of being a new parent. Roger said he had hallucinations too, but he felt that it’s “normal” so didn’t think too much about it. But I see it as “abnormal”, so with this mindset, I tend to be negative and fall deeper into baby blues. He encouraged me to take it slowly, rest well and not to take the medication as he’s afraid I’ll be too dependent on it.

Roger is always a good adviser in my life and miraculously, after his “lecturing” I started to see things from another perspective and my outlook changed immediately. A few minutes ago I was “worried, negative, slow and exhausted”, after sorting things out, I was “relief, positive, fast and energetic”…what a surprise! So it’s the mindset after all, like what Dr Pang said!


That evening, I was still afraid of night time and insomnia. I wasn’t that confident that I can fall asleep naturally. After dinner, Roger said “come! Let’s go out for a breather with Cola!” So we left the babies with mother-in-law and drove to Punggol Riverside. It was like back to the days before babies and we really enjoyed the 30 minutes walk along the peaceful river, echoed by trendy pop music from the pub/cafe and restaurant. We were so energized instantaneously! Cola was very happy too!

Guess what? That night, I fell asleep instantaneously. It was like waking up from a bad dream, all the mental blocks went off miraculously. The medication which cost us $200? LOL, all in the fridge R.I.P, Roger said what Dr Pang said is definitely worth $200 and he told me he’s so relief he got his wife back finally (well, previously I was pregnant and bedridden for 8 mths).

And we returned to Punggol Riverside with our buddies for wine and coffee a few days later, enjoying life whenever we can squeeze out 1-2 hrs of breather moment. Mental relaxation is equally or even more important than physical relaxation!

So if you are experiencing baby blues or know someone struggling with it, here's 10 tips to conquer baby blues! God bless!

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10 Tips to Conquer Baby Blues

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10 Tips to Conquer Baby Blues

Baby Blues are terrible. When we should rejoice at the birth of our little ones, we are suddenly hit by this overwhelming downward feelings. I had my fair share of baby blues and here are 10 MUST READ TIPS to conquer baby blues!

1. BE MENTALLY PREPARED

BE MENTALLY PREPARED that baby blues can hit anyone anytime anywhere (yes, even the father too). Try to stay as objective and rational as you can if it hits you. You will know it when it hits you. Remember, it is not abnormal, in fact, it is common and you can recover from it. For the symptoms, click here.


2. TALK TO SOMEONE

TALK TO SOMEONE about your feelings even if it’s irrational. Don’t be afraid that they’ll laugh at you or belittle you. You will be surprised how normal they’ll view it. Your recovery will be faster when there’s somebody with you in this battle. They may be your hubby, your close friends, sisters, parents, or even a counsellor. In moment of urgency, when you need somebody to talk to, you may call KKH Mental Wellness at 6394-3739 for enquiries regarding Perinatal Depression Support Group.


3. WORK OUT A RECOVERY PLAN

WORK OUT A RECOVERY PLAN with your close one. It may be a shared responsibility feeding schedule, getting help from others to reduce your household load, dog therapy, 1 hr outdoor breather per day, taking naps during day time, watching your favorite Korean drama, etc etc. Try what you think is the best remedy for your current situation. Be confident, you and your close one will know what’s best for you.


4. IF YOU’VE SUICIDAL THOUGHTS, TELL SOMEONE IMMEDIATELY!

IF YOU’VE THOUGHTS OF HARMING YOURSELF OR YOUR BABY, TELL SOMEONE IMMEDIATELY! If you’ve suicidal thoughts, you may call the 24hrs SOS hotline 1800-221-4444. If you need psychiatrist’s advice, you may call IMH crisis hotline 6389 2222 or visit IMH A&E for an assessment by psychiatrist on what’s the best option for you.


5. TAKE UP PARENTING ROLE AT YOUR PACE

DON’T JUMP INTO IT, TAKE UP THE PARENTING ROLE AT YOUR PACE. Like what I’ve experienced, by placing the cot in the bedroom straight away after discharge is very detrimental to the post delivery / caesarian recovery. Since baby blues are also caused by the physical changes after delivery, thus the faster you recover physically, the faster baby blues will fade off naturally. Try to rest as much as possible, eat as nutritious as you can, sleep whenever you have the time, and arrange some light recreational activities (walk by the river, etc) from time to time. Only when your body is ready, your mind will be ready for the parenting role.


6. LEAVE THE HOUSE, GO TO A SHORT RETREAT

IF YOU CAN’T TAKE IT, LEAVE THE HOUSE AND GO TO A SHORT RETREAT. If you feel that you can’t take it anymore and will break down anytime (e.g. panic attack, shout or cry uncontrollably, jittering behavior, etc), arrange for a short getaway at your friend’s house, your maternal parents’ house, a hotel, wellness centre, etc. Have enough rest and recuperate well before returning home to face the challenge with a rejuvenate soul.


7. IF YOU HAVE INSOMNIA, TAKE NAPS DURING DAY TIME

IF YOU HAVE INSOMNIA, IT’S NORMAL, TRY TO TAKE NAPS DURING DAY TIME. It’s a natural instinct that you’ll have difficulty sleeping as new born will require 2-3 feed per night (imagine x 3 for triplets!), thus it’s perfectly normal that you have hallucinations of baby crying and insomnia initially. Don’t worry, once you body get used to it (usually 1-2 week), your body will work out a balanced system so that you have enough rest at night and won’t miss your baby’s cry. To cope with lack of sleep, try to take naps during the day time. Remember, even if it’s 30 mins, even if it’s on the sofa, it’s still considered as part of your sleep. Add them up, you could have plenty of sleep already. Don’t start on courses of sleeping pills immediately, trust me, the insomnia will fade away naturally.


8. CHANGE YOUR MINDSET, YOU’RE A PARENT NOW

You may use to have a “happening” lifestyle; clubbing, drinking, or traveling frequently, and had complete control over when to eat, sleep, play etc. But once you become a parent, everything change…you tend to “lose control” over your life, even the most basic aspect of your life such as sleeping is greatly affected. And you got to accept it, BECAUSE YOU’RE A PARENT NOW. Grow up! Everyone of us have to reach this stage in life. If you have a choice, would you prefer to stay childless or bear with the hardship of parenting for the initial few yrs and enjoy the family life with children later on? Well, since you’re a parent now, you’ve the answer already.


9. DON’T WORRY EXCESSIVELY FOR YOUR BABIES

See things from another perspective and life won’t be as bad as what you think!

See things from another perspective and life won’t be as bad as what you think!

As what the Chinese said 儿孙自有儿孙福,莫为儿孙作远忧 which means “your children will have their own destiny and fortune, thus do not worry excessively for them”. You are not a supermom either. Thus even if your babies have jaundice or illness, it’s not your fault! Don’t blame yourself. In fact, it’s very common for babies to have jaundice, flu, cradle cap, vomiting, diarrhea etc, it’s part and puzzle of growing up.


10. LEAVE IT TO GOD, HAVE FAITH

Yes, having faith is very important, our heavenly Father is there for you. Reach out to Him for strength, guidance, and wisdom. You will be STILL when you know He’s there for you.


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OH NO! MEDICAL BILLS!

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OH NO! MEDICAL BILLS!

I’m sure this is the first thought that most dads will have upon hearing they’re gonna have multiples. But can you imagine, given the limited population in Singapore, how many triplets can occur in this tiny island? Who can we turn to for advice on local medical expenses? Well, the answer is “zero”, nobody. We have checked forums but under the threads for multiples, there are only a few pathetic entries and almost all are twins parents. Sign…the complication, risks, and medical expenses for higher order multiples pregnancy is way way way above singleton or twins pregnancy.

HIGH COST!

As quoted from Dr Heng from Parkway (East Shore) Private Hospital, who helped us with fertility treatment, “GET PREPARED FOR S$100K PER BABY“. Many were shocked and couldn’t believe it. Even Straits Times and RazorTV reported about it (view here). “But the private ward charges are ok, and comparable to restructured hospitals, so how can it amount to $100k per baby?” Let me explain further on the “hidden cost”.

  • Beside the mummy's ward charges, babies who require additional NICU/special care unit will cost a bomb.
  • Triplets or higher order multiples will be born pre-term. Count yourself lucky if you pull through to 34-35 week, but most of the triplets are born prior to 30 week. The earlier babies are born, the longer they’re required to stay in NICU, sometimes for mths.
  • Triplets C-section delivery require at least 3 pediatricians, a team of obstetricians who expertise in high-risk pregnancy, a huge team of experienced mid-wife/nurses. Can you imagine the cost involved for engaging these experts at “private rate”?
  • Ok, treatment cost at the NICU (oxygen mask, medication, scans, etc) will be at “private rate” too. What if babies need additional surgeries?
  • Lastly, how about the extensive weekly prenatal consultations, scans, monitoring, hospitalization, injection, medication, etc etc?

So what should we do? Our private doctor’s advice was: “Buy Insurance”, and she threw a prudential brochure to us. So…we called the agent and…WE WERE REJECTED BY THE INSURANCE…as we’ve triplets. So, we came to a dead end. If we stay with the private hospital, we’ll be in debts for many years. With no choice and no people to turn to for advice, we were like the blind.

WHICH HOSPITAL?

Shall we switch from private to government/restructured hospital? If so, which restructured hospital? Which doctor? Which class of ward? So many questions yet so little resources and people with past experiences whom we can consult.

Thanks to a blessing in disguise, I was so sick and dehydrated during my 1st trimester that I needed hospitalization badly. The private doctor said it’s very expensive to be warded and could only provide a 1 hr drip on a small bed in her clinic. It was really quite pathetic. So we asked her if there’s any more emergency, what should we do? She said “GO TO KKH“. After a few days my conditions worsen and hubby fetched me to KKH A&E without 2nd thought. So that’s how we ended up in KKH.

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Yes, there are many complaints that the waiting time is very long in KKH A&E, but for my case, they let me rest on a bed in their monitoring room while waiting for my turn and place me under 1st priority. There are even free apples to fill our empty stomachs while waiting. And it was like close to midnight. We were so touched. “Ok, don’t worry, you need a drip and a jab to stop your morning sickness, we’ll arrange for hospitalization.” No questions asked on whether we can afford or not, as we can always opt for subsidized ward. (YEAH!!)

Many peers of our generation prefer private hospital as KKH is where our moms went to in the past. Ask any elderly moms out there and she’ll complain that the nurses were very fierce, service and facilities were so-so, and a whole lots of horror stories, etc etc.

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Hmm…so if you’re earning a decent income and can afford delivery in private hospital, why not? Further more, KKH “private suite” charges the same or sometime higher amount. However with triplets, it’s a totally different story. And so, we switched to KKH.

But the reasons we switched is not merely because of the cost. It’s the huge amount of expertise, resources and facilities all within 1 hospital, dedicated for women (especially pregnancy), that changes our minds. There are so many doctors, nurses, experts around, I feel so safe, protected and well-taken care of.

And KKH is no longer the old haunted house look-alike hospital your mom remember. The new KKH looks like a space ship! Isn't it cool?!

Opt for the “private suite” follow up and a dedicated doctor (whom you requested for, experience in multiples pregnancies) will follow you throughout the pregnancy. You will find yourself in a lounge-like private suite with free coffee/milo and apples…so much better than my previous private doctor’s small, pathetic and cramp clinic.

For multiples pregnancy, you may also consider NUH or SGH for subsidized rate. Since you’ll need extensive follow up and weekly consultations/scans, location should be a prime decisive factor too. Ultimately, do consider that KKH manages numerous high risk and complicated pregnancies referred from other centres locally and abroad. It has the best neonatal outcomes in Singapore has the largest number of NICU/special care beds and private delivery rooms (this is crucial as critical multiples pregnancy cases will be warded here for close monitoring of the babies’ heart beats and contraction etc, I was warded in this type of room at week 30).

If you think you can always stick with your private doctor and only switch to KKH during emergency, please reconsider an earlier switch over (preferably in the 1st trimester), because:

  • Priority (bed/NICU) will be given to existing patients
  • Dangerous and hard to make prompt decision due to lack of prenatal records. Restructured hospital follows SOP and always record a lot of details (my case file is 2-3 inch thick). But private Dr may not do so and when we requested our private Dr to fax over existing records during my 1st KKH admission, it’s only 1 piece of hand-written paper. The nurse was so shocked and even asked me to check with the private Dr if their fax machine had broken down.

RESTRUCTURED HOSPITAL? ARE YOU SURE?

Many people thought that since they pay a premium price for private Dr, their services should be premium too. WRONG WRONG WRONG! Ok, if you’re still not convinced by my real life experience above, please consider this…you are only assigned to 1 private Dr. In cases of emergency, if he/she is not around, or unable to treat you for high risk issues (which is common for higher order pregnancies), what shall you do? Hmm…as what our previous privateDr advised, “GO TO KKH”.

Ok, if you wanna statistic, our previous private Dr seldom come across triplets case in years of practice, and was only handling 1 more triplets case during my pregnancy, I’m only her 3rd triplets case…whereas in KKH, they’re handling many triplets per year, for example, during my admission at week 30, there were another 2 triplets moms warded too. And recently I got to know this other KKH triplets mom-to-be who is also about the same gestation period as me.

Well, some hear horror story that they’ll be “pushed” from one department to the next, example from the Diagnostic Center (for scans) to the Dr’s clinic, to the pharmacy and you can spend hrs just for 1 appointment. But remember this, for multiples pregnancy, better equipment and more experienced Sonographers are required as it’s not an easy task to scan multiples accurately. And you will require bi-weekly or weekly scans to monitor babies’ growth and well-being. If you opt for “Private Suite”, the Dr also has the ultrasound machine in her room but she’ll still request for a more detailed scan from the Diagnostics center (I prefer that too). Everything under one roof, isn’t it better?

WHICH DOCTOR?

If you read my other blog entry, you might realize we also had trial and error in selecting the right doctor. We had 2 recommendations for KKH obstetricians: 1) Friends’ recommendation – a Senior Consultant who is experienced in fertility treatment, 2) Mom’s church sister’s (who’s a doctor too) recommendation – a Consultant who is an expert in handling twins & multiples. We thought the senior consultant will be better so we waited one month to see her, alas, she’s not suitable. Hmm, and we were referred by her to another doctor who coincidentally is the same doctor recommended by our mom’s church friend. We should have followed our mom’s recommendation in the 1st place...

So, this lovely, encouraging, experience, and gentle obstetrician, who is like an angel to us and help us to reach beyond national average gestation period is Dr June Tan. Without her, I won’t be able to have the courage to keep all 3 babies (opt out of selective reduction) and reach beyond week 34. Meeting the right Dr with the right vibes will not only give you positive energy, but also the positive outcome to your pregnancy.

DOWNGRADE FROM PRIVATE TO SUBSIDIZED WARD?

You may wonder, if you opt to be followed up by a dedicated Dr in the “private suite”, can you still opt for subsidized class during admission or delivery subsequently? YES YOU CAN. No worries, every admission will be deal with individually. Prior to each admission, you’ll be advised via “financial counseling” based on the 1)estimated bills according to your condition, 2)costs comparison among wards A-B1-B2-C, 3)amt that can be claimed from medisave. They’ll then advise you which ward to choose etc. Although the private Dr will not perform the delivery if you opt for subsidized ward…there’s still a team of highly qualified Dr experience in multiples birth to perform the C-section.

On the other hand, if your pregnancy went smoothly beyond the national average gestation period, babies are estimated to be over 2kg, so you opt for A or B1 private ward delivery package (as you wanna your Dr to deliver for you), but unfortunately, the babies are born with some issues and need extensive treatment (considered as high risk case), KKH can still downgrade you to subsidized ward so that babies hospitalization (neonatal charges such as NICU, treatments etc) will follow the subsidized rate too.

PRENATAL HOSPITALIZATION SUBSIDY

If you’re entitled to subsidy, why not? Yes, staying in subsidized ward may make you feel “uncomfortable” but look at the amount of $$ we saved for my 3 prenatal hospitalization. And they might even upgrade you to B2+ with air-con if B2 or C wards are full. Which was what happened in my 3rd admission during week30, I was upgrade to B2+ air-con ward but they only charged me C class price (yipee!)

1st admission during 1st trimester: 2 days

2nd admission during 23rd week: 3 days

3rd admission during 30th week: 3 days

MEDISAVE, MEDISHIELD, INSURANCE

Medisave of both mom and dad can be used jointly (e.g. 70% from daddy’s account, 30% from mummy’s account) for the mom’s prenatal hospitalization, delivery hospitalization and babies hospitalization. The admission staff will check the system on both of your medisave balance and you can decide the ratio.

For mom’s delivery, depending on the ward class and type of delivery, a lump sum of medisave called the “MMP-Medisave Maternity Package” is claimable (e.g. estimated $3950 claimable for “B1 ward – C-section -3 days stay package”). For KKH, the package is inclusive of standard misc items such as blood test, medication, dressing, pads, etc, so that you won’t be shocked that the bill will shoot up after adding lots of “hidden cost” (we heard that this is what happen in mt E).

For babies hospitalization, it’s max $450 claimable per baby per day of stay. E.g. if you have triplets staying for 10 days, it’ll be $450x3x10 claimable. Babies hospitalization charges will follow mom’s ward class, thus if you opt for subsidized ward (B2+, B2, C), your babies’ charges will be subsidized accordingly too. Still troubled? No worries, the “financial counseling” prior to delivery admission will advise you which ward to choose.

Medishield doesn’t cover pregnancy unless it endangered mom’s life or result in serious consequences. Thus for all my prenatal hospitalization, I can’t claim for it. Secondly, it doesn’t cover hospitalization for babies (e.g. NICU cost).

For Insurance, Prudential is offering this pregnancy insurance PruFirst Gift which can be bought from week18 gestation, and cover death benefit (for the expectant mother and baby), pregnancy complications (mum), congenital illness (baby) and hospital care. BUT it’s only up to twins, triplets rejected.

Still troubled, no worries, you will still have Baby Bonus (cash gift) and maternity leave salary to help cope with it.

ADDITIONAL INFO ON INSURANCE

“There are some pregnancy complication/maternity related insurance from Great Eastern Life but you got to sign up with them 10mths before pregnancy, good for those who are planning to conceive. The first is “SupremeHealthshield” payable by medisave that covers pregnancy complications. Another is their PinkLife policy that has a rider that covers some pregnancy complications and congenital illness of the newborn. Other insurance companies (NTUC, prudential and AIA) do have similar policies but benefits and coverage will be different.
Contributed by Joyce Tan (another Singapore Triplets Mom)

BILL COMPARISON

Every case is unique thus to have a better picture, you may refer to the tables below (total bill size including treatments for normal delivery, but not inclusive of babies NICU):

Comparison of Restructured Hospitals

Average cost per prenatal appointment

Comparison of Restructured and Private Hospitals

KKH RATE

For PRs, foreign residents or non-residents rates, please click here.

If you’re still worried on the cost, no worries, for restructured hospital, a team of medical social workers will assist you in the bill, it might be applying for additional grants, or implementing an installment plan, etc.

Hope that our experiences and the information we gathered along the way will be able to assist you. Mummy, we know it’s already very tough to handle the emotional and physical challenges for multiples pregnancy, so Daddy, please stop worrying on the costs by choosing the right hospital now. Get on your feet for your wife needs you more than ever and do stay positive to encourage her to go on and on. The more positive both of you are, the higher the chance you will have longer gestation period and thus healthier babies, and thus lower costs.

May God Bless You!

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OMG! How did you get triplets?

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OMG! How did you get triplets?

Hi, so you know that I've triplets, and perhaps you have this urging temptation to ask...
1) Is it IVF? (no)
2) Do you have any family history of twins or triplets? (no)
3) Wow! Your husband is very “power” (hmm…no comments, but he prefers me to say yes)
4) You are very “power” (LOL, no)
5) It’s like striking the lottery! (hahaha ya, it's God's gift!)
So how did I get triplets?
And what is it like during a triplet pregnancy?
You will be in for a SURPRISE!


God heard our prayers and we finally succeeded in 2010. The nurse was so shocked when I called her, she shouted from the reception area to Dr Heng, who was in her room…and she requested us to see us on next day immediately. (Read my sharing on how I battled infertility)

LITTLE DID WE REALIZE THAT THIS IS GONNA CHANGE OUR LIVES FOREVER.

On 6 Sep 2010, the scan showed our first ray of hope. And we “hooray” in the clinic. Dr Heng joked that there might be more than 1 as I responded so well to the Puregon jab (4 eggs were released from the ovaries). She hoped it would be twins instead of triplets as it’ll be really tough to carry triplets… the mom will require bed rest at the later part of her pregnancy and blar blar blar… We didn’t take it seriously then, and even thought that it might be fun to have twins. So to double confirm, we did a repeat scan in the following week.


Week 5, at a dog run event, we still didn’t know what lies ahead of us.

Week 5, at a dog run event, we still didn’t know what lies ahead of us.

Me at week 5, before knowing I have triplets.

Me at week 5, before knowing I have triplets.

At Week 6, and still able to direct an outdoor photo-shoot.

At Week 6, and still able to direct an outdoor photo-shoot.

At week 6, naughty me, jumping on a trampoline during the photo-shoot, unaware of the shock we’re gonna hear soon.

At week 6, naughty me, jumping on a trampoline during the photo-shoot, unaware of the shock we’re gonna hear soon.


ON 13 SEP...

SHOCK #1

We’ve strike the lottery! Dr Heng spotted 3 sac in the 2nd scan and her first reaction was “Oh No…” Roger’s face turned as white as sheet (LOL)…and I was soooooo scared.

And the adventure begins.

SHOCK #2

Roger was concerned with finances. Dr Heng told him to prepare $100k per baby as they would be born pre-term and required NICU (up to 2 mths of private hospital’s ICU). Then she tossed a prudential agent card to us and suggested us to buy insurance.

Whereas for me, I asked her what is the chance to deliver them smoothly and am I able to do it? She assured me not to worry as she also had another case of triplets concurrently.

SHOCK #3

Later, after much research, we were shocked to “discover” that only roughly 55% of triplets make it as a complete set, the rest will either be reduced to 1-2 babies or none of them survive.

SHOCK #4

We were rejected by the insurance agent. “Sorry we don’t accept triplets, twins yes, but not triplets or more…”


SHOCK #5

On 27 Sep appointment, the scan showed that one of the sac was very small, it’s vanishing, so Dr Heng prepared us mentally that it might not survive and it may trigger the other 2 to stop growing too. I was soooooo sad and pray for the best.

Fortunately, the small baby make it, and while I thank God…


SHOCK #6

We found out that Mummy of triplets has a high chance of developing complication and life threatening symptoms during pregnancy. If the babies are born too early, they may not be healthy too. So Roger suggested “selective reduction” (killing 1 fetus) which is vastly practiced oversea to increase the chance of survival for the other 2 fetus. He was worried for my health, babies’ health and the costs.

Initially I was rational and practical, so I agreed. But after a few days, as the thoughts of “killing my own baby” became more and more realistic, I cried and scolded Roger for suggesting it in the first place. At that point, we didn’t know the gender yet or how “healthy” the babies were…what if we kill the wrong baby? And so we decided to let God guide us. If any baby is to go, He (God) will decide, not us. And so all 3 babies were given a fair chance to survive.


SHOCK #7

UNBEARABLE 1ST TRIMESTER. Yes, it nearly killed me. 3 fetus means 3 times higher level of HCG, which is the main cause of morning sickness. I could hardly get out of bed, and threw up after almost every meal. Roger had to rush home during lunch time. One night, after hitting my ultimate threshold, Roger rushed me to KKH A&E and I was immediately admitted for 3 days on drip as I was suffering from severe dehydration. Fortunately, I survive. It was at this point we decided to switch from private hospital to KKH, where there will be subsidy rate for NICU and more doctors around to attend to me during delivery (at least 3 pediatricians, and a team of O&G who expertise in multiples).

But still, we didn’t dare to announce the triplet pregnancy, and kept it very secretly within close friends and family members only. One can never be sure until the end of 1st trimester. We dare not name our babies or buy baby stuff.

SHOCK #8

WHAT?! selective reduction again??!!! When we switched to KKH, we chose to be followed up by an O&G Dr who specializes in fertility treatment. We were really looking forward to see her, alas after waiting for 1 month (as her schedule was very packed), we were shocked by her reaction and negative remarks during the 1st appointment. Instead of encouraging us, she kept repeating that triplet is a high risk pregnancy and asked why didn’t the private Dr warned us of the high risk before taking the Puregon jab…it sounded like we were 2 gullible adults cheated by the private gynecologist. Well… who could have thought that I responded so well to the first trial of jab when 1yr+ of oral medication didn’t work at all (zero egg…no egg at all)…everyone was shocked including Dr Heng.

And the worst part was, she suggested selective reduction. WHAT?! Just when both of us had quietly put this issue aside since 3 fetus were growing very well, this Dr suggest killing of 1 baby AGAIN? Then she said…”if you opt for selective reduction, it has to be done now (in that week or the following), if not will endanger the pregnancy…but KKH requires a panel of doctors and several weeks to approve, so the fastest is to switch to NUH (faster in approval). WHAT?! Upon telling us all these, she then referred us to another Dr who specialize in multiples, who is very busy and we can only see her in the following week. The end. We were out of her room in 5 min.

OMG…the feeling of rejection and being kicked around and thinking of killing my baby, made me so sick and dishearten for the entire week. Fortunately, the Dr who was referred to take up our case is such a motherly and encouraging Dr and she didn’t mention “selective reduction” or how unsuccessful the fertility treatment was or how dangerous/high risk it is to carry triplets. I dunno, it just clicked, our frequency clicked and I immediately knew that I’m in good hands. She respected our decision to keep all 3 babies and assured us KKH has the resources and facilities to help us, not to worry. She is like an angel to us – Dr June Tan.


SHOCK #9

3D scan showing the miracle triplet formation.

3D scan showing the miracle triplet formation.

2nd hospitalization during 2nd trimester. Thank God, my morning sickness subsided during the 2nd trimester and I happily hop around buying baby stuff. This is the photo taken before our shopping trip (week 22). I was so radiant…but after an afternoon of shopping and extensive walking and standing, and an unfortunate incident of losing my balance on the home platform, my cervical length dropped drastically from the normal above 3cm to less than 1.5cm (signs of pre-term, aaaaaaaahhhhhhhhhhhhh!!!). I was admitted for 3 days of strict bed rest. A tag “CRIB” was stick to my bed which means “complete rest in bed”. And I started to have occasion contraction from then onward.

At week 22, prior to the tiring shopping trip.

At week 22, prior to the tiring shopping trip.

We’re gonna have 2 boys 1 girl! Doctor refer them as Triplet ABC A (boy), B (boy), C (girl)

We’re gonna have 2 boys 1 girl! Doctor refer them as Triplet ABC
A (boy), B (boy), C (girl)

Thereafter, I was very much grounded at home for plenty of bed rest and had to be on wheel chair for every hospital appointment.


SHOCK #10

Weekly thigh injection. Ok, those who know me will know that I’m very very afraid of injection. And at this age I’ll still cry during injection. Unfortunately, to stabilize the pregnancy, since week 23, I gotta have once a week to twice a week injection of Progesterone to my thigh. It is very painful but soon… I got used to it and sometimes the nurses are even more panicky than me (LOL). As you can see, these are the bruises and marks on my thighs.    


SHOCK #11

All confinement nannies rejected us and 1 even quoted us S$4200. Ok, S$4200 for 1 month of help, which is double the standard of S$2000. After 2-3 weeks of disappointment and rejections, we finally gave up and decided to employ a maid instead. Fortunately Roger’s mom agreed to help us out. She will quit her job and move in with us. What a big big big sacrifice and we’re speechless at her unconditional love and care.

AND EVEN MAID REJECTED US!!! OMG, can you imagine this, even maids rejected us upon knowing that we have triplets…finally we receive a “yes sir, I’m willing to come” from an Indonesian maid in a Skype interview last week…keeping our fingers cross now…

Babies’ side profiles.

Babies’ side profiles.

At week 26, I’m as big as my friend who’s full-term (week 40)!

At week 26, I’m as big as my friend who’s full-term (week 40)!

At week 26, and already soooooo big!!

At week 26, and already soooooo big!!

At week 29, I can still go out and have breakfast…but in the following week…

At week 29, I can still go out and have breakfast…but in the following week…


SHOCK #12

At week 30, strapped with devices and confined to the bed in Delivery Suite.

At week 30, strapped with devices and confined to the bed in Delivery Suite.

3rd hospitalization during 3rd trimester. Under the care of “multiple specialist” Dr June Tan, she guided us safely through the 2nd trimester and I finally reached the safe zone 28 week, whereby babies has high chance of survival upon delivery (but under intensive care). Alas in week 30, I was woke up from sleep at 4.30am by consistent and painful contraction every 5-10 mins for 3 hours or so, and was admitted for anti-contraction drip on the following day. I was also given 2 shots of steroid to enhance babies’ lung development.

Fearing that the drip won’t work, they warded me in the delivery suite (yes, where mummy stays during labor), and we even heard nurses shouting “push push push” next door. Fortunately the drip works, contraction level drops, but I developed so much side effects (increase heart beats, blur vision, vomiting, dizziness), that they had to put me off drip even before 1 course was completed.


SHOCK #13

Grand escape from KKH! I was soon transferred to normal antenatal ward on day 2 and put on observation and anti-contraction oral medication. In the morning of day 3 (Friday), Dr June Tan was satisfied with my results and gladly announced that I can be discharged after a final tracking on contraction level and babies heart beats. She assured me that feeling occasional contraction is normal for multiples and as long as it’s non-consistent and bearable, I can safely rest at home. Thus the nurses completed all the discharge documentation, and the pharmacist popped by to pass me all the medication to be taken at home.

BUT THEN… the nurse was unable to track an accurate measurement as the babies kept moving and the charts were on and off, on and off. So they were requested to repeat the tracking at 5pm. And so we waited. Alas after dinner, there was still no evaluation and by 8pm, we were shocked that most of the doctors had gone home and the on-call doctor was so busy, she couldn’t even squeeze out some time to read our chart. The nurses advised us to stay overnight…but knowing that it’s Friday and Dr June Tan won’t come in during the weekend, we knew that if we don’t get out on Friday, we would be grounded in the ward over the weekend.

So Roger (the escape artist) urged me to get changed, while he quickly packed my belongings and wheel me out to the nurse reception within 5 min. Upon seeing our strong desire to be discharged, the nurses called the on-call doctor and finally by 10pm, she arrived.

BUT THEN (by 11pm)… she’s a junior doctor and upon seeking the advice from a senior doctor, and seeing signs of contraction on the chart (which is normal for multiple pregnancy), she rejected our request to discharge. And so, we tried to reason out with her by repeating what Dr June had said earlier on.

Finally, I trashed out the magic verse “ok, if anything happens, I will bear all responsibilities”. Surprisingly, it worked immediately. Like a magic spell in Harry Potter, we were out of the hospital in 5 min, after signingthe “I will be fully responsible” declaration form.

And we finally reached home on the dot at midnight.


As the babies grow, my tummy sometimes form odd shape and lately I woke up with 2 humps like a camel.

As the babies grow, my tummy sometimes form odd shape
and lately I woke up with 2 humps like a camel.

WEEK 32
Our scheduled C-section is on 11 Apr 2011 (mid week 35) and we are praying for the best. I’m in the midst of week 32 now and hopefully we can reach our goal.

WEEK 33
Updates! Now I’m in week 33, confined to bed & home, couldn’t go for a professional studio photo shoot, so Roger took some photos of me at week 33, well…better than nothing. At least what you see is really 100% me at home, not edited studio shots with flash lights and background props etc.


WEEK 34
Updates! I’m now in week 34, the KKH appointment yesterday (5 Apr 2011) was good! Babies are growing fast within a few days! Now all 3 are above 2kg and looks like my goal to deliver them next week (week 35) is achievable! It’s such a miracle! Praise the Lord! Roger took some photos of me yesterday prior to the KKH appointment:

WEEK 35: DELIVERY
We are so so so lucky that the pregnancy journey is coming to an end and along this winding road, with so many odds and possibilities that the pregnancy will end up in disaster, we keep to our faith that God will lead us and bless our babies with a smooth delivery. So on 11 April 2011, in week 35, 3 healthy babies are born by C-section: Asher 李宇恒 2kg, Brayden 李宇哲 2.2kg, Charlotte 李宇心 2.2kg! Praise the Lord for the miracles!

Brayden and Charlotte had slightly low blood sugar so they spent their first night in “special care unit” for close monitoring and feeding. Thereafter, they were fine and returned to the normal nursery. On day 5 of my admission, all 3 were fit and healthy to go home with me. What we thought is mission impossible (deliver beyond the national gestation period for triplets and 3 babies are able to go home with mom) and see it as a fairy tale which will only happen to others, occur right in our lives!!!

Here are the video and photos of this blessed delivery!

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10 Tips to Overcome Multiples Pregnancy

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10 Tips to Overcome Multiples Pregnancy

When we first realize it’s a triplet pregnancy, my hubby’s face turns as white as sheet and instead of feeling happy, tons of emotion and thoughts went through my mind.
- Am I able to carry all 3 babies to full-term?
- Will they be healthy?
- Am I able to go through the tough pregnancy?
And we are the only couple who left the consultation room with worrisome expression…


My pregnancy journey is full of ups and downs. Beside the torments of deciding whether to opt for selective reduction, I suffered greatly from severe morning sickness and was hospitalized for drip. It’s like the darkest days of my life, with 80% of the time resting on bed, unable to function normally (like surfing the web or watching TV) as I was so weak. What a beginning. Certainly very disheartening. There were multiple times I expressed feeling of regrets of getting pregnant to my hubby and the medical staff. I felt like crying but was so weak even to cry. I could only sleep to overcome the physical and mental torture. Fortunately my condition improved upon the 2nd trimester…but…

For the full story of my pregnancy ups and downs, click here.

Ok, since the purpose of this post is to encourage those who are also going through difficult pregnancy, I’m gonna leave the ups and downs aside and talk about how we walk through this tough phrase of life to carry the triplets till 30 over weeks.

You may notice that I always use “we” instead of “I”, that’s because pregnancy doesn’t only involve the mummy, but the daddy as well. So here are 10 tips on how to overcome a tough pregnancy…


1) ACCEPT YOUR FATE

I used to be a regional marketer. Traveling, leading an exciting and hectic career life was so ME. It was like my identity source, where I drew most of my self-esteem, self-worth, and pride. Prior to my pregnancy, I was a full-time MBA student / real estate agent / ecommerce entrepreneur / model. As you can see, I always packed my life with excitement and tons of challenges. Just when I was about to expand my ecommerce business, my world was suddenly changed upon pregnancy.

I was confined to bed rest. Friends started to ask where am I, why I’ve not being updating my Facebook status, etc etc. But I couldn’t even reply them. I was so so so weak. It’s like… the clock stop ticking. Roger had to rush home during lunch time, but I vomited most of the time…sign…I was so depressed…

After several weeks, it was only when Roger read a very meaningful article to me, about a triplet mom who overcomes her pregnancy blues by accepting the role of a “patient”, with the only goal of nurturing the babies in her, so as to prepare them for the best when they are born. I can’t recall which book was it, but it certainly changes my view.

Let go of the past, accept the fate.
Accept the role of a patient, and have sufficient rest.
You have only 1 goal now, to nurture the babies in you.

So what if you can’t mop the floor, continue your job or go for your usual outdoor activities? Forget it! The most important task now is “pregnancy”!!!


2) TALK TO OTHER TRIPLETS MOM, YOU’RE NOT ALONE

Singapore is a very small country with barely 5 million population so you can imagine the lack of support network for triplets moms here. Fortunately, there’s a triplet mom staying in my mom’s block and when I visited my mom during the weekend, I happened to see her at the void deck. Upon introducing myself, she was very helpful and we exchanged mobile numbers. Although she’s very busy juggling with her 2 yrs old triplets boys, she SMS from time to time to encourage me. This little gesture is so powerful it keeps me going on and on.

Subsequently, we did some research and found a multiples support group. The constant exchange of advice, resources, emailers, reminded us that there are many struggling couples like us out there, and we are not alone.

TRIPLETS POWER! A great success to our playgroup! What a crowd! Will upload the video soon :)

Posted by WinnieTriplets on Sunday, January 29, 2012

3) SUBSCRIBE “DISCOVERY HOME & HEALTH

There are so many programs featuring successful multiples birth and tips on parenting multiples, we felt so normal after watching them, so please subscribe, you are not alone, there are many triplets families out there who are doing fine.


4) WATCH “JON & KATE PLUS 8″

This is such a motivating program about a couple with a set of twins and sextuplets!!! If you think your pregnancy is tough, then please watch this video. Their program are mostly aired on Discovery Home & Health, and TLC.


5) BELIEVE THAT YOU CAN DO IT

It’s very important to stay positive and believe that you can do it. It is where you’ll draw your strength from. If you’re a Christian… believe that “God will not put you through more than you can withstand”. Since He has planned the triplet pregnancy for you (1 out of 8000), He will surely pull you through. Pray and let Him guide you. The pain or discomfort will pass soon.


6) LEAVE THE READINGS TO YOUR HUBBY

Most of the books or articles on multiples are pretty factual and the more you read, the more worry you’ll be. The statistics towards triplets pregnancies are not that rosy and encouraging. But not all multiple pregnancies are the same. These statistics only serve as a guideline but that doesn’t mean you’ll be one of them. Let your loving hubby read all those stuff and filter out before transmitting to you. It’s less negative when factual stuff are heard in the most loving and caring tone from your hubby.

Here are a few books we recommended:


7) WHEN YOU’RE READY, LET YOUR FRIENDS KNOW

Believe me, you will be more than surprise to receive warm concerns and request for visitation from friends you didn’t expect. Friends whom I’ve not met for years, initiate to visit me when I’m confined to bed rest. Acquaintances and ex-colleagues leave sweet and caring messages on facebook. All these are very crucial to help you through the last stretch to home ground.


8 ) SETUP THE NURSERY AND BUY BABY STUFF

nursery.jpg

Nothing can be more impactful than visual encouragement. I understand you may not dare to buy baby stuff initially so as to avoid disappointment if the pregnancy ends prematurely, but once you think you’re ready (maybe in the 2nd trimester), start planning and setup the nursery to mentally encourage you that this is real, you’ll have 3 babies soon. Whenever you’re discouraged or sad, pop into the nursery for that boost of motivation. Tell yourself you can fill up this room with babies and you can do it.

Imagine how you will play with them, how you will discipline them or feed them, etc. Imagine how they’ll look, will they resemble your hubby’s features or yours? Will they have the same characters as you? How would you dress them up? Do you prefer the same colour dressing for all 3? LOL, it always bring a smile to my face whenever I think of the future.


9) NAME YOUR BABIES AND ADDRESS THEM INDIVIDUALLY

When you’re ready, name your babies instead of calling them baby ABC or 123. Talk to them and gently massage your tummy whenever they kick…”Asher, mummy loves you”, “Oh Brayden, you’re so naughty today”, “Little Charlotte, you’re having hiccups?”

Strangely, there’s a bonding between mom and babies even before they’re born. I have tried it a few times and it works miraculously. For example, baby C was quite tiny as compared to her 2 brothers so I encourage her to grow more and be strong, within 2 weeks, she overshoot her brothers. WOW!

At week 26, telepathy session with my babies.

At week 26, telepathy session with my babies.

10) START A BLOG

The best strategy to shut off negative thoughts is to occupied yourself with something more meaningful. If you’re on bed rest most of the time, place a laptop on a bed tray and start blogging. Share your experiences with others. Who knows, your words may change the fate of another lady across the globe.

Hope you’re feeling more positive now Share this article with those in need of encouragement. If you have some more tips to share, do leave a comment. Cheers!

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Battle against PCOS & Infertility

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Battle against PCOS & Infertility

Sadly, I have PCOS. A condition that strikes around 1-2 in every 10 women, and is the main cause of infertility. I never know that I have it. And this is the journal of my emotional battle against PCOS and infertility. I am not trying to promote any doctors, medication or treatments and this is just a sharing of my story.

So I'm still in the dark.

So I'm still in the dark.

I started noticing that I might have some health issues during school days. Back then, I had very irregular menses, sometimes once every 3 mths or so. The menses were so heavy and painful that I was always sent straight to the sick bay in the school. When I’m slightly older (college), I went to a Gynecologist who referred me to KKH (women specialist hospital). But then, no thorough examination was taken, and after waiting for hours (well, it’s a subsidized clinic after all), I was given some contraceptive-pills-alike to regulate my menses. The End. Useless, and complete waste of time.

I carried on with my hectic lifestyle throughout my early twenties and couldn’t be bothered by the menses thingy. I thought it would “recover” as I grew older and many aunties consoled me that the menses irregularity and cramps would “go away naturally” after pregnancy.

But then, I never realize I may not even get pregnant. FOREVER.


In my mid 20s, I got married to Roger and we plan to enjoy our marriage life to the fullest. We didn't want any kids then but I had so much motherly instinct that I bought a dog shortly after our wedding. Cola is such a cutie pie isn't it?

But then…as we brought him out and carried him like a baby…we were rather odd standing beside couple with real baby. So 2 years later, we finally decided to try for “a” baby, when Cola no longer fills up the empty gap in our lives. It's a mutual feeling, we always admire others who have babies.

I stopped the contraceptive pills (hooray!). We heard that it takes awhile after that to get pregnant, but half year down the road, there was still no progress. I suspected that something is wrong. After much procrastination, I finally picked up the phone and fixed an appointment with a famous gynecologist – Dr Heng. At the same time, I also consulted a famous TCM doctor (Traditional Chinese Medicine) and started boiling pots and pots of smelly/yucky Chinese Herbal Soup.

Soon, Dr Heng diagnosed that I have PCOS, or in layman terms, it's imbalance of hormones/ovulation problem/no eggs release from ovaries. I was given Clomid and a type of diabetic medication. She didn’t explain why I need the diabetic drugs (although I wasn’t suffering from diabetes), and just told me it’s also a type of drug for fertility treatment. (????) Worse still, the TCM doctor said there is no remedy for treating PCOS… and she can only prescribe me some standard Chinese Herbal medication to work hand in hand with the “western” medication.

This is exactly how I feel after leaving the clinic.

This is exactly how I feel after leaving the clinic.

After a few mths, I couldn’t take it. At that time, I always went to the appointments alone. Can you imagine, walking into a clinic, packed with pregnant ladies and their babies/kids, while you are “fruitless”… and you know this mth is a failure too cos your menses come…and the consultation reply is always the same “no egg release, carry on with the same medication, increase the dosage, good luck”… I hate the “Good Luck”, I hate it.

I had my first melt down when I met a classmate in the clinic. We were both at the reception counter with our hubbies, she was about to give birth soon. Upon seeing me, she was very happy and asked if I’m pregnant and how many mths etc. I don't know how to reply her. Really, I don't know. I just said, oh, I came for my irregular menses problems, not pregnancy. And I could see that she doesn't know how to reply me too. It was very awkward (at least for me). Just when I thought “ok, let’s get out of here and forget about it”, the pharmacist came to the reception counter, threw me a huge huge pack of diabetes pills and told me “ok, so this is for your diabetes, this is for…”

I wanna shout “For God’s sake, I don’t have diabetes!” For the rest of the journey home, I was totally quiet in the car. Roger sensed something wrong. Finally, I couldn’t take it anymore and burst out in tears. (tears are welling up in my eyes as I’m typing this…)

  • I hate taking diabetes pills when I don’t have diabetes.
  • I hate the yucky smell of TCM herbal soup, lingering in the kitchen, spreading all over the house. It’s like I’m a very sick patient.
  • I hate the “Good Luck” from nurses and their sympathetic look.
  • I hate entering a clinic crowded with pregnant women and their babies.
  • I hate it when families, relatives and friends asked “so, when is your turn?”
Marriage was so fragile then.

Marriage was so fragile then.

It was so mentally torturing for me that I gave up. I buried myself into work and stopped the treatments. My career life was already very stressful and there’s a limit to my threshold. So I chose career first and was on frequent oversea business trips. Our marriage was affected. Our hearts grew further and further apart. Anything can trigger a quarrel or fight.

When I look back now, I realize God has tested and strengthened our marriage through lots of challenges and temptations before blessing us with babies. The final test came in 2009 when Roger went to California for a 2 mth training and I just started a new job as a Brand Manager.

With a heavy work responsibility and still on probation, I couldn’t apply for 2 mths leave to join him. The office is located far away from my home and I gotta pick up driving (I had never driven since passing the test 10 years ago) and drove for hours to and fro work. On average, I slept less than 4 hrs per day and had to work over the weekend, so much so that I’m always the last to leave office. It’s crazy. Worse still, one of my client is a super crazy woman. And when I said crazy, I meant it. She’s totally crazy and mentally unstable.

With Roger gone and me alone in Singapore, I couldn’t take it. That’s when I realize how important Roger is in my life. So I took a 1 week unpaid leave to visit Roger and I will always remember how we hug on the chilly street outside his apartment when I arrive in San Francisco after midnight.

When Roger was away for work, I toured around San Francisco on my own. Sitting alone at the park, at the beach, strolling on the street alone, enjoying the bus ride alone, visiting the museums alone, that was when I had lots of time to “rethink” about my life…on the last day, as I was lying on the green pasture at Los Angeles Getty Museum…I finally made the decision…

…that the most important thing in life is FAMILY.

After returning from the trip, I threw in my resignation letter without second thought and by 2010, I started to pursue my dreams (setup my own online fashion business, took up MBA) and I’m back on track with the fertility treatment.

I told Dr Heng about my resistance against diabetes pills and so she only prescribed Clomid for me. The TCM doctor also started to try acupuncture on both of us. But, after months of disappointing non-responsive acupuncture, TCM and Clomid, to the extend that I developed allergic symptoms to Clomid, we were about to give up again. I told Dr Heng, “well, if it’s fated that we won’t have a baby, then let it be…I don’t wanna go for IVF…just let it be.” The truth is, I don’t want to burden my darling with the high cost of IVF, especially when he’s the sole bread winner.

Dr Heng was very nice, she offered an alternative medication and asked if I’m willing to try Puregon injection instead. “Ok, why not?” The cost is around $800 and requires 6-8 days of daily self-injection (per menstrual cycle) to the tummy area. She suggested to try it 3 times (3 cycle) and if it still can’t work, then we have to consider IVF. “Hmm ok, as long as it’s cheaper than IVF, why not?”

I cried when I thought of the daily injection as my greatest fear is injection. Luckily I had enough tummy fat to cushion the pain (that's the only only time I appreciate my fats, LOL). Roger offered to help with the injection, but I told him to “GET OFF!!!”, as his hands were so shaky and he was even more panicky than me.

God heard our prayers. We finally succeeded by Aug 2010. And it was only the first trial. The nurse was soooooo shocked when I called her, she shouted from the reception area to Dr Heng, who was in her room…and she requested us to report in the next day immediately. He has blessed us with a set of triplets.

LITTLE DID WE REALIZE THAT THIS IS GONNA CHANGE OUR LIVES FOREVER.

LITTLE DID WE REALIZE THAT THIS IS GONNA CHANGE OUR LIVES FOREVER.

More tips to improve fertility
Some of them might by myths, some are advice from doctors, but we followed all of them. I dunno which one works, or which one doesn’t, but no harm trying right?

  • Stop consuming microwave food
  • No coffee or alcohol days before “trying to conceive”
  • No smoking (including second hand smoke)
  • Have sufficient rest physically and mentally
  • Lady: don’t go to the toilet, shower or bath immediately after intercourse
  • Guy: switch from tight underwear to boxer
  • Guy: switch from tight jeans to comfortable pants
  • Guy: no hot shower/bath, room temperature water preferred (strictly no hot spring)
  • Guy: consume more red meat before “trying to conceive”
  • Guy: no mint
  • Guy: cut down on strenuous exercise especially heavy weight lifting

If you are about to start fertility treatment, be mentally prepared for the ups and downs journey. Hubby should be tested too, as all your efforts in taking the medication/jab will be in vain if he has an issue and untreated properly. Statistic has shown that most of the PCOS ladies are able to conceive eventually, so never give up. Most importantly, start the treatment early and don’t drag on it as age plays a crucial role in fertility too.

If you are in the midst of this battle and feel discourage, here is a song dedicated just for you.

BEFORE THE MORNING – JOSH WILSON

Do you wonder why you have to
Feel the things that hurt you
If there’s a God who loves you, where is He now?

Maybe there are things you can’t see
And all those things are happening
To bring a better ending

Someday somehow you’ll see you’ll see

Would you dare would you dare to believe
That you still got a reason to sing
Cause the pain that you’ve been feeling
It can’t compare to the joy that’s coming

So hold on you gotta wait for the light
Press on and just fight the good fight
Cause the pain that you’ve been feeling
It’s just the dark before the morning

My friend you know how this all ends
You know where you’re going
You just don’t know how you’ll get there
So say a prayer

And hold on cause there’s good for those who love God
But life is not a snapshot
It might take a little time but you’ll see the bigger picture

Once you feel the weight of glory
All your pain will fade to memory

It’s just the hurt before the healing
Oh the pain that you’ve been feeling
It’s just the dark before the morning

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Should I Reduce To Twins?

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Should I Reduce To Twins?

You might have landed in this page either out of curiosity or you’re facing the most difficult moment in your life and trying to seek more real life opinions before making the decision. We’re not advocating or discouraging the option of selective reduction… we’re merely sharing what we have went through and hopefully will help you in making your decision.

For the benefits of those who dunno what is selective reduction, (as quoted from Wikipedia), it is used to reduce a higher-order multiple pregnancy to a twin or singleton pregnancy, so as to avoid the medical issues generally related to multiple births…this procedure is done by injecting Potassium Chloride into the selected fetal heart…to stop the heart beat. Well… for those who don’t need to go through this torment, you may feel that “Reduction” sound hmmm… relatively medical or technical, but to those who had or are experiencing it now, this word is far too simplified to describe “ending the life of your selected baby”.

reduction2.jpg

I feel that it’s like killing, my hubby feels that it’s like an abortion, and we both struggle emotionally for weeks and mths during the 1st trimester. It’s a test of our love and our faith in God, to make a decision that nobody can make for us, not even our doctors or our parents can decide for us.

SINGAPORE CONTEXT In the end we didn’t opt for it and I really have to thank the medical system in Singapore for making it so hard to get approval for this procedure in restructured hospitals. In KKH, a panel of doctors will evaluate each case and can take weeks to approve, while NUH’s approval time line is shorter, it still takes sometime before one can have it done. As it has to be completed in the first trimester, by the time we were suggested to reconsider this option after switching to KKH, I’m already at the end of 1st trimester and nothing can be done. We’re not sure about the practice in private hospital, you may like to consult with your private doctor.

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This is the summarized version of our ups and downs with selective reduction:

Shortly after we realized it’s triplets, Roger (my hubby) suggested “selective reduction” which is vastly practiced oversea to increase the chance of survival for the other 2 fetus. Initially I was rational and practical, so I agreed. But after a few days, as the thoughts of “killing my own baby” became more and more realistic, I cried and scolded Roger for suggesting it in the first place. At that point, we didn’t know the gender yet or how “healthy” the babies were…what if we chose to kill the wrong baby? And so we decided to let God guide us. If any baby is to go, He (God) will be the one to decide, not us. And so all 3 babies were given a fair chance to survive.

When we switched to KKH, we chose to be followed up by an O&G Dr who specialize in fertility treatment…she suggested selective reduction. WHAT?! Just when both of us had quietly put this issue aside since 3 fetus were growing very well, this Dr suggest killing of 1 baby AGAIN? Then she said…”if you opt for selective reduction, it has to be done now (in that week or the following), if not will endanger the pregnancy…but KKH requires a panel of doctors and several weeks to approve, so the fastest is to switch to NUH (faster in approval).

Upon telling us all these, she then referred us to another Dr who specialize in multiples, who is very busy and we can only see her in the following week. OMG…the feeling of rejection and being kicked around and thinking of killing my baby, made me so sick and dishearten for the entire week. Fortunately, the Dr who was referred to take up our case is such a motherly and encouraging Dr and she didn’t mention “selective reduction”… She respected our decision to keep all 3 babies and assured us KKH has the resources and facilities to help us, not to worry.

For the full story, read my post “OMG! How did you get triplets?

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Why didn’t we opt for it?

- Each fetus has it’s own sac so the risk of complication is much lower.

- One of the fetus showed signs of vanishing initially but survives ultimately, their survival spirit encourages us.

- All 3 of them grow equally well, so who are we to decide which one to go, when we can’t determine which one has problems or even know their gender during the 1st trimester? What if we choose the wrong baby?

- It’s not their fault that they landed in a crowded uterus, and have to fight for survival with other siblings. In fact, most of the multiples pregnancies are due to fertility treatment. So who are we to take away their chances to survive?

- There’s a risk that selective reduction may terminate the whole pregnancy, so we might end up with no babies.

- It’ll cast a shadow (especially the mother) for the rest of our lives. When we look at our surviving babies in the future, somehow there won’t be 100% happiness.

- It helps when both of us are Christians and we believe “God will not put us through more than we can withstand”. If He has planned the triplet pregnancy for us (1 out of 8000), He will surely pull us through.

- For triplets, there’s still a greater chance of success, but if it’s quadruplets, than we might think otherwise.

We’re really fortunate and blessed that my pregnancy is comparatively better than other triplets cases in KKH. During the same period, 3 triplets cases end in pain, #1) 2 sharing the same sac didn’t make it during the 2nd trimester and the 3rd one in its own sac was endangered, whole pregnancy terminated. #2) Delivered at week 21, all 3 cannot make it. #3) Delivered at week 25, 1 may have some problems, the other 2 might survive. Of course, all 3 cases didn’t opt for selective reduction initially…

We also notice that the egg and sperm quality matters a lot too. I have heard of cases whereby the sperm or egg have quality issues, the pregnancies end in miscarriage even if it’s conceived naturally. Thus it’s better to solve the roots of the problems (by seeking treatment from gynae or male specialist) and have a much safer pregnancy than to rush into it and suffer from great disappointment when the pregnancies end prematurely.

So thank God, we didn’t opt for selective reduction in the first place.

If you still have doubts about it and need more advice, please read this article which changes my mind. It’s so powerful, I bet it’ll make you think twice too.

If you’re considering for reduction mainly based on financial reasons or parenting issues, oh please…subscribe to Discovery Home and Heath now, there are so many successful stories on triplets birth (The program is called “Baby Story”). One particular program which encourages us a lot is “Jon & Kate Plus 8″, they have a set of twins and sextuplets!! Watch this:


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