Hand, Foot and Mouth Disease

This is totally unrelated to my fertility journey but an experienced that I have along the way which I find that majority of us did not know about. From the previous post, I have mentioned that I had the Hand, Foot and Mouth Disease (HFMD) when I went to the hospital to remove my stitches.

To begin with, I had fever, cold and a really bad sore throats where I can see ulcers surrounding my tonsils. That happened around 21st to 22nd August 2018 and I went to my nearest government hospital for treatment. At that point in time, the doctor confirmed my symptoms to be viral infections. So, I took the medication to treat the infections and by 23rd August, my throat was not hurting anymore. On the very same day when I woke up, I noticed red spots similar to eczema from my neck till my décolleté. It was itchy and bumpy which I thought was my eczema reactions as I do have eczema. So, I had antihistamine and put on my medicated ointment that I used for my eczema before I head to the hospital. 

As I arrived in the hospital, I just felt that my lips and face started to have the tingling sensation and I felt rather itchy all over my body. I thought probably my viral infection was not completely healed and so I just wait patiently for my turn to remove the stitches. When the nurse was cleaning and removing the stitches for me, the nurse asked me whether I am sensitive to something because my whole belly were full of red spots. I knew at that time something was not right because eczema usually do not react in this way. After the consultation, I rush to the toilet and check on my body and I saw how it turns out to be worse than I thought. The red spots spread from my cheeks, neck, chest, body, back and even my hands. I told my husband that I think I need to see a doctor. 

We arrived at the KPJ Hospital in Damansara Kim. A nurse did an initial checks on me and the first thing that he asked me was to show him my hands and my bottom of my foots. I knew at that time what they were trying to conclude as I heard of HFMD breakout recently among kids. However, I was still shocked to see the bottom of my feets had the red spots too! I felt trypophobic and really uncomfortable. The nurse said that based on the initial symptoms, most likely I had HFMD. A question that pops up in my mind at that time where also, I get a lot of questions as well after that, was "I thought HFMD is for children or babies? I am at my 30s and I have HFMD?!"

So, here is the answer for everyone who still have the notion that HFMD is for children only:

Adult can also get HFMD although it is most commonly in children or infants. 

I was too skeptical at that point because I thought it could just be the usual chicken pox which I already have it in my early years or I could have dengue but I do not have any body ache whatsoever. When the doctor finally attend to me after an hour, I took a blood test just to confirm although she seems to have conclude the whole HFMD symptoms by looking at me. The blood test took probably 2 hours or more and I felt tormented. The doctor interpret the results with a vague explanation and she just said that some kind of protein level is abnormal and so that concludes I might have HFMD.

Below shows a brief explanations on HFMD based on my research and if you just need a quick understanding of it:

WHAT YOU NEED TO KNOW ABOUT HFMD?

• HFMD is a combination of various viruses which I will not have any idea what they are called since I am not a medical person. Just say that the viruses that causes the same skin illness like chicken pox, hives, measles and dermatitis. So, a different combination of the viruses can lead to HFMD.
• While it is common for children and infants, adult can get it too. I find that many people have the misconceptions on who can gets HFMD and I got a lot of questions on this. So, the reason that it is most common in young children and infants was due to the fact that the immune system was not developed completely to fight against such viruses. In my case, I can probably said that I had it because of my low immune system from post-surgery and also due to my long term hypersensitive skin that I had all these time. Also, probably I have contacted with a kid who happened to carry those viruses. 
• HFMD is contagious illness. Hence, I found that there are cases where the babies had HFMD and the mother can get it too. Therefore, not just the kindergarten or day care has to close down for disinfectant but the mother would need to be quarantined or separated from other kids as well. It is really not easy!
• HFMD in adult is worse than children/infants. This is true and my take on this is that adult body has exposed to various contamination, bacteria or virus, and takes longer time to heal with a larger body frames.
• There is no cure to HFMD but only prevention. In that case, there is no medication to treat HFMD. However, you can prevent this by ensuring that you and the kids wash your hands occasionally and just keep everything clean. 

WHAT CAN YOU DO IF YOU HAVE HFMD?

(Disclaimer: I am not a medical practitioner or have any knowledge to any medical conduct. Hence, this is just based on my experience and the method that I used to overcome HFMD. There can be other ways you may come across from other sources and that is fine for you to experiment and see what's work for you. You should consult your doctor whenever possible.)

• Food to avoid : Seafood, soy sauce, sweet sauce, oyster sauce, spices, chicken, eggs, dairies, duck. Basically avoid high in toxicity food as what Chinese believe. 
• Food to take : Vegetables, fish, pork, lamb, rice, anything cold like ice cream that will allow you to swallow easily, avocado, oats. 
• Apply calamine lotion if your rashes are watery similar to a blister. Mine was not watery but itchy, so I stopped using calamine lotion because it is too drying after some time. 
• Avoid exercise or movement that causes perspiration as it will agitate the rashes even more. Short walk around the house will be sufficient.
• Avoid scratching the rashes.
• Wear house slippers to walk easily. I used the hotel slippers which I have gotten during my trips.
• Separate all your cutlery with others as your saliva is contagious.
• Use anti-bacterial wipes as often as possible to ensure good hygiene.
• Quarantined / limit mobility to avoid spreading the viruses to others or expose to other viruses. Let your day care, schools, workplace or housemates aware of your illness to ensure they disinfect the place and create awareness.
• Ensure cool and dry air in the room and wear comfy clothing that will not causes scratch or itchiness to your skin. Try using humidifier. Try not to wrapped your body and ensure there is air circulation for your skin.
• Shower at least twice a day using mild soap or soap for sensitive skin. In my case, I use Pentarsol. 
• Soak your body with Neem leaves. This is a remedy that I was told by my aunt where people bathe with this leaf when they have chicken pox. So, I just tried and it does help to relieve the itchiness. I use a large pail that can fit my body and let the Neem leaves (tear the leaves into pieces) soak in the water. I put a few drops of tea tree oil as well before using it to wipe all over my affected area including my face. It is advise to pound the leaves and just apply the juice, but I find that it is too hassle to do it. 
• Gargle with salt water as often as possible.
• Drink plenty of water to keep hydrated!
• Get a lot of rest and sleep as it helps the itchiness and increase your immune system.
• The only supplement I take was Vitamin C just to boost my antibody.

I did not take any medicine at all throughout the time. Below shows the progress. Note that you might find the image disturbing as it looks like I am an alien. I cried on the next day of my hospital visit because I couldn't recognized myself in the mirror. My face were swollen and my lips were huge. I was terrified. 

This was taken a day after I got HFMD and using the all the method above. Please don't mind the blood stain on my belly button as that is from the stitch removal. :

Some progression on Day 3 as my face was no longer swollen and rashes were almost gone on my face. The rashes started to turn flat and less reddish :

This was Day 5 and the rashes has gone lighter but it's still there. I still religiously use Neem leaves and maintain the diet that I have mentioned above.

After 3 weeks, the rashes were almost gone but the affected areas starts to dry and skins were peeling off my legs and hands like snake skins.

Today which is slightly more than a month from the day I had HFMD, everything seems to be back to normal. No more peeling of the skins. It took so much longer than I thought. I read from the website that usually it will take 7-10 days to fully recovered but in my case, I think it took me 21 days to truly see the rashes subside but not until 1 month that I see the skin's peeling off.

I hope this is informative and could help those who get HFMD. I truly hope that none of us would have to endure this underrated but common disease. But if you do, do not panic and do not worry about it. It will go away slowly but surely. Always remember that prevention is possible : be aware of the surroundings and ensure good hygiene. 

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- K a t e -

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Journey on PCOS #3 : Laparoscopic Ovarian Drilling

What is Laparoscopic Ovarian Drilling? - In layman's term, it is a surgery where the membranes surrounding your ovaries are being punctured with several tiny holes. Usually this technique helps trigger ovulation for women with PCOS.

By the name itself, it does sound rather painful but it is not that bad as compared to other surgeries. Most of the time you are put under anesthesia and so you won't feel anything during the whole procedure.

During the day where I've made decision to undergo this surgery, the doctor and nurses would brief on the Do's and Don't for the surgery. Like most of the other surgeries out there, fasting is required before performing this surgery. P/S: If you are a first timer who undergo surgery like myself, I would suggest to make a note when the doctor explained how to go about the whole pre-surgery requirements because I were not prepared. The explanation went too quickly and when I got back home, I have forgotten most part of it.

A few weeks prior to the surgery, I had to induce my period and the doctor will scheduled the appropriate date to conduct the surgery. After that, you will need to fast for few hours (depending on your surgery schedule which the nurse would have informed you by then) before the surgery.

If this is your first time and wondering what to bring along, here are some of the items which I have packed:

• Water Flask - you would need to keep your body warm and try not to take cold or too hot water.
• Sweaters/Jackets - to keep you warm.
• Extra loose clothings & Comfortable undergarments - *optional* depending on whether you will want to stay a night in the hospital. Initially, I was told that this surgery do not need to be warded but I ended up to stay a night in the hospital due the pain and fever that I had after the surgery. Loose clothing including undergarment is preferable because you can't put pressure on the wounds. I suggest bringing an oversize but wearable underwear. Reason being is explained under 'Sanitary Pads' below. 
• Lip Balm - to keep your lips hydrated.
• Sandals - wear something comfortable to walk around, preferably slip-on type as you may not be able to squat after the surgery.
• Toothpaste and toothbrush - in case you want to feel refresh before discharged the next day.
• Sanitary Pads - *IMPORTANT to know but optional* This is quite important in my opinion if you are trying to safe some cost as the hospital where I were in will charged for sanitary pads, not by pieces but they will provide whole box of maternity pads. Post surgery, the nurse will put the maternity pad (first piece is FREE) for you which is really thick but smooth and unlike normal sanitary pads which have adhesive. Unfortunately, you will need to use your thigh to hold on to it as you will not be wearing underwear during and after surgery. Using your imagination, you can sort of understand why it is important to use your own sanitary pad (must be high absorption for large volume of liquids) and have an oversize underwear in order to help you hold the sanitary pads instead of your thigh gaps. However, I managed to go to the toilet and move about with the maternity pads, so this is entirely up to you whether you want to use your own sanitary pads. 

My surgery commenced at 2.55pm on Aug 12, 2018 and completed in about 1.5 hours. By the time I woke up, I was shivering so badly because of the anesthesia. It was really cold and the nurse provided few layers of blanket for me. It does help a little bit but I were in this condition for few hours before it starts to subside. 

 *the surgery was bearable but inserting this needles was really painful*

I were having fever on and off after the surgery, probably I am not used to it and my body is just weak at that time. I was given painkiller that is Paracetamol occasionally till my fever subside the next morning. There will be blood discharged similar to having period and that is why a maternity pad was given and I have mentioned the reason why you should have your own trusted sanitary pad readied (as mentioned above). The pain I would described as similar to a menstrual pain or cramps. To be honest, I am not sure how period cramps can differs from each individual but I believe that is the pain that I am getting. It is still bearable in my opinion. 

The surgery will leave small incisions in 3 areas i.e your belly button, left or right  and bottom of your belly. Basically they insert the camera in one of the incisions, a laser in another incision, and a tool to cool the wound made by the laser in the final incision. Post surgery, you will be able to see a video of the holes made on the ovaries and the doctor will explained if there is any Fallopian tube blockage or any complications arise. Below shows the look of it with waterproof gauze pad after I have discharged from hospital and back to my home sweet home. You can literally shower with it and do not put pressure on it! 

After about 1 or 2 weeks, I got my stitches removed and on the same day, I developed Hand, Foot, and Mouth Disease (HFMD). Now, I do not know if this is due to the surgery or coincidentally I encountered the virus somewhere, but it happened right on the day I removed my stitches. It was really terrible and I will talk more about HFMD for adult in the next post. The incisions made were not that bad and after a months now, I barely can see any scars in my belly button but there were scarring on the other two. I still continuously apply bio-oil and hopefully, the scars can be reduced. 

In short, you really needs to take care of the hygiene, diet and rest a lot post surgery because your body is most likely stressed out from the surgery and immune system will tend to be poor after that. I have hypersensitivity and I do think that this might be a caused for my slow recovery, contrary to what I have read from the internet of those who undergo ovarian drilling.

I hope whoever reading this will find it useful and give a better view of what you will be expecting if you were to do ovarian drilling. Good Luck and feel free to drop me an email or comment if you have any questions.

. . . 

- k a t e - 

*Updates as of 19 September 2018*

My period came after a month since the surgery without inducing with any medication. I am excited and looking forward to monitoring my ovulation. Wish me luck!

Journey on PCOS #2 : Medication Works?

I started my first medication i.e Clomid as per advice from the doctor. This medicine will help with ovulation and for some people, this works well! I returned back to see the doctor about a week after I have completed the medication or after my period has ended (as mentioned previously, the medication needs to be taken simultaneously when the period happened).

I had a mixed feelings while waiting for my turn in the facility. The various thoughts of 'What-If' were lingering in my mind as I planned what should I do next if this doesn't work. Yet, I tried to think positively and that led me to unnecessary elation. As I heard my name, my heartbeat just stopped; I was nervous. As my husband and I sat down, doctor look through the report and then proceed with the ultrasound to look at the ovary. To my disappointment, the doctor said that the medication does not seems to help since I am not ovulating. The eggs were there in the ovary but not maturing.

As we discussed together with the doctor on what are the options again, it took us awhile to think about what do we want to do. Doctor suggested that we try the medicine again but this time with higher dosage. Since I am not ready for IVF or any other surgery, I decided to try again with the medication. The medicine remained as Clomid but was told to take 2 tablets per day instead of 1.

So, the cycle repeated for another month as I patiently look forward to my period through consuming Microgynon. So far, I continued with Metformin while taking other drugs as the doctor said it is fine to continue with Metformin where it helps for PCOS patient. I do noticed an abrupt weight gain but I was not sure if this is the caused of drugs or because I am eating a lot. I felt like I went through mood swing and mentally depressed at some point. I am still not sure if this is the effect of hormonal medication or the emotional challenge due to the constant waiting and anticipation of another disappointment. Does anyone have the same issue as mine?

Putting that emotion aside, the time gone by swiftly and we had another appointment to see if it works this time. On June 9, 2018, we went through the usual procedure again and enduring the long wait for your name to be called. The result remained the same and I felt disappointed again. At this point, I really think that there is nothing much that can be done to my ovulation - Is just useless! The doctor convinced that this is normal and it happens to some patients too. Once again, we need to think about what to do next and I started to really get tired of all these. Fair enough, the doctor mentioned that some patients do choose to go right into IVF because they do not want to take anymore medication and just keep waiting. At that point, we spoke about the cost of IVF and it is really costly for me. While at that time I was considering the Ovarian Drilling, I told my husband that I was afraid to drill anything into my body. I have not had any surgery before so, the thoughts of surgery left me with cold feet. At that very moment, Dr.Tan suggested if we want to try another medication which is like Clomid but again some people responds to it. Without hesitation, I agreed to go on one more round of medication. This time I am taking Femara. I look it up on the internet and notice that Femara usually provide higher chances of ovulation for those who do not respond to Clomid. It sounds promising to me but I have learnt not to have high hopes at this early stage.

I do not notice any different while taking Femara as compared to Clomid. Everything as per usual and yes, I still have some challenged emotionally. I am grateful that my husband being really patience during these period and always supporting me when I had a breakdown.

Another 3 weeks passed by and we are back again in the fertility center. I was hoping that this time might yield some good news since I have such a positive vibe on that day. Unfortunately, it remained the same result, but, I was not disappointed but rather feeling numb to the conclusion. I have thought about what next if this 3rd round of medication does not work prior to this appointment. I knew I will want to go through Ovarian Drilling. I have read many articles on the website to see other people feedback on this surgery. Also, Dr.Tan has been explaining to us how this work. Another method that the doctor suggest is Intrauterine Insemination (IUI) which is placing the sperm inside a woman's uterus to facilitate fertilization. However, the chances of getting pregnancy is really low - probably 30% - 40%, while Ovarian Drilling is about 60% and IVF about 80% - 90%. With that rating, I decided to go for the drilling based on the fact that this surgery is rather safe and will only take 1 hour, some patients even can discharged on the same day! Also, the cost of this surgery is around RM 10k which is rather standard in my opinion.

So, the preparation to go on this surgery begin.

To be continued...

. . . 

- k a t e - 

Journey on PCOS #1 : Discovering Infertility & First Treatment

If you have read the "About the Author" post which essentially the first post in this blog, you will know that I sort of have the idea that someday I will have difficulties when it comes to having a baby due to my irregular menstrual. 

Once I got married, my husband and I have decided to plan on getting a baby. As usual, we just tried and let it be since we are not in a hurry. As we approached 6 months since our marriage and I realized that my menstrual did not happened for a long time, I was worried. At first, I went to the ParkCity Medical Centre to check on my menstrual condition as I am afraid that I have early menopause. The doctor "suspected" that I have PCOS but he dare not conclude for sure since he said that he can only assume based on what he can see from the scan. Also, he mentioned that I do not looks like a person that has PCOS - there were no symptoms such as diabetes, weight gain, acne, and etc. He prescribed me with Metformin at that time and said that I should continue taking it till I have a baby since usually this drugs/supplement can help to regulate menstrual and control PCOS. I took it religiously for 1 months but nothing much happened. 

So, we decided to reach out to a fertility specialist just to get a second opinion and to confirm on whether I do really have PCOS. By referring to various friend's recommendations, we were convinced to go with Alpha Fertility Centre located in Kota Damansara. It was not the usual hospital or big building to be, but they are highly acclaimed as it is always overwhelmed with humans. Hence, we made the appointment and settled with the appointed doctor - Dr. Tan. We were told Dr. Collin is the prime doctor that people go for but his schedule is usually full. P/S: Probably, you will need 3 months in advance to book for his consultation. When you make the appointment, the administrator will ask some questions in regards to your last menstrual or last intercourse, etc. This is important for them to provide you the timeline to clear the sperms to ensure that when they run the test on that day, the results are accurate. 

On 13 April 2018, we had our first consultation with Dr. Tan. Although we had our appointment set in advanced, the typical waiting time was 1-2 hours. The misery of waiting was real. I suggest that you choose weekdays rather than weekends if you are impatient. However, I find that weekdays can sometimes make no different. The best thing is, get yourself equipped with some entertainments and snacks while waiting for your turn.

During the consultation, we provided every details of information to the doctor and really make use of the time to ask anything that we needed. Then, he performed pap smear on me to analyze my ovary to confirm on whether I have PCOS. As a result, the doctor explained to me on how to interpret the screen and why he concluded that I have PCOS. The next step was to decide what to do with it and typically, below are the options available similar to what you may find in Google:

1) Medication to trigger ovulation
2) Ovarian Drilling
3) In Vitro Fertilization (IVF)
4) Intrauterine Insemination (IUI)

Dr.Tan explained each and every treatment to help us better understand what are the side effects (if any), the cost of the procedure and his opinion based on our situation. Indubitably, we decided to start with medication. He prescribed us a medicine called Clomid and a medicine to induce my menstrual. There will be a timeline on when to take the medication, estimated date that the period will come, and when is the next appointment for follicle checks to see the respond. The next appointment should technically be around 5-7 days after your last day of period to ensure conducive consultation. P/S: In case the admin mentioned that any day will be fine for a consultation while you are on this medication, please ask her politely to check with the doctor and to confirm. This happened to us once and we ended up getting there too early to even see anything. It was complete waste of time and money!

I would prefer to try medication first if you have not and if you have the patient to wait for the possibility of getting pregnant. This is because it is more economical, is a 50/50 chance and if it works, you will just need to focus on timing. However, it is completely up to you based on your condition, not just PCOS but your financial, health condition, age and etc. I do know someone who has PCOS and taken only Metformin and Clomid, and within few months, they got a son. I have heard that some women ended up giving up on medication because it is too time consuming and they change their mind to go right into IVF. So, you have to decide what treatment you are deemed to be more comfortable with. In my case, I would prefer a "natural" pregnancy in the sense that I do not need to extract or combining anything to create a life. Also, IVF and other options leaning to more expensive procedure.

To be continued ...

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- k a t e - 

About the Author

The Present :

My name is Kate and I am from Malaysia. At the point of this post, I am in my 30s this year and married to a loving husband a year ago. When I was younger, the thought of having a family or a child has never been part of importance. However, life can be such an introspective thing and one day, I find myself drawn to the laughter of every kids that I see. It was then, I knew I wanted a child and I discussed with my husband on whether we are ready to have a family of our own. It was a guileless answer and we start our planning.

The Past :

Most people might think that I have plenty of time to conceive as I am only at my 30's and still in a honeymoon stage. First of all, I'm not desperate but rather I knew my irregular menstrual* will have an impact to my fertility. *I am talking about having menstrual once in 4 months since I was 14 years old and aggravated when I was 28 years old where I have only twice in a year. I'm not too bothered to understand the significance of this when I was younger as I do not have period cramp, I have difficult time understanding all these menstrual cycle theory in the science class, and I save on money to have had to buy sanitary pads. I bet this make it sound envious for the normal ladies but I think this is an issue that I hope more women out there understand and take precaution of such cycles. To begin with, I am always a heavier and short person. I work really hard and often stress is my adrenaline to get things done. I do not believe that stress is bad as I think there is good stress; but, more often than not, doctors, friends or families associate irregular menstrual with stress. Perhaps, that is true but again I ignored as I could not find a reason to get any treatment or understand about what is wrong with having irregular menstrual. To me, it's just normal, until now...

Diagnosis:

After about 6 months of trying to conceive and nothing happened, we received a recommendation from our relative to refer to a fertility specialist. Before that, I did went to another general hospital to have pap smear test as I have not had menstrual for the past 5 months. That was the second time in my life where I was told that I might be having Polycystic Ovary Syndrome (PCOS). The first time was when I visited a gynecologist whom I thought were so exorbitantly priced - I ignored.  So, we made that appointment and to summarize it all, for the third time I was told that I have PCOS. This time, this doctor was firmed on this. PCOS is typically a common caused of infertility. If I can use the definition found from google, PCOS is when the hormonal imbalance interferes with the growth and release of eggs from the ovaries (ovulation). To put it simply, if you don't ovulate, you can't get pregnant , or , if you do not have regular menstrual, it means you do not ovulate and so, the chances of you getting pregnant is lower. As far as I know, PCOS is treatable and I do think that if I would have known or aware of this when I was way younger, I could have avoided the treatment that I have gone through now.

Purpose:

I am not an expert per se and not a doctor, whatsoever. I am merely sharing my experience and to allow people who also has similar situation as I am, have better understanding of what I chose to do to battle PCOS. Now, there are no absolute reason on why one can have PCOS. It can be caused by genetic, unbalance diet, and etc, but I was told by my doctor that globally, there is no one caused for PCOS but there are many ways to get it treated now due to the improved technology, better healthcare research and discovery. However, it can't be cured. I decided to start a blog as I realized there is so few people in Asia who talks about PCOS. I had spend an immense amount of time trying to read about PCOS from people in the Western countries where the healthcare system can be quite different from mine. I have no idea of what to do but I just keep researching and had regular consultation with the fertility specialist. One day, I stumbled upon a local public figure through Instagram and I saw her post about PCOS. She even had a youtube video about her having PCOS. I was really happy that finally someone talks about it. Perhaps, many people talks about it but it just wasn't enough. There is one sentence that she said which really resonates to me, it goes something like this :

"Maybe I have not thought about having a kid, but when one day you want to have one, and you realize that your body is going to be a place for a LIFE, it is scary when you have PCOS". - Linora Low -

I read those comment and that is when I realized there are women out there who wish to find some answers to PCOS but not many of them obtain a respond. That is when, I decided to create this blog. It may not help much but I hope someone might find it useful. This is really just a beginning for me and I hope to share my journey with those of you who had PCOS. Be patient and stay strong! We can get through this together.

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- k a t e -