Gestational Diabetes?

On Saturday, 23 February 2013, I went for my Glucose Challenge Test (GCT) which is the screening test for gestational diabetes (GD). I was 27 weeks pregnant when I did the test. The GCT involves drinking a sweet, lemonade-like drink containing 50 grams of sugar and then they take your blood one hour later. They say you don't have to fast beforehand but they didn't say you HAVE TO EAT so I turned up to my 10:00 am appointment on an empty stomach, only to be turned away and told to eat something first before coming back. So I quickly ate a Ham, cheese and tomato sandwich and a cup of tea at a nearby hotel, and came back to do the test. I finished by meal 15 minutes before the test.

And that, I think, is why I failed the GCT. I ate too close to the test. 

Dr Harry was very gentle when he told me the results at my checkup on Friday 15 March. He said I'll need to do the Oral Glucose Tolerance Test (OGTT) to rule out gestational diabetes because my result after the 1 hour test was 9.6 which was higher than the normal range of <7.8 mmol/L.

Without any delay, I booked my Oral Glucose Tolerance Test (OGTT) for Tuesday 19 March 2013. I was told I had to be on a 3 day diet of high carbs, followed by a 12 hour fast before the test. This test is to diagnose diabetes and involves taking 3 blood tests over 2 hours. Before drinking the 75 gram sweet drink, they tested my urine for glucose using a pee stick (looks similar to a pregnancy test) to make sure that it was normal, because if it was too high I could feel sick after drinking the sweet drink. Then they took my blood, and told me to drink the drink, which is horribly sweet.

I wasn't allowed to leave the premise or eat/drink anything for the next 2 hours so I just sat around reading Apocalypse Z: The Beginning of the End by Manel Loureiro (translated by Pamela Carmell) til my next 2 blood tests (1 hr intervals in between).

After the test, I was so hungry, I ate a single Adana shish kebab plate all on my own and promptly fell asleep when I got home because I ate too much carbs. 

I was a bit worried during the days leading up to my next checkup. I was beginning to think that I had GD because my grandparents have diabetes and I hadn't been eating very well during the pregnancy. I've been eating large meals, snacking on Calippo ice blocks and other sweet stuff in between and drinking coca cola *gasp*. 

In the belief that I had GD, I downloaded On Track, a glucose tracking app to manage my glucose level, in case it got to that, but I got turned off logging my food in this app because I didn't know how to calculate or look up carb numbers and couldn't find a simple nutrition look-up app. So, I downloaded Doc's Diet Diary, a basic food log app so I could start tracking my food consumption. I've been logging my food consumption for the last 5 days now.

My checkup is scheduled for tomorrow, Tuesday the 26th of March but I just couldn't wait for the results so I called Dr Harry's office this morning. Anne, the receptionist called me back an hour later with the result - 

THANK THE LORD, I PASSED! I don't have GD! My score after the 2 hour test was 6.9 mmol/L which is within the normal range of <7.8 mmol/L.

No more worrying about gestational diabetes, but this experience has certainly taught me that I need to watch what I eat, exercise more and trust in the Lord.

But first things first, I must celebrate with some Tim Tams and a can of coke. :p

Old habits die hard.

Hello Sydney!

When I was 26 weeks pregnant, I moved back to Sydney after spending over 4.5 years living in Jakarta.

In preparation for my flight to Sydney, I had booked five weeks in advance to see Dr Ivan to get my medical clearance letter but a few days before my appointment, I got an sms from Morula Clinic advising me to re-schedule my appointment as Dr Ivan was going to be out of town for a few days. Unfortunately, I could not re-schedule as the half a dozen calls I made to Morula Clinic just did not get through. So, I had no choice but to see a different doctor, Dr Bramundito at RS Pondok Indah (RSPI) , who is pretty good and RSPI appear more organised in terms of admin and ease of communication. By the way, I was flying with Qantas and I technically didn't need a letter unless I was 28 weeks or over but I got one just in case.

When I got to the airport, I mentioned that I was pregnant at check-in and they asked me how along I was and if I had a medical clearance letter. I think if I had said no, they'd have let me off, but since I did, they photocopied my letter and must have flagged me as 'High Priority' because when I went to the boarding gate, a bleep went off and I saw on their computer screen that I was 'High Priority' but no one at the airport said anything to me about what is meant, like whether I could board early with all the people requiring assistance or anything. Anyway, I was quite capable of waddling my way around and didn't really need any assistance, though it would have been nice to jump the queue!

My flight was uneventful though I must say I felt quite bloated and made regular trips to the bathroom - good thing I asked to be seated near the toilets (six rows away from the back toilets is not bad). Even when I was not pregnant, I'd still feel quite bloated. I watched The Sessions on board, starring Helen Hunt and I hoped no one was looking at my screen because there was a lot of nudity and sex scenes - not a film to watch in public, but since I had started, I didn't want to quit half way in fear of what other people might think or say about me.

I have now settled in Sydney, and am living back at home with my Mum and brother and his wife. Life is breezy. I'm not working and don't plan to, but I've been busy doing the bookkeeping for my Jakarta Church in preparation for their AGM in a few weeks.

I finally got around to booking the Childbirth/Parenting and Breastfeeding workshops at my local public hospital because the classes at Westmead Private were fully booked out. I had wanted to book the Westmead Childbirth workshop back in November but I didn't because I didn't know if DH would be in Sydney. I've booked the Childbirth workshop for early April, whether DH is here or not, I can always go with Mum. The hospitals recommend that you take the Childbirth classes about 6 weeks before your due date in case you deliver early and so you can do the classes with people with similar due dates. The breastfeeding class is scheduled for early May.

I saw my Sydney OB, Dr Harry A. Ngo, a Vietnamese doctor on Thursday 28 February for the first of my Australian antenatal check ups. Smaug is fine, he's already in the head-down position, and moving a lot. He weighs about 1.1 kg and was dated to be about 28 weeks which is on track with my pregnancy. From now on, I have to have fortnightly check ups. That's fine with me, as it means I have a reason to go to Bankstown and have some nice Viet food.Dr Harry also consented to collect Smaug's cord blood too.

DH and I have decided to store Smaug's cord blood for 18 years with Cryosite Ltd. It will set us back about A$3,000 (Plan A) but we see it as insurance for any future medical problems eg leukemia. Our friend Lis banked her daughter's cord blood about 2 years ago so we put her down as our referral and she consented to have her Refer-a-friend bonus of $50 applied to our payment plan.

We also asked Dr Harry about circumcision for boys and he said most OBs are not trained for that and if I want it done, I'd have to consult a General Surgeon. I'm not too fussed about it but I think that DH's side of the family are pro-circumcision. I'm not sure why but it's common for boys to be circumcised in Indonesia.

Heading into the third trimester, I can say that I frequently get back pain, hip joint pain and powerful but not painful kicks from Smaug. They don't hurt a lot but it's uncomfortable and I feel like I need to massage the area on my tummy where I was kicked to ease the discomfort. I also have restless sleep, and pee on average about 2-3 times a night. My stomach has grown a lot since I hit 6 months, and I have awful red stretch marks. My Mum had it too but the redness has faded, leaving white stretch marks which are not too unsightly. I've gained over 9 kg and am now over 70 kg.

Baby Shower at 24 weeks

On Sunday 24 February 2013, we had our Baby Shower when I was 24 weeks pregnant (ie 6 months pregnant). Because I was departing Jakarta at 26 weeks, I didn't want to leave the Baby Shower too late because I had a lot of last minute things to do before my departure. Originally, I had planned for Sunday 10 February but that would have been the first day of the Lunar New Year and many of my friends would not have been able to come because they'd have to visit their families, so we moved it one week earlier.

The afternoon Baby Shower was held at 3pm at my MIL's house in Permata Hijau, and it went very well. I think that for many people, it was their first Baby Shower, myself included, so not many people knew what to expect, which is fine because it's a relatively new thing in Indonesia, even among some of my expatriate friends from countries other than the United States. We invited men, women and children although I know traditionally, it's usually reserved for females only.

My parents-in-law helped out immensely. Amongst other things, my FIL prepared home-made roast and corned beef which involves a lot of cooking and re-cooking, especially the corned beef. My MIL organised practically everything else:

• from setting up tables and chairs and re-arranging furniture, 
• preparing the finger foods (which was just delicious, think smoked salmon on toast, greek salad etc), and beverages. 
• she even hired two bartenders to serve drinks, a large A/C for the outdoor area, a tent and arranged a balloon guy to pump floating gas into the balloons (not helium, some other gas). 

What did I do? Well bits and pieces, DH and I prepared the 3 Baby Shower activities:

1. Words of Wisdom: Advice Cards for the Parents-to-be, to be stuck on a board for all to see. We chose three winners: K, Vee and SS and they each won a Nokia 101 phone. 
2. Baby Name Suggestions board. During the Baby Shower, people were invited to write baby name suggestions on a board. Sof suggested Smaug, the dragon from The Hobbits - she even drew a picture of a dragon next to the name. Since then, a few people from my church, have nicknamed the baby 'Smaug'. 
3. Messages for the Baby: Guests were invited to write messages for the baby using T-shirt markers on two cotton onesies. The onesies won't be worn on the baby, it will only be a memorabilia from the Baby Shower. 

I also ordered 120 mug souvenirs for the Baby Shower as well as 5 dozen cupcakes from Chocolate Amore (they stock some cupcakes in Kemchicks @ Pacific Place Mall). The cupcakes were very nice and affordable at Rp 210,000 per dozen. 

I was surprised to find that Debenhams in Senayan City sold many Baby Shower accessories like banners, ballons, party favours and invitation and advice Cards. I do warn you that it's not cheap - we spent almost Rp 1,500,000 on baby shower accessories during the Lunar New Year sales. 

We also set up a Wii for the kids but there weren't many kids who came, though it did get used by Sof, Na and Ji2. 

At around 4pm after many of the guests had arrived, my vicar, Rev. Ian gave the opening speech and prayer which was a real blessing. Three years ago, he also prepped DH and I before our marriage so it was nice to have him at another of our key milestones in life. DH also gave a bilingual speech after Rev Ian. He was somewhat unprepared but he pulled it off nicely, with the help of a few cans of Heineken prior. After that, we started opening the gifts and reviewing the baby shower activities.

It was a nice and happy event, and a lot of my extended relatives and friends from all walks of life were able to mingle and get to know each other. It's hard to bring different groups of people people together but I thought it went very well.

We received many wonderful gifts and all will be used on the baby for sure - surprisingly we didn't receive any diapers! We didn't prepare a Baby Shower wish list so I was very grateful for some of the more practical gifts that we received because I would never have thought to include them (in no particular order):

• Safe n Sound Britax 'Lifestyle' convertible car seat for babies aged from 0-4 years. This was given by K, PS and SS. PS went all the way to Singapore and brought it back for us! This car seat is a compact model, meets Australian Safety Standards and we'll be able to use it for a good while!
• Panasonic 'D-Sterile' dish dryer. This was given by Shan & her husband and is a wonderful gift because not only does it sterilise baby bottles and the like, it's big enough to sterilise plates and various kitchen accessories. I tried to find one in Sydney but I don't think they sell this in Australia. 
• Allerhand Messenger diaper bag. This was given by Sin and is an excellent quality diaper bag that comes with many pockets, components and looks conspicuous enough to pass as a Messenger bag. He also picked out a great colour for DH to wear! Allerhand is a German product and if there's one thing they're known for, it's their quality. 
• Lastly, DH's family and relatives generously donated money to help us out. With this, we'll be able to buy some nursery furniture when we get back in September. 

We are so blessed to have everyone's love and support. I feel assured that Smaug will grow up around many people who love and care for him. But we could not have done any of this without Jesus for it is through his Grace and Love that he has given us Smaug and everything to come. Thanks be to God!

20-week Morphology Scan

This arvo, my mother-in-law (MIL) accompanied me to see Dr Reino Rambey, an obstetrician (OB) who specialises in Ultrasonography at Visi Scan Clinic in the BIC Building in Jakarta.

In summary:

• It's a BOY! ^___^ My boy was quite active and frequently sucked his thumb. 
• All fetal measurements are within normal range (being 10-90%), though generally it's below the 50th percentile, meaning it's a bit on the small end but still normal! Of course, all parents want their babies to be above average but not everyone can be above the 50th percentile...
• The femur length (FL) is one week behind (17th percentile) which is okay, though, I did get a bit anxious after reading online that a short FL is a soft indicator for Down Syndrome (DS). But I do have short legs and a long torso so maybe my baby takes after me in that respect. I'm 168cm/5'5" and DH is 174cm/5'7". DH has long legs though. 
• I'm seeing my usual OB, Dr Ivan Sini, next week so I'll show him the results and ask for his medical opinion about the FL being short. I'm wondering if I should consider amniocentesis for peace of mind, though it wouldn't change the fact that I'm keeping the baby. My first trimester nucal translucency test at 13 weeks was good and showed I had a very low risk for DS. Age = 30, NT = 1.3mm, BhCG = 22.5 U/L and PAPP-A = 3.83 U/L. 
• Placenta is positioned high and anterior. Cervix closed, heart rate 153 bpm, Estimated fetal weight (EFW) is 341 grams which is equivalent to the 42nd percentile for 20 weeks gestation. Amniotic Fluid Index (AFI) is 12.3
• My estimated date of confinement is 23 May 2013, which is only 2 days later than my Estimated Due Date by LMP. 
• All in all, a healthy and normal pregnancy. As doctors call it, an 'unremarkable' pregnancy, which is perfectly fine with me! 

After the scan, I sms'ed my Mum in Sydney to update her on the progress of my pregnancy and to inform her that her first Grandchild will be a boy. I would have liked to tell her in person but I'm sure she'd rather find out ASAP than wait until February when I arrive. After all, I did tell her in person about my pregnancy when I was 10 weeks in, and at that time, she responded in confusion (she asked my MIL 5 times if I was really pregnant and asked me once), then came speechless shock as the news dawned on her and finally with overwhelming tears of joy. I got a bit emotional seeing my Mum cry. It was a joyous day for Mum because her son was getting married that weekend and her daughter was going to have a baby. 

Anyway, on the way home, my MIL asked me whether I've been thinking about baby names. This topic is a bit 'touch and go' as I didn't want to offend her in any way but would prefer to keep the list of potential names secret until the baby was born. I did tell her I'd like a biblical name but one that's not too common, to which she mentioned that DH's paternal grandfather's name was Abraham... x_x  A bit too old-fashioned for me. DH prefers a name that, when shortened to a nickname, sounds good and not too cheesy. 

I've started using the almond oil that I bought from L'Occitane. I do like it as it seems to absorb well into the skin but the odor is quite strong for my liking. 2-3 big squirts is enough to cover my belly and breasts. I showed my belly to my friends Shanty and Tris the other day and Shanty, who's already had two kids said my skin is thin so I should really use a belly oil as thin skin will likely give me stretch marks. And she advised me not to scratch my belly too. Actually now that I think about it, my MIL warned me about that too but the advice didn't sink in until another person suggested it. 

I read that genetics plays a big part in stretch marks. I can't remember if Mum had prominent stretch marks, I recall seeing stretch marks on her belly but I don't think they were too bad. I'll have to ask her over Skype some time. She'll probably want to show me her stretch marks over webcam too... XD

5 months pregnant in Jakarta

Hello, and welcome. This is my first pregnancy and I will be blogging periodically about my pregnancy journey so I can remember it in years to come.

Today, 2 January 2013 marks the fifth month or 20th week of my pregnancy. I am half way through my pregnancy! ^___^

Tomorrow, I have my 20-week morphology scan at BIC Jakarta with Dr Reno. I was told at my 17-week scan that I might be having a *** but my obstetrician, Dr Ivan Sini at Morula Clinic (part of Bunda Hospital) said to hold off from buying boy themed things until a few weeks more when the gender is absolutely certain. 

Tomorrow, my mother-in-law (MIL) will accompany me to the scan because my Dear Husband (DH) will be out of town for work. 

I have been taking multi-vitamins (Nature's Plus Prenatal tablets) containing folic acid and extra calcium (Caltrate). Dr Ivan says that in Indonesia you don't need to take Vitamin D. I also have another multi-vitamin called Elevit which I bought in Sydney but I want to use up my Nature's Plus vitamins first.

In terms of symptoms, since the start of the second trimester, I have had: 

• restless sleep and wake up with a stiff back most mornings. My sleep quality isn't as good as it used to be because I'm constantly changing positions at night or going to the toilet. I try not to drink anything before bed. 
• my stomach is slowly getting bigger but I have no visible signs of stretch marks (yet!) but my bump is pretty much visible to the keen observer. No hiding that!
• My breasts are still expanding and filling up. I think I've gone up a cup or two. I have a roadmap of veins all over my chest and breasts.
• My nipples are getting darker, larger and more lumpy. About once a week, I have sore nipples like someone is pinching them for a good 20 mins or like having ice against them. 
• I've only gained about 2 kg since the start of my pregnancy and most of that weight was added in the last 2 weeks. The Dr was not worried at my last scan (17 weeks) because the baby was growing well (measured 180 grams compared to the average of 140 grams) and so the weight gain of the mother is not so important. Thank the Lord that my placenta is working well!
• People have commented on how my skin looks good but I honestly don't see any difference. Indonesians have an old wives' tale that predicts you will have a girl if the mother looks nicer during her pregnancy. 
• My skin is rather dry all over. Yesterday I bought a new body oil for my belly from l'occitaine. It's called Almond Supple Skin Oil and it cost me Rp 600,000. It's designed for pregnant women so it's safe to use. I haven't used it yet as I absent mindedly left it in the car. 
• constipation, that is, two or less bowel movements in a week. I have been eating more than usual but I don't go to the toilet as frequently as I should be. 
• A few times a day, I will feel movement in my belly. From weeks 15-19, I felt what feels like a bubble or popcorn popping near my belly button. Now, it doesn't feel like a pop but more like a weak jab. 
• My eyes feel drier and I should use eye drops but I haven't been. 
• Occasionally at night, maybe once a week, I get leg cramps in my calf. When I do, I stick my heel out quickly to stretch out the muscle. 
• I have noticed an increase in white vaginal discharge but it doesn't smell. At least I'm not spotting anymore. I was spotting for almost one month from weeks 5-8 and my Dr said he could see a small sub chorionic hematoma but the bleeding cleared up in week 8. I was on progesterone pills  (Duphaston) until week 13. 
• My vagina has stopped itching, I was itching during half of the first trimester. I thought I might have had thrush or a urinary tract infection (UTI) for a while but my lab results came back clean so I guess not. I have been using a feminine wash daily called Lactacyd which I think has been helping as I no longer feel itchy down there.
• I'm more absent minded and emotional. Just watching a sad TV commercial can bring on the waterworks.

In terms of baby shopping, during my recent trip to Hong Kong, I bought: 

• Combi Miracle Turn Premier stroller (Purple Leaf design)
• Medela Swing breast pump
• Ergo Baby carrier in purple with a beige infant insert
• 1 Grobag sleeping bag tog 2.5 (size 6-18 months)
• 6 Charlie Banana cloth diapers with disposable inserts
• Pigeon disposable breast pads 2 x 51 pairs = 102
• Jaco Breastmilk storage bags (120 bags)
• various maternity clothes

There's a lot more stuff I have to buy but I don't want to buy too much too early. Some people are very superstitious about that kinda stuff and don't want to buy things too early in case things don't turn out well. But I have no doubt that my baby will turn out okay because he/she is God's gift and God always knows what's best for you.