Wednesday, December 2, 2015

Fathan : Prolonged Jaundice

Fathan, seperti abang-abangnya, diagnosed as G6PD deficient. Jaundice starts on day 1 of life and being treated up to intensive phototherapy. Discharged on day 6 of life at TSB level of 197 (11.5).

Masa discaj, nurse ada bagi referal letter from MO peadiatric to MO KKIA to monitor jaundice and weight. Tapi aku tak terus pergi klinik. Aku berurut dulu seminggu tu, sambil tunggu nurse datang buat lawatan ke rumah dulu. Dah habis urut 7 hari, nurse tak datang pun lagi. Rupanya ada miscommunication. Hahaha..Day 15 baru nurse datang. Fathan still kuning lagi. So nurse suruh pergi klinik petang tu jugak.

Reading TSB turun, tapi masih belum melepasi paras normal -- 86 (5). So Fathan had few weekly series of visit KKIA, and the TSB reading are as per listed below:

Day 6 (discharge from hospital) -- 197 (11.5)

Day 15 -- 158.1 (9.3)

Day 22 -- 119 (7.0)

Day 30 -- 137.7 (8.1)

Day 35 -- 112.2 (6.6)

** TSB reading kadang ada yang ratus-ratus kadang belas-belas. Nak convert dari belas ke ratus tu, darab dengan 17. Vice versa kalau nak dapatkan reading belas-belas. Faham tak? TSB reading kat atas ni aku bagi dalam 2 bentuk. Yang dalam kurungan tu, darab 17 akan dapat bacaan di luar kurungan. Dah anak 3 ni baru aku tau sifirnya. Pening jugak dulu sebab hospital bagi reading ratus2, kkia pulak rendah sangat reading tapi kena datang gak banyak kali..Confuse makcik... Huhu..**

Bila Day 30 tu, reading tiba-tiba naik balik. So, MO KKIA diagnosed as prolonged jaundice and suruh refer Klinik Pediatrik Hospital Ampang for blood test. Basically to find out the reason of the prolonged jaundice. Kalau full term babies, selalunya jaundice akan hilang dalam 2 minggu. Premature selalunya lambat turun (3 weeks) sebab hati dia lambat matang and that the babies are relatively small in size. So kalau term babies still having jaundice after 2 weeks, considered as prolonged, and they will examine urine, stool colour, thyroid function, liver function etc. Fathan ni sebulan dah, belum hilang lagi kuning. One of the reason is due to G6PD deficient tu lah. Tapi rekod abang-abang dulu, 2-3 minggu je dah ok..

So, Day 44, we went to Hospital Ampang. 4.28kg dah berat awak Fathan oi.. Bila pakar tengok record of previous TSB result, dia kata "6.6...pun refer??" Aku pun explain lah yang 6.6 tu the last reading. Klinik suruh refer masa reading tiba-tiba naik tu. Then doc tu examine Fathan. She said, physically looks pink. And then dia kata, looking at the previous record, ignoring reading yang day 30 tu, nampak menurun, which is good. And since Fathan doesn't look yellow anymore, dia suggest to do basic blood test first. Should the result appear to be negative, hospital akan contact for further assessment to be conducted. Otherwise, just ignore the test, means ok je lah, nothing serious.

Doc tu explain lah kat aku. basically jaundice ni happens in all babies. Sebab, masa baby dalam kandungan (fetus), sel darah merah fetus dipanggil Hbf {Ours are Hba}. Hbf ni sangat cekap mengambil oksigen dari ibu semasa dalam kandungan. When a pregnant mom inhale, most of the oksigen inhaled is being utilized by the mom herself. Only little amount left for the baby. So, fungsi Hbf ni, ambil baki-baki oksigen yang tinggal tu untuk fetus. Bila bayi lahir, dia mula bernafas sendiri. Hbf is not needed anymore. Hbf will slowly be replaced with Hba. Proses penguraian Hbf will cause jaundice. Kalau hati bayi belum matang, its either proses penguraian menjadi lambat or hati tak mampu nak proses penguraian tersebut. Kalau hati telah matang tapi jaundice masih ada or lambat turun, terdapat kemungkinan faktor lain seperti breastmilk jaundice or thyroid. Breastmilk jaundice, mungkin sebab faktor pemakanan ibu. Ibu masih perlu teruskan breastfeeding seperti biasa and jaundice will insyaAllah be reduced, only that it takes longer time. Dan mak tak boleh ambil jamu..huhu..

So for Fathan, he undergone basic blood test, and Alhamdulillah nothing serious. Probably it was just breastmilk jaundice. Dalam seminggu lepas tu, rasanya he is free from jaundice sebab mata pun dah elok putih, takde lagi kuning-kuning kat hujung anak mata. Alhamdulillah. Aku pun, takdelah nak berjamu selagi jaundice tak hilang. Dah 60 days, baru aku berani ambil jamu..huhuhu..


Syukur Alhamdulillah it wasn't thyroid ke apa. Alhamdulillah membesar dengan sihat, minum susu dengan penuh semangat.. Hehe.. Nak masuk 3 bulan dah awak. Cepatnye lah masa berjalan..

No comments:

Post a Comment

Copyright to ily's
Designed by UMIESUEstudio 2015