After a full 3-day of not knowing why Noe refused to extract milk from Rani’s breasts, it has now been concluded that Noe experienced a difficulty due to “overactive milk ejection reflex”.
What happened during the last 72 hours was causing so much stress to Rani and me. All of a sudden, Noe just went on strike beginning Tuesday, 29 March at 3:00am. Having seen him in that condition, I deliberately, and with guilt, fed him a small bottle Enfalac at 1:00pm and he was given another one inside Parent Craft’s consultation room at TMC. Ms. Wong Boh Boi and Ms. Grace cleaned up Rani's glands with Medela's robust suction machine (yes, it is a machine indeed) because they thought Noe was not able to extract the milk due to some clogging; which could be partially true, although not completely solving the case. Ms. Wong could not find a solution even after Rani had come back for the second visit the next day.
I could imagine how sad it was for Rani who had hoped for the best; mother's breastmilk. Rani felt depressed and began finding ways to avoid using teats through spoon feeding. Later in the evening, Ibu Tuti came just in time to provide support to Rani during the evening on Wednesday. Noe seemed to manage the spoon feeding quite well although not as fun as breastfeeding, of course.
Luckily my smart wife managed to find Ms. Doris Fok, an independent senior lactation expert affiliated with NUH, this morning, who was available to give Rani a full 2-hour long consultation and declared that the problem was due to hyperactive lactation inside Rani’s glandula mammae.
As a result, Rani told me that Noe was able to get on top of the mammae, positioning himself against gravity force, for a good 5 minutes. It was a big relief indeed now that Noe is being trained to climb up the big mammae mountains something that could be nicknamed "Twin Peaks", I’d say.
What a day! I had a full morning at work but a terribly sleepy afternoon in the office… with a complete satisfaction over Ms. Doris’ precise analysis.
Let’s greet Nenek Airiza tonight as she is flying back in town to help Noe get back on track…
PS: Hmm..what kind of birthday cake does Rani like? April's Fools Day is coming soon.
Now that I am a bit more settled at home with fairly regular nursing activities, finally I now have the chance to try to write something about what had happened on Tuesday, March 15.
Part 1 – Last Pregnancy Exam
The check up on the last week before March 15 Dr. Chang has become worried because the baby did not gain much weight inside the placenta. The placenta has started to become calcified (with calcium deposit, that is), which means that the pregnancy condition has started to become over mature. Together with my unstable blood pressure, high content of uric acid in blood, and swelling all over the body, all adds up that this pregnancy can become high risk and not conducive for the baby’s growth, hence delivery is required. Since I also did not show the sign of going into labor soon, the doctor recommended labor induction, which we agreed to. Doctor asked me to take a rest on Monday evening, before proceeding into labor on Tuesday.
Part 2 – Labor Induction Progress
On Tuesday morning, March 15, we are prepared to go to the hospital. Ibu prepared a nice breakfast of rice and fried chicken.
I was admitted into labor ward at . The nurse put on device to monitor the baby’s heartbeat and administered enema to clean my bowel. In merely 10 minutes, I had a great urge to pass motion and very quickly my bowel was cleared.
At Dr. Chang came and gave me Prostine to induce the labor process. It was just slightly painful because the tablet was put deep into the cervix. From then on all can be done was just wait. It will take at least six hour until the labor process starts. I managed to finish the book that I bought the day before “The Trouble with Islam” by Irshad Manji.
At around I was transferred from the labor ward to observation ward while waiting for the medicine to slowly work. At that stage I still did not feel anything, so I decided to just take a walk around the ward area.
At 11.30 I got toast and Milo for snack. It was just the right time, as I was really hungry. Soon after, the baby monitor continued to run. I started to feel small pain and pressure in my womb area.
At Dr. Chang came back to monitor my condition. The opening was 2cm. He also said that the baby is doing really fine, his heartbeat was stable. He then broke the water. Half an hour later, the pain became more pronounced and more regular in interval. I could feel when the pain came and Indi assisted me with his inner-power breathing exercise that really helped alleviate the pain. He learned that from martial arts guru named Kang Dicky in Bandung 5 years ago.
At I was re-admitted into the delivery room. Internal exam was done and I was still at 2cm, but the pain became stronger. Indi prepared the hydrotherapy tub – simply, an oval shaped bath tub. The hot bath was really soothing and helped to reduce 75% of the pain. I became very relaxed, and this helps the cervix to open up even more. Even my mucous plug was released in the water. After one hour in the tub, Dr. Chang re-checked the opening and it was at 6cm opening. He then said that the labor may start four hours from now, since usually the opening increases by 1cm every one hour. Then the nurse re-attached the baby heartbeat monitor.
After one hour monitoring the baby heartbeat, the pain becomes stronger and a bit more frequent. Indi stayed by my side all the time, helping me with the breathing – 5-second inhale via nose, 5-second hold in chest and 5-second exhale through hissing. Since the pain started to become less bearable, I asked the nurse whether I could return to the hot hydrotherapy tub again. The nurse checked the opening at about and it was already 5-6 cm and hence she did not allow me to go back to the tub. The nurse asked me to call her when I felt the push against my pelvic area, somewhat similar to the urge of passing motion. Then the nurse then started to prepare all the necessary things for labor.
Part 3 – Labor and Postpartum Hemorrhage
After the last cervical check, the pain peaked for half an hour. The pain was really great that I could not handle myself to do the breathing relaxation exercise anymore. The nurse pass me the oxygen-nitrogen mixture to help me to relax, but did not really alleviate the pain. I became really devastated and Indi kept encouraging me to hang on to it. Each time the pain came, I wailed “it’s coming, it’s coming!”, but I did not scream. I asked Indi to call the nurse. The nurse asked whether I felt a push in my pelvic area, and I said yes. She asked me to hang on to the pain and she called Dr. Chang in. She said, “Don’t push yet, hang on!” and I tried really hard.
While Dr. Chang prepared himself, the nurse put my legs against the leg rests, and taught Indi how to help support by back and exert my body forward when I pushed. Then I wailed “The pain is coming, it’s coming!” The doctor and the nurse asked me to push really hard. And indeed I tried really hard, although I was unsure that my push would help the baby to get out of my belly. But it turned out my push really worked.
Two pushes, the baby was out crying in his high pitch tone. Dr. Chang commended my effort for the smooth delivery saying that I should have more children – five or six more, he said.
The nurse put the red baby on my arms, and I started to count the fingers and toes. All are complete. He was indeed a boy. Indi was really excited and started to take pictures and video – I think he was not sure which one to use for this magical moment. Then the nurse took the baby out to be cleaned and weighed. Indi followed the baby and called my mom.
The doctor continued with taking the cord blood out. Then he proceeded to get the placenta out and to stitch my lower area. He commented that I was lucky to only have minor stitches, not needing epiostomy (perineal incision).
Then the nurse informed me that the doctor was cleaning the inner part of the cervix. I started to become uneasy and wish that the process will end up soon, because I was really hungry and thirsty.
But the last part of the process seemed to drag a little bit longer than expected. I felt some liquid gushing out of my lower part in large quantity. Observing the doctor’s reaction, I suspected that I was hemorrhaging. I then remembered one scene of a movie where a mother died from childbirth hemorrhage and I thought, “oh no, not now”. Slowly I started to lose my energy and getting thirsty. The doctor started to administer emergency procedures. All the nurses were called in to help in the ward. Indi and Ibu said that they were enjoying Noe ‘s company outside in the hall way but they were curious why there were so many nurses coming in and out of the delivery room.
An IV was required really fast, but the nurses had difficulty finding my veins. After several painful punctures, the nurses managed to put on the IV. But the doctor said that I was not responding to the medicine, and he asked the nurse to increase the dosage. Meanwhile, I still felt blood gushing out. Then three nurses gave me a very painful uterine massage in the abdominal area which was supposed to help the uterus contract and thus stop the bleeding. It was so painful but I did not have the energy to scream, and one nurse forced me to breathe in the oxygen, perhaps to reduce the pain. It was the most painful part of all, and I wailed in pain. The nurses kept saying, “I am sorry, I am sorry”. They’re sorry that they have to give me such a painful procedure.
I did not know what else that everybody was doing on my womb. I saw ultrasound equipment being brought in. I also saw big metal equipment being taken out from the shelf to be inserted inside me. I just closed my eyes to it; I did not want to see. I thought, “Whatever, I just hope this ends soon”.
Amidst the emergency situation, Dr. Chang asked me, “Rani, I am getting Dr. Tan here, she is a very senior doctor and she will give second opinion, are you OK?” I just nodded weakly. Meanwhile, the nurses kept giving me the painful uterine massage, but I was too weak to scream or wail.
After that, a good sign. Dr. Tan said that the bleeding has started to stop, and the uterus has started to contract. After re-checking everything, indeed the bleeding has stopped. The nurses then put my legs back in normal position. But I had become really weak. I felt really cold and thirsty, and I started to shiver. The doctor asked, “how do you feel?” and I answered, “I am cold”. It was really comfortable when the nurse put on warm blanket on me. I think the doctor kept asking questions to me to ensure that I am still conscious.
The first question I asked the doctor after the fiasco was, “Can I eat? I am very hungry”.
Too bad, I was not allowed to eat for the next 12 hours. I can only have water.
PS: When I went to the doctor for check up the week after, he informed me that I did not lose one liter of blood, but in fact, THREE LITERS, which is half of the content of my body's blood.
Part 4 – The aftermath
After everything’s over, Indi and Ibu finally entered the room. I was so exhausted and weak that I needed to tell Indi that I would not able to breastfeed until tomorrow. Little I knew that I would regret this decision, because our baby was given formula in bottle until the next day. The first nipple our baby sucked was bottle’s nipple, and I believe this is one factor contributing to my sore nipple condition later on.
My condition was being monitored in the labor ward until . I was so thirsty but could not be quenched no matter how much water I was given. In the mean time the nurse repeatedly took samples of my blood. Was it ironic; I lose so much blood yet they kept pricking my veins to take more sample of my blood? I don’t want to lose more blood.
I was then transferred to the High Dependency unit (some kind of Intensive Care Unit) to monitor my condition for the next 12 hours, while administering the necessary drugs to avoid further hemorrhage. Should something bad happen, I presume I would be immediately operated, that’s why I was not allowed to eat nor drink. The monitoring device kept making beeping sound and I was unable to sleep at all. There was minor bleeding at and the nurses gave me another painful uterine massage.
The next morning Dr. Chang came and informed me that my condition has been stabilized and I could be transferred to regular room. I guess the critical stage has finished.
Then at the nurse brought Noe near my bedside so that I could start nursing. But Noe has been given bottled formula and hence he couldn’t correctly latch onto my nipple and this caused sore nipple a few days later. I still regret that I was too weak to nurse him within few hours of his life.
Later in the evening after having difficulty brastfeeding, I was offered fresh A+ whole-blood.2 bags of 450ml came in handy when you needed as badly as I did.It took about 3 hours for each bag to finish.Oh yes, many people came that evening… I think Indi has mentioned all the names in his previous entry last week.
I was allowed to come home on Friday, March 18 soon after we felt the next pain: paying the bill that ended up being 300% higher than our budget.Indi felt that he deserved detailed explanation for all the fees and he did receive satisfactory info from the admin folks.So much about understanding how healthcare business works in Singapore but it sure was efficient!
Part 5 – Naming our baby
How about our baby’s name?Do we have a full 3 part name yet?
We’ve been consulting many friends and Hawaiian name experts which produced the following combo:
Kainoe (phonetic: ka-ee-no-ey)
Why Hawaiian? That’s the place where Indi proposed to Rani.
Last week before Indi said to me and asked Bapak Hindro, Ibu Tuti and Oom Anto via SMS:
“KAINOE _ _ _ _ _ _ _ _SOEMARDJAN. Apakah ada nama tengah jawa dengan 8 huruf dan dimulai dengan huruf “O” ? Jadi jumlah hurufnya 6, 8 dan 10 sedangkan urutan abjadnya K, O dan S.Interval nya sesuai dengan order yang berlaku.Noe sifatnya sepertinya serius, terutama pas ngeden e’ek.
Bapak Hindro said, at about the same time Rani did:
“Ontoseno, abangya Gatotkaca yang hidupnya di dalam bumi. Atau Ontohod?”
“Sakti, dia jilat jejak orang, mampuslah orang itu. Dia nggak bisa dikalahkan. Akhirnya ditipu Kresna, disuruh jilat jejaknya sendiri, mati.Ngga ada cacatnya.”
Ibu Tuti said:
“Cocok, Ontoseno yang muncul akibat dari pada sebab dalam suasana Kainoe.Saudara dia bisa ambles laut, Ontorejo.Tapi bagusan Ontoseno, bunyinya lebih enak.”
“Ya bagus! Ok, sudah Kainoe Ontoseno Soemardjan. Ralat: yang ambles tanah Ontorejo, yang ambles laut Ontoseno.Jadi sudah pas sekarang.”
Oom Anto said:
“Ontoseno itu kakaknya Gatotkaca, anaknya Bimo dari Ibu Nagagini, putri dewa laut.Dia gak ada lawan, bisa masuk bumi, bayangan orang kalau dijilat aja orangnya bisa mati.Makanya dia gak boleh ikut perang Bharatayuda sebab gak ada lawan! Boleh juga tuh nama!”
“Onaniwae, 8 hurup!”
“Kainoe Ontosoro-h” (ref. nNyai Ontosoroh adalah karakter seorang wanita kuat di Buru Quartet nya PAT)
“Kata Atik nama jawa nya “o” pada di belakang, jadi harus dibalik: Otrahus, Okranus, Oles….”
Bratasena dengan Arimbi mendapatkan putra bernama Gatotkaca, yang dapat terbang tanpa sayap. Dari perkawinannya dengan Nagagini memperoleh putra bernama Antasena yang dapat masuk ke dalam bumi dan menguasai samodra.
Yesterday Indi went to ICA to register the birth certificate and it is now set in stone, ladies and gentlemen... the one and only....
"Kainoe Ontoseno Soemardjan"
Would you like to see more photos of us at home?
"Noe enjoying his first morning at in the morning sun at home"
"He was in the womb a bit too long, many says, that's why he has lots of baby skin to peel off... by boy, look at how long those toes are... definitely a Soemardjan baby!"
"Doctor Nenek Airiza (Rani's mom) takes care of Noe like a pro... Noe is the 8th grandchild and one more coming soon from Vienna"
"Finally, we took our first family picture when WenWen and Darwis came to visit us yesterday"
...After a few days of occupying a tiny space in Thomson's nursery, Noë has now taken control of the house... (no, I am not the one in control anymore)
Below is a picture of him in his cozy cot at about 2:00 pm on Friday, 18 March 2005. *Cot courtesy of Mas Judhi Prasetyo)
When I looked at Noë sleeping so peacefully in his room, it reminded of this passage:
Your children are not your children. They are the sons and daughters of Life's longing for itself. They come through you but not from you, And though they are with you, yet they belong not to you. You may give them your love but not your thoughts. For they have their own thoughts. You may house their bodies but not their souls, For their souls dwell in the house of tomorrow, which you cannot visit, not even in your dreams. You may strive to be like them, but seek not to make them like you. For life goes not backward nor tarries with yesterday. You are the bows from which your children as living arrows are sent forth. The archer sees the mark upon the path of the infinite, and He bends you with His might that His arrows may go swift and far. Let your bending in the archer's hand be for gladness; For even as he loves the arrow that flies, so He loves also the bow that is stable.
-by Kahlil Gibran-
Beautiful, isn't it?
In fact, I took a picture of Rani entitled Halfway to Miracle, which, for me, signifies women's "omnipotence" in the Universe.
Very well... from this point onward, I will let Rani continue reporting the progress as we need to reorganize the house and monitor new inventory at home.
All I could think of was just Rani's survival after losing 1000 ml blood.
This morning we arrived at the "high dependency" room when Rani was in deep sleep. She looked exhausted and that was a good thing knowing the fact that she had fought hard for the last 24 hours.
Noë on the other hand, was just enjoying life in the nursery. He'd been given formulas 4 times before Rani tried to give breast milk - but Noë was just too sleepy around noon so we waited until he got hungry.
Around 5 pm Noë was brought to Rani's ward and with the help of Jane, the Filipino nurse, Rani managed to get Noë's interest in tasty breast milk. Oh yes, Rani received 2 bags x 450 ml of fresh and tasty blood type A+ from the bank.
Oh yes, we did have many visitors tonight. Let me see... we had:
Natasha and Andika around 10am, Mas Judhi, Mbak Ami, Aily Algo and also Fauzia and Ira around noon, Anti and Zera in the afternoon, Femmy, Karyn and Leona at sunset, Philip, Sandy (?), Donatus, Dimas, Mas Iwan, Mbak Oka, Niken, Elizabeth and Anthony after dinner time
But, with all due respect to my son Noë, he just did not seem interested to talk to them... I wonder why?... maybe because Rani's breast milk was the main focus of the evening for him? Maybe so... :)
Now I am writing this from home and I feel like I need a good night sleep. I am happy... happy for Rani's speedy recovery. Let's catch up with her again tomorrow.
Read the full article...
Noë is now healthy and adjusting to the new environment really well. He wishes to have breast milk but Rani apparently is not yet ready to give it to Noë yet. Why?
Immediately after giving birth, Dr. TC Chang told me that my dear wife Rani experienced "postpartum haemorrhage" and is currently being taken care of inside a high dependency room. When I left the hospital at 10:00 pm, she said there was still some sign of bleeding, although it may have been caused by the uterus pushing exceess blood out of the system, but I am not so sure about the cause of it. I have yet to find out more when I return at 7:30 am. Surprisingly, her blood pressure was quite normal even though she had lost about 1000 cc of blood.
Let us hope and pray for her speedy recovery as she is fighting hard to overcome the challenges.
Fotografer.net members may view the coverage done by our good friend Judhi Prasetyo: with some photos to view. All New Soemardjan
I must admit that Rani is much tougher than I am... I am speechless when seeing how well she handled the pain. Her pain threshold is way way above average.
Noë's umbilical cord blood was extracted and cryogennically frozen in CordLife , a private bank for cord blood stem cell
Noë opened his eyes after being cleaned up and weighed.
That's all for now, folks... I shall get back to you with more details soon.
Bagi Anda semua yang ingin tahu dimana letak Ambalat, mari kita sama-sama pelajari supaya kalau ada yang mengajak bicara tentang sengketa wilayah laut dengan Malaysia kita bisa dengan secara jelas menggambarkan lokasi daerahnya.
...kalau mau jujur, Pulau Ambalat dan sejumlah pulau kecil lain di sekitarnya termasuk Sipadan dan Ligitan masuk dalam wilayah Kesultanan Bulungan yang sejak Indonesia merdeka menjadi salah satu wilayah kabupaten di Kaltim.
wah, ternyata Ambalat itu ada di Bulungan... wah kalau begitu dekat SMA 70 dong ya!
Tapi... ternyata ada berkata bahwa Ambalat itu bukan pulau....
Sengketa wilayah maritim di Ambalat jelas diakibatkan karena masing-masing pihak melakukan klaim wilayah maritim tertentu. Jadi ini bukan sengketa wilayah kedaulatan dalam arti kata 'sovereignty', melainkan sengketa kedaulatan terbatas atau jurisdiksi untuk mengelola badan dan dasar laut, terutama hal sumberdaya alam yang terkandung didalamnya.
Ambalat ini bukan sebuah Pulau, melainkan sebuah kontinen. Sebuah wilayah kelola potensi sumberdaya alam. Yang saling diklaim masih dalam wilayah yuridiksi Malaysia dan Indonesia.
Menurut konvensi hukum laut, pilihan pertama penetapan batas antara dua Negara, bila belum ditentukan dan berlaku sebelumnya, baik untuk batas laut wilayah, maupun untuk batas bersama wilayah ZEE dan LK, batas itu adalah garis median (tengah) antara garis-garis pangkal teritorial kedua Negara. Garis pangkal teritorial, dibedakan antara garis pangkal normal (garis pantai air terendah) dan garis pangkal lurus yang menghubungkan titik-titik terluar garis pantai air terendah pada pulau-pulau dan atau tanjung terluar, termasuk kemungkinan dipakainya 'low tide elevation'.
WARNING: Before you read my reasons, please try to separate the "issues on possible vested political or selfish motives inside Dinas Pajak" from "the true conceptual ideas behind fiscal at departure."
Substantially, Indonesian fiscal policy at departure points is only a tax withholding system on Personal Income Tax; therefore it is considered "wise" to keep doing fiscal levy in order to generate overall revenue for the nation. Another point is that it is a device for controlling capital flight (let’s not get into this at the moment).
Fiscal policy at departure points, in my opinion, should be maintained and well exercised until the Personal Income Tax collection is fully implemented. It is one of the best methods of collection Personal Income Tax.
Therefore, my suggestion is for the Government to enforce the collection of Personal Income Tax so that there should not be a need to fiscal policy at departure points anymore. The Government can act immediately by informing the citizens that: “they can get their fiscal refunded when they file their Personal Income Tax” (thus, indirectly providing an incentive for people to pay tax properly).
PS: And, yes…. The solution is really that simple:
"Get the personal income tax collection process right so that there is no need for fiscal at departure"
If you want to give useful and constructive comments, please write your name or email address where I can contact you. Why? so we can clarify each other's points and learn from this discussion.
And if you complain that you are losing Rp. 1 million per exit trip, then you just have to make yourself pay the correct income tax first so that you can be eligible for a refund on your Rp. 1 million spent.