My breastfeeding experience

When I was pregnant with my boy there were two things that I decided I wanted to do. One is breastfeeding and the second was using cloth diapers. Breastfeeding was not even a choice; it was just the natural thing as I remembered my mom feeding my two younger siblings. We never had formula milk in the house (perhaps my elder brother did have but totally before my time). Anyway, I thought that breastfeeding is cheap, easy (no need to wake up and mix up the formula at night) and it comes naturally.

I was wrong on all counts. Perhaps it is relatively cheaper considering that baby Azry is fairly healthy with no major illness. But breastfeeding is hardwork. It is a commitment. It requires discipline.

Hardwork because I would need to pump to feed him when I am away. People who only need to pump only twice per day makes me envious. I need to pump at least four times to get the ounces that Azry needs. One early morning, twice at work and one at night. With that I had to be committed and disciplined.

And one major thing I realise after 7 months - no breastfeeding experience is the same. Mom's only problem with feeding us was soreness - and I was the number one culprit who likes biting the nipple. She has no issues with supply and my brother fed until he was nearly four. And so when I was fussing over my periods of low supply (as seen with the low volume I pump) my mom was saying I was being paranoid and as she did not take any supplements nor have any special diet to keep up the volume. Demand and supply- that is what she says.

But then, I realise. There was a major difference between me and my mom. I am working and mom was a housewife. I have 11 hours of separation and no sucking every day. That is minus one major stimulant to keeping up the supply. Sucking promotes prolactin release by the brain and this promotes milk formation.

Hence my search and research into milk production and galactogogues. By research I mean google and google scholar search and old wives tale. Clinically proven was metoclopromide or maxalon - a medication used to treat vomiting. The stimulating effect is actually a side effect of the drug which causes hyper prolactinaemia. I haven't tried that though as I am keeping it as a last resort effort.

Another remedy keeps popping up during my research : fenugreek or in Malay, halba. It is usually used in Indian cooking or in 'nasi dagang trengganu'. Apparently, fenugreek helps by stimulating the glands which is a modified sweat gland. It also lower blood sugar level and promotes good cholestrol in milk. Initially I bought a herbal tea remedy with fenugreek and other herbs thrown inside. It was damn expensive and the smell was bad. I smelt like a curry house- really! Anyway, I drank it twice but it gave me severe headache - whether is was due to the hypoglycaemia effect or smell I was not sure.

Then I went to my local pharmacy - fenugreek is available as supplements; I was so happy but my joy was shortlived. It is not available in this country because no one buys it. And then, my pharmacist gave me a good idea "Why don't I make my own fenugreek supplements". So in a Phineas and Ferb manner I instinctively knew what I was going to do that day. Make my own herbal supplements.

Anyway, I after about a month and a half I think it does help. I forgot to eat it for two days last week and my pumping session became a stressful event. Half an ounce to 1 1/2 oz only per session per breast. That was not enough for ever hungry baby Azry: he needs between 18 to 22 oz per day at the sitters. And when I resumed the supplements I managed to get 2 to 3 oz per breast per pumping session - this is after a day of re-starting.

So, I still do hope I can achieve my intermediate target in breastfeeding i.e. Fully breastfeed till 1 year of age (I hope I do not need to buy formula milk at all). It is already 7 1/2 months but I am taking it one day at a time.

Diving Log 2011

For the past 1 year I haven't posted anything on my love of diving. The last diving trip I went was in July 2010 where my precious housing got flooded. Since then, no trips. It is plainly because I was pregnant and later delivered my first child in April this year. There were plans to dive in September when baby boy was about 5 months but was later scrapped as we realise that leaving him a whole day in the hotel with someone who does not look after him often is a bad idea. Bringing a infant to the island at a time when the weather changes and waves may be high was also not very ideal. Hence my abstinence from breathing compressed air in 2011.

Hopefully, I can resume my passion in this coming year. It is possible with some major adjustment.
1. Baby sitter needs to come too (in this case granny)
2. Looks like no backpackers unless they have good rooms and fairly good facilities (for baby and the sitter)
3. The area is fairly accesible with no major transport issues

So I am keeping my fingers crossed. 2012 here I come.

Random thoughts

Remember the times when you were a kid many adults treat you as if you were invisible? The times when you line up at your favourite 'nasi ayam' stall and in the end a 'busy hurrying' adult cuts the line by saying she is in a rush and you ended waiting an extra 10 minutes because the so-called rushing adult had to have 10 packets of rice to go. Or the times when you asked someone whats going on and the answer is "you are a kid, you won't understand". Well, I sort of remembered the feeling when such a thing happened to me and hence I appreciate all those adults that makes me feel like an equal when such situation presented itself. One example of my favourite adult was the Hospital Kuala Lumpur rojak man (link).

Therefore, when my four-year old niece wanted to help out bathing my son and change his diaper I let her. She helped me with squirting the bath foam unto my hands, applying talcum powder all over baby Azry's body, helped to chose his outfit and also apply lotion on his limbs. She was grinning ear to ear when he was all ready and smelling so fresh and nice and proudly announced to everyone 'Kakak Aida tolong Azry mandi'.

Seeing her so happy makes me feel elated. Yes, kids have feelings too and by allowing her to help out makes her feel responsible and is part of the family.

Note: Not all is well as there was a bit of cleaning up to do after that; as although the talcum powder was meant to be on the baby loads ended up on the bed. That's the price I paid to get that cute grin and also cut a bit on the 'sibling-rivalry' (or should I say'cousin-rivalry) that she has been showing to the baby.

Modern Day Fountain of Youth?

The fountain of youth was a legendary spring that supposedly restores the youth of anyone who drink its waters. So many aspiring immortals and explorers in history set out to discover the location of this spring. The idea of just drinking a miracle water to keep oneself healthy and young without doing anything else is just too hard to resist. In this modern day such idea is still capturing the minds of many but in a different form. Today, instead of exploring the thick jungle of the Amazon the so-called fountain of youth presents itself at your doorstep in a nice expensive packaging with terms like the 'ultimate anti-oxidants'; 'anti-cancer'; miracle drink etcetera.

Being healthy is not just looking good externally i.e. it is not just being thin- though that is the main aim of many who purchase these expensive dietary drinks or supplements. Being healthy to me is being able to climb five flight of stairs without even breaking a sweat. Being healthy is able to run after your kid in the house without huffing and puffing away. It is the cardiovascular health that is important; the health of the pump that helps to sustain our life from the 4th weeks of life as a foetus till the last beat of our death. No amount of 'miracle water' or supplement can keep the heart healthy if it does not get it fair amount of exercise.

The 20minutes of exercise three times a week is the minimal effort that is needed to keep your heart in top condition. However, the thought of spending your precious time for yourself is so daunting that people rather go in throngs to establishment that advertise "..no injections, no exercise needed...". To the doctor the standard answer to a suggestion of exercise is " No time la doctor". Uh...duh!

Another aspect of healthy living is eating well. Supplements are only needed if you do not get sufficient amounts from your diet. Knowing your food and its health content is essential aspect of keeping yourself healthy; and knowing your portions and the healthier way of cooking is essential in preventing obesity. All of this requires effort which many are not willing to undertake. Takeout counters are much easier than making your own sandwich.However, I must admit I too love the occasional McDonald drivethru excursions especially after a long day in the operating theatre... I am only human after all.

Lastly, no amount of rejuvenating anti-oxidant drinks could counter the ill effects of smoking and alcohol. So if you are thinking of purchasing the expensive bottles of some miracle berries to offset your nicotine and ethanol intake, don't. It is better to just stop smoking and drinking; and it is cheaper too, it doesn't cost you a cent.


So to those who are thinking of asking me how to keep oneself healthy and vibrant and expects a shortcut way, please don't. Just go and watch the Biggest Loser and exercise with Jillian Micheals/Bob Harper. As they say in the show there are no shortcuts.

(Note: this is written as a response to my non medical friends who keep bugging me for some secret to keep oneself thin and healthy; and then annoying me by not following my advice and then asking me about some miracle drinks or supplements that they spent hundreds purchasing)

Business as usual

Next Monday I will be back at work after 4 months of leave (3 months maternity and one month of my accumulated leaves from last year). It is of mixed feelings going back but I actually miss working and operating. I will miss waking up late with my boy; I will miss the afternoon naps I have while feeding him; I will miss watching all the re-runs on the telly and so much more. It has been a good break after working for 12 years.

However, I am eager to get back into the OT. My fingers and hands have been itching to fix something or more accurately someone who is broken. It has been a long time since I truely operated as an orthopod. It has been a year. Ever since I got pregnant I have been on 'light duty' and I had to stay away from the usual trauma cases. This is because majority of the 'usual' orthopaedic surgeries requires image intensifier (II) which uses radiation, which may be detrimental to a developing foetus. In cases which I had to come in, it became a bit more lengthy as I had to leave the OR when it was time to use the II. And in other cases like hip and knee surgeries which required brute strength, my concerned boss would ask me to just assist as he is worried my gynae Mei Lin would scold him if the exertion causes premature contractions or worst case scenario an abortion. So for the past 1 year I end up supervising the MOs doing local cases; did most of the ward rounds and the paper work; and stayed more in the clinics.

So come Monday, it will be back to the usual business and oh boy... I would have loads of patients in the clinic - so many people have been waiting for me to come back and has been postponing their appointments since 4 months ago.Oh boy!

Aida and Ariff Cameron Adventure

Cameron Highlands has long been a favourite holiday destination for my family. It was a huge treat for us kids ad my dad always dream of having a plot of land there. So last weekend most of the family headed uphill to enjoy the cool highland temperature. My dad was estatic as he had all his 3 grandchildren to accompany him. I am not sure if the two youngest realise the difference of environment as Azry is only 3 months old and Ariff just turned one. However, for Aida who will be four this is her third or 4th time in Cameron and she already had her 'plans' of what to see.

Aida's to do list for Cameron was:
See Strawberry farm(eating strawberries was not as she said they were too sour :)
Visit tea plantation and eat scones and jam (actually that is atuk's plan)
Go to see the bee farm (and see the bees buzzing around)
Feel the coldness
And see the flowers and insects

'having tea with atuk at Boh's tea house'

'Trigona bees at the Bee Farm'

'Having a closer look'

''Rock and cacti garden at Al Mashoor'

We stayed at the at Dr Ayob's house in Kampung Sedia homestay. It was a 3 bedroom kampung house with 1 bathroom, 1 toilet and a fully equipped kitchen. Surrounding the house are strawberry farms and vegetable plots. They were just planting cabbages when we arrive hence no photos of fully grown vege to show.

This time around we decided not to go to Brinchang which is higher up as the jam was ridiculous. We thought by coming non peak season there would be no jam but then according to the locals the jams were a normal occurance every weekend and it becomes massive during peak seasons.

Places visited this time

Ladang Boh Sg Cheding (Habu)

Bee Farm (Habu)

Strawberry PYO in Kg Sedia (Opah Strawberries and jams) which had really amazing strawberry muffins and also strawberry acar....and Al Mashoor

Ijan went to Bharat Tea - apparently they have the best scones ever!

Mom went up to the market and pasar malam (jam was over by 9pm)

Anyway, the find of the trip was the strawberry 'acar' (pickle). So sedap it really reminds me of Kak Nuzi's acar buah (It has been a year since she passed on)

"The gang"


Aida and her 'au-pair' at the Tea Plantation



Atuk , Ariff and Aida

Though Azry is still too small to appreciate the trip the rest of us enjoyed the cooling break from the chaos of KL. As it is, mom is already thinking of the next trip up... this time hopefully Marina and Ode will join us.

Evolution [ ev-uh-loo-shuhn ]any process of formation or growth; development]:any process of formation or growth; development

This blog has been neglected for a while. Past 1 1/2 years I have been busy with work, 2 miscariages, one 'successful' delivery hence lack of trips especially diving trips to update. My last dive was July 2010 to Redang and well, it is nearly a year and my gills are definitely dry. Hopefully, my next trip will be in September after the fasting month (keeping my fingers crossed!!)

Anyway, as my life is currently evolving at a fairly fast rate with new experiences and relationships I thought that a new blog title is warranted. UnderH2O Lover was a tribute to my love of diving and the ocean ecosystem but to create a new blog and leave this one idle would be definitely sad. This blog has made me a few good friends and I think has helped to enhance my poor writing capabilities. Therefore, keeping the blog and changing its title would be more logical and I feel the most apt title would be 'Evolution of My Life'. I hope I would not bore people with everyday mundane things but I do hope to document some aspect of my new experience as a mom. Gosh, writing the word mom do sound a bit surreal but yup I am a mommy.

So, welcome to 'Evolution of My Life'

Life Goes On - Part One

Life has its weird twists and turns when you least expect it. Three years ago when I was a happily 'confirmed bachelorette' suddenly someone pops into my life making me re-evaluate my state of happiness. A few months later I was undoubtedly hitched and a new chapter emerged.

Two was definitely better than one as not only I have a life partner, I had a travel and diving buddy all rolled into one. It wasn't without hitches I must say. After being single and free for a long time I was almost set in my ways. Having to think bout the other half and compromising was the difficult part (and I was a difficult person) but we have managed so far.

After a while, the honeymoon phase ended and the next phase started. Trying to conceive we thought should be the next step in our evolving relationship.

It was a difficult time for me. First, I wasn't sure at mid-thirties I would be able to get pregnant so easily. And with me having exposed to radiation at work makes me think it might be a uphill task. So I was set in my mind not to worry if it never happens. Then the inevitable happened, two magenta lines on a pregnancy strip test confirmed our suspicions. At that time, I was elated but at the same time apprehensive. Whoa... suddenly the reality of being responsible and less self centered hit me and I was overwhelmed. It may have been the hormones but I wasn't sure that it was entirely due to that. I remembered I kept reminding myself that a third of pregnancies do not get past the 1st trimester (just in case something unwanted happens) My merman was rock solid and surprisingly took every ounce of doubt I had and converted it into a wall of support.

However, the joyous feeling turned into state of uncertainty by the end of the 7th week. I had not much pregnancy symptoms apart form my missed period. But having gynecologists as friends ensured me to an early ultrasound scan at the 5th week and subsequently at 9th week. At that point, the fetal sac looked suspiciously unhealthy and they still had not detected the fetal heart. Since I was a fellow physician and friend no one wanted to be the bearer of bad news and they decided to give it a chance and wait another 2 weeks for re-scanning. At the 11th week it was confirmed that the fetus was non viable and I had a missed abortion.

I was immediately admitted for a 'evacuation of products of conception' (ERPOC) that was done the very next day. That was the first time I went for any surgery, what an experience being on the receiving end of the operating theatre. It went well without any complications and by the evening, I was back at home resting. To tell the truth, at that time I had no feelings at all - three weeks of uncertainty had certainly prepared me for the worst.

We went back to our normal routines and planned life ahead as usual. Three months later we were hopeful again. This time around, at five weeks a trans-vaginal ultrasound revealed what we never seen or heard before the fetal heart sound. This time around I was more 'careful': rested excessively, became a bit of a sloth by walking slowly and taking the lifts only, ate well and selectively and followed whatever people are telling us we shouldn't do.

However, we still went on a planned holiday to Kota Kinabalu as we thought that a very slow paced leisurely holidays should be alright. No trekking, snorkelling nor diving was planned, just sight seeing in a car in KK and Kundasang. However, both of us fell sick with stomach flu and high fever. Back in KL I had light brownish stains and immediately went to see my gynae. Another scan with doppler was done and we were assured that it was still viable as the blood flow to the placenta was abundant. However, I was put on progesterone, just in case and was ordered to strictly rest at home. At that point, i was still having symptoms of stomach upset and resting was a bit hard as I had to go to the loo often.

After a day of resting I suddenly had a severe stomach cramp and the staining turned into blood. Merman rushed me to the hospital and an immediate scan revealed that the foetus was no longer viable. Again, I was admitted for another ERPOC. At the ward, while changing clothes I suddenly felt a gush of fluid coming out with a huge lump falling into the toilet bowl. Although used to seeing blood I was shocked as it all came out of me.... It was a very dramatic moment.

A nurse came to assist and she took out the lump from the toilet bowl. It was the size of an orange. I saw the placenta with a bean-like shaped fetus attached to it. it was so surreal. A scan and vaginal examination revealed that the abortion was complete and I indeed do not need another surgery.

At that point we were both thinking of where we went wrong. This time it was sad. We saw signs of life and how it perished. I was more emotionally affected this time around. However, apart from my close circle of people I chose not to talk to or inform anyone else about it. Being a realist I find it overbearing when people give their words of hopes and support. They usually mean well, but my brain is just not wired to perceive it that way. It annoys and irritate me. I coped by allowing myself to grieve for a while and after that just decided to let things be and just go with the flow.

And indeed it is true, life does go on......