Tuesday, May 31, 2011

New kid on the blog - part 3

It was finally the morning of the surgery. I had never entered an operation theatre in my life before so I had no idea what to expect. They asked me if I wanted to go for general anesthesia or epidural. I knew that general anesthesia would be great because I would just go in and come out without being conscious of anything in between, but I had been told that GA could make the baby groggy and that would mean that the neonatologists would not be able to do an accurate assessment of the baby's condition. So I opted for epidural. A note on that. Yes, you feel no pain at all but you can totally feel the tugging and pulling they do! I wasn't sure if that was normal so I actually turned to the anesthetist who was standing by my head and said, "Excuse me, I can feel some tugging. Is that normal?" (On hindsight it was quite comical for a patient in the operation theatre to say that in the middle of a surgery.) He assured me it was normal.

In about half an hour, the surgeon moved the screen separating my face from hers and said, "Congratulations! The baby is out." The baby is out??? What did that mean -- the baby is out?? "Of course she is out, but is she alive??" I wanted to scream. Well, she had said 'Congratulations' and they all looked pretty relieved so I figured the baby was indeed alive. They stitched me up and I was wheeled to the recovery area for a blood transfusion. Later, I was taken to the recovery ward, where finally I saw Viv. He told me that the baby had been immediately taken to the neonatal ICU (NICU) for assessment. Her Apgar score was quite good, 8 followed by a 9.

I could see she was already papa's girl. Viv's lucky number is 9 and his birthday is 9/9. The surgery was scheduled at 9, the baby's weight was 990 gm, her final Apgar score was 9 and she was born at 10:01 am. Where's 9 in that, you ask? Well, 1001 is binary for 9, isn't it? (When I pointed this out to Viv, he was so thrilled! Nerds of a feather flock together...)

My blood pressure continued to be very high even after the delivery and so I was still on full bed rest. Viv went down to see the baby and took pictures with his phone. She was covered with tubes and sensors all over. Trust me, that is not the first view of your baby you want. She had been classified as a VLBW, which has nothing to do with the LBW we all know and love. VLBW stands for Very Low Birth Weight, and such infants are at a high risk of... well, everything. The lower the weight of the baby, the higher the chances of complications are, including some long-term ones. The IUGR had made her smaller than regular babies born at the same 32 weeks.

Just when I thought Viv and I could just stop worrying about me and focus on the baby, we realised it wasn't so. My blood pressure stayed high and just wouldn't come down. They gave me a medicine called Adalat which quickly brings down the BP but also gives you the mother of all headaches. When I was asked to describe the pain on a scale of 1 to 10 (10 being absolutely unbearable), I gave it an 8.5. It really was. But what to do, Adalat ka yehi faisla tha. Heh heh! I read that the effects of preeclampsia could last for weeks or months after delivery so I really had no idea when I would have the sensors and BP cuff and the catheter (Ugh the catheter! Don't even get me started on that.) off me. Worse, they would not let me go see my baby. First, I wasn't allowed off the bed, and second, they were probably worried my BP would shoot up even more if I saw the baby in that condition.

Finally, after staying in the recovery ward for days (again, a place where most people stay only for a few hours), they said I could sit in a wheelchair (my stitches made it impossible for me to walk) and go see my baby who was in the NICU.

Let me give you a peek inside the NICU. Well, when you first enter, it's scary. Alarms are ringing everywhere, there are funny lights all over and you are greeted by the sight of many struggling babies 'trapped' inside glass incubators, with wires and tubes all over them. It looks like some kind of an heartless experiment at first, and you want to kill the evil guys, but then you realize that the 'evil guys' who putting their hands into the incubators and 'torturing' the babies are actually the angels who are trying to save these innocent lives.

Viv wheeled me into the NICU and took me to her incubator. Even though I had seen her photos on his phone, nothing had prepared me to see a baby of that size, in an incubator, struggling to get the tubes off herself. It was really heart-breaking. I could hardly see the baby. Instead, I saw a tiny, fragile 'thing' with an eye mask covering the upper half of the 'face' and a large breathing tube with two prongs going into the nostrils, covering the rest of the face. Other tubes led from her hands and legs to machines. Where was my baby? She was in an incubator under blue lights (for jaundice), hooked to a lot of machines with alarms that seem to go on forever. I did not break down though as I had anticipated. However, looking at her in this condition, on all the different kinds of life support, I went numb.

Yep, that is Viv's hand and that is Xena next to it. That's how tiny she was.

As premature babies' bodies are not equipped to handle nutrition that is not through the umbilical cord, they had put her on the IV drip and were going to test her tummy for tolerance towards milk. Mother's milk is truly nectar for premature babies as it has antibodies which are critical to the infection-prone babies. The doctors had asked me to express milk and send it to the NICU for the feed testing. Now here's the thing. When your baby is suddenly delivered at 32 weeks, your body simply isn't prepared to immediately start producing milk. Here I was, placing an order for milk, when it seemed like my body had gone on strike and the workers were complaining that production could not start that early as the factory had not been set up. "Well, what can I do? The CEO is already here! Surprise visit and all that. You just gotta do it." Luckily, they were going to test her tummy using 1-ml feeds first so within a few days I was able to send that much (in a syringe no less)!

Meanwhile, they finally discharged me with a lot of strong BP medication. They also asked me to buy a monitor and record my BP at home three times a day. The doctors said that preeclampsia-induced high BP is something that can take its time to go and there's not much I could do about it other than taking medication.

After that, our lives revolved around hospital visits. I was up and about in two weeks, and even though the stitches still hurt, I often forgot that I had had surgery. The focus was just to make sure Xena was stable and putting on weight. I could not believe it -- I had put on 13 kgs over the course of the pregnancy, and my baby did not even take up 1 kg of it.

All babies lose weight initially and Xena did too - about 45 gm. I remember being so elated when she put back 7 gm of that. Who imagined we would be celebrating our baby's weight gain in grams? But Viv and I did.

Initially, her body rejected the 1-ml feed, but the next round was better. They started slowly increasing the feeds to 2 ml, 3 ml and so on. While regular newborns were drinking 50-60 ml, my baby was on 2 ml.

Her jaundice was very persistent. While it is common for newborns to get it, it usually goes away with a few days of phototherapy, while for Xena, it was on for weeks.

Daughter of the notorious Bhai, Xena had started her gunda-gardi in the NICU pretty early. She bullied the doctors and nurses and almost always had her way. They were sick of resetting the tubes and sensors because she would just pull everything out. At first she was on breathing tubes with 22% oxygen, but she kept pulling it off. They even folded a thick piece of cloth and placed it over her neck so her hand couldn't reach her breathing tubes. In spite of that, she managed to pull them off. It was her way of saying that she didn't need the tubes and could breathe on her own. Finally, the doctors shook their heads, rolled their eyes, and took off the tubes as a challenge to her. Lo and behold, she really could breathe on her own!

Most premature babies are passive and weak, and pretty much lie there in the incubator. Not Xena! The social worker allocated to our case (the hospital allocates a social worker to the parents of all premature babies) said that in her 12 years of working in the NICU, she had not seen a more active baby than Xena. All the nurses we met said, "Oh your baby is so active. She kicks and pulls away all the tubes!" One of them even joked that they were considering changing the 1-nurse-to-2-babies ratio and allocate a dedicated nurse just to prevent Xena from pulling out the tubes! She was so tiny that the nurses could just pick her up with one hand! (New meaning to "She's a handful." huh?) and yet so powerful that it was next to impossible to wrench away a tube from her tiny fists. "Fight the battles, baby, not the tubes!" I would tell her.

Her initial heart scan showed a condition called Patent Ductus Arteriosis (PDA). Basically an artery called the ductus arteriosus lets the blood bypass the lungs because the fetus gets its oxygen through the placenta. The ductus normally closes soon after birth so that blood can travel to the lungs and pick up oxygen. When the ductus does not close properly, it can lead to heart failure. In most babies, the ductus closes on its own, though in some cases it reopens. For Xena, it closed, but before we could celebrate, it reopened. Thankfully, it closed again and no surgery was needed.

Meanwhile, we registered her birth at the ICA and were asked to get her passport made within 42 days! There is no way we could get a photograph of her face or her thumbprint for the passport. So we had to get a special social visit pass made for her so she wasn't considered an illegal resident. Sheesh. Didn't think paperwork would be another thing to think about in the middle of all that.

She did well in the NICU, breathing on her own and putting on weight and tolerating higher feed amounts. In two weeks, she was stable enough to be transferred to the step-down NICU. This was also part of the NICU but it was for babies who did not need very intensive care. However, the very next night, we received a call from the hospital to say that she had had a very bad desat. I didn't even know what a desat was -- apparently it's when the oxygen saturation in the blood drops because the baby forgets to breathe. Apparently, Xena had stopped breathing and had started to turn blue. They managed to resuscitate her by putting in a ventilator, which is basically a tube that goes all the way to her lungs. She was transferred back to the NICU, all feeds were stopped and she was put back fully on IV again. We rushed to see her and she just looked so frail and helpless and there was blood around the lung tube.

The doctors suspected necrotising enterocolitis (NEC) as the reason why she had the desat, which really surprised us because NEC is a very serious condition related to the baby's diet, and breast milk is known to help prevent NEC. She had been fine on breast milk all this while. However, we found out that the nurse in the step-down ICU had given her formula milk for a day because she thought there was no more breast milk! You can imagine how furious we were because here we were, ferrying 7-8 small bottles of breast milk to the NICU every day -- there is no way the milk could have gotten over. When we asked her to check again, she found 12 full bottles! Breast milk plays a critical role in preventing NEC, and no wonder that within 24 hours of having the formula, she was back in the ICU. We read this scary article about NEC and were very traumatised to know that one in four babies dies of NEC.

So she was off feeds and on IV and antibiotics for a week, with 8-hourly scans. They also took took a lot of blood for tests and cultures and another transfusion was needed. Once she was stable again (and had kicked off the breathing tubes) she was transferred back to the step-down ICU. However, based on our last experience, we decided not to go over the top with joy. And sure enough, they told us that one of the visiting moms had contracted chicken pox so they were checking with the moms of all babies if they have had it before. I had never had it which means Xena did not have the immunity against it. They gave her a jab with antibodies, and luckily there was no adverse reaction.

By the time, she was 1 month old, she was stable again and weighing 1400 gms. They only discharge premature babies after they reach the 2-kg mark. She put on weight a few times but lost again to go back to 1400 gms. The weight loss was partly due to the energy she spent in crying. It was really heart-breaking to see her cry of hunger (her milk feeds were heavily calculated and controlled), pain and discomfort, but we could do nothing. They let us put our hands through holes in the sides of the incubator to touch her though.

Her next round of gunda-gardi involved the feeding tube through which they gave her milk. One day, she cried so hard, she got really agitated and pulled out her feeding tube all the way from her stomach! I nearly fell down with shock when I saw her waving the end of the tube at me in a "Look ma, no tube!" gesture. They put in a new feeding tube, this time through her nose. They tried to get her started on bottle-feeding but premature babies are not able to coordinate breathing, sucking and swallowing at the same time. Also, the doctors said that the effort she would have to make to take in milk any other way than the tube would be so much that she would lose weight, and their priority was to have her gain weight.

One of the doctors had told us that when it comes to premature babies, they take one step backward for every two steps forward. Sure enough, each time she made some progress, we got some bad news too. Premature babies tend to get hernias as their inner abdominal wall is very soft. Xena's abdomen scans showed two hernias. One was an umbilical hernia which docs said should go away by itself but the other was an inguinal hernia for which she would need surgery. Surgery on a baby of that size?! Doctors said that she was too small for surgery at that time so they would wait till she was about 2 kg. I was totally freaking out at the thought of her being under anaesthesia.

We found it difficult to follow the NICU visiting hours, as it was painful to leave if she was crying. We just had to trust that the nurses would pacify her. She was turning out to be quite independent though -- the other day, she was crying and the pacifier kept falling off. I had to leave and the nurses were busy tending to the other babies so I put the pacifier in her mouth and told her 'Mummy has to leave now. Will you hold your pacifier, baby?' and she did!! On one hand, I was happy that she could 'take care of some things herself' but it was also heart-breaking that a newborn didn't have her parents around all the time to tend to her needs.

When she reached the 1.5-kg milestone, she was moved out of the incubator into a cot. This meant that she was more 'accessible' to us and we didn't have to put our hands into the holes in the incubator just to touch her. She was still on the feeding tube though, as bottle-feeding was causing desat.

We had started kangaroo care, which is a technique where you hold the baby skin-to-skin. This helps to create warmth, security and bonding in babies who have to stay in the NICU for very long. So I would go down to the hospital for kangaroo care every day. About kangaroo care itself, well, if you can put your baby on your chest and button up all the way, that is one tiny baby. Viv also tried it once but I told him vainly his kangaroo care doesn't come with a value-added service like mine did. You see, I sang to the baby during kangaroo care. Muahahaha! Singing was easy. The tough part was choosing which song to sing. Of course, the big song those days was 'Sheela ki jawani', but that was perhaps a tad inappropriate for a baby. So I sang the title song of Main Hoon Na because I truly did feel like that about her:

Kiska hai yeh tumko intzaar, main hoon na
Deh lo idhar bhi ek baar, main hoon na
Khamosh kyun ho, jo bhi kehna hai kaho
Dil chahe jitna pyaar utna maang lo
Tumko milega utna pyaar, main hoon na


Of course, sometimes she took my words too seriously, especially when I sang "Khamosh kyun ho..." and she would wail to a degree that exhibited the exact opposite of khamosh. (Erm, she also cried if I went off-key. Sheesh.)

I would sing a different song each day and over the days, I found out which songs she liked. Main hoon na, Tinka tinka and Sau gram zindagi were her favourites. When I'd first heard the Sau gram zindagi, I loved the melody but I wondered what exactly what the words meant. Sau gram zindagi? 100 grams of life? What did that mean? Ironical that the song came to have its own meaning in my life, where we were literally counting the grams of life on Xena. Sometimes the wait for her to get home seemed so endless. I celebrated my first birthday as a mother without my daughter. I celebrated my first Mother's Day without my daughter.

We got so used to seeing her that she didn't seem small to us anymore. In fact, I pointed to one of the other babies and told Viv, "Look look, GIANT BABY!!!" He said, "Erm, that is not a giant baby. That is a regular-sized baby. Our baby is small."

On 30th April, she was finally moved out of the setp-down NICU into what they call a 'special care nursery' (SCN) where they trained her to bottlefeed without having a desat. The SCN was a crazy noisy place, with alarms beeping all the time, the only thing louder than those were the babies wailing ("I'm a celebrity, get me out of here!"). Xena quickly made herself at home, and I could totally imagine the gunda-gardi at night with the babies bullying the newcomer babies and demanding 'hafta' of the order of 'char peti milk'.

Xena did well in the SCN, but as usual, there was the not-so-good news. Her brain scan showed a small bleed. Premature babies are at risk of such haemorrhage, and doctors said that as long as it does not progress, it should resolve itself. Her heart scan confirmed the small hole that one of the doctors had initially suspected. She also had anaemia. The doctors will do follow-up for 8 years (!!) as premature babies are susceptible to a host of problems involving developmental milestones such as speech, walking and learning.

As for what caused all of this, the doctors are not sure. It had definitely something to do with the placenta, as the surgeon who did the c-section said that she found a large blood clot behind the placenta, which itself was half-detached. "We were surprised the baby hung on for so long in spite of that!" She said. Apparently, even a day's delay in the surgery could have spelt danger. I am just thankful that even though all this happened, Xena and I were in good hands. The doctors and nurses did such an incredible job taking care of us (and pretty much saving our lives) that I was ashamed that I had had doubts at some points about transferring to a 'government hospital'. I wish I could donate a large sum of money to the hospital, but their bill already made sure of that. ;)

Viv and I attended classes on taking care of premature babies at home. They even had a session on infant CPR, which we attended, hoping the entire time that we would never have to use it. We were very nervous about taking her out of the controlled hospital environment with all the sensors and monitors that alarmed as soon as something went wrong. Even when we held her in the hospital, we would be constantly watching the heart rate, oxygen level and breathing rate. We heard a horror story of someone whose baby went home to come back to oxygen support the very next day because she caught an infection at home.

Xena's hernia surgery was on 19 May. I still remember watching my tiny baby being taken into the operating theatre. When she came out, she was hungry and in pain, and was crying a lot. She was still on IV and they could not give her any milk, so they gave her a pacifier and she kept it on for four hours straight, hoping that maybe suddenly milk will come out of it. It was really heart-breaking to see that. Two days later, she was discharged. She was stable, could bottlefeed, and had recovered well from the surgery. Her homecoming on 21 May, more than 2 months from the time she was born, was a strange experience. We were excited and nervous at the same time. On her first night at home, Viv and I pretty much stayed up all night watching her, with the sole aim of keeping her alive (I kid you not.). We tried to recreate the hospital environment as much as possible so it would be easy for her to do the transition. We wash our hands every time before touching her. She is in an air-conditioned room all the time. Even at night, there is always a light switched on. She is not allowed visitors. Viv and I have not even kissed her face yet. When we feel like kissing her, we kiss the top of her cap.

Though she was born two months ago, medically she is considered a newborn as they count the age for all developmental milestones from 40 weeks of gestation. Xena is still tiny; we did not even buy any bottoms for her as the newborn tops reach her ankles! She has been home for over a week now, and we are still learning how to take care of her. The biggest challenge remains winning her trust. Premature babies who spend months in the ICU do not trust anyone. They associate human touch with pain, discomfort and disturbance. They have only experienced needles and sensors and incubators. They have not felt anyone's loving and caring touch. They develop a fierce kind of independence and self-reliance. So when they get home, it is difficult for parents to make them feel secure as they don't even trust their own parents. This comes across in small ways such as getting startled when touched (even if it's to just change the diaper) as they feel it could be someone trying to poke a needle, sleeping with both hands in mid-air in front of her face in a 'don't touch me' gesture, trying to snatch the milk bottle away (they feel that it would be taken away before they finish) or simply and most heart-breakingly, looking at the parents with distrust in their eyes. We are still working to overcome all of this and make her feel truly at home.

***

Some of you have asked me why I never mentioned all of this on the blog when it was happening. Well, here's the reason. The bar is a happy place. It has always been and it will always be. I wanted our story to reach at least a small positive point before sharing it. And even though we don't know what is in store for us and baby Xena in the future, for now we are in a happy place. Xena is alive, stable and home.

In the beginning, whenever I thought of everything that was happening to us, and saw my 990-gm baby, small and frail and helpless in the NICU, with so many tubes and needles, a lot of thoughts haunted me initially - Why us? Why our baby? Viv and I are good people, what did we do to have this happen to us? And that's when I realised it -- there is a lot of suffering in the world and we humans have to share it all. What have we done to deserve a perfect life? Why should we expect a perfect life when our fellow human beings have to go through so much pain and suffering? In the end it all comes full circle. We could either sit and cry every day or we could be strong and brave and positive. We took the second option because that is what would help our baby. The little one was fighting so hard at her end, she had so many well wishes coming her way, how could we let her down by being negative?

And why did I write all of this in such excruciating detail now? Because if some day, Xena, Viv or I forget to appreciate the value of life or the power of good wishes, we can come back and read this to remind ourselves.

At the end of it, I told myself what I have said again and again -- Everyone has problems. You just gotta make a bigger deal of the happy stuff.



Sunday, May 29, 2011

New kid on the blog - part 2

You know how most advice we give people or people give us is just words? Well, once in a while, you get a piece of really good advice that changes your life.

One of Viv's colleagues heard about what had happened to us, and asked Viv to speak to his wife who was a gynaecologist at KK Hospital. Viv spoke to her and her advice was this - "Switch to KK immediately." At first we were a little apprehensive. KK was a government hospital, not where I had imagined giving birth to my baby. Secondly, our doctor in the private hospital knew our case history and starting from scratch with a new doctor and a new hospital didn't seem like a good idea. But there were important considerations, one being that staying on at the private hospital with the $1000-a-day NICU costs would make us go bankrupt. The costs would be lower at KK. Secondly, we found out that the neonatal team at KK was very good. Also, as I told Viv, "This is Singapore. Even a government hospital can't be that bad."

There was a problem though. One-third of Singapore's population is born at KK so if you call to get an appointment, the earliest slot they would give you would be 2 or 3 months later. By then, my baby would probably already be born! Viv's colleague's wife came to our rescue again and got us an appointment for the very next week.

We saw the doctors at KK who studied all our reports and scanned me a zillion times again. During one of the scans, they said that there was a possible gap in the baby's cerebral hemisphere. So in addition to being classified as 'severe IUGR', they also added 'possible FA (fetal anomaly)' to my case file. In addition to the chances of her survival, we now had her heart and brain to worry about. Every week I would make my way to KK to be scanned again. The baby was still growing very very slowly. They transferred my case to the HRC (high-risk consult), a team of doctors who work on high-risk pregnancies.

In late February, I received a call from the hospital. The doctor said that the HRC had recommended that I get admitted as soon as possible as they suspected that I could give birth prematurely anytime so it was safer to be in the hospital if that happened. I was due in mid-May. This was end-Feb. "So when should I come and get admitted?" I asked. "Today." Said the doctor.

So I packed my hospital bag and made my way to KK. I was immediately wheeled to the delivery room and plugged to the CTG machine to monitor the baby's heartbeat. The plan was to monitor the baby's heartbeat and deliver immediately if the baby showed any signs of distress. I was keeping my fingers crossed that delivery could be delayed as much as possible so that the baby had enough time inside to get ready for the outside world. The lungs of the baby are especially vulnerable if delivery is done too early, so they gave me steroid injections to mature the baby's lungs. "These injections will be quite painful," said the doctor, to mentally prepare me. If I had foreseen the next one month of my life, I would have laughed at that statement. For the pain caused by the steroid injections was nothing compared to what I was about to face.

I had taken time off work for the prescribed bed rest and my mom had flown down to take care of me. She was to fly off the day after I got admitted (she had to go to the US to my sister). Unfortunately, the delivery room I was in only allowed the husband to go in and so for a while it looked like Mom would have to go off without even meeting me! Fortunately, nurse Thong (No, I am not making up the name) in the delivery room was kind enough to sneak my mom in for a quick 'Good bye and good luck' hug.

My time in the delivery suite was extremely uncomfortable. I was on full bed rest, hooked to a couple of machines, one of which churned out a continuous printout of the baby's heart rate. I was asked to lie on my left side to maximise blood flow to the baby, and it was very uncomfortable to lie on my left side 24-7. On some nights, I would wake up to find myself on my right and freak out completely, leaning over to see if the baby's heart rate was all right. Viv was with me all the time, and would stay up at night to keep an eye on the heart rate.

For the next few days we kept our eyes glued on the CTG machine for any drops in the heartbeat, or 'decel' as the nurses called it. Baby Xena, being the extremely jumpy baby that she is, really made the nurses work for their money as she would kick the sensor off and the signal would be lost and the nurses would come running to set it on again. However, on some occasions, there would be an actual decel and I would be put off food and immediately on IV to prepare me for delivery if needed.

I stayed on in the delivery room for four days. An interesting thing I found out was that the charges in the delivery room go by the hour. Mainly because most women go in only for a few hours and don't walk in with a tent and picnic basket, intending to settle there like I did. No wonder the fattest part of our very fat hospital bill were the delivery room charges.

Another interesting thing we found out is that even though there is only one NICU, the charges for the baby's stay depend on what class of ward the mother was in. Since we expected Xena to be in NICU for a few months, we were advised to pick the lowest class of ward - Ward C. Viv was apprehensive. Ward C meant that I would not have a dedicated gynaecologist. Whoever was on call that day would be the one attending to me after reading my case notes. Ward C meant a shared space with 5 other beds, no air-conditioning, a common bathroom, noisy visitors, curtains in the name of privacy, and obviously no couch for the husband to stay over. Ward C was not what I had had in mind for my pregnancy. But we had no other choice. If Xena survived, we needed to be able to afford her NICU care. So even though Viv said I could go for B1 or B2 if I wasn't comfortable with C, my answer was the usual, "This is Singapore. Even Ward C cannot be that bad."

A few days later, they decided that baby Xena really did not intend to come out so soon, and they moved me out of the delivery suite to the general ward. The plan was to still continue to monitor the baby's heart rate but three times a day for an hour each instead of being hooked to the machine and not being able to move. I still remember how thrilled I was to get 'unstrapped' and actually be able to move about. I sent a message to Viv from my very simple bed in ward C, "I am not strapped! There is a ceiling fan! As far as I am concerned, this is a 5-star hotel!"

Every morning, the nurses would do their rounds in the ward and the senior nurse would brief the others on the case histories. I was so sick of hearing the same thing every morning when they passed my bed. They would say my name, followed by "Severe IUGR. FA." whereas others' would sound something like "Delivered last night. Discharging tomorrow." On some mornings, I felt like getting up and declaring before she could, "Severe IUGR and FA. That's me. Argh! Happy now?"

I would watch my neighbours come and go, and I would just sit there and wonder. Most of them stayed only for a day or two. They would be warded upon delivery and have their babies brought to them every few hours. Visitors would come and see the babies, and I would just sit there and wonder.

There was only so much time I could spend in the ward staring at the CTG graph. Viv got me the iPad and for the first time ever, I appreciated that purchase. I spent long hours researching the terms related to my case. Once in a while, I would blog too, to get away from it all. Oh by the way, the Sheela I'd mentioned in this post was the head nurse of the ward. Heh heh!

However, within a week, I was back in the delivery suite as the baby's heartbeat dipped a lot. They stopped my food and put me back on IV to prepare for an emergency delivery. Baby Xena was determined though and managed to steady her heartbeat again. So back I went to the general ward again. This happened about six times in total. So I ended up mentally preparing myself six times for an emergency delivery. But the brave little girl hung on for dear life and the decels were not very persistent.

So it just looked like I was to keep shuttling between the delivery room and the general ward and stay in the hospital on bedrest from Feb till May. Then there was that scary night when I woke up to find myself bleeding. If you have seen 'The Time Traveller's wife' you will know what exactly I felt at that moment. I just had enough time to make a phone call to Viv before I was wheeled away to the delivery suite again. "This is it," I though. "Either I have lost the baby already or I am going to." Back I went to the delivery suite and back I went on IV again. The heartbeat showed some sharp dips but steadied again. The doctors said that if this kept happening, they would cross their fingers and hope that I reached at least week 34 before I delivered so that the baby had a better chance. Her weight, calculated from the measurements taken during the scans, was only around 800 grams and so she needed to stay in as long as possible. For the uninitiated, regular babies born at term weigh between 3 and 4 kg and I could not imagine what would happen to a baby born at 800 grams.

I suppose my long stay in the delivery ward was a standing joke among the doctors who, being on rotation, rarely saw a patient twice. Some of thom got really friendly with me. The doctors in the delivery ward would grin and ask me, "Still here, Sayesha?" and the nurses in the general ward would grin and ask me the same question. Some even said, "Ah, welcome back, Sayesha!" Then there was the time when I had barely gone back to the ward when I was sent to the delivery suite again. The nurses laughed and I laughed with them. It really was getting ridiculous.

And because I was such an 'interesting' case, sometimes the doctors would bring with them a host of curious medical students. They would then politely ask me if they could prod my abdomen and I would politely oblige.

Sometimes, in the middle of the night, I would hear the screams of pain from the neighbouring rooms, followed by the wail of a baby. I would wonder whether I would ever get there.

I still had blood tests done daily and sometimes twice a day. Sometimes they would have trouble finding a vein that had not already been poked recently. In that sense, I sure donated a lot of blood. They would scan me every 2 days to monitor the baby's growth. Around early March, when the baby was weighing about 0.95 kg, my blood pressure started to go up. They also measured high blood pressure in the umbilical cord and suspected a problem with the placenta. On one of the days, my BP showed a reading of 191 and I was wheeled to what they call the triage as the delivery rooms were all full! The triage had a very narrow bed in an extremely cold room, and I was strapped to the CTG machine again, lying on my left, my upper abdomen hurting like crazy. The other women waiting there were taken in, in the order of pain and I was the second last. Xena was jumping so much the graph went bonkers and I wasn't sure if something horrible was happening to her or the sensors had just gone off. They don't allow even the husband into the triage area so I was there all by myself, panicking my heart out.

Finally I got a room, and they did more blood tests, one of them being for preeclampsia. Preeclampsia is this pregnancy-related conditon where the mother develops high blood pressure and high urine protein. Apparently it happens to 1 in every 5 pregnant women. If untreated, preeclampsia can lead to eclampsia and cause the mother to have a seizure. The only cure for preeclampsia is immediate delivery of the baby. Preeclampsia and eclampsia can also cause the placenta to detach, cutting off all nutrient supply to the baby.

Unfortunately, I was found to have severe preeclampsia. My blood pressure was shooting up. They were doing all they could to keep it down. They gave me medicine and it didn't work. They gave me stronger medicine and it didn't work. Then they injected magnesium sulphate into my IV inlet. I asked them what it did. "This will prevent you from having a seizure." Holy cow. They had to make sure my condition didn't progress to eclampsia. Suddenly I had a Kuch Kuch Hota Hai moment as I actually wondered if I should also write letters to my daughter a la Rani Mukherji. (Yeah you can take me out of Bollywood and put me in a hospital, but you can't take the Bollywood out of me.)

My kidneys had already started to fail. The urine protein reading was 10 times the normal amount. It looked like there was no way out but to deliver the baby. All this while they had been focusing on keeping the baby in for as long as possible. Now it looked like keeping the baby in posed a threat to my life. "You are our patient too," said the doctor. "We can't put your life at risk." Once again it seemed like it was straight out of a Bollywood movie. "Hum maa aur bache mein se kisi ek ko bacha sakte hain..."

So they decided to deliver the baby. It was to be an emergency c-section, but they wanted the neonatologists to be prepared as soon as the baby was born so they could immediately attend to her. So it was kind of a 'scheduled emergency c-section' at 9 am the next morning (17 March). In my one-month hospital stay, I had been wheeled to the delivery suite six times, and yet, that was not where my baby was meant to greet me. I was going to be wheeled into the operation theatre instead. Viv asked me to get some rest the night before, but neither he nor I could fall asleep. We did not know what would happen the next day. Due in May, the baby was going to be forced out in March. What if something horrible happened that night itself? Would we really have a baby to hold the next morning? We did not know. I wanted to sleep so that these questions wouldn't keep popping up in my head, but sleep was far away. It really was the longest night of our lives.

[Read New kid on the blog 3rd and final part - Xena's two months in the hospital and her gunda-gardi in the ICU]



Friday, May 27, 2011

New kid on the blog - part I

You know how sometimes time simply seems to fly? It appears as if on Monday you received a wedding invitation from a couple, on Tuesday you attended their wedding, on Wednesday they told you they are pregnant, on Thursday you received an sms that went something like 'Blessed with a baby boy/girl weighing xx kg. Mom and child are doing well.' and on Friday you get an email (from the child, no less) saying, "Uncle/Aunty, please come for my 1st birthday." How does that make you feel? (Yeah, old, I know.) For most people, that's how fast and smooth the baby section of their lives seem to go. Of course, not everyone has it fine and dandy. There are also couples that are advised to terminate their pregnancy due to complications, or those who have to deal with the baby's and mother's lives being in danger, or those whose babies have to be in the ICU for months. But then these things are so rare and they always happen to other people, don't they?

Well, that's what we used to think too. Until the day Viv and I woke up to realise that we were the other people.

So the story starts on 9 Sep 2010 when Viv opened the birthday gift I gave him. It was a small box and inside was what looked like an iPod. But it wasn't an iPod. It was a positive home pregnancy test. (Yeah, I know. Cool way to break the news to your spouse. Touching and disgusting all at the same time.) I was toying between this and a highly dramatised version of a popular Bollywood scene of the 80s - "Main tumhaare bache ki ma banne wali hoon." but chose this one finally, because it meant that I did not have to buy Viv a separate birthday gift. I told him that this gift was so great that I did not owe him any more birthday gifts for the next decade. And he actually agreed.

We were elated. I was particularly excited because my sister, who lives in the US, was going to have a baby boy at the same time as I was going to have a baby girl! (Yes, I know. My mom shook her head at us and said, "Hey bhagwaan, main kahan jaaun?") We spent hours on the phone comparing symptoms ("Ooh you threw up breakfast? Yeay, me too! Same pinch!"). The first few months went by the usual way - throwing up, clothes getting tighter, wearing loose tops so no one at work suspected it till it was time to tell them, weird cravings (fortunately for Viv, no mood swings), etc. Speaking of weird cravings, the weirdest I had was for baby food. Yes, you read that right. And not just any baby food, but Cerelac (original), the baby food that I had had as a baby. Poor Viv went to Mustafa and got me three tins. (Yeah, he's a keeper. I know.)

We went for the usual doctor visits and everything was looking great. Until that one particular day when the doctor seemed to be frowning at the ultrasound. He measured the head and abdominal circumference, and the femur length a few times. His brow deepened. We asked him what the matter was. "The baby looks a little small.", he said. Small? So what? Babies are supposed to be small, aren't they? Besides, not all babies are born the same size. Some are just small. So we were not too worried. Until the next visit when the baby seemed to have fallen further behind in growth. The doctor asked us to go for a more detailed scan. The detailed scan said that the baby was fine structurally, but she was definitely very small. The case was classified as severe IUGR (intra-uterine growth restriction). IUGR is when the baby does not grow at the expected rate, and it can happen to a variety of reasons ranging from placental problems to chromosomal abnormalities.

"So what's next?", we asked the doctor. He said that he would continue to monitor the baby's growth, but suggested that we go see a specialist for a Doppler test to check if the blood flow through the placenta was all right. So we went to the specialist and that's the point where the faint lines of worry on our brows so far started to deepen. The specialist took a really long time scanning me, and then called another doctor who also spent a really long scanning me, and finally they said that they suspected that the baby had a heart condition called coarctation of the aorta. I still remember clearly what he typed in his report to my doctor - "Irrespective of the reason for the IUGR, prognosis looks poor." Then he turned to ask us what our religion was. It was a really strange question to ask, I thought. It was only later that I realised that he was trying to find if we had any religious restrictions regarding termination of the pregnancy. Termination?? I could not believe I was listening to someone talk about termination while my baby was kicking inside. But we had to be practical. If the baby really had complications such as a possible chromosomal disorder and a heart problem, what kind of quality of life were we promising her? The specialist left the decision to us but he was leaning towards termination.

We called my doctor and told him everything. He asked us if we were for termination. We said we needed some time to think about it, and that's when he told us that we had two days to decide and go through it because I was already in week 24, after which termination of a fetus is illegal in Singapore. Two days to decide whether we wanted to kill our baby?! I need not describe what Viv and I were going through. We decided to go for an amniocentesis the same day and try to get the results as soon as possible, even though normally it takes a few days for the fast results (that looks for a few common chromosomal defects) and a few weeks for the full results. Amniocentesis is this really scary test where they poke a needle all the way into the womb and collect some fluid right next to the fetus and test it for genetic abnormalities. We figured that if the test indeed showed a serious problem, we would at least have a solid reason if we went for termination instead of a 'suspected heart condition' in the baby. Amniocentesis has a 0.5% risk of miscarriage so there was a chance that even if there was nothing wrong with the baby, the test could do something to her! But this was really the best we could do so we went for the test. I had a screen in front of me where I could see the very long needle approaching my baby as the doctors carried out the test. Worse, they did not get any fluid at the first attempt so the test had to be done all over again!

I asked the doctor how the termination process would work if we opted for it. He said they would induce labour. Induce labour at 24 weeks?! I was to go into labour and give birth to my dead baby?? Only I know how I managed to keep myself from breaking down right there.

We were to get the FISH (Fluorescent In Situ Hybridization) test results in two days' time. This meant that if the results were poor and if there indeed was a serious genetic problem, we would go for termination the very same day. I went home, stayed in bed all day and bawled my eyes out, something I can't ever remember doing before. Meanwhile, Viv asked our doctor if we could get a second opinion on the scan. Our doctor recommended someone and got us an appointment for the next day. This doctor also scanned me for a very long time but did not say anything till the end. And what he said gave us the first ray of hope for the first time in several weeks. "I see no coarctation whatsoever.", he said. No coarctation whatsoever. Two contradicting opinions. Both experts in their field. What were we to do?

This doctor did say that he detected a hole in the baby's heart but it was something that could only be studied once the baby was born. He also said that if we were to keep the baby, I would need to go on immediate bed rest. The baby, if she survived, would most likely be premature and would need ICU care for months. He warned us of the ICU costs in the private hospital where my doctor was. Apparently a bed in the neonatal ICU can cost about $1000 a day. Yes, you read that right. $1000 a day! He showed us a picture of a similar case - an Indonesian couple who had twins and spent $100,000 on hospital bills. Bankrupt, they moved back to Indonesia.

So we went back to our doctor the next day who had the amniocentesis results with him. "The results are bad..." I heard him say. "Bad?? The results are bad??" My world came crashing down. "Back!" he quickly clarified. "Back, Sayesha, back. The results are back!! And everything looks fine." There were no genetic problems reported by the FISH test, although we would still need to wait a few weeks to know if there were none of the less common chromosomal defects. So, at that point in time, the only thing we needed to consider was the coarctation of the aorta. He left the decision to us. Though the test had ruled out major genetic disorders, severe IUGR still carried the risk of intra-uterine death. Add to that the possibility of the heart problem (coarctation and/or the hole) and the underlying reason for IUGR, which could be anything, and eventually manifest in anything.

We came back, called our families, and spoke to each other at length. And finally we made our decision. We would not voluntarily let our baby go. There just didn't seem to be enough evidence for us to opt for the worst. The baby was actively kicking, she had always been a kicker. Though I would have given anything to ask her what was going on inside, or to be able to deduce from her kicks what she wanted us to do, that was not to be. So in the end, we decided that if the baby was meant to leave us even before she met us, we would let it be her decision to make, not ours.

Read New kid on the blog - part 2.



Thursday, May 26, 2011

I kid you not!

Putting an end to all the speculation in the comments section of the last post, I introduce to the bewdas, baby Xena. :)


Nicknamed so for obvious reasons, this warrior princess was displaying her formidable fighting skills even before she was born. (And I am not just talking about the kicks and punches she regularly administered to me.)

Stay tuned to know more about the fights she fought and will need to continue fighting.



Tuesday, May 24, 2011

No return/refund, only exchange

Aish (in her best "Excuse me, this isn't what I ordered" tone) - Who is this??? Where's the baby sister???

My sister - Well, you don't have a baby sister, Aishu. You have a baby brother.

Aish - But I didn't want a baby brother! I wanted a baby sister!!

Sis - But you have a baby brother. We can't just leave him here in the hospital and go home, can we?

Aish - Yes, let's leave him here in the hospital and go home.

Sis (horrified but staying calm) - Erm... But think of what would happen if we just leave him here?

Aish - Hmmm... Someone else can take him home.

Sis - Look, he's crying. Shall we take him home? Please?

Aish - Hmm... okay fine, we can take him home for now. But later, we will exchange him for Mausi's baby girl.

***

I will now leave the bewdas to digest the news while I go and write another post with the dramatic details.



Monday, May 16, 2011

Random review: Khoon bhari maang

So I convinced Viv and my mom-in-law to watch Khoon Bhari Maang on TV with me. I had seen it when I was a kid and sold it to them as the 'ultimate 80s' revenge saga'. And boy, was it entertaining as hell (though not quite in the same way as a regular entertainer).








Here are my random thoughts after watching the movie:
  • Does anyone remember how popular the song 'Hanste hanste' was? We used to sing it in all the time in singing competitions in school, because it was an easy-to-sing, suitable-for-family-audiences kind of a song.
  • I quite like the song 'Jeene ke bahaane laakhon hain' too.
  • It was really Rekha, wasn't it, who was pushed into the lake? Crocodile or no crocodile, it takes guts to be pushed into a random lake by a fellow actor. *Respect* to Rekha for not using a body double!
  • Speaking of body doubles, I was wondering why Rekha had her hair open like Kali Mata in the last scene, because it totally didn't go with the rest of her outfit (black leather). And then I realised that they needed a body double to do all the jumping and somersaults and the long hair just helped to conceal the fact that it was a guy doing the jumps.
  • I was glad to see that Rekha spoke to her plastic surgeon in English. Warna aaj kal toh... even policemen abroad seem to speak Hindi in some of the movies today! Of course, Rekha had to do the obligatory 'face the camera and translate in Hindi' act - "Ek naya chehra... jise koi pehchaan na paaye..."
  • The surgery scene was quite graphic, huh? And the blood they used both in this scene and the one with the crocodile was such a dhinchak red! I am glad that shade is not used anymore.
  • Tom Alter was, as usual, the staple Hindi-speaking Caucasian in all movies in the 80s. Though in this movie, thankfully he only spoke two words in Hindi.
  • Hell, I had completely forgotten that Shatrughan Sinha was in this movie! So Rekha marries like three guys?!
  • Kader Khan was soooo annoying in the scenes with the vet. And his dialogues were so bad I am sure he wrote them himself. I am so glad they have stopped doing a completely independent comedy track in today's movies.
  • One must say Kabir Bedi cut quite a dapper figure. And amazingly, he still looks the same today!
  • I knew that one of Sonu Walia and the Baaliya guy was there to run between the shooter and 'shootee' and save the shootee's life, but had forgotten who it was. Glad it was Sonu Walia.
  • Why oh why did they have to shoot the horse in the climax scene? And Rekha's character being an avid animal-lover, asking the wounded horse to carry on because "izzat ka sawaal hai"??
  • Towards the end of the movie, when Rekha drags Kabir Bedi to the same lake with the crocodile, I turned and asked Viv, "So do you think she will push him in, or will Shatrughan Sinha appear and say, 'Kanoon ko apne haath mein mat lo, Aarti'?", he said it would obviously be the latter. Heh heh, I thought to myself. (She actually does push him down.)
  • And lastly, if there ever was an award for the ghastliest costumes used in a song, it has to go to this one!






Sunday, May 15, 2011

Have a Bolly good time V

Here's the fifth of the Bollywood A to Z quizzes. The theme for this one is 'Bollywood child artists'. See if you can identify A to Z?

A and B, who starred opposite each other in movie C, were incidentally cast as brother and sister in the movie D as child artists. D was directed by E, who also went on to direct the cult classic F, in which G appeared as a child artist. G, who had also appeared on a tin of baby food, was cast opposite A in H, his debut movie as a grown-up actor. H was directed by I, who used to direct blockbusters such as J, but has gone kind of bonkers lately. J starred A and K in the lead. K was cast as a child actor in the hit movie L, where he went to pee in the middle of the title song. One of K's hit movies had him playing uncle to three kids, one of whom was played by M. M was seen recently in the mindless comedy N, which also starred O. O's uncle P starred as a chubby boy in movie Q as the younger version of his father. As a child, P's wife R was cast in a double role in the movie S. R's uncle-in-law T starred in controversial movie U directed by P's father. In U, V played the young version of the rather scantily clad lead actress (and also Miss Asia Pacific) W. W and X played siblings in a 70s' flick Y. X's son Z starred as a child qawwali artist in a song in his father's movie. To close the loop, Z and A starred in a terrible movie directed by I, where they were on the run, with nothing less than a nuclear bomb in tow.



Tuesday, May 03, 2011

Word for word

My in-laws like to watch this health programme on TV called 'What's good for you?'.

The other day, I was in the computer room when the programme was on. Suddenly I heard my Dad-in-law shout, "Wah wah!"

"Wow, he must really like the programme..." I thought to myself.

And that's when I realised it. The programme had started and he was just calling my Mother-in-law who was in the kitchen. (In Tamil, the word "wa" means "come".)