Time flies fast

yes, sure it does. Had my 4th jab yesterday exactly 4weeks after the 3rd one. The hesitation somewhat subdued. Maybe to the fact that I was busy w work.. It’s never-ending that I have less time to think about myself. Yikes!
On the other hand, I had around 2 months of period-free time already. As fasting month is coming in, I’m looking fwd to not missing any day so I don’t have to make up (puasa ganti) any of them. Like last time, I just realized I had 3 days left so I did it straight from Tuesday to Thursday this week. Fuuhh nasib baik sempat.. Kalu tak kena la bayar fidyah jawabnya…
Ok, some update from my appointment w prof. On my 3rd visit, during the scan, my uterus somehow was ‘introverted’ as it gets smaller in size due to the thin lining. Prof said he probably needs to do some ‘tweaking’ if ART (artificial reproductive technique) is required later. My husband was the one who felt the ‘twinge’ upon hearing it, sampai pucat tu hehe
But luckily on yesterday’s visit, it went back to it’s original position bcos the scar tissues had vanishes, as prof put it. So alhamdulillah.. Right now I’m looking fwd to finishing the courses. Yeah!
Till then, wishing my Muslim readers a blessed Ramadhan..

 

The perks of being ‘single’

I’ve been ‘single’ for the past week. Hubby went for out-station work in Bintulu, Sarawak (east Malaysia), while I myself went to Singapore. We went to KLIA airport together on Monday but headed our own way when boarding into different gates. Its been few times we had such co-incidents (or planned to co-incide, hehe) of flying on the same day from the same airport, and i loved it! Why? so hubby cud do the driving- We usually leave the car at Putrajaya Park & Ride, which used to be free, but not anymore. It costed me RM 30 for 5 days/4 nights- still good compared to airport parking. Another reason is I can get into the golden lounge if I got lucky bcos DH can bring a companion 😀

Marina Bay Sands hotel, Singapore

I was actually on company trip for a summit which was held at the Marina Bay Sands- it’s a huge area comprising of hotel, convention centre, museum, casino & shopping complex. Here’s a pic of the hotel, 3 buildings with what seems like a ship on top. To me, it looks more like the banana boat. Ppl have to pay to get to the top so you can have a bird-eye view of whole Spore.

I dont know if I got the same chance if I already had a baby by now. Maybe, but I wud have to think of babysitter, food, stored breast milk etc (am sure the list is much longer). Probably I wudnt even have the heart to leave my baby at home with someone else..

I believe this is the best time for me to give all out to my work which requires me to go out and about quite often since the past few years. I still have few outstation trips in plan, hopefully could settle it all by end of the year or before raya, just in time for me to TTC.. We could only plan, but the best planner is the Almighty. All that happen, the work, the infertility issue, the delay in getting treatment, the medication course, the wait before TTC- is what’s best for me, alhamdulillah…

On another note, I’m already 5 days late according to my Period Tracker app- which is a good sign that the Zoladex works for me. But I’m still getting the period pain symptom like sakit pinggang– pain at the waist & abdominal cramps. Possibility of getting pregnant? Probably not but I’ll have an HPT test before my third jab this coming Thursday, just to make sure or more for the fun of it. Another thing to do on the list is to get DH to get a new GL- guarantee letter from his company’s health insurance since the last one only valid for 2 months. Cant believe I had my lapo that long already- how fast time flies..

I also experience constipation which is getting worse… From some reading that I did this could be the side effect of zoladex. I feel quite worried about this so I’m gonna ask my doc soon (why la I dont have his handphone number yet??) As of now, I’m putting more fibre from fruits and wheat into my diet which eases the ‘process’ remarkably. Sometimes I drink milk just to get the ‘lactose-intolerant’ effect when I know it’s not good for endo diet (but somehow it doesn’t work like it always did before). Let’s just hope that I wont contract any harmful disease now or later..

 

An ode to Nenek

On 9th June 11, Nenek (granny to my husband) passed away peacefully at 11.30am in KL General Hospital due to heart failure. Pls send your prayers to her, al-fatihah..

She was a lovely lady, with a warm smile & heart

She was the reason I feel so welcomed to the family

She lent her ears & understood whenever everybody else didn’t

She didn’t judge like others always mistakenly do

She was a strong woman, when she lost her husband 2 years ago

Now that she’s gone, she’s joining him in the eternal life

I’d pray that we will all be joined again as one big family in heaven

Amin…

Nenek passed away at 75 years old. A mother, a grandmother & a joyful person- she will be dearly remembered by many. It’s pretty sad that she didnt get to live to see her great grandchild, but when I have a baby of my own later, I will surely tell him/her the story about Nenek.. Ya Allah, Engkau cucuri lah rahmat Mu ke atas Allahyarhamah & tempatkan lah dia di kalangan org2 yg beriman & mendapat redhaMu, amin.. 

 

2nd zolly shot

I went to see my doc for 2nd Zoladex injection (2 out of 6) today. Surprisingly not so many ppl were around, maybe due to the school holiday season.. the time for weddings and balik kampung.

The place I'm frequenting within these few months

I had my list of questions ready in my head. As soon as we walked into the Prof’s room and sat down, after the usual intro of the purpose of the visit, which everybody in the room already knows by then, we blurted out the mind-boggling questions

• I still had my period after the 1st shot, why? Prof: yeah, that was expected because during your first shot, u’ve already started your cycle- which was true, I had it on my CD7 (CD=cycle day) so the uterus lining has been formed leading to the menses.. most probably u wont get your next one
• What if I still have my next one? Prof: that is possible, but it’ll be very light, like spotting
• What if it comes out like normal? Prof: we might have to change your medication.. do you experience hot flashes at night? it’s the normal symptom bcos if u do, then it indicated the med is working. Me: yeah, but I think everyone does bcos the weather is just so hot nowadays =P

By this time, I was already headed to the bed where he started to scan my abdomen.. uterus looks fine at normal size (5.45cm long, as far as I could remember), ovaries shrunk due to the med, no cysts visible.. then the time for the shot, I was first injected with what seems to me like a buffer solution- this was quite painful. After that I was given the Zoladex implant, which was not as painful.. and we’re done. Headed to the table again, more questions coming up

• Can you tell from the lapo the other day, for how long have the endo been there? Prof: hmmm…i couldnt tell exactly.. bcos it started small (now he took a pen & drew a small dot).. after many menstrual cycles, the endo couldnt get out, so it became bigger and bigger (while drawing bigger circles around the dot), turning into a cyst, just like yours.. blah3 (questions now more on the images taken during lapo..)
• Is it safe for me to take supplements or herbs like Evening Primsore Oil? Prof: that’s fine.. just dont take too much pati ikan haruan (fish essence) since it can cause overhealing & colloids at the surgery site (alamak, ada jugak minum 3-4 botol haritu betul2 lepas lapo..tapi dah stop dah)
• As I am in my zolly course, how do you determine if the endo has completely gone, apart from the scan, is it possible to do a CA125 test? Prof: Doing a CA125 test during the course will not show the actual result, so it is better to do it after the course (but it wud be good to see the progress, wudnt it?)

Prof scheduled me for my 3rd jab on 30th June (exactly 28 days from now, yay!). He cautioned that after the 3rd one, I might experience joint pain at the knees, like many older menopausal women do.. hmm, maybe I should take calcium or magnesium then? Nak kena study jugak nih.. Thanks doc for entertaining this inquisitive mind!

 

Suprised Aunt Flow visit

So who is this Aunt Flow? (let’s call her AF as most ppl do) It’s the regular monthly visitor for all healthy grown-up ladies- yes, it’s your menstrual period or the red flag.

I’m on my first injection of Zoladex and was told by my doctor that I shouldnt get my period but to my surprise, it still came knocking on my door (well, not literally). Let’s recall how zoladex works- it contains goserelin acetate, which is a type of gonadorelin (LHRH) which controls the release of luteinising hormone (LH) and follicle-stimulating hormone (FSH) by the pituitary gland, and subsequently stops the oestrogen production (talking about chain effect!). In treating endometriosis- a condition where tissue resembling the womb or uterus lining (endometrium) grows in other places in the body, the growth of this tissue is stimulated by oestrogen, so decreasing oestrogen levels with goserelin will stop the growth of this tissue.

One of the side effects, though, is this- Vaginal bleeding. This usually happens in the first month after starting treatment and usually stops on its own. Tell your doctor if the bleeding continues. It doesnt say how long the bleeding usually lasts for but I also read somewhere it should stop spontaneously. It’s not yet a month from my first shot (just 19 days), and about 25 days since my last flow (which is a bit earlier than my usual cycle of 27-30 days).

Tried looking online if others do face the same problem as mine, and I’m quite relieved because there are!

http://patient.cancerconsultants.com/druginserts/Goserelin3_6.pdf says In 5% or less of women treated with ZOLADEX, FSH and LH levels may not be suppressed to follicular phase levels on day 28 post treatment with use of a single 3.6 mg depot injection. In certain individuals, suppression of any of these hormones to such levels may not be achieved with ZOLADEX. Probably its bcos I have yet to get to 28 days post injection, so it’s not fully functional with my body yet.

During the first two months of ZOLADEX use, some women experience vaginal bleeding of variable duration and intensity. In all likelihood, this bleeding represents estrogen withdrawal bleeding, and is expected to stop spontaneously.– ahah, there you are!

…In these two studies, ZOLADEX led to amenorrhea (absence of menstrual period) in 92% and 80% (danazol-treated), respectively, of all treated women within 8 weeks after initial administration.

Will have the 2nd injection on this coming Thursday. I definitely need to ask my doctor about this.

 

Mixed feelings

Yesterday I went back to my in-laws after having lunch at a complex. While on our way, Mama told us a cousin with his wife will be visiting with their 6-month old baby. My initial thought was, how am I supposed to react.. I told hubby about this, but his respond is predictable, not the type I’d like to hear albeit making the most sense- just act normal.

When we reached home, the cousins were already there.. this was the first time we’re meeting them after the baby was born. Upon seeing the cute lil face, my heart melted.. I naturally hold him in my arms and he didnt budge a bit. and i felt happiness at that instance.. happiness that I know will only last for that meeting only.. I could only imagine (for now!) how proud their parents are for having such a beautiful and adorable baby!

Today a good friend of mine in high-school posted a picture of another friend’s wedding. I totally forgot the date and I actually dont want to remember any dates right now, especially the ones involving my school friends because I know there will be lots of babies and preggers around! Not that I dont want to meet them and share the joyful event, but I just dont want it to add to my misery (damn, do i sound bitter already?)

I dont mind meeting those who are close to me. Infact, I am still happy for them- those who just got married and pregnant right away, those already having one and share the experience, those waiting for their 2nd or 3rd baby… they have every right to be happy. but to be around too many of them (and who are not close enough) at the same time is not really the situation I want to be in right now.

I showed hubby another pic that my friend took- 4 of them with very huge bellies as if they will explode anytime soon :p Hubby asked, why look at them? Think of those who are less fortunate than us- who have yet to get married, for instance.. Well, I guess he’s right (although I think that will be a totally different case..) I need to be more thankful which I always tend to forget. Thankful that I have a loving husband who I can share my life with, thankful that we can enjoy lots of time together, just the two of us.. Above all, God is the best planner and I’m sure He will reward us more if we become thankful enough.

“Jika kamu bersyukur maka Aku (Tuhan) akan menambah (nikmat) itu kepada kamu. Dan jika kamu engkar maka sesungguhnya seksa Aku amat pedih.” – (Surah Ibrahim, ayat 7)

 

Life after lapo & during zoladex

It’s been 2weeks+2days since my lapo. I think I’m recovering very well- started driving after one week and now i can practically do my daily chores like normal healthy ppl (though i do feel a slight twinge on the right side when i over stretch it). I dare not do cardiac exercise yet like jogging, afraid that my unseen inside might not heal completely yet.

Physically, my wounds from lapo are completely healed now leaving 2 tiny scars, less than 1cm each. Though barely seen, I’m applying vit E oil with the hope they will completely vanish soon. The one on my belly button is hardly seen- Prof is really true to his words 🙂 the bruises around the cuts n from the zoladex injection (the needle is pretty big) are completely gone, yayy!

I’ve read a lot of -ve side effects from zoladex. But so far, I don’t hav any major problems with it, apart from the hot flashes & sweats- which I think most Malaysians are experiencing now due to extremely hot weather.

This might be a bit embarrassing to share, but I think after my lapo our baby-dancing session is more enjoyable bcos the pain that used to come with it is gone! 😀 (or was it just my imagination?) but one thing for sure, I had my menses one day after my lapo, and there was no more dark blood clots, but only normal red came out (whoops, sorry if it sounds yucky already!) the lapo really did wonders on me. Think its bcos most of the endo cells been zapped off. Thank God, I’m glad i did this lapo..

 

Menopause- temporarily

Before I did my lapo, my doc told me that I could get to ttc naturally within 3 months post-op. I was ecstatic upon hearing this, because if I could get to conceive right away, I will probably have the little bundle of miracle by early next year! Reading on the topic laparoscopy for endo mostly show higher rate of success in conceiving which gives me even more hope.

However, after the surgery when Prof came in to tell me that I was diagnosed with stage 3 endo that I need to take Zoladex for 6 months, I was kinda reluctant. Zoladex is a goserelin which, in treating endo, decreases the oestrogen level that helps growth of endo tissues. So taking it will stop the uterus lining from forming, therefore stopping ovulation as well, or in other words- menopause.

It’s quite funny that someone in her 20’s already goes into menopause, luckily it is temporary…

Administration and dosage of Zoladex

• Zoladex comes as a single dose syringe applicator with 3.6mg depot injection (it slowly releases the drug over four weeks)
• Zoladex is given as a single injection into the abdomen subcutaneously (under the skin) every four weeks
• Zoladex can be started at any time during the monthly cycle and is given for a course of six months maximum
• Zoladex is not suitable for the treatment of children

When Zoladex should not be used (contra-indications)

• Pregnancy
• Lactating women (breast feeding)
• Known hypersensitivity to GnRH Analogues

Precautions in the use of Zoladex

• Zoladex should not be used for more than one course of six months as it can cause loss of bone densit
• Zoladex should be used with caution in women with known metabolic bone disease

Some notes on Zoladex

• Make sure that you are not pregnant before starting treatment. A pregnancy test is advisable.
• Barrier methods of contraception should be used during treatment (until periods restart), as Zoladex is not a contraceptive.
• Periods generally return within two to three months after completion of treatment.
• It is advisable to have one period before trying for pregnancy.
• Some patients have a loss of bone density during treatment with Zoladex. This should be reversed within about six months of the treatment ending. Patients who are underweight, smoke, have a familial history of osteoporosis or are approaching the menopause may wish to assess the risk factors of bone loss.
• Recurrence of symptoms occurs in 40-70% of cases especially with severe disease where endometrial deposits and lesions such as ovarian endometriomas and recto-vaginal nodules occur. Surgical resection of these may be necessary.

My doc didnt give me any contraception pills, is it bcos he’s confident that I will not get pregnant within the course? Well, i dont want to wish I wont get pregnant, but I sure dont want it to affect my pregnancy either!

I’ve calculated the date that I should take the injections, the last one should be in September end (yay, boleh puasa penuh thn ni, insyaAllah). So if my period returns in 2-3 months after the treatment, which will be around November, I can try to conceive in December. Wahhh bersemangat nyer!

Some physicians advocate medical suppression with a GnRH-agonist such as Lupron, Synarel, or Zoladex for up to 6 months after surgery for severe endometriosis before attempting conception. Although at least one published study found this to improve pregnancy rates as compared to surgery alone, other studies have shown it to be of no benefit. This is one of many issues regarding endometriosis that there is not universal agreement about among infertility specialists.

But I really wish I could complete the course earlier.. I’ll ask the doc if maybe I can do a CA125 test each time before I take the injection to make sure my endo is already in subdued state, then I dont have to finish all the course 😉 And this same doc also says that getting preggy is one way to treat endo.. hmmmm camne ni?

 

Mother’s Day stings??

It’s the time of the year again- Mother’s Day. In social network pages, there’s a lot of wishes going around from husbands to wives, sons/daughters to mothers etc. My mom is not the type of person who’s tech-savvy enough to go online, so I just SMS her and called her later in the day to make sure she’s received it. I’m thankful for having her in my life though there are countless times that I’m in disagreement with her.

I’ve read an interesting article from a blog on coping with mother’s day for the infertiles (definition: Not able to conceive after a year of regular intercourse without contraception). Here’s the extraction from it-

Sure, you’re thankful for your mother (unless she’s adding insult to injury by telling you about so-and-so’s new baby), but truthfully, Mother’s Day is just a horrible reminder of what you’re not, what you want so desperately to become and even, perhaps, what you might never become. Strangers will wish you a happy Mother’s Day, oblivious to your heartache hidden behind your silence. But, for someone coping with infertility, every day feels like Mother’s Day, so by the time that one Sunday in May rolls around, it’s like another gallon of salt poured on the wound.

If only Mother’s Day was contained into a single day (you could just sleep through it), but no, instead TV shows, magazines, advertisers spend at least two weeks gearing up for the big day. Segments like “What to get for Mother’s Day,” or “The special mom of the year” seem to make up a large portion of programming. And just when you think you’re coming up for air with a commercial break, advertisers have to scream about their Mother’s Day sales or promotions with images of unattainable motherhood/parenthood. You might try to hide in the darkness and anonymity of a movie theater only to be bombarded by the “Babies” trailer (and no, I’m not creating a link to it). Seriously?! It’s like a conspiracy.

I don’t think there’s a good way to deal with Mother’s Day, but if you are lucky enough to have a loving partner, then make it a date-day and do things that don’t involve families: take a romantic bath together, eat at a fancy restaurant, go see an R rated movie. Also, there isn’t enough that could be said about taking solace in your fellow infertile friends. They understand your isolation and the tragic pain of Mother’s Day, so get together with them — there’s (emotional) strength in numbers.

No matter which way you go on Mother’s Day, I want you to make the day about you and the fragile feelings that need to be sheltered from this Hallmark holiday. After all, Mother’s Day is about showing appreciation for a mother’s hard work, well I say, no one is more committed and hard working than a woman trying to have a baby. So here’s to you my fellow infertiles!

I particularly like the second last statement. Yes, the commitment, hard work & patience of TTC makes us who are in the same boat deserve the appreciation equally as all the other mothers out there.

 

Post-op @ after laparoscopy

I had three plasters on my lower abdomen over the surgery key-holes, one on the belly button, the other 2 were a bit lower, one at each side between the pelvic and pubic bone. The night after the surgery, when I tried to brush my teeth, I think I accidentally ‘leaked’ some liquid medicine from one of the holes. I called the nurse to get the plaster changed, but she was afraid something else might happen so she just put another one on top of it to stop the leakage.

The morning of my discharge, Prof came in again to check on me so I told him about the leakage. He slowly opened the plaster showing the cut that has been done- this one is on the lower left side. It is indeed very small, only about 1cm long & no stitches for that one. Which gave me quite a relief- ooohh, kecik je… Prof then joked about the one on the navel is hardly seen, I could put on the bikini straightaway without ppl noticing the scars! 😀 haha, nasib baik Prof ni dah haji, kalu tak nnt, tak pasal2 kena pandang slack

I was advised to take soft diet, so I had porridge which my mother-in-law brought in for me.. thanks Mama! After paying the bills (for extra charges on the deluxe room- panel only covers single room) and before discharge, I was prescribed with antibiotics (augmentin), pain-killers (arcoxia) and zoladex to be kept in the fridge at home (under 25C) and bring again the next week.