Tuesday, January 8, 2013

2nd Baby ¦ G6PD, Jaundice

بِسْمِ اللهِ الرَّحْمنِ الرَّحِيمِ

Since aku bersalin malam, haruslah bermalam kat wad kan afterwards. The next day, masa HO round pagi tu, the first question aku tanya kat HO bila result test darah tali pusat keluar. Of course, my main concern is whether si adik pun G6PD deficient or not. Knowing that my first SON is G6PD deficient, the doc can only smile and said that the chances is very high since second baby is also a boy.

Sementara tunggu result keluar, aku hanya mampu tawakal je. Almost tengahari, enchek HO tiba-tiba menjenguk sambil sengih-sengih...
"Puan, good news...Confirm G6PD deficient"
"Good news eh...hmmm...kena check in 5 days kat pediatrik la ni..."
"Itulah...macam tu la nampaknya"

Aku redha je. Dah boleh menduga. Dan dah bersedia..
InsyaAllah kali ni aku lebih kuat..
Lewat petang baru aku discharge wad post natal..Saje lambat-lambat, tunggu Ma, Ayoh ngan Mama datang dulu...Dan jugak, nak jumpa Faheem dulu sebelum masuk wad pediatrik (wad 4A)..Bila dah masuk wad 4A, cuma hubby je boleh visit..
Lepas rindu puas-puas dengan abang Faheem dulu...
Sempatlah Ayoh & Ma tahnik kan baby.

Masa Faheem dulu, dia kena warded exactly 5 days.
Faqeeh pulak, extended another 2 days.
Jaundice detected on 36hours of life.
Masa 3rd day jaundice dah sampai abdomen.
His total serum bilirubin (TSB) reading was 210, 261.6, 261, 268, 255.6.
Bila second reading naik jadi 261.6, doc suruh start phototherapy.
Kalau ikutkan, the reading is below the photo level. Untuk berat Faqeeh (2.83kg), photo level is 285.
Tapi, since dia G6PD deficient, doc takut jaundice naik mendadak, so precaution action was taken.


The day yang TSB reading drop from 261.6 to 261 is the fifth day. Patutnya dah boleh discharge, kalau ikut ideologi engineer aku ni la...Anything that is below the limit should be fine..itu aku punye engineering judgement ah..huhu..
Tapi kata puan doc, she still want to monitor. Sebab, the reduction is too small with phototherapy treatment. Jadi dia sangat risau kalau jaundice naik balik. Rebound jaundice. Plus that, she said that jaundice normally starts at day 5 for normal babies. With G6PD it could be even worse.
So, extend another day to monitor for rebound jaundice. Pasang photo lamp until 12 midnight. Then tutup, balut baby kemas-kemas. Doc datang pukul 3 pagi ambil darah for TSB..


Unfortunately, result TSB naik jadi 268. Lagi tinggi dari hari sebelumnya.
Memang confirm doc tak allow discharge sebab katanya with that kind of reading, anytime je boleh naik to 300+.
Kata puan doc, banyak case jaundice for normal baby yang dia allow balik with that kind of reading, then datang balik hospital with TSB reading of 300+. So for baby with G6PD deficient, she does not want to take a risk. Its better to treat it early before things become worse.
The treatment pulak, double photo until petang. Petang doc akan ambil darah for TSB, if reading turun, off 1 photo until 12 midnight.

Masa doc cakap pasang double photo, mata aku dah panas da..Bila doc pergi je, meleleh terus airmata...Kesian my little baby..Dengan suara makin serak, kulit macam terbakar, badan jadi kering...Tapi fikirkan demi kebaikan dia, aku kena kuatkan semangat supaya baby pun sama kuat. He is a fighter, I know it for sure..


That evening, result turun to 255.6. HO allow to off both photo lamp. Tapi aku yang macam risau.
"Tutup dua-dua ke doktor? Pagi tadi doktor cakap kalau result turun tutup satu lampu sampai pukul 12. Then baru off another lampu."
"Kalau tengok result ni, saya rasa ok dah. Dah boleh tutup both lampu...ermmmm...mak nak balik esok tak?"
"Nak.." laju je aku jawab..huhu..
"Ok, saya bagi mak pasang 1 lampu sampai pukul 12."
"Lepas tu ambil darah lagi ke doktor?"
"Tak ambil darah dah."
"Then esok macam mana nak tau ok ke tak?"
"Pagi esok MO akan tengok"
Aku berfikir lagi...Mungkin nampak obvious sangat kerisauan kat muka aku...HO tu sambung lagi..
"Camni, saya bagi mak pasang lampu sampai pukul 4. Tanpa ambil darah. Pukul 4pg mak tutup lampu sendiri. Tapi 1 lampu je tau. Nanti orang question kenapa pasang lampu tapi tak ambil darah. So pukul 4 tu mak kena make sure lampu tutup la ye."
"Ok. Terima kasih doktor."

Aku terpaksa biarkan Faqeeh tidur bawah lampu photo tu lagi, dengan hanya pakai diapers. Terketar-ketar dia kesejukan..
Pukul 4pg, aku tutup photo lamp, bedung Faqeeh kemas-kemas, aku biarkan dia tidur dalam pelukan aku untuk hilangkan kesejukan. Nyenyak dia tidur..Alhamdulillah...


The next morning, bila HO datang round, aku tanya boleh discharge tak hari ni? HO jawab, tunggu pakar.
Then HO round lagi dengan MO. MO cakap nampak ok. Jaundice at face only. Plan for discharge. Continue photo lamp until discharge. Tunggu final decision from specialist. Hati aku dah berbunga riang.
Then, another round dengan specialist. Specialist cakap, continue monitor sampai petang without photo lamp. Monitor for rebound jaundice. Aku agak hampa disitu. Ingatkan tengahari dah boleh discharge. Extend ke petang pulak..


Later that evening, HO dengan MO datang round. MO tanya aku
"Mak nak balik?"
"Mestilah doktor. Dah seminggu daya kat sini.."
"Boleh, ambil anak bawak lari..." MO tu gelak...Sabar je lah aku..
Lepas examine Faqeeh, MO cakap boleh discharge but to come again kalau nampak kuning sampai chest..Come directly to hospital, walaupun tengah malam...


Alhamdulillah..After 7days terperuk dalam wad tu. Another important thing, kiterang plan nak buat aqiqah hari Sabtu tu, means genap seminggu umur Faqeeh. Hubby dah siap order kambing and catering. Risau jugak kalau terpaksa cancel off the plan. Alhamdulillah discharge hari jumaat petang, so the plan for the next day tu still on..




Baby Faqeeh was discharged on Friday evening. Balik Ampang dulu kemas-kemas barang, tunggu Maghrib.
Then balik Gombak. Terpaksa travel malam sebab discharge lewat petang.
Aqiqah was done on Saturday.
Awal pagi sementara aku berurut, hubby cukur rambut Faqeeh.
Lepas Zohor buat doa selamat dan makan-makan.


Hari Isnin baru hubby report delivery kat KKIA Ampang.
The next day, nurse datang rumah. Baby still nampak kuning.
Nurse suruh datang klinik hari Rabu for TSB.
TSB reading on Wednesday was 11.2. Kena repeat lagi TSB on Thursday.
Alhamdulillah TSB reading on Thursday dropped to 7.9.
Tak payah repeat lagi.
Alhamdulillah..

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4 comments:

  1. Ili.. G6PD tu apa ek? Google tp xpaham..

    ReplyDelete
    Replies
    1. Kurang enzim dlm sel darah merah...so, sel darah merah die mudah pecah/terurai..
      Masa bby ni, plg bhye bile kena jaundice. Sbb compare dgn bby lain, kuning die akn naik cpt & mendadak. Sbb tu kne warded at least 5hr utk monitor. Klu ade jaundice tgk ah cmne..tu yg bby kne tahan srminggu hr tu sbb kuning die agk tinggi..
      Pastu, die xleh mkn kacang parang, n xleh expose dgn ubt gegat, ubt nyamuk...sampai bila2, n keturunan die pun mgkin akn ade jgk...bnde ni xde ubt pun..klu dia mkn kcg patang, dia akn jd pucat, kencing jd merah sbb srl daraj merah pecah..the only treatment is masukkn drh...

      Delete
    2. Oic... Thanx Ili.. Slalu terbaca, tp xtau amende tuh.. Hope ur baby doing fine.. (^_^)

      Delete
  2. ank aty qaleef eeman pon ade g6pd....

    ReplyDelete

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