The Usual Suspects (Part 1)

No encounters with Alyssa paying KKH a visit can be recorded in just a single blog entry so dear peeps, you can expect several entries for this latest episode. Lol.

It all began when I woke up to a nasty shock on Saturday morning. Alyssa was running a rather high temperature. She was fine the night before, finally no running nose and no cough. She barely recovered from the flu which she had suffered from for more than a month, and now, fever? Paracetamol hardly help relieve her fever. I had to feed her the painkiller every 4 hours and finally, there came a point where the medicine DIDN'T help with her fever at all. (Note: According to the Pharmacy techician, paracetamol is supposed to be fed to the child every 6 hours, but the duration in between can be shortened to 4 hours if the child is suffering from high fever. They are not supposed to take paracetamol more than 5 times in 24 hours.)

At this point, I decided to bring her to our favourite place: KKH (again). The decision was made for several reasons:

1. The fever cannot be controlled anymore with the paracetamol (and by right, babies less than 1 year old should not be fed ibufen, an Non-Steroid Anti Inflammatory Drug used for the relief of symptoms for arthritis, fever, etc.)
2. There are no other symptoms accompanying the fever. Could it be something serious?
3. Alyssa was refusing food (again)

By the time we got to KKH, Alyssa's temperature has gotten up to 39.4 degrees and we were told to go to passage 11 immediately. That's what I like about KKH. They really make sure children get attention quickly if they are sick. Anyway, the doctor checked her and found nothing wrong with the ears and throat and decided that she needs a urine test. Then, the nightmare began.

It first started behind passage 11 where we have to feed her the paracetamol again, this time in slightly higher quantity as compared to the usual dosage. There, Alyssa screamed her head off, as if we were abusing her, even though we were just trying to feed her some paracetamol. I could see the horrified look on the faces of other parents and children, as they watched us struggling to feed Alyssa the medicine, and Alyssa struggling not to be fed the medicine. Then the nurse handed us a cup of Pedialyte to be fed to Alyssa over an hour. As Alyssa had refused all drinks during the day, the Pedialyte had to be given to her to ensure that she's not dehydrated and also to replenish whatever electrolytes she might have lost during the course of the day. The Pedialyte was also administered to help her pass urine so urine test can be done.

That was another nightmare. Alyssa spared no energy for struggling and screaming while we tried to feed her the drink at the waiting area. Everyone was horrified by her screams and some parents even walked over and stood around to see what was going on. We were supposed to feed her at 15 minutes interval, but we ended up taking the entire hour to feed her just 60ml of drink. Not to mention, much of the drink ended up on the floor and on my face as she made many successful attempts of spitting the liquid out. She was a ferocious baby. While it may seem like a long wait we had just to see the doctor, it was not. The hour passed even before we knew it.

As she still hadn't passed any urine during that terrifying hour, the doctor told us to wait for another hour, since we are already there and our home is too faraway from KKH. Luckily this time, Alyssa decided to cooperate with us and passed urine.

Now, you must be wondering how they collect a baby's urine. Nope, they don't perform the test on the baby's diaper of course, or ask the baby to pee into a container. They attach specially made bags over the baby's private part to collect the urine.

As only very little amount was excreted, I did not even transfer the urine into the container they gave me, but just handed the urine bag directly over to the nurses. After 5 minutes, the nurse came to us and told us preliminary test indicates Alyssa is positive for urinary tract infection and further tests need to be carried out in the lab to confirm the finding. We will have to wait for another hour for the lab test.

There goes my Saturday night.

New discovery

Wow wow wow. I made some new discovery today while surfing around looking for new recipes for Alyssa.

According to www.huggies.com.sg, using appropriate chopping boards is a way to ensure food safety for your baby and wooden chopping boards have been shown to yield the lowest bacterial covering after use and washing. I never knew that! I always have the perception that plastic ones will be cleaner because the wooden ones look so dirty. I had even suggested to my mother-in-law to get plastic ones in the future. Looks like I have to tell her otherwise.

So far, I haven't found any recipes suitable for Alyssa. If you peeps happen to come across any interesting ones, please send me the recipe or the link. Thanks!

The New Huggies.com

Wow!!! I received an email update from Huggies.com and this is what it says:

So, I decided to check out the site to see what it is all about.

I got a pleasant surprise after I signed in:

Note I can actually have a full profile on Huggies.com now, like I do on Facebook? It's one of the rare sites I came across that has integrated a social network function! It's something I've always thought a business should do and Huggies.com have done it! Huggies is really making the effort to engage the mommies and give them reasons to return to the site.

However, the question I have is, what makes the mommies want to spend time on the site maintaining a profile when they already have enough to do on Facebook (not to mention taking care of the babies)? Plus, they won't have as much friends as they would do on Facebook. While it is good effort, this might be much easier accomplished if they work with the social networks i.e. Facebook or Friendster. Instead of asking the mommies to establish a new profile on Huggies.com, it could be possible they import their basic profiles from the social networks. In that way, their activities on Facebook can also be posted on Huggies.com, easily making Huggies.com a more dynamic place. Users are also more familiar with the (social network) interface, thus making it easier for them to update profile/status when they are on Huggies.com. This is in addition to the knowledge that these social networks are extremely viral tools. Activities by these members can be seen by their friends, and ta da, there you go, it's marketing to NEW potential customers, besides engaging and retaining the old ones.

But it is too early to say Huggies.com wouldn't do well. We shall see.

Good effort Huggies! I love your diapers!!! (More discounts please!)

Re: New Year Resolutions and Wishes

I was just looking through my blog to see what I've been rattling on for the past year and came across interesting entries e.g. my quarrel with Desmond over a Louis Vuitton bag, my mahjong adventures. Then I came to this: my resolutions and wishes for 2009.

It's almost end September, meaning there's less than a quarter year more to go for 2009. I wonder how much effort I have put in to achieve my resolutions (thank goodness I blogged about it, otherwise I would have forgotten that I even have any resolutions or wishes to begin with). It is evaluation time.

These are my resolutions for 2009:

1. I wish for my little adorable daughter to continue to be healthy, grow well, talk to me soon, be a really smart girl and look more like a girl (last time we went to Plaza Singapura, the whole world mistook her for a boy. Kids in the lift commented that HE is so cute).
2. I wish my marriage will continue to be a happy one and Desmond will find a career suitable for him.
3. I wish I'll build my career this year.

Seriously, wish no. 1 is really very much a wish that I have little control over. It's mostly up to Alyssa. Ok, I may have some control over the part she falls sick and appearing like a girl. I try my best to clean her stuff every weekend to make sure things she uses are clean and I've bought her tons of pink dresses. But she still falls ill frequently. I can't even track how long she's had this latest stuffed nose of hers and she's only just recovered from a case of bronchitis. Wish no. 1, fail.

Resolution no. 2. Ok, I think I'm quite happily married (most of the time). Desmond hasn't found a suitable career yet, though I'm trying very hard to help him. I just wished he'll take resume writing more seriously. Note peeps, I'll be introducing a job search series very soon, based on my experience with Desmond. Look out for that.

Resolution no. 3. I have to confess I did nothing about this for the most part of 2009 but that is about to change very very soon. :)

Hmmm, I suppose I've attained 40% of my resolutions and wishes. Not too bad considering what a crazy year it has been with Alyssa falling sick so frequently, but I think I can do better. It's also probably time to think of new resolutions and brace myself for the challenges ahead.

Alyssa's Diarrhoea - Part 6 (The Follow-Up Appointment)

So, Alyssa returned to the clinic for a follow-up appointment 2 weeks after being discharged from the hospital. Prof. Phua was the one who followed up on her condition, thank goodness. It feels good to know your kid is being looked after by some Superstar Award recipient (By the way, good marketing tactic by the hospital. LOL.)

Anyway, we did not have to wait too long for our turn at the gastroenterology clinic and while we were waiting, Alyssa was happily standing on and moving around the seats. She had started learning to walk then and parents, do not underestimate a child's enthusiasm for learning. They seem to have endless energy when they are bent on achieving something. I had to sit there and endure a child who could never stop moving and trust me, it is a very tiring task.

We learnt during this visit that Alyssa is a proportionally small child. That is, she's not only thin, but also short. We wondered if that's a good thing. At least her below-average weight wouldn't be so much of a concern now as it matches her height. Now, I also wonder if her weight problem is due to my alcohol consumption during the first month of my pregnancy (hey, I didn't know I was pregnant, that's why). I read that babies with low birth weight can be a result of alcohol consumption during pregnancy, so mothers-to-be, beware. (http://www.ehealthmd.com/library/smokingpreg/SAP_alcohol.html) Luckily Alyssa isn't showing signs of mental retardation, otherwise I'll kick myself for it. Actually, I don't think there's anything wrong with her growth rate (her weight then was supposed to be 3x her birth weight and she wasn't too far from that, considering she had diarrhoea and her diet had been compromised due to the illness).

Alyssa seemed to be fine now that there wasn't any signs of diarrhoea during the 2 weeks after the discharge.

Prof. Phua also checked her immunisation records and asked if we were intending to give her the pneumococcal vaccine. At that point of discussion, the pneumococcal vaccine was an optional vaccine the parents can choose to have for their baby. This changed when the Ministry of Health decided this week that it will be a compulsory vaccine from now on. The probability of a child catching pneumococcal diseases is actually quite low, however the complications of the disease are devastating. The child usually does not recover fully from the infection and may be left paralysed or dead. As Alyssa is at a high risk for catching the disease since she's in contact with alot of kids at the infant care, he suggested that she has the vaccine as a good precautionary measure. It is very good advice and Desmond and I decided that we bring her for the vaccination when she turns 1. (Note: different doses of the vaccine are administered to children of different ages when they have the first dose of the vaccine. E.g. babies lesser than 1 year old will require 3 doses of the vaccine whereas babies aged one year and above at the time of the first dose will require only 2 doses of the vaccine.)

Actually, I had went for the follow-up appointment with a few questions for Prof. Phua that had nothing to do with the diarrhoea. I thought it'll be good to make my monies worth.

1. Alyssa fell off my bed last week. Is she fine?
2. Are carrots good for babies?
3. Is it ok for the food Alyssa ate, to turn up in her poop?
4. Can he give her some medicine for her flu?

1. Alyssa fell off my bed last week. Is she fine?

Yes, Alyssa fell off my bed the week before the follow-up appointment. It was definitely our mistake. We thought she was sound asleep and left her so on our bed, thinking that she would call for us if she wakes up, like she would normally. Turned out, she decided to look for us instead of calling out for us when she woke up and fell off the bed in the attempt to do so. There was a terribly big bump on her forehead and it became so dark due to the bruise when we found her on the floor (now we know how 印堂发黑 come about?!). She also cried non-stop for a good 15 minutes or so even though I tried my best to pacify her. I can imagine she must have been really traumatised by the accident.

Prof. Phua gave us the painful look when we told him of the accident and asked if she vomited or bled (from ears or nose) after the incident, to which we replied there was none. We then learnt that the longer the child survived the fall without any of the abovementioned symptoms, the higher the likelihood that she is alright. A skull x-ray is thus not needed in this instance. That made perfect sense, though not always the case. There was a news in the papers that a child's head injury went undetected for years and was later on aggravated when he had another unrelated accident, causing him to slip into a coma. I just hope that she is really fine. Prof. Phua also gave us some suggestions to prevent such incidents from happening again, e.g. to lay the floor with mattresses so the impact of falls would be lessened. Of course, the best thing to do, really, is to let her sleep in her own cot. It is a little hard though, since she's had the habit of sleeping on our bed as if it's hers and would refuse to sleep if she was put in her cot. Moral of the story: NEVER let the baby sleep on your bed from Day 1.

2. Are carrots good for babies?

Carrots traumatised me ever since she started her porridge diet, largely because of opinion differences between my mother-in-law and I. I think there's nothing wrong with feeding her a fifth or a quarter of a carrot once a week over the weekend while my mother-in-law thinks it's too much carrots. She would usually come over to me when I'm cutting the carrots and tell me it's not good for the baby to have too much carrots. I would then tell her that I don't really think that's too much carrots for her when I only feed her once a week and come on, we all know that carrots are full of goodness (except they turn people orange if there's really an over-consumption). We didn't quarrel over it but still, it was quite uncomfortable situation so I decided to find out from Prof. Phua if carrots are indeed bad for babies and how to tell it's too much carrots.

To answer the question, Prof. Phua looked at Alyssa's soles and hands. If someone indeed had too much carrots (or even pumpkins), their hands and soles would turn orange (first) due to the excessive amount of Vitamin A present. So, Alyssa wasn't having too much carrots! Then he said, everything should be consumed in moderation (that is, carrots are ok if they aren't consumed in too great a quantity). Tada! There's nothing wrong with me feeding my baby carrots!

3. Is it ok for the food Alyssa ate, to turn up in her poop?

It is also normal for the food babies eat to turn up in their stools, most commonly: carrots (and one other thing he mentioned which I cannot remember). Not all food are that easily digestible by the baby at this moment but rice is one thing that SHOULD NOT turn up in their stools (by turning up in their stools, I mean you can see the carrots in her stools in the exact form she had them). Ok, check. Another mystery solved.

4. Can he give her some medicine for her flu?

Alyssa had been having running nose and it didn't seem to be going away so I decided to ask Prof. Phua for some medicine. However, all he was going to give me was chloropheniramine, to which I think isn't very effective, as compared to medicine e.g. Zyrtec. What Prof. Phua would later tell me, was however, contrary to my belief. Zyrtec doesn't really relieve symptoms from viral infections and is actually more effective for allergies. Chloropheniramine works better for viral infections. This is really strange. So why is Alyssa responding better to Zyrtec? This brings us to an important question which I have not thought of asking: how do we tell a child is having sinusitis and not a viral infection?

It is typical of sinusitis effects to be more pronounced under particular environmental conditions such as, in the mornings, when the child is in air conditioned rooms, whereas viral infection effects are more consistent, regardless of the environment. From my observations, Alyssa was more likely to be having a viral infection, rather than sinusitis, even though she is at a high risk of suffering from that since it runs in Desmond's family. However, it is certainly something I should look out for in the future.

Generally, Prof. Phua thinks it's alright for a child to catch a flu, as long as she remains happy, so we really don't have to worry too much. Of course, I told him about the problems we face, such as the accusations of us not doing enough to make the child well, but he assured us that we should not let such accusations get us, as long as we have done whatever we could to help the child (that is, we've brought her to the doctor). Sometimes we just need to let nature takes its own course.

Overall, it was a good follow-up appointment and Prof. Phua is my favourite doctor now. :)

Alyssa's Diarrhoea - Part 5

Her stools remained watery (there was one time when there was a puddle of water when we were changing her diapers). She even vomited once (Note, there is a difference between a baby having a reflux reaction and vomiting. Reflux in babies is common, where small amounts of milk backflow, out of the babies' mouth after consumption. This is because babies' stomaches are quite small (about the size of their fists or a golf ball), so they are easily distended by the milk, and their lower esophagus valve may be immature and may not tighten up when it should. http://www.webmd.com/parenting/baby/bottle-feeding-9/spitting-up. The condition tends to improve as the baby grows up. Vomiting, on the other hand, is a forceful reaction.) I could hear her stomach churning very loudly and saw that she was turning pale when she was about to vomit. The next thing I know after I asked if she was ok, I got puke on my shirt. It was yellowish-greenish liquid that came out of her. I was really worried, however, had no choice but to send her to the infantcare. Thank goodness she didn't not vomit anymore for the rest of the day.

Persistent diarrhoea and vomiting yellowish-greenish liquid are not good signs. Vomitus containing bile (a green substance) may mean blocked intestines (http://www.babycenter.com/0_vomiting_9955.bc) while persistent diarrhoea may signal certain intestinal diseases that is potentially dangerous. (http://www.health24.com/medical/Head2Toe/777-778-783,11814.asp). Alyssa's condition did not improve after a week, and being really concerned she might have contracted some of these terrible intestinal diseases, we decided to send her back to KKH. Another reason was also we needed to confirm she's fine, if there's nothing wrong with her, so the infantcare wouldn't bug us anymore. They were really worried about Alyssa's condition and that the disease, if there's any, may spread to the other kids at the infantcare.

The doctor decided immediately upon seeing her to admit her for observations as 2 weeks of diarrhoea may signify something more serious. We were sent to her ward at 11pm and waited for the doctor visit. Alyssa was really funny when the doctor was interviewing us to get more information on her condition. She sat on the nurse's desk and tried to snatch the doctor's document. Everyone found her quite amusing, apparently. The doctor even offered her Tigger keychain to her, until I cautioned her that Alyssa's quite likely to put that thing into her mouth.

Again, we had to wait for her to poop so that tests can be carried out on her stools to determine the cause of her diarrhoea, only this time, the diarrhoea decided to stop. She did not poop for the 2 days she was hospitalised, until the doctor who saw the her the last time came and did a check on her. The doctor-in-charge of the ward decided that the doctor who looked after her the last time she was hospitalised was the best candidate to follow up on her condition as he's the gastroenterology expert of KKH (he's Prof. Phua Kong Boo. We later found out he's the recipient of some Superstar award at KKH and there's a full body picture of him at the clinic). He decided to send her home again, with more advice than the last time.

1. The baby is probably ok if she still appears happy, like Alyssa, even though she may be having watery stools.
2. Porridge is better than milk for baby if she is having diarrhoea. This is because milk is more likely to spoil/be contaminated than porridge.
3. Solid food should be Alyssa's focus now. (We were also concerned that she was refusing milk)
4. Chicken is a good source of proteins for baby. (I can't remember if it's because it's easily digested)
5. Baby doesn't have to pass motion everyday. She is only constipated when she shows difficulty in passing motion.

He wasn't so concerned about her diarrhoea, but more about her height and weight. Apparently, she's supposed to be 3x her birth weight then and she has some catching up to do.

Luckily, this ended the diarrhoea episode and we just have to bring her back for follow-up check-ups about 2 weeks later.

Some interesting things did happen during this stay though. For example, she had biscuits for the first time in her life.

Overall, we were just so glad she's finally recovered after such a long period of time. I can only say it's really not easy being a parent.

Alyssa's Diarrhoea - Part 4

OMG. I can't believe a month went by just like that and yes, I'm still at Alyssa's diarrhoea, Part 4, when she's down with bronchitis now. Anyway, I should finish the story.

So, she got admitted into the hospital for the first time. It was the routines when we got to the ward. The doctor came and asked for the details of the entire diarrhoea episode and we were trying our very best to recall the happenings in its entirety while Alyssa was happily walking around her bed. I don't know how she managed to look so happy all the time, even when she's so sick.

Anyway, as diarrhoea patients don't just lose water but also electrolytes, the doctor decided to take some of Alyssa's blood to see if she's dehydrated where water and electrolytes are concerned. They took Alyssa to a special room for blood taking and since it could potentially be a traumatic experience for mothers to see their babies screaming in pain, I was advised to stay out of the room. Even before they started drawing the blood, we could already hear Alyssa's screams from outside. The screams just got worse during the blood drawing. When that was done, the doctor commented that she was a mighty baby who managed to give the nurses a few slaps.

Since Alyssa could potentially be dehydrated and may require the drip, the doctor decided to insert the connector into her hand first so she needn't be poked a second time. A thick piece of cardboard was attached to her wrist to prevent Alyssa from bending her wrists and hurting herself since a needle was stuck there. Besides being a mighty baby, she was also a baby without any concepts of pain. To my horror, she tugged at the tube which was sticking out of her hand and I had to ask the nurse to hide the tube from her. When the tube was missing, she went chewing on the cardboard. She eventually managed to free the cardboard from her wrists after 2 days of gnawing at it. I can't believe how mighty my baby is sometimes.

After she settled down, we had to wait for her to poop so we could collect her stools for testing to find the reason for the diarrhoea. She pooped about 5 times for the 1st day and the soy milk made her stools look and smell worse. The doctors couldn't do much while we waited for the test results and only fed her Lactoel Fort in an attempt to make her diarrhoea better (not that there was anything else which could be given to her). She did better the second day and actually did not poop for 12 hours till the next day. This was an indication to the doctors that the diarrhoea had stopped and the doctor-in-charge decided to send her home even before the tests results are out. By the way, stool tests will typically take 3 days for the results to be out.

I, for one, was quite happy to take Alyssa home. While Desmond stayed in the hospital during the day with her, I took the night shift. For the two nights Alyssa stayed at the hospital, I had to go to the hospital after work, go home to bathe and change, then return to the hospital to spend the night with her. It didn't help that the foldable bed at the hospital wasn't comfortable at all and it was freezing at the hospital. I left directly for work the next day from the hospital. One can imagine that I was really worn out during that few days.

I took the day off knowing that she could go home to spend the day with her and make sure that she was alright. However, her appetite took a turn for the worse when she got home and the diarrhoea returned...