Sebelum mencedok atau memetik 'ilmu' dari laman ini, anda tidak perlu meminta kebenaran tetapi diingatkan membuat semakan sendiri terlebih dahulu dengan doktor anda atau guru anda sebelum mem'forward'nya kepada orang lain dan memikul tanggungjawab akibatnya.

Pohon doa kesejahteraan dan limpahan rahmat Allah ke atas guru-guru saya dan juga pesakit-pesakit saya yang banyak mengajar saya bidang ini. Segala pujian bagi Allah (peringatan ini untuk diri sendiri) . Mudah-mudahan, taubat saya diterimaNya dan segala dosa saya diampunkanNya serta saya terus dilimpahi rahmatNya. Sekiranya ada kesalahan, pohon dibetulkan, saya terbuka kepada teguran.

Sebarang percubaan berbentuk komen atau soalan bertujuan mengiklankan apa sahaja perniagaan atau blog sendiri tidak akan disiarkan. Blog ini bukanlah untuk iklan menjual barang. Peace.....

Wednesday, 25 June 2014

Mari Bersenam

BMI adalah salah satu kaedah mengetahui sama ada kita mempunyai berat badan berlebihan ataupun ideal.



Bagaimana hendak mengira BMI?

Formula BMI = (berat dalam unit kg) / (ketinggian dalam unit meter dan kemudiannya diganda-duakan)

BMI (dalam unit kg/m2)

< 19                      : underweight
19 - 24.9               : ideal
25 - 29.9               : overweight
30 - 34.9               : obese
35 dan selebihnya : morbid obesity.


Mari saya tolong kirakan berat badan ideal (dalam kg terhampir) berdasarkan ketinggian kebanyakan wanita Malaysia.

Bagi yang mempunyai :

- ketinggian 5 kaki 1 inci (155cm)     : berat badan ideal adalah di antara 46-59kg
- ketinggian 5 kaki 2 inci (157.5cm)  : berat badan ideal adalah di antara 47-61kg
- ketinggian 5 kaki 3 inci (160cm)     : berat badan ideal adalah di antara 49-63kg
- ketinggian 5 kaki 4 inci (162.5cm)  : berat badan ideal adalah di antara 50-65kg
- ketinggian 5 kaki 5 inci (165cm)     : berat badan ideal adalah di antara 52-67kg
- ketinggian 5 kaki 6 inci (167.5cm)  : berat badan ideal adalah di antara 53-69kg

Bagi yang mempunyai ketinggian selainnya, silalah kira sendiri ya.


Bagi kita yang mempunyai berat badan melebihi BMI 24.9 ini, sama ada overweight mahupun obese, bukan senang hendak menurunkan berat badan semula. Terutamanya bagi wanita yang mempunyai sindrom PCOS (makan sedikit tetapi berat cepat naik, sebaliknya bila kurangkan makan dan bersenam berat badan lambat turun berbanding rakan-rakan kita yang lain)

Tetapi tidak ada jalan yang berkesan melainkan kurangkan makanan berkarbohidrat (terutamanya gula) dan lakukan senaman secara berkala/routine.



Bagi yang pernah ke bangunan klinik (Blok B) Hospital Pantai KL ini, inilah 'muka' baru pintu lift. 

Lift kiri



Lift kanan.
Haa....tak boleh mengelak punya.



Heheh
Segan juga nak berdiri tunggu lift (sebab tangga tu ada di sebelah kanan lift ini).

Klinik saya di tingkat 4 (alasan).
Dulu-dulu rajin juga menapak naik tangga 4 tingkat. Sampai atas memanglah jantung berdegup kencang. 

Lepas tu, mula mengelat.
Naik lift sampai tingkat 3 sahaja dan kemudian gunakan tangga untuk naik setingkat sahaja.

Lepas tu, mengelat lagi.
Turun tangga sahaja. Bila nak naik ke tingkat 4, guna lift all the way up, haha.




Tetapi bila pandangan dah tak boleh dielakkan. Pusing sana sini pun, nampak 'iklan' yang sama. Maka saya pun bersemangat menghidupkan azam lama.

Yang ini pula pada pintu tangga di blok C dan D. Saya suka gunakan ini untuk ke Teater Pembedahan. Lagipun cuma satu tingkat sahaja, macam kat rumah :))


dan dalam setiap lift pun, ada 'iklan' ni.

Ouch!



Ehem-ehem.....

Puan-puan;

Marilah kita bersenam.

Jangan mengelat.

Makanan pun kena jaga.
Makanan berkarbohidrat, cuba kurangkan jadi separuh.
Kalau sebelum ini biasa makan sepinggan nasi, kurangkan jadi 'separuh' pinggan.
Kalau sebelum ini biasa makan 2 keping roti, kurangkan jadi sekeping.
Contoh sahaja.
Kalau tak boleh tahan juga nak makan banyak, mulakan dengan berhenti minum air bergula dan makanan manis.

Ya.

Jangan minum air bergula dan makanan manis.
Gula termasuk dalam kategori karbohidrat ringkas, sangat mudah untuk ia bertukar kepada lemak jika tidak digunakan/dibakar secara aktiviti fizikal.


Memang ramai yang tak suka bila dinasihati "Puan kena turunkan berat badan ni".

Susahnya nak turunkan....


Tetapi ingatlah;

Obesiti menurunkan peluang kehamilan. Berlebihan lemak badan mengatasi 10-15% sahaja didapati meningkatkan hormon estrogen dan ini mengurangkan peluang kehamilan.


Obesiti juga meningkatkan risiko keguguran.

Jika BMI kita overweight, risiko keguguran meningkat kepada 20%
Jika BMI kita obese, risiko keguguran meningkat kepada hampir 40% (38%)


MARILAH KITA BERSENAM UNTUK KESIHATAN TUBUH DAN JANTUNG.

SAYANG JANTUNG, SENAM-SENAMKAN....

Ouch lagi!



Psssst...

Peringatan ini sebenarnya untuk diri sendiri (sebab dah masuk kategori overweight, wuaaaaaa) yang kadangkala bersifat Dewan Bandaraya apabila makan dan apabila ditegur anaknya "Bila Mama nak mula diet ni?" saya pun bagi jawapan yang sama "Esok la...".


Wednesday, 4 June 2014

IVF Forum





One-hour session.
We adhere to almost Swiss-time punctuality.
Registration : 8.30-9am
Session starts at 9am, GMT +8 for Malaysia time zone
I have to be specific when talking about time here :))
30-minute talk followed by 30-minute Q-and-A and free consultation.

(Only a small group of couples is preferred (20 couples). Don't worry, this is a monthly session. I take turn with another IVF specialist/fellow)


Either in Bahasa Malaysia or English.


As always, please allow time for possible traffic congestion (although unlikely as it is still during school holiday, but it's Saturday when people go out shopping and eating outside) and also time to look for parking space.

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So, what's news?

Apart from the usual IVF talk (why, when, process etc etc),



Come and listen to the explanation as to why we advocate

BLASTOCYST STAGE Embryo Transfer.

See the difference above?
The sizes, for example.





Even blastocysts have gradings.
Even blastocyst embryo transfers do not result in 100% pregnancy rate.
But still,
Blastocyst Embryo Transfer (Day-5 or Day-6) gives the highest pregnancy rate compared to
Day-2 or Day-3.





So, we transfer your embryo/s on Day-5 or Day-6 when they should have developed into blastocyst stage (the top embryo)

Two embryos (mostly, in >85-90%)
or
One embryo (sometimes, in 10-13%)
or
Three embryos (in a small selected group, about 2-3% ie in those who had had unsuccessful IVF attempts or if there is only 1 blastocyst while the other 2 are still behind blastocyst-stage)

Never four embryos with this approach




No more on Day-2 (4-cell embryo). This embryo still remained at cleavage-stage (blastomere) on Day-5.





Not on Day-3 anymore (6-8 cells). The same with this embryo although it was already on Day-5.




and preferably not at morula stage, unless necessary (if the embryos are still at that stage even on Day-6)





 Blastocyst, dear.....




Blastocyst......




(seru lagi)

..........'Blaaaaaaastocyyyyyyyst'....

  :)


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Embryo selection is very important.

EMBRYO SELECTION.



Apart from 'rezeki',

..... probably that is why our pregnancy rate has always been maintained at above 50% every month, this year (except for January when it was 44%). All in. Every patient who underwent/completed the cycle until ET was included in these statistics (all age group including those who had taken the medicine 'wrongly' not as instructed).

One of the highest (if not the highest) pregnancy rates in IVF centres in Malaysia, considering I do NOT do IVF/ICSI using oocyte donor or surrogate mother or sperm donor (expectantly the pregnancy rate should be higher if oocyte donor, sperm donor and surrogacy are included).

This is higher than the pregnancy rate in normal couples (15-25% per cycle).

- Nothing to boast around as this can also happen to any IVF centre that does blastocyst culture.
- Nothing magical.
- Nothing to do with me (as I am not God)

We need to have a good IVF lab and embryologist.
That is factor number 1 in determining IVF success.

No 2 : patient factor.
- Healthy eating.
- Ideal body weight.
- Do not smoke.
- Have faith and do not easily give up.


ICSI-blastocyst : the way forward for us.

Embryo Culture until Day-5 or Day-6 is already included in the package price.



Sekian.




Green Earth untuk hiasan (memandangkan gambar2 embrio biru sahaja).

Cekur. 
(Sila abaikan rumput dalam background, maklumlah Puan rumah ini 'rajin' berkebun)
Sedap daunnya dihiris halus dan dimasukkan dalam bancuhan cucur udang. Isi/ubi cekur pula ditumbuk dalam ramuan pecal ikan pari/terung.



Daun kaduk. 
Kalau malas nak buat 'mieng kam', makan sahajalah daun tu seperti ulam.



Se'lautan' daun pegaga yang tumbuh syok sendiri. Sedap dijadikan ulam begitu sahaja atau dibuat urap.
Siapa yang singgah, silalah petik sendiri.




Semua kenal ikan gelama ni kan?



Kenal ikan ini?
Ingat pantun yang ada ikan gelama tu?



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Betul! Ini ikan kekek!


Hmm......

Malaysia tanahairku

Summer all-year-round.

Hujan berlian rupanya.......

Terasa sangat kerinduan ini.....


Monday, 2 June 2014

Perhatian (pesakit IVF Jun 2014) dan Selingan

Selamat bercuti.

Foto untuk dikongsi bersama sambil menghayati keindahan ciptaanNya.


Enchanting sunset view dari PLUS highway.
(err.....bukan saya yang memandu waktu ini tau)


Juga untuk renungan bagi mereka yang masih belum berjaya hamil dan sesiapa sahaja yang lain yang ditimpa 'kesusahan' dan merasakan dirinya 'malang' ;



renungkan dan ingatlah lagi;


Every cloud has a silver lining.



"Dan sesungguhnya akan Kami berikan cabaran kepadamu dengan SEDIKIT ketakutan, kelaparan, kekurangan harta, jiwa dan buah-buahan. Dan berikanlah berita gembira kepada orang yang sabar. 

(Iaitu) orang yang apabila ditimpa musibah, mereka mengucapkan : Inna lillahi wa inna ilaihi raji'un"

Al-Baqarah : 155-156.




Saya juga masih bercuti sekolah lagi. 

Saya masih meneruskan tempoh berpantang bercuti bersempena cuti sekolah anak walaupun di mana sahaja termasuk di KL demi menghormati 'mother-dotter bonding session' :))



ACHTUNG BITTE
Attention please
(TOLONG BERI PERHATIAN)


Kepada pesakit-pesakit IVF bulan Jun ini;




Pohon IKUT SETIAP ayat yang saya telah beritahu secara lisan dan juga yang tertulis pada borang IVF anda, kerana setiap satu mungkin berbeza daripada pesakit yang lain. Beri perhatian kepada perkara besar mahupun kecil. Pay attention to little things....




Little things are more exciting as they make you wonder (and be amazed at) how on earth can a person be so meticulous and 'OCD' ? 
(The above miniature people ara less than 2cm tall and there are millions of them

Teliti setiap satu ya.





dan sebagai pesanan tambahan (anda telahpun diberi pesanan supaya terus menghubungi saya apabila didatangi haid);


- Whatsapp DAN (bukan atau) email saya.

- Saya akan balas, cuma mungkin LAMBAT beberapa jam atau paling lama pun sehari.

- Jangan risau, selagi saya belum balas, SAMBUNG ubat yang sedang diambil. Jika habis, beli lagi. 

- (sekali lagi) Jangan risau walaupun anda masih belum memulakan suntikan rangsangan. Kaedah saya untuk anda mungkin tidak sama seperti kaedah saya untuk pesakit lain.

- Sekiranya pada Jumaat akan datang ini (6hb Jun) anda didatangi haid dan saya masih belum membalas whatsapp atau emel anda, sila BERHENTI dahulu ubat yang sedang diambil ie jangan ambil ubat tersebut pada waktu malam hari Jumaat itu. Pil terakhir adalah pada Jumaat pagi itu. Itu sahaja. JANGAN mulakan apa-apa suntikan dahulu. TUNGGU sehingga saya balas (tengah malam/awal pagi Sabtu 7hb). Jika saya masih belum membalas, sila whatsapp sekali lagi pada pagi Sabtu tersebut.

- Sesi 'soal-jawab' ini hanya berkaitan dengan ubat/suntikan IVF sahaja. Soalan-soalan lain lazimnya akan kekal sebagai sesi 'soal TANPA jawab' sahaja, harap maklum dan jangan berkecil hati ya.




Sekian.

Sementara itu, untuk santapan minda

See and think,


If some people can be this meticulous, what excuse do we have to do 'cin cai' work?




To start with, there are many of these miniature people.

When I say many, I really mean a lot!


Imagine....

Within just one square metre, I repeat; ONE sq m; they can do this.


 Kasi dekat lagi sebelum ambil gambar

Then zoom in.
You see?




Again,




See this?


Now, zoom in again (otherwise you cannot see their expression/action)



We, well she can spend more than 30 minutes on each sq metre section, and there are hundreds (if not thousands) of sections. If the miniature people are just below 2cm tall, imagine how small the sheep and dogs are.


sanngup membongkok nak ambil gambar ni....

...and she would capture what she called interesting scenes.....

......every handphone-sized sub-section tells a story....



...and she would also 'peep' inside the train....


....and looked into the inside of the building.....






There are so many interesting sections that would either make you want to just have a glance (as you'd be afraid that there wouldn't be enough time to see all) or made you stop for a while and 'enjoy' every little thing they'd worked on and now they want to show you. 


Another example,



At the airport public carpark (yes, public carpark only, not yet the rest of the huge airport )




 ...you can see this.....



 ...and this...

...and this :))
(sempat mengata)




.....and here, you can see....

...this...

...and this....


....and this...

...and many others too....



....and that was just at the airport public carpark section.

...in this room where the ongoing video was played and the arrivals and departures of the airplanes were on time as displayed on the monitor. Not to mention almost real take-offs and landings of the model airplanes at the end of the picture, according to the time stated on the electronic board.


When in actual fact, this attraction is famous for its huge network of trains (of course with railways). 




....one of the rooms...
Wait! No! Not one. A quarter of that one of many rooms.



Of course, their famous (miniature) port is also there.

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.


Now, ask ourselves again;


Where do we position ourselves?

How meticulous or 'cin cai' do we want to do our job?

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and answer honestly.


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Many who have known my Clone well can guess what's in her sometimes-it's-Calvin-like mind. Sampai habis bateri hp dia and she then used mine to continue taking pictures. With serious looks as if she was deep in thought, taking close-up then zoomed-in pictures, she would sometimes turn to me with a big grin;


"Ma, imagine if ...... "
(I know that you want to know what she said, but I'm not telling, but then again, it's not difficult to make a guess)

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then;


"Ma, I want to come here again tomorrow!"


Haaaah?   Another 'a few' (read:many) hours on little things again tomorrow....?


Layan sajalah, Labu.
Dah namanya mother-'dotter' bonding session.



So;


Meet My Clone
(She has grown up, the picture on my profile pic was years ago)


aka my 'copy-paste' (what her friends sometimes call her)

aka my photocopy (what my Prof refers her as)

She is now 15.





Dari jauh, memang muka kami serius/sombong pun. Bila pakai cermin mata, saya nampak macam gurubesar yang garang. Nak buat macamana....




 at times we are like sisters or even bff




but most of the times, we are quarrel buddies.
She still likes to make funny faces.



Susah nak dapatkan gambar proper dia senyum macam ni. This smile was unexpected because before this take she gave funny/weird faces, that's why muka saya pula yg serius.




In the same morning before check-out today, she can be really funny and the next hour,  really sweet.




She was then 8 or 9, I can't remember. Kami baru lepas 'bergaduh' masa ni. The conversation usually ended the same;

"Tak nak kawan Mama"

"Habis tu...Mama nak kawan dengan siapa?"

"Mama kawan sorang-sorang"

and that made her feel that she had won the quarrel and all was well again until the next quarrel episode.


This is the same person who still causes me headaches (at much less frequency now) and prompts me to take leave whenever there's school holiday.