05 June 2013

Review Heart Doctor Report at SGH Obstetrics and Gynaecology (O&G) Centre

So we went back to O&G to review the report with the gynae and we talked about my wife's heart surgery done in Thailand. This time we brought along a memo from the Thai doctor who operated on my wife, we also told the gynae that last time we checked, the Thai doctor said my wife can have baby, but only one child at the most, and there will be a 10% risk. The gynae then gave us two options, one is to go for abortion but we must do it within 24 weeks of pregnancy as that is the legal limit, two is to continue with the pregnancy and they will monitor closely, of course we choose the latter.

The gynae then told us that they have to take my wife off Warfarin and put her under Low Molecular Weight Heparin (LMWH) for the next 7 weeks starting from today, by the way, my wife is about 5 weeks pregnant now. She said this is because the baby will be developing vital organs from the 6th to 12th weeks so it's important to avoid Warfarin during this period, and the alternative blood thinner for this period will be LMWH  And from the 13th week onwards until close to delivery, my wife should go back to Warfarin. Then when we are close to delivery, we will need to change back to LMWH  She also mentioned that vaginal delivery will be too much for my wife's heart and we will need to do a Caesarean delivery.

Unlike Warfarin which is taken orally, this LMWH has to be injected under the skin, but not into the muscle, sounds like a delicate task, and it has to be done twice a day, 12 hours apart. I've done it for my wife just now, it wasn't as difficult as it sounds, she didn't bleed at the point of injection, and she feels ok so far, I think that should do it, phew, but she was yelling every time I push in the liquid so I had to do it really slowly, a little bit at a time. I'm glad I did ok considering I never did anything like that before.

Finally, we got an appointment on coming Monday for a blood test to make sure the LMWH is working as intended, and at least we seem to be moving forward, I hope we can reach the 12th week with no problem.

For those searching for LMWH, the brand I'm using for my wife is Clexane, one syringe contains 60mg Enoxaparin Sodium and qs ad 0.6ml water.

So today I paid,
S$58.85 for repeat consultation under associate consultant.
S$211.80 for 14 days of LMWH; 28 syringes.

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