Contact me !

If you need to contact me , please write to me to this email ID : manjupadmasekar@yahoo.com. I will be happy to help.

Monday, October 28, 2013

Cerclage on Wednesday !


They have decided to do cerclage on Wednesday due to the delay in Chlamydia test results. I am so thankful to all the love and prayers. I  am trying to be strong so that my DH remains strong too. I will not wish this situation on anyone. Will update after everything becomes OK.

Friday, October 25, 2013

Let us try our best, if not let nature take its course.....

This what doctors told us. My cervix is dilated and my membrane is bulging in. I am on tocolytic drug, strictly bed ridden, only bed pans allowed. I am really not in a good situation, might be all will end ! Only prayers can do miracles. I won't be able to reply mails or comments. My hands are shivering, my heart racing because of tocolytic. Sorry, I can't type anymore. If there is no prmature labour I will have a cetclage on Monday. Pray for my little ones ! Sorry, if I am pulling you along with my uncertainity. I don't need pity please, just some cheering up, so that I can be happy amidst all this !

Tuesday, October 22, 2013

Attention Singaporean Blog Readers !

ATTENTION: Couples who are undergoing or have undergone multiple IVF/TTC cycles

A Singapore TV program for Mediacorp Channel 5 entitiled “For Better or Worse” is looking to feature real life accounts of couples who are currently or have battled infertility and childlessness and have exhibited exemplary strength and dedication in unusual circumstances.

In their union as husband and wife, they have trounced all odds and emerged triumphant through their mutual love and respect for each other.
 
Please contact Maziah at maziah@oak3films.com if you are keen on sharing your story as this would be a great platform for you to inspire other families in similar situations. Your participation will be greatly appreciated :)

Wednesday, October 16, 2013

Update on my short and sweet cervix

Dear Friends,

Thank you all for your kind and encouraging words ! I cannot thank enough and you all will never know how much it has helped me.

Cervix is the mouth of the uterus. It has an internal opening and external opening called as internal and external os. The openings are tightly closed during pregnancy(external os will be bit open in women who have had previous pregnancy and delivery). It measures anywhere between 2.5-5 cms during pregnancy. It keeps the babies secured within the uterus and also prevents infections.

I am now 18 weeks pregnant. My cervix started at a length of 4 cm at 10 weeks and it was 3.5 cm at 13 weeks. But I read that any measurement earlier than 15 weeks are not reliable. The doctor measured my cervix at 17w1d and it was 1.9 cm. I was immediately sent to labor and delivery department. My uterus contraction was measured. There was no contractions. The doctor there checked for infections, the test results came back clear. They wanted to do a cerclage. Cerclage is a procedure where they would stitch the cervix at the place which is closest to the uterus. In this way, it is believed that, cervix becomes stronger and holds the babies safely inside until delivey. The risk with having short cervix is that, it might open prematurely and can lead to labor and premature expelling of the fetus. Scary right ? For twins, having a cerclage was found to cause more harm than good because the procedure itself could trigger preterm labor !

This is why I am so scared. This week is hell. I managed to get out of the hospital in an hour on Thursday. They wanted to give me antibiotic and magnesium orally, as prophylaxis, and I could take that from home too. I am sure lying down there, without my DH nearby, would have driven me mad and made me so insecure. So I decided against hospital stay. I read a lot this week about short cervix. A short cervix doesn't mean it is incompetent and will lead to premature labor but studies show that the risk of premature labor is high with short cervix. I was not even close to viability, which means, a fetus becomes viable or in other words a fetus can survive out of the womb only after 24 weeks. I had so many 'what ifs' in my mind all through the week. What if I go into preterm labor, what if my uterus gives up, what if I lose my precious little ones, what if they are born prematurely and suffer in front of my eyes, so many what ifs...... I was scared, I broke down several times. I limited my activity, I got up only to use toilet, I am in the recliner most of the time. My DH brought progesterone gel and insisted that I use it. Today, after 6 days, I went for another cervix check. My cervix measured 2.38 cm. Even though not a drastic improvement, it has improved a bit and the best thing about my sweet cervix is, its internal and external os is tightly closed. As labor gets nearby the cervix shortens and starts to open from inside. Imagine the stem of the funnel, that is how the cervix is. When it starts to open, the internal os of the cervix becomes 'v' or 'u' shape just like the mouth of the funnel. The baby's amniotic sac can bulge through it and it can also bulge outside the cervix too if the external os is open - very scary ! Having read all the information and scary stuffs, I was so shattered. But today's ultrasound has put our mind in peace. I do not want to have a cerclage because of the dangers involved (premature labor). My cervix condition as of now doesn't demand an emergency cerclage. I just pray God that it holds the same for many more weeks to come.

This journey is much scary, with moments of hope and desperation. I have to remain strong and sane until the day I hold my little ones in our hands. I am on bed rest as of now. If my cervix improves a bit more in the next visit I will be happy; atleast let it not shorten. 

Another problem I face is regarding weight gain, whatever I eat, I am not gaining much. I lost 3 kgs during the first 14 weeks and I gained that back. I never thought eating could become such a problem. Any suggestions ?

Thank you so much for all the kindness, this blog helps me to be strong.

Manju


Thursday, October 10, 2013

17w1d update!

Where should I start ? The babies are fine but...... Today I had an appointment with gynaecologist. I waited long for this, 5 weeks! My gynaecologist is on holidays. Yesterday they called me and said my gynaecologist is ill and whether I would like to meet other doctor. We said yes. Today morning I met a new doctor. She measured my cervix and it was only 2 cm. She immediately sent me to the clinic where a tocodynamometer was used to measure uterus contraction. Fortunately my uterus was not contracting. They took several vials of blood and checked my cervix again and took samples to check for infection. They have kept me in hospital bed rest. My DH was devastated. He was asking how will I stay at home without you. I want to cry, I just want to go back home. I don't want to stay here and I don't see any benefit in it. They want me to stay in the hospital for 3 days, hopefully on Monday I will have all the results. If there is no infection they want to do a cerclage which doesn't seem to help with twin pregnancies. I  donno what future holds for us. I wish we could hold our babies in hand safe and healthy. I want my DH to be happy, I know how much he loves the little ones. Something within me is saying nothing will go wrong. I am trying hard to talk to some doctor and get out of hospital. This clinic is just 5 minutes from my home. No place can give the warmth and protection a home gives and I want to be with my husband. I know people will be praying for us but whoever reads it please pray! All these are very new and I am so afraid, but more than that if something untoward happens my DH, my in-laws and my mom will be broken down. Their pain will be unbearable for me than my own. I am lost within myself and so many fear haunts me .......hope everything goes well. I have one roommate here in the hospital. She doesn't seem to speak English or German. She has a newborn baby. I love watching them both :) I wish I could hold the little one for sometime but afraid to ask her and what language should I use ? But first I should get out of this hospital and be with my DH, I am trying to talk to some doctor and hopefully soon I got to see someone, I am determined to get out of here.If anyone of you have faced the issue I am going through, please do help me!

Wednesday, October 2, 2013

Basic Infertility Workup Which Every Couple Struggling to Get Pregnant Must Do !




Please do a complete workup before starting treatment haphazardly!

You need to do ALL  the following simple medical tests:

Semen analysis for your husband ( to check his sperm count and motility). Read more at www.drmalpani.com/sperm.htm

Blood tests for you for the following reproductive hormones – FSH ( follicle-stimulating hormone),LH ( luteinizing hormone),PRL ( prolactin) , AMH ( antiMullerian hormone) and TSH ( thyroid stimulating hormone) on Day 3 of your cycle, ( to check the quality of your eggs). Do this from a reliable lab such as SRL ( http://www.srl.in/). Day 1 = Day the period starts.

HSG ( hysterosalpingogram, X-ray of the uterus and tubes, www.drmalpani.com/hsg.htm)  on Day 8 of your cycle ( to confirmYour fallopian tubes are open);

The vaginal ultrasound scan on Day 10-11 should check for the following. A. ovarian volume b. antral follicle count c. uterus morphology d. endometrial thickness and texture

Tuesday, October 1, 2013

Alternative Medicine Versus Western Medicine for IVF patients – Friend or Foe ?




This article is the brainchild of Dr.Malpani. Thank you Dr for giving me permission to reproduce it in my blog!


Indians were unaware of western medicines up to until three centuries ago. Ayurveda, a form of traditional and alternative medicine was practised in India for centuries. Infertile couples in olden days were treated by Ayurvedic or Unani medical practitioners by using plant-based medicines and, in addition, they provided life-style advices too. Undoubtedly, such medical practices are very effective for some forms of infertility and many infertile couples would have achieved their dream of starting a family via using them. When some couples found no luck with such treatments, they sought the help of the supernatural power to give them a baby; many went from temple to temple in search of God’s grace! Since knowledge about the functioning of the reproductive system and its defects were very much limited during that time, infertile couples at one point of time had to accept their fate and move on with life. Many resorted to adoption as a means of enjoying parenthood and some remarried so that they got a chance to propagate their genes and made sure their generation didn’t end prematurely!  


Times have changed today. Since the practice of Ayurvedic medicine was done by word of mouth during ancient days and is vigilantly guarded among families, the enormous knowledge our ancestors possessed about different curative plant compounds, their mode of preparation and the principle behind such practices are eventually lost! Although there are medical schools which teach Ayurveda, there are very few Ayurvedic practitioners existing in India today. Western medicine being based on strong scientific-evidence and rationality, gained importance eventually and is widely followed in today’s India. With improvement in biomedical research and the knowledge gained thereof, ground-breaking discoveries have emerged in the field of reproductive medicine. As a result, modern age infertile couples have enormous treatment options to deal with any kind of infertility problem. With patience and persistence most infertile couples can hope that their dream of having a baby will become a reality!


But the ironical truth is, even today, many infertile couples feel uncomfortable to use western medical advancements that are available in the field of reproductive medicine. The reasons are twofold: many western medicine based infertility treatments are costly and not everyone could afford to spend so much, as a result, many resort to traditional medical practices like Ayurveda or Unani (which are comparatively much cheaper) even though the chance of success is very low or even nonexistent for many infertility ailments using such traditional approach. The other reason is that, unfortunately, still many Indians believe that western medicine is evil and pose many unpleasant side-effects. Especially if you have a granny at home who never went to a modern hospital and managed all her and her family illnesses using traditional medicine, the first advice you receive will be to seek the help of an Ayurvedic medical practitioner for your infertility problem! Some even depend on “faith healers” like “witch doctors” to cure their infertility problem.


So, if you are faced with infertility problem what will you do? If IVF patients depend on such alternative medicine for improving their chance of success, does it make sense? How do doctors who practice western medicine view it when their patients depend on alternative therapies to cure their infertility problem or to improve their chance of success?  Although alternative medicine is practiced world-wide, a lot of infertility specialists are not always happy when patients depend on such treatments. They feel that the patients are being fooled by these primitive systems of healthcare and they pity them for wasting their precious reproductive period by following treatments, which they think, are fruitless.


Doctors who practice western medicine spend many years in medical school, acquiring their degrees. They then work hard at acquiring practical experience in a hospital, so that they can get a license to practice medicine. IVF doctors study for as long as 10 years before they can hang out their shingle as IVF specialists. Not only are they proud of their expertise and experience, they naturally want to guard their domain jealously. They have a low opinion about alternative medicine and its practitioners because they are poorly trained and they acquire a degree in as little as 6 months. Many IVF doctors feel that such degrees are of no value and are just a “license to kill”. Also, they often have a superiority complex, because only western medicine has modern technology (such as vaginal ultrasound scans and endoscopy) at their disposal, to make an accurate diagnosis, based on which they can recommend the right course of treatment on a scientific basis. They think that alternative medicine practitioners do not have the same depth and breadth of training as they posses and many doctors feel that alternative medicine clinics are encroaching on their territory. They look down on these doctors as being quacks, who have no effective therapeutic interventions to offer because they lack any evidence to prove their efficacy.

On the other hand, many alternative medicine practitioners are equally happy to bad-mouth infertility specialists who practice western medicine. They scare their patients by telling them that IVF is “artificial” and the babies born out of IVF are “weak” or abnormal. While some envy the high income an IVF doctor gets, others genuinely believe that the holistic options which they offer have a higher success rate. They feel that IVF is like band-aid therapy, and does not attempt to fix the underlying problems in the infertile couples.


As a result of this conflict between the doctors who practice western medicine and alternative medicine, patients end up getting confused as to which is the reliable argument. In order to try their luck, they shuttle back and forth between these two medical practitioners and finally get frustrated with the treatment process and many end up sacrificing their dreams of a baby being born to them. If this is the case, how should a responsible doctor react? What advice should they give their patients?


We need to remember that many infertile couples will actively seek out alternative medicine options, even when undergoing treatment for IVF. These options are highly respected by their family elders and deeply rooted in their culture. They are also much less expensive. Hence they believe quite logically that even if they have not been proven to help, they will not cause any harm (although this is not true)! This is why they want to cover all possible bases and try them out, to ensure that they have not left any stone unturned in their baby chase. There are tons of anecdotal success stories of women who have conceived after taking a particular herbal concoction; and this, even as the scientific base of alternative medicine is not always strong.


Doctors who practice western medicine must understand that unless and until they take into account the cultural healing beliefs of the patients and learn to incorporate them within their treatment regimen in a rational way, it is impossible to achieve patient satisfaction. Improved patient satisfaction will lead to better compliance to therapy. Cultural competency of the healthcare provider is very important to help patients get the best medical care and also to be successful in one’s own medical profession.

Alternative medical practitioners should also understand the limitation of the treatment they can offer to an infertile couple and encourage them to seek appropriate infertility treatment from western medical practitioners when needed. After all, a patient with a blocked fallopian tube cannot be cured with Ayurveda and Unani medicines. Giving patients false hope and wasting their precious fertile period is very unethical on their part.


Every infertile couple has to decide wisely about their treatment options. Of course, there are some problems which can be cured by alternative therapies (for example anovulation due to PCOD!). But there are problems like low sperm count, blocked fallopian tubes and much more which cannot be cured using herbal concoctions. A well-educated patient will know for sure which treatment should be opted for, after analyzing their medical problem. It is also wise to find a balance, for example when you are going through IVF and if your alternative medicine practitioner advices you to take a herbal potion which he might think will help create a healthy environment for embryo implantation or which might balance your hormones, then it is nothing wrong in trying it, provided such advice is given by a reputed practitioner who is not a quack. Please do not believe in the claims of mushrooming internet sites which are claiming to provide you with herbal therapy to make your IVF a success. First, you will never know if what they are providing you will be of benefit and the next concern is, it should not harm you or your IVF cycle. Remember, many herbal medicines carry the risk of being contaminated with heavy metals!


Rather than taking a confrontationist approach, patients would find it a lot easier if IVF doctors and alternative medicine practitioners could learn to work together for the wellbeing of the patient.
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