I went to the office this morning - to settle the LNPT, MC, and to claim the Ellaroo..

Everybody in the office was so concern on what had happen to me. They wondered why I have to face all the hassle and gone for the chemo treatment. I just replied – it’s the medical procedures.

When I was diagnosed with this illness, I was so sad – to lose the baby and to know its an abnormal pregnancy, however there’s people came and approached me that by having molar pregnancy is not the end of your fertility. Some shares stories about their relative – having molar and continue to get pregnant 6 months later, and also this lady said to me she used to have molar pregnancy and continue to have normal baby 8 months later. Then, when I asked them about the blood monitoring and beta-HCG, they seems to be unaware.

So, what if I just run from my chemo treatment?
Not turning up for my blood routine check-up?
Ignore all the medical reports and just get pregnant?
What will happen then?

I found this answer:
Molar pregnancies and their management is the easy part. The problem is when they are ignored, not followed adequately, or inadequately treated, because then major problems occur. If a previous pregnancy ended in a miscarriage and there was no pathologic specimen it may have been an unknown molar pregnancy. If the last pregnancy was a normal term pregnancy and delivery, then nobody would be expecting choriocarcinoma to develop. But it can and it is usually not diagnosed promptly. It can be anywhere in the body and is a very aggressive cancer. It metastasizes widely and early. It is very invasive and destroys the tissue. It bleeds profusely. If it is in the brain then signs of a stroke or seizure may occur; if in the lung then the patient may cough up blood; if in the uterus then irregular bleeding.

Hidup dan Mati itu di tangan Tuhan. Tapi dalam keadaan ini, kita diberi pilihan – memilih untuk hidup atau sebaliknya..

Since my chemo course is like a day on and a day off, I was given a choice whether to keep the IV for next chemo or set up a new IV for each chemo session. I chose to keep it – sebab each time nak pasang adalah sakit sangat kena cucuk and now I have like more than 5 tusukan IV di tangan – 1 during giving birth to Zahra, 1 during my first DnC, 2 during my second DnC (nurse tak jumpa vein so kena cucuk 2 kali), 1 during my first chemo session, and now another one for the third chemo session = Total 6 IV shots (arghhh…)

Tu tak kira ngan tangan lebam-lebam sebab kena amik darah for beta-HCG monitoring. Even though, I’m not phobia having needles here and there in my body, but somehow, kalo dah banyak kali macam ni jadi boring jugak – mual.. bila la nak sudah ni..

But satu je cons nyer: Nak amik wuduq tu jenuh la skit.. But apapun, Solat Itu Wajib :-)

Sapaan seorang teman – Wah, bersemangat sungguh.. Siap buat blog lagi..

Hehehehe..

The idea of making a blog specifically for my excursion with molar pregnancy came out when I was browsing any information related to molar and chemo in the net. I came across molar pregnancy support group – www.molarpregnancy.co.uk. But I was actually hoping to get real life experiences from people suffered with this illness - however I managed to find none from local but one from Canada; and I was so inspired by her – http://chantelle-blog.blogspot.com.

Her writing has lead me to all information regarding molar pregnancy and the chemo processes – how was the chemo procedure, the side effects, bleeding matter, beta-HCG patterns and such and I hope by writing my own experience I can help those mother out there who undergo the same condition as me.

And I also wish that my story will be end like hers. Aminn…

Sejujurnya, aku menulis bukan untuk menunjuk-nunjuk apatah lagi menagih simpati. :-)

Today was my 3rd day chemo session. I arrived at PPUM at 8.30am, and reaching Ward 10U, mostly everybody (who know me – the Dr, Nurses, other patients, cleaner) greeted me. The ward community was so warm.

----

Staying in the hospital for few days give me a new perspective. I used to work in a hospital but working and staying as a patient is vast different.

I met a few patients which their cases are much more serious than me – one having an ovarian cancer as young as 14 years old, my roommate having cervical cancer few years back and now its seems to coming back, and this one untie who’s been staying in there for three months due to vaginal cancer.

Drs and nurses are also quite helpful. This one Dr, a HO to be exact, pity her sebab asik kena marah je ngan senior Dr. And this very young nurse, baru je masuk keja was so paranoid, wearing double of gloves and mask and what so ever protection she can wear to protect herself from the chemical used for chemo – muda lagi saya ni kak, tak kawin lagi.. hehheheh.. And a Medical student who came to interview me told me that she regretted chosing the path – long working hour and high commitment.. heheheh – macam-macam kan..

Apa pun, having to stay in Ward 10U PPUM for 3 days was an experienced for a life times. Thanks all for being very helpful and generous.

Kalo kita rasa kita ni sakit, ada orang lagi sakit dari kita – Muhasabah diri part III.

KEHAMILAN MOLAR

PENDAHULUAN

Kanser anggur ataupun di dalam istilah perubatan dinamakan Koriokarsinoma (”Choriocarcinoma”) adalah sejenis kanser yang jarang berlaku tetapi ianya boleh dirawat dengan rawatan kemoterapi. Kanser anggur adalah salah satu spektrum di dalam penyakit yang dikategorikan sebagai ”Gestational Trophoblastic Diseases (GTD)”. ”Gestational” adalah istilah perubatan yang bermaksud kehamilan manakala ”Trophoblast” adalah merujuk kepada uri ataupun plasenta. Dengan perkataan lain, penyakit GTD ini adalah penyakit yang mempunyai kaitan yang rapat dengan ketumbuhan yang terhasil dari proses kehamilan yang tidak normal melibatkan uri ataupun plasenta.


GTD boleh dibahagikan kepada beberapa jenis dan 4 kategori yang utama adalah :

1. Kehamilan Molar/Anggur

2. Invasif mol (”invasive mole”)

3. ”Placenta site throphoblastic tumour”

4. Koriokarsinoma (Choriocarcinoma)



Jenis pertama iaitu kehamilan Molar/Anggur adalah yang paling kerap berlaku tetapi ianya bukan kanser dan hampir semua pesakit akan dapat dipulihkan sepenuhnya dengan rawatan. Manakala jenis 2 hingga ke 4 merupakan kanser yang memerlukan rawatan seperti mana rawatan-rawatan kanser yang lain.


KEHAMILAN MOLAR/ANGGUR


Perkataan anggur digunakan kerana rupa bentuk ketumbuhan yang dihasilkan oleh persenyawaan yang tidak normal ini menyerupai buah anggur.

Istilah yang lebih tepat untuk jenis kehamilan ini adalah kehamilan molar (”molar pregnancy”) jadi untuk keterangan selanjutnya istilah kehamilan molar akan digunakan sebagai ganti kehamilan anggur.

Kehamilan molar tidak dikategorikan sebagai kanser dan punca kejadian kehamilan molar ini adalah disebabkan oleh kelainan yang berlaku semasa proses persenyawaan di antara sperma (benih lelaki) dan ovum (benih wanita). Akibat dari persenyawaan yang tidak normal ini maka terbentuklah kehamilan molar.


Kita tahu bahawa persenyawaan benih lelaki dan wanita akan menghasilkan embrio dan embrio ini akan dibawa melalui tiub falopian dan bergerak ke arah dinding rahim. Seterusnya embrio akan melekat pada selaput dinding rahim dan akan membesar menjadi bayi atau janin di dalam kandungan. Walau bagaimanapun di dalam kes kehamilan molar, tidak terjadi janin tetapi digantikan oleh ketumbuhan yang berbentuk seperti gugusan anggur ataupun kelihatan seperti buih ataupun sista-sista kecil.

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KANSER ANGGUR ATAU KORIOKARSINOMA (”CHORIOCARCINOMA”)

Istilah koriokarsinoma adalah istilah yang lebih tepat digunakan untuk kanser jenis ini, ”korio” adalah istilah yang diambil dari vili korionik (”chorionic villi”) iaitu salah satu komponen uri manusia. Istilah karsinoma pula merujuk kepada kanser yang berasal dal sel-sel epitelial. Disebabkan kanser ini mempunyai atau berasal dari salah satu komponen uri atau plasenta maka salah satu ciri khusus kanser ini adalah ia boleh menghasilkan hormon HCG (”Human Chorionic Gonadotrophin”) yang sangat tinggi malah lebih tinggi daripada wanita-wanita yang hamil. Penyakit koriokarsinoma boleh berlaku kepada sesiapa yang pernah hamil termasuk kepada wanita-wanita yang pernah mengalami kehamilan molar. Tidak seperti kehamilan molar, koriokarsinoma boleh berlaku di mana-mana organ badan seperti hati, limpa, paru-paru, tulang belakang dan otak. Koriokarsinoma boleh juga terjadi di dinding rahim. Koriokarsinoma adalah sejenis kanser yang agresif tetapi sangat sensitif kepada ubat kemoterapi menjadikannya salah satu kanser yang boleh sembuh sepenuhnya. Koriokarsinoma boleh merupakan salah satu komplikasi jangkapanjang kehamilan molar. Walau bagaimanapun kemungkinan berlakunya komplikasi ini adalah sangat kecil di mana cuma 2-3 peratus sahaja kes koriokarsinoma berlaku selepas kehamilan molar.


Koriokarsinoma boleh berlaku bila-bila masa dari beberapa bulan sehingga beberapa tahun selepas sebarang kehamilan samada kehamilan normal, keguguran ataupun kehamilan luar rahim. Koriokarsinoma yang berlaku beberapa tahun selepas kehamilan normal dikatakan jenis yang paling agresif.


TANDA-TANDA DAN GEJALA-GEJALA KORIOKARSINOMA


Memandangkan koriokarsinoma boleh berlaku di mana-mana sahaja organ badan maka pesakit yang menghidap kanser jenis ini boleh mengalami berbagai-bagai tanda dan gejala.

Berikut adalah di antara gejala-gejala dan tanda-tanda yang mungkin dialami oleh pesakit koriokarsinoma:

a. Batuk berdarah dan sesak nafas

b. Sakit kepala dan lumpuh sebelah badan

c. Sakit tulang belakang

d. Ketumbuhan dan perdarahan di bahagian faraj.

e. Bengkak perut dan kuning mata

f. Hilang selera makan dan turun berat badan


Faktor yang paling penting yang memastikan pesakit ini menghidap koriokarsinoma adalah kandungan hormon HCG (”Human Chorionic Gonadotrophin”) di dalam badan mereka. Jadi ujian darah bagi mengukur hormon HCG ini adalah satu kemestian jika sekiranya doktor mengesyaki koriokarsinoma.

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RAWATAN KEMOTERAPI


MEMAHAMI KEMOTERAPI


Salah satu kaedah rawatan kanser yang sering diberikan kepada pengidap kanser adalah ubat kemoterapi. Kemoterapi tidak dapat tidak akan mengubah kehidupan anda. Disamping mengalami perubahan dari segi penampilan fizikal dan emosi, anda mungkin juga akan merasa sukar untuk bercakap mengenai apa yang anda rasa kepada orang lain. Dengan memahami bagaimana kemoterapi bertindak ke atas sel-sel yang normal dan tidak normal dalam diri anda, diharap anda akan lebih tabah dalam menghadapi sebarang kesan sampingan yang dialami sepanjang dalam rawatan ini. Apa yang penting adalah anda perlu sentiasa berfikiran positif di dalam menjalani rawatan kemoterapi ini.


APAKAH ITU KEMOTERAPI


Kemoterapi ialah rawatan yang menggunakan ubat-ubatan yang khusus untuk merawat sesuatu penyakit kanser. Di sini, kemoterapi merujuk kepada penggunaan ubat-ubatan khusus untuk melawan dan memusnahkan sel-sel kanser yang sedang merebak dengan cepat dalam badan anda. Ubat ini akan memasuki sistem pengaliran darah anda dan pergi ke seluruh badan untuk membunuh sel-sel kanser yang tidak dapat di buang melalui pembedahan atau di musnahkan oleh rawatan radioterapi. Bila lebih dari satu jenis ubat digunakan, ia dipanggil kemoterapi kombinasi.


BAGAIMANA KEMOTERAPI BERTINDAK


Terdapat banyak jenis ubat kemoterapi yang digunakan untuk merawat kanser. Ubat kemoterapi sebenarnya banyak yang dihasilkan dari tumbuh-tumbuhan seperti contohnya ubat Paclitaxel yang digunakan untuk merawat banyak jenis kanser. Ubat kemoterapi ini dihasilkan dari kulit pokok yew. Terdapat beberapa kategori ubat kemoterapi yang mempunyai perbezaan dari segi bagaimana ubat-ubat ini mematikan sel-sel kanser. Secara amnya semua ubat-ubat kemoterapi mematikan sel-sel kanser dengan cara bertindak mengganggu atau merencat proses pembiakan sel-sel kanser. Ini dilakukan dengan cara merosakkan DNA ataupun baka sel-sel kanser melalui berbagai-bagai kaedah seperti mengikat (“cross-linking”) ataupun memotong DNA tersebut. Akibat kerosakan DNA ini maka sel-sel kanser ini akan mati. Ubat kemoterapi lebih berkesan terhadap sel-sel kanser yang cepat membiak. Kadangkala ubat ini tidak dapat membezakan di antara sel-sel kanser dan sel-sel normal yang juga cepat membiak seperti sel-sel dinding usus, mulut, organ reproduktif terutamanya ovari, sel-sel rambut dan juga sel-sel sum-sum tulang. Sel-sel ini mungkin terdedah kepada kesan ubat kemoterapi walau bagaimanapun dengan kaedah rawatan yang terancang dan teliti oleh Pakar Kanser, kesan-kesan ini dapat diminimakan malah jika sekiranya berlaku ianya adalah lebih bersifat sementara.


APAKAH FUNGSI RAWATAN KEMOTERAPI

Rawatan kemoterapi mempunyai beberapa tujuan, diantara tujuan rawatan kemoterapi adalah seperti berikut :

A. RAWATAN UTAMA. Sebagai kaedah rawatan utama kanser. Contoh rawatan kemoterapi sebagai rawatan utama adalah di dalam kes kanser anggur ataupun koriokarsinoma.

B. KEMOTERAPI ADJUVAN. Untuk mengurangkan kadar kejadian semula kanser kepada pesakit-pesakit yang telah menjalani rawatan utama contohnya rawatan pembedahan. Rawatan kemoterapi ini dikenali sebagai rawatan adjuvan ( “Adjuvant chemotherapy”). Contoh rawatan ini adalah rawatan kemoterapi ke atas pesakit kanser ovari yang telah menjalani rawatan pembedahan.

C. KEMOTERAPI NEOADJUVAN. Sebagai rawatan permulaan sebelum pesakit menerima rawatan utama. Tujuan rawatan neoadjuvan kemoterapi ini adalah untuk mengecilkan saiz kanser dan dengan itu rawatan pembedahan yang akan dijalankan akan menjadi lebih mudah. Contoh rawatan neoadjuvan ini adalah rawatan ke atas sebahagian kes kanser pangkal rahim dan kanser ovari.

D. KEMOTERAPI PALIATIF. Peranan terakhir rawatan kemoterapi adalah sebagai kaedah rawatan untuk mengurangkan penderitaan pesakit kanser yang sudah tidak dapat disembuhkan lagi. Ini dinamakan Kemoterapi Paliatif ( “Palliative Chemotherapy”). Contoh rawatan ini adalah kepada pesakit kanser pangkal rahim ataupun kanser-kanser lain yang merebak biji kelenjar Para-aortik dan menyebabkan penyumbatan saluran buah pinggang dan menyebabkan salur buah pinggang dan buah pinggang menjadi bengkak (“hydroureter, hydronephrosis”). Pesakit akan menghadapi masalah sakit pinggang dan jangkitan buah pinggang. Biji kelenjar yang besar ini juga boleh menekan urat saraf dari tulang belakang dan menyebabkan kesakitan bahagian belakang. Tujuan rawatan adalah untuk mengurangkan kesakitan dan mengurangkan kesan penyempitan. Rawatan kemoterapi paliatif ini tidak bertujuan untuk menyembuhkan penyakit kanser pesakit tetapi untuk mengurangkan penderitaan akibat kesakitan.

Soalan yang ramai sangat bertanya..
So di sini ku amik je dari net - info related with Molar Pregnancy.
...

What is a molar pregnancy?

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Trophoblastic disease is an uncommon complication of pregnancy. To understand it we must first look at a normal pregnancy. This consists of two 'parts' developing in the womb.

The foetus or developing baby, the placenta (or after-birth), which has many functions including the feeding of the baby and the removal of its waste products. The placenta is made of millions of cells called trophoblasts.

These two parts normally develop together, in parallel, the end result being a healthy baby and a placenta which is no longer needed, so the latter is expelled just after the baby is born (afterbirth).

In trophoblastic disease there is an abnormal overgrowth of all or part of the placenta, causing what is called a molar pregnancy or hydatidiform mole. The term seems strange but is similar to that used for a harmless growth on the skin, which is also called a mole.

As with skin moles, a hydatidiform mole is often harmless. However, it can keep growing and, if left untreated, can bury itself into the organs around it, including the uterus (womb) and even spread via the blood to other distant organs including the lungs, liver or brain. It is once it has reached this stage that it can have serious effects.

Although a hydatidiform mole is not cancer and rarely even becomes cancerous, it can behave in similar ways. Most of the treatment is aimed at stopping the disease process long before any of these things happen.

Different types/stages of moles:

• Hydatidiform mole
• Partial Mole
• Complete Mole
• Persistent Gestational Trophoblastic Disease
• Choriocarcinoma

HYDATIDIFORM MOLE

The commonest kind of trophoblastic disease, where the overgrowth is benign but may spread to other parts of the body if not treated. This is further subdivided into:

PARTIAL MOLE

Where part of an apparently normal placenta overgrows (proliferates) and part develops normally. There may be a developing foetus present, but this is genetically abnormal and cannot survive outside the womb. This is where two sperm enter the egg and instead of forming twins forms an abnormal foetus.

Partial Mole

COMPLETE MOLE

Where the whole placenta is abnormal and usually grows very rapidly. There is no developing foetus in these pregnancies. This is where one sperm enters the egg but only half of one set of chromosomes are present and do not develop into a foetus.

PERSISTENT GESTATIONAL TROPHOBLASTIC DISEASE

Where part of the mole remains in any part of the body despite initial treatment by the gynaecologist. Even a tiny amount of mole anywhere in the body can grow quickly and cause problems, so active treatment of this condition is very important.

CHORIOCARCINOMA

A very rare but curable form of cancer where the placenta becomes malignant. This can arise from a molar pregnancy or an otherwise normal pregnancy or miscarriage. Choriocarcinoma can also spread throughout the body, usually to organs like the lungs, liver and brain.

...

What causes it?

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Molar pregnancy is thought to be caused by a problem with the genetic information of an egg or sperm. Factors that may increase your risk of having a molar pregnancy include:

• Age. Risk for complete molar pregnancy steadily increases after the age of 35
• History of molar pregnancy, particularly if you've had two or more
• Possible ovulatory disorders
• History of miscarriage
• A diet low in carotene (a form of vitamin A). Women with low carotene or vitamin A intake have a higher rate of complete molar pregnancy
• Living in certain geographic locales (especially Southeast Asia and Mexico)

It is however, worthwhile noting, that the number of times a women has been pregnant doesn't influence her risk.

...

Treatment Regimens

---

Up to 10% of diagnoses require additional treatment other than the D and C and urine testing follow up. This is in the form of chemotherapy.

Each individual’s case is different but the vast majority of patients begin on Methotrexate. This is also used for arthritis and skin conditions. It is administered by intra-muscular injections (buttock) followed by a Folinic Acid (NOT folic acid) tablet exactly 24 hours later. The usual regimen is to have four injections on alternate days with Folinic Acid in between but regimens differ at different treatment centres. You will stay as an in-patient for the first part of the course of treatment as the chemotherapy could cause heavy bleeding and other side effects. You will then continue as an outpatient either at your treatment centre or it may be possible to arrange it at your local hospital to avoid commuting long distances.

As mentioned previously measurements of BhCG are used to monitor treatment response. It is essential with all chemotherapy regimens that BhCG is measured regularly. In general an adequate treatment response is defined by a 50% reduction after each course of chemotherapy.

The level of BhCG may reach normal (different regions aim for different levels between 2-5) or become undetectable when there is still a residual tumour burden of cells. Therefore with all regimens, treatment is continued for at least six weeks.

I've got lots of nutritional foods given by people who cares..
Thanks a zillion..

*Hakikatnya tak tahu bila la nak makan semua ni.. heheheh..

3rd time for drain feeding..

Kali ni dapat 9oz..
Rasa macam nak makan je pills itu.. then realize comment from Aja.. Thanks, no wonder la susu ni makin bnyk jer..
Ish aku ni la..

28 December 2008

First let me start by wishing beloved hubby Happy 31st Birthday. I love you.. *grin*

My second chemo treatment started at 9.30am today. The faster they run it, the quicker I can go home.

Mat came at 11am. I can’t help but broke in tears. Yela, selalunya dia datang ngan Zahra but today he came alone.

Chemo ended at 1.00pm. Packed and ready to go home.


One the way home, I cried and cried.. Sampai rumah pun nangis-nangis lagi – dugaan berpisah dengan Zahra adalah yang terberat setakat ini.

Muhasabah diri part II – Semua adalah Pinjaman Semata. Dia yang berhak lagi Berkuasa.

I pumped at 1130pm before going to sleep. Managed to get 5oz – boleh lagi nak pam tapi sebab malas nak tukar botol so let it be jela.



Dr has prescribed me with suppress lactation pills, which I have to claim at the pharmacy before going home tomorrow. I asked Dr, ‘What type of pills is this?’ and he told me is kinda hormonal pills.

Erm, I’m thinking on not taking the pills. I am going for natural sources to suppress my lactation, no more hormonal pills. I had enough with Noriday and Postinor. I think my body can’t accept those pills – I’m not blaming the pills causing my molar pregnancy but somehow been thinking maybe it does has an effect.

Before going to sleep, I called Walid, heard Zahra voice at the back and suddenly I broke into tears. Sedihnya, esok Umi balik umah but then Zahra tak ada.

I felt perfect. Tak de rasa sakit-sakit atau pening or what so ever. Must be the drug still in little dosage. Just that I’m bleed and felling hungry most of the time.. heheheh (mencari alasan untuk makan..). And one more things, I’m constipated. Susah nye nak membuang – rasa macam dalam pantang plak.

I have a chat with the senior nurse just now. She said that I must by hook or by crook complete my chemo courses without any delaying. If I have chemo appointment on Monday, meaning I must come on Monday not on Tuesday nor other day. This is very crucial. Once the treatment has been delaying or disrupt, the level of Beta HCG might quickly increase and later on I have to sort of like restart my chemo regime, but this time with higher drug dosage – erm, scary isn’t it?.

Besides that, SN also told me that my course would be like:
10 days chemo session – chemo berselang dengan pil (meaning 5 days chemo, 5 days pills) – then, they take my blood for reading the Beta-HCG level – if the level shows stagnant or drop very little then they’ll start again the 10 days chemo session with higher dosage of drug. Basically after the second session the Beta HCG level will drop and continue to drop (depend on the person itself).

And during the course, I must not get pregnant! This is vital. If I get pregnant, the beta HCG level will rise and even the baby that I’ll carry is normal, my condition would be worsening. I might get a healthy baby but at the same time a cancer maybe develop in any parts of my body – this is more scary right.

But SN also added that, after all courses complete, level of Beta-HCG show >2u/l for 3 continuous months, then the Dr may allowing me to TTC.

Apa pun semua ni di tangan Allah SWT. In paper it might look easy, but in real life it might be different. Dan semua juga bergantung pada masa – cepat atau lambat.. yang paling penting aku kena sentiasa berdoa..

“Ya Allah, ku mohon yang terbaik dari-Mu.. amin”

27 Disember 2009

Mama called semalam. They are coming to visit me today. And they also come with a desire. They wanted to take Zahra back to Ipoh, so that I can coming back home and rest and by this Zahra can also be train to wean.

Mat called later to acquire my opinion. I don’t know what to say. I told him that it might be a good idea for weaning Zahra but knowing Zahra, she will be freaking out loud without me or her Walid. Mat then added its better for mama taking care of Zahra – good for family bonding.

And we decide that, Zahra send to Ipoh, and Ummi coming back home to rest.

Balik rumah without Zahra would be a different big story.

The Drs and nurses kept on telling me I wore my baju terbalik.
The tali-tali should be in front not at the back.

My answer: I purposely wore it terbalik..
Tak suka tali-tali tu sebab at any tilt can show your inner skin.
Somemore I wore sweater, so can cover the back yang bertali-tali itu.

Kata orang tua, pakai baju terbalik ni murah rezeki.. ekekekeke.. eh, betul ker?

When nurse came in at 5am to take by body temp and bp, I asked her if I can get any breastpump as my breast engorges. She said she can lend hers – she’s using Pureen. Alamak, takut nye aku.. tak penah guna ni – memilih la pulak tu!! Then she asked where I want to put the expressed milk, and I said it will go into the drain – tak bole guna due to chemo effect. ‘Oh, chemo..’ she mumbled and left the room.

Half an hour later, she came back – brought the hospital pump – Medela Lactina.
She said its better for me to use the hospital pump rather than use hers – she doesn’t want the chemo drug to contaminate her milk later. And I’m so relieved to see the brand.. heheh..

From my point of view, Medela Lactina works like Spectra3 – single pump with monotonous suction. Bunyi quit loud but bearable la.. tak la kacau orang katil sebelah tuk tido. I managed to get 9oz to feed the drain.

After pumping.. legaaaa…

I went to sleep at 10.30pm. At 2.00am, I woke suddenly. Ya Allah, breast engorged. So full and it hurt sangat. Clever me not to bring any breastpump. I tried not to focus on it.. tried to get back to sleep.

At 3.30am, again I woke, but this time around I felt like immense period pain. Sakit sangat perut ni and when I went to toilet peeing, lump of blood coming out from my vaginal. I guess the chemo really done its job. The room was so cold I’m shivering inside – takut kena bentan jer.. I went back to sleep with bended body, pain in the stomach and breast engorgement.

I tried hard to sleep. Everything seems suddenly to linger in my mind..

I remembered my conversation with one office clique in the surau.
L: Lama tak nampak ko?
Me: Aku cuti hari tu.
L: So, how’s your pregnancy? Dah bape bulan ek?
Me: Tak jadila.. Gugur.. but bukan baby pun.. false pregnancy.
L: False pregnancy?
Me: Yup, aku dapat molar.
L: Molar? Molar Pregnancy? Kau….. (becoming so shocked.. and her faced change immediately).. Best friend aku died because molar pregnancy tau. Dia dapat molar when her first pregnancy 4 years ago, then go treatment chemo semua and Dr cakap dah recover. She tried TTC and when conceived second time dia gugur.. then terus tak de anak. Dia meninggal early this year sebab sudden blood clog in brain, which been confirmed by the Dr due to her previous molar pregnancy tu… (suddenly cried)
Me: Insya Allah aku ok. My Beta-HCG result dah turun pun.
L: Ko jaga diri ko baik-baik tau. Allah memang uji orang yang baik-baik macam ko, macam dia pun baik jer..
Me: (Just smile)..

Erm, baik..
To be frank, aku rasa aku tak la baik sangat (but not to the extend jahat la)..
manusia biasa sering buat kesilapan. Alhamdullillah, solat tu tak de tinggal, but yet, tak la terus solat time azan berkumandang.. selalu delay gk (bende dunia jugak yang di-prioritized.. huh).. dan kekadang selalu juga mencuri masa kerja untuk kerja-kerja lain – OUM, swimming during lunch hour selalu drag till 2.30pm, gi bank, Alamanda and such.

As directly with Allah SWT pun aku ada banyak dosa. Tudung pun start pakai at 2003, Al-Quran pun setakat baca Yassin je dan erm, banyak lagi la kalo nak dilistdown….

Deep down inside, aku syukur aku sakit sebenarnya. Terasa Allah sayang kat aku- kafarah dosa-dosa lama, insya Allah.

And you Mole, I’ll fight. I’m all arm. Raining season has long ended. Demi untuk membaiki hubungan aku dengan Allah SWT, aku akan fight.. I won’t let you taking charge on me.. Not till Allah decide..

26 December 2008

Pagi at 11.00, we sent Zahra to the taska. Walid and I have decided that I should stay in the hospital at least 10 days, so that we can basically train Zahra to wean. Susah sebenarnya nak putus susu ni- like last nite, she cried and cried when I refused to nurse her. Umi ni plak kesian, so bagi la susu itu.

Jadi kami berharap agar dengan Umi staying in the hospital she would be sooner forget about breastfeeding. And I can also have a good rest.

My chemo procedures started at 4.00pm. First, I’ve been injected with 2ml Dexamethasone Sodium Phosphate, altogether with 3ml of Grasinetron (anti –nausea). Then, I’ll have to wait for half an hour before the chemo regime start.

My feeling after been injected with Dexa-M was quite funny. All of sudden, I felt itchy at my private part which last like 10 second.

After 30 minutes, the nurse came in and replace the glucose bag with the chemo drug, Methotrexate. I’ll have to take this drug in 500ml normal saline. Nurse told me the course will take like 2 hrs.

In the mean time, I can enjoy playing Zuma.. heheheh..

----

My first chemo treatment ended at 6.00pm. After chemo, what I felt was:
1. Very thirsty with dry mouth – even in between chemo I do drinks a lot of water, sempat gi toilet for peeing lagi, and
2. Extremely hungry (I can eat a horse.. heheh) – luckily they served dinner at 6pm. So I can eat immediately.

At 7.00pm, I went down, buying chocolate, ice-cream and strawberry milk shake – to indulge myself for successfully complete the first chemo session.. dan lapar pun ye jugak.. habiss la.. gemuk la kunanti, heheh..

By the end of this first chemo treatment, I’ll have 4 more sessions to go.. Chaiyok..chaiyok..

Btw, tomorrow no chemo, instead just consume pill – Calcium folinate.

----

At 8.00pm, I started to fell some chemo effect:
1) Lidah rasa lidas macam lepas makan nenas
2) Kaki, especially bahagian peha rasa lenguh sangat-sangat

This is how my chemo treatment look alike

Menanti hari esok yang mendebarkan..

Malam ni kita enjoy makan dulu.. heheheheh..
& Zahra juga enjoy nyot nyot Umi puas-puas ok..
- kira nanti dah besar baca blog Umi ini, bukan Umi nak kita putus susu.. but demi kebaikan bersama.. :-)
*btw, ku di PPUM Wad10U

Yeay, I can come back home tonite..

Home sweet home - walaupon macam kapal nak pecah.. ekekke..

24 December 2008

I woke at 5am. Rasa macam malam yang sangat panjang – or it just me having enough sleep for the first time since 1 and 8 months.. hehehhe.. Later, nurse came in to take my bp and body temp.

Soon after, I expressed my milk – rasa breast penuh sangat, and Alhamdullillah, this morning managed to get 6oz – lama dah tak dapat 6oz in one shot.

My blood result has come out: Beta-HCG aroung 13500 u/l – decreased but stil higher. Thus, Dr suggested for chemo which will start this afternoon.
My feeling: Berserah kira ini yang terbaik.. insya Allah.

At 3.00pm since Walid and Zahra stil haven’t come yet, I expressed my milk – for the last time ever. After this, no more expressing nor direct feeding.

Walid and Zahra come.. Wah, terasa rindu sangat-sangat..
Kita main, main dan main until 4.30pm, which they have to leave goodbye as I’m going for my chemo treatment.
Like a very sad ending story..

Then I wait, wait and wait – for the chemo treatment – but no one turn up, not any Dr nor nurse. Sya came to accompany me. Fed up on waiting, I asked the nurse. And they told me because of some miscommunication my chemo treatment will start on Friday instead.
-- alahai, kalau tak tanya ni mesti ku tak tahu.. tak de sapa pun nak datang inform.

So, I asked permission to just go home. Nothing much I can do just lying in the bed in the hospital, somemore I’ve returned my breastpump and I think it is a huge waste if I cannot express.


-susu yang berjaya diexpres = 15oz-

23 December 2008

We went to the hospital at 11pm. As usual, going to public hospital is ain’t like going to the private. Everything was way too slow. I kept telling myself, “Sabar.. sabar..”.

I finally get admitted around 2.00pm. When we get the room, first thing first is to feed Zahra – she was hungry and it’s already her nap time.

A whole bunch of Dr later came in, took my history, telling me things I’ve already hear and read, the consequences and else and as usual taking my blood for tests.
Zahra woke up at 3pm and both of them left me heading home. I’m sad, but nothing much they can do if they’re staying.

At 4.30pm, I was taken for chest x-ray. And on the way back, guess who I met – Uztaz Haron Din with his wife, in the lift. Really glad to see Orang Alim bila kita tengah sakit macam ni.. even he’s not visiting me, but it seems that he does visiting me.. heheheh

Malam at 8.00, I expressed my milk, Alhamdulillah, managed to get 5.5oz. Then, came to realize that I don’t bring enough bottles to place the milk. So, I rushed to the shop downstairs to buy some bottles but then get this slight idea, - baik beli drink, botol dapat, minuman pun dapat.. hehehhe.. so I bought 2 bottles of Homesoy (kudos to the cute little BPA-free bottles).

Nite without Walid n Zahra for the first time was indescribable. I missed Zahra warm body beside me.

22 December 2008

Today I brought Zahra to the An-Nur Pead Clinic. She’s been infected with chicken pox, and since the clinic is situated next to the An-Nur O&G Clinic, I went in to peek on my result, which shortly found out that I’m stuck in the clinic as the Dr wanted to see me. While waiting for my turn to see the Dr, I asked the receptionist regarding my latest result of my beta-HCG levels - turn out to be not so good – the amount doubled within a week.
And there was me, with sick Zahra, sitting nervously to see the Dr. I called Mat, and luckily he’s able to accompany me to see the Dr. Its good actually – so that he also get the clear picture what had happen to me.
Dr Fatimah said that she’s no longer can handle my case, as for that, she referring me to the PPUM. And I have to be admitted as soon as tomorrow. How shocking was that!!!

I’m going to leave poor sick Zahra with only 5 bottles of EBM (amounted 25oz) for the first time ever.

I cried more harder…

Melihat kepada graph beta HCG (yang sepatutnya semakin menurun), it tell me that something is not right somewhere. The fact is, i still feel sick - i can fell my breast becoming swollen, nausea every morning when brushing my teeth, and frequently going to the toilet to urinate (just like a pregnancy symptoms).

When my graph hit a plateau, Dr Fatimah told me that the dark cloud was still there - has not been removed and at any time will burst to rain and make a big flood.

I was actually prepared for any bad outcome. I have read and read and read, mostly everything about molar pregnancy - the fact of chemo treatment higher for those happen to have complete molar pregnancy = like 7 out of 20 patients.

I was prepared. I am prepare!

But still I cried and cried and cried for some reason that I'm not prepared..

Me: Kalau chemo biasa nye berapa lama?
Dr: There would be 10 courses but stil depends on your Beta-hcg levels. If it drops tremendously than its a good sign but if it drop very slow, you may take longer course.
Me: Will I be admitted?
Dr: During the course, yes.. Like a month.. But sometimes, you'll have on and off, meaning you'll be admitted then later you can go home, then coming back for treatment in the hospital and so..
Me: Does chemo hurt?
Dr: Macam biasa, you'll have hair falling, bruise, sore mouth. But its all temporary.
Me: Can i breastfed my DD?
Dr: Oh, yang tu tak bole. You kena stop immediately..

Me: *start to cry harder and harder*

-------

Me: Sapa sayang Zahra?
Zahra: Ommi..

Beta HCG is the indicator to detect pregnancy - normal or ectopic.

However, this type of protein also an indicator to detect any abnormal growth of cells in the body, i.e. metastasize type of cells.

For normal non-pregnant women, the level of the beta-hcg should not approaching 2 u/l.
In my case:
21 November 2008 (detected molar pregnancy) = 779 539 u/l
21 November 2008 (after d&c) = 573 108 u/l
1 Disember 2008 (after 2nd d&c) = 5401 u/l
5 Disember 2008 = 2793 u/l
12 Disember 2008 = 7697 u/l (red alert: it increased)
19 Disember 2008 = 14 428 u/l (beeping red alert: it increased and doubling within a week!)

Friday, 21-Nov-2008 01:37
There is no baby – its Molar
I was admitted to the hospital. Having a slight bleeding, I rushed to the hospital. My sonogram was shown something not normal - I'm having molar pregnancy. Quote: KANDUNGAN anggur (molar pregnancy) kebiasaannya dikesan pada tiga bulan pertama kehamilan. Ia boleh memberikan tanda loya, muntah pening kepala yang terlampau disebabkan kandungan hormon kehamilan (ß-hCG) yang berlebihan. Pemeriksaan ultrabunyi juga dapat mengesan kandungan molar sebelum ia menyebabkan tanda yang lebih teruk seperti pendarahan banyak. Sebaik saja dikesan, kandungan molar perlu dikeluarkan melalui proses “suction&curettage” dan disahkan melalui ujian makmal. Sangat jarang kandungan molar tidak dapat dikesan sehingga tujuh bulan melainkan jika ia bersifat separa molar. Ini dapat disahkan melalui pemeriksaan makmal (ujian histopatologi) ke atas uri terbabit. Di dalam kandungan molar lengkap pula, tiada bayi wujud melainkan hanya tisu molar saja (menyerupai gugusan anggur kecil). Wanita yang mengalami kandungan molar dinasihatkan tidak hamil dalam masa dua tahun pertama atas sebab berikut: - Kandungan molar berpotensi menjadi sejenis kanser (choriocarcinoma). - Pemeriksaan susulan bertujuan mengesan kanser terbabit dan memberi rawatan (kemoterapi). Peluang sembuh dengan rawatan dilaporkan tinggi sehingga 100 peratus. - Ujian darah (ß-hCG) dilakukan bagi mengesan kemungkinan kandungan molar aktif semula atau menjadi kanser. - Kehamilan juga menyebabkan kehadiran hormon yang sama (ß-hCG), ini menyebabkan sukar membezakan sama ada seseorang turut mengalami pengaktifan semula molar ataupun kanser. Dalam hal ini, rawatan kemoterapi terpaksa diberi (walaupun sebenarnya ia mungkin tidak perlu). Kandungan molar tidak menyebabkan wanita sukar hamil berikutnya. Malah, golongan ini dinasihatkan mengamalkan kaedah pencegah kehamilan untuk mengelakkan mereka hamil buat tempoh seperti di atas. Untuk memastikan anda tidak mempunyai keadaan lanjutan kesan kehamilan molar terdahulu anda perlu menjalani pemeriksaan doktor serta pemeriksaan kesuburan. I have this mix feeling. I'm sad as I not be able to conceive for at least a year and half but then I'm relieved as the mutation occurred has made the cells becoming molar instead of me having a Turner/Klinefilter/Down syndrome baby. Setiap yang berlaku ada hikmah nya.. insya Allah..

We've planned to give sister/brother to Zahra in the year of 2009.
As going for the planned, we TTC somewhere in the mid June, and successfully conceived in September.
Things started very well as planned.. however the road suddenly became bumpy..