On a Hiatus

I guess I will be putting this blog on a hiatus since it seems unlikely that I will continue with the IVF treatment in near future. I may be back IF the hormones therapy for Uterine Cancer works on me. At least it was the doctor's plan for me to continue with the IVF if my cells are able to turn back to normal with the hormones therapy.

I'm keeping my fingers crossed and hoping that the hormones therapy will work. Good Luck to me!

What does it mean to have cancer?

What does it mean to have cancer? I have been pondering over this question again and again  over the past 1 week.

I think to most people, being diagnosed with cancer seems to be a death sentence. Images of people suffering after undergoing chemo flashed across my mind. It definitely felt like a death sentence at first. I had been more emo recently and had been crying every now and then even before the day op as my sixth sense told me that the doctor had suspected it to be cancer. But the day when the doctor confirmed the results, it was probably the first time in a long long time when I bawled my eyes out until they were swollen the next day. I had to apply ice to my eyes to make it less swollen so that I can head out. I told myself that I can't keep crying over this. I don't want to keep crying over something that I have no control over because I knew that no matter what, life has to go on. Whether I am happy or not. So why do I want to let my quality of life be affected? I don't want to spend the rest of my life this way. 

I started reading up about Endometrial Cancer (Uterine Cancer). It helped me understand what could be the possible reason that I am down with it but it does not answer the biggest question on my mind now. So, I am diagnosed with Uterine Cancer at Stage 1. Then now what? What am I supposed to do next?

Life didn't feel any different. While I was there crying, life is still going on. Nothing will stop for me. Nothing.

Maybe it is because I was diagnosed during an early stage so this death sentence didn't feel so real yet since it is supposed to be still "curable". Or maybe because I have yet to speak to the Gynaecological Cancer Specialist. So I have yet to be really put into perspective on what am I supposed to expect.

I did not tell a lot of people about my condition because I feel there is no need to. The only people I told were the friends whom I am closest to and my colleagues because it is impossible for me to hide it from them. I really find it pointless to let everyone know. So what if I tell them? There is nothing they can do about it. The biggest irony is that I probably have to keep reassuring people that I am alright, I am perfectly fine and they do not need to worry about me. I do know they mean well and they are just concerned about me and I am really touched. Maybe it is my character but I do feel abit awkward when my friends are over-concerned about me. In fact, I told my gf that I think she is abit over dramatizing the whole thing. Even though I think she was being really sweet as well. 

Let me say this again... I am fine. Really. Life goes on with or without me... Being diagnosed with Stage 1 Uterine Cancer is not the end of world.

Uterine Cancer

I knew the results of my Ultrasound Pelvis was bad. I actually asked the Doctor if it is cancer. However, being doctors, they probably don't want to give me an answer unless they are 100% sure. So all they told me then was that the possibility of cancer is there but they will need me to undergo D&C and do a biopsy of the cell sample collected before they can be certain. 

I guessed I do know how bad my results were because I could sensed that the date and timing of my D&C was squeezed. KK actually did not have any availability until April. However my doctor pushed them and told them she will perform the op herself and which was why they managed to squeeze the date of my op into March. 

I went through the D&C and was scheduled to be back at KK two weeks later for the review of my results. However, I received a call from KK within the week to ask me back earlier, saying the doctor would like to discuss my results with me. This was a call that I had dreaded. I knew they would not have asked me to go back earlier unless it is bad news. After that call, I received sms from KK reminding me to go for some Diagnostic Imaging a day after my new review date. I was puzzled as I was quite certain I was not informed to do any Diagnostic Imaging at all. On the day of my review, KK called to remind me to fast for my MRI and CT Scan. Because I am supposed to go for MRI and CT Scan, I was quite sure that the results of my biopsy most probably mean I have cancer even before the review. 

I had hoped that I was wrong. Unfortunately, it was not the case. The doctor told me that based on the biopsy, it looks like it is Uterine Cancer at Stage 1. However, this was only based on 1 set of result that they had on hand. They would need me to do a MRI and CT Scan to confirm it had not spread to other parts of my body. 

I did my MRI and CT Scan the next day. The only thing I am hoping for now, is that the cancer cells are contained in my uterus and had not spread to other parts of my body. My biggest dread now, is how am I going to break the news to my parents. I have still not figure that out yet. Sigh...  

Not so Good News

I went for my second appointment with hubs on 07 Mar. This appointment was supposed to review on the results of all the tests that we had done in these 2 months. 

My results did not turn out well. There are some abnormalities found based on my ultrasound scans and the Xray of the HSG that I had done 2 years ago. I am thus scheduled to go for a day op to carry out a scrapping through D&C to determine the path forward. 

I am trying hard to convince myself and stay hopeful that this is just a case of very bad hormones imbalance and had nothing to do with cancer. 

The doc did mention that if not for my abnormal results, the plan was to start us on the IVF procedure already. Sigh... 

The cost after subsidy is breakdown into $7.80 for medication and $68.50 for the consultation and another full blood count required before my day op. 

Ultrasound Pelvis

I went for the ultrasound scan of my pelvis area on 04 March. I managed to secure the first appointment of the day and so I was all done within an hour. 

KKH will provide you with a leaflet with information of the Ultrasound to prepare people before the procedure was conducted so that they will know what is to be expected. The leaflet also contains information of the Do's and Don'ts.   

The pelvis ultrasound scan was performed using both methods, Transabdominal scan (TA) and Transvaginal Scan (TV). The whole procedure takes around 30 to 45 mins.

The cost of the Pelvic Ultrasound Scan is $72 after government subsidy. We are allowed to use our Medisave to pay for this scan. 

Long Journey Ahead

I visited my usual gynae, Dr. Lim yesterday. I have the history of prolonged menses and it had been bugging me for a very long time. To top off that, I do not seem to be ovulating even with the help of medication. Hub had done a sperm analysis perviously, sperm count and all are pretty fine but it seems that his army of sperms are not THAT fast swimmers. The prolonged menses and the motility of hub's sperm was the reason why my gynae recommended us to try IVF.

Dr. Lim was quite glad that we had decided to go for full subsidy for IVF. In fact, he was the one who encouraged us to try IVF via the referral letter from polyclinic then to KKH. He felt that this was the best way to minimize the amount of cash we have to come up with since IVF is going to be a long journey. 

I was lamenting to Dr. Lim about the long waiting time to do this check, that check and finally see the  doctor for the review. I was asking him if it would have been better if we take on the route of a private patient and stick to one doctor. Maybe it will help to cut down the waiting time in between all these. Right now, my second appointment is like 2 months after my first appointment. To be honest, I am kind of impatient to wait for so long. A bit sian leh... 

Dr. Lim said that even if I stick to a specific doctor, that doctor will still be bounded by the appointments of the hospital for all the checks. So he doubt it will be any much faster. The only way to make this faster is to go to a private clinic/hospital. That will however, means that we will definitely need to come up with a lot of cash. Sighhhhh... The dilemmas of life. Money vs. Time. Unfortunately, I have neither. So there is nothing I can do except to continue waiting~ 

我快等到花儿也谢了~ ( Ĭ ^ Ĭ )

Second Blood Test

I received a call from KKH on Monday. They said the doctor had just reviewed the test results and would like me to go back for a second blood test together with my husband. The first thought that came across my mind was "Shit! Something must have went wrong. Otherwise there is no reason why they will ask me to go back for a second blood test." I forgot to ask the lady who called me for a reason of why I am required to do a second blood test.

I called hubs after that and he asked me to call them back and check with them instead of me getting so worried over what or where went wrong. No one picked up the call. It could be because it was already after their office hours by the time I tried to call back.

After having some time to think it through, I suspect it could be the case of the low haemoglobin level. Low haemoglobin level could be due to Thalassemia which is often checked if people are looking at having children. I suspected it was also the reason why hubs need to do a blood test just in case I really have Thalassemia.

We went back to KKH on Saturday for the blood test and I was right about them wanting to check if I have Thalassemia. I was tested negative for Thalassemia previously when I was at the polyclinic. However, I am not sure if I had kept the medical report on it. So I decided to proceed with the test anyway just to have some records. Hubs said he got "poked" all because of me. :P 

The cost of my second blood test and hubs came up to be $69.40 after subsidy. 

Blood Test on Day 2 of Period

I was instructed to return to KKH on the second day of my period for a blood test. I was wondering why is there a need to purposely do a blood test on the second day of my period and so I went online to do a search. 

So for the benefit of others who are as puzzled as me, here is why:

The main purpose of performing the blood test on Day 2 or 3 of the period is to check whether there is a good reserve of eggs in the ovary and that the hormonal system leading to their release is intact. This is done by checking on the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH). 

I found a detailed explanation of the importance of FSH and LH from RMC of Connecticut. 

Apart from the tests for FSH and LH, I am required to conduct a full blood count, test for Thyroid Stimulating Hormone, Prolactin and Rubella Virus IgG Antibody.

The total cost for all the blood tests is $109 after government subsidy and a huge bruise on my arm. :(

Semen Analysis

Hubs went for a Semen Analysis today. He made the appointment for semen analysis when we were at KKH for the first appointment. Basically, Semen Analysis is conducted in order to know the quality and quantity of the sperm.

The nurse who helps you to book the appointment will advise you with the Do's and Don'ts before the test. As a guide, below is some of the Do's and Don'ts:

• avoid ejaculation for 24 to 72 hours before the test
• The semen sample has to be collected and sent to the lab within 1 hour.

The cost of the Semen Analysis is $75. There don't appear to be any government subsidy for this test. 

First Appointment at KKH

With the referral letter from the polyclinic, I went to KKH IVF Centre on 05 Jan 2016 for my first appointment. Hubs took leave together with me that day. We arrived at KKH half an hour before our appointment and waited for our turn to be registered at the counter. We waited for around 15 minutes before our turn came. The lady behind the counter requested for the referral letter and both our NRIC which I supposed was for the purpose of subsidy and proceeded to register us. 

As we wanted to come up with minimal cash and maximum subsidy, we are not allowed to choose a specific doctor to tend to us. Instead, we will be tend by a team of doctor. It can be Dr. A seeing us today and Dr. B seeing us the next time. All these will be based on the resources and manpower allocation. 

I was given a queue no. and was asked to proceed to another room for a routine test. The routine test includes taking my height and weight and blood pressure. After this was done, I was told to wait for my turn to see the doctor. 

It was the beginning of the long wait... I think we probably waited for around 2 hours before we finally saw the doctor.

Once inside the room, the doctor began to ask us some questions to establish some facts and history. 

The doctor asked us a few questions such as:

- How long have we been married for?

- How long have we been trying for a baby?

- During the time we are trying for a baby, how many times did we make love in a month?
- Is there any pain when we have intercourse?

- How long is your menstrual cycle? How many days did it take to clear?
- Do I feel pain when I am having my period?
- Did my hubby have any mumps before?

- Any tests that we did prior to this that makes us decide to come for the IVF treatment?

There are other questions that she asked which I could not remember. 

I was to make an appointment for a pelvic scan and a blood test on the second day of my menses. Hubs was to arrange for an appointment for a semen analysis to be done. After all these tests are completed, we were to go back for a review of the results and also to bring along any reports from that I had from my gynae and the results of any tests I had done prior to this. 

The appointment for sperm analysis was sometime in the following week. However, the appointment for pelvic scan is on 04 March 2016. My review will be held on 07 March 2016 which is 2 months later. 

The cost of my first appointment after government subsidy is $37. 

I have a feeling that this journey is going to be a long one. I will think I better save my leave and not go on any holiday this year... Sigh... 

Referral Letter from Polyclinic

We visited a polyclinic near our place on a Saturday to obtain the referral letter. My impression of polyclinic had always been the memory it had instilled into me when I was young. I remembered when I was young, I would need to reach the polyclinic as early as possible. Otherwise the waiting time could be really long. However, gone were the days when you had to wake up really early just to make sure you are one of the first few to reach the polyclinic. Nowadays, the polyclinic allows one to make e-appointments now one day before you visit the polyclinic. I think this helped to cut short the waiting time as you are only required to reach the polyclinic close to your appointment time.

Getting the referral letter from the polyclinic was not difficult. The doctor at the polyclinic asked us the reason why we would like a referral letter for IVF. He asked a few questions such as how long have we been married for, how long have we been trying for a baby, is there any reason why we will need to go for IVF just to have a baby. I guess those are kind of the standard questions they are supposed to ask. 

After speaking to the doctor, we headed to another counter where they helped us prepare the referral letter and also book an appointment. We chose to go to KKH for the IVF procedure. After all that is done, the only thing left for us is to wait for the date of the first appointment. 

We obtained the referral letter in mid Oct 2015 and managed to secure our first appointment at KKH on 05 Jan 2016. So I think as a gauge, the waiting time for the first appointment at KKH IVF Centre is slightly over 2 months.

My Unexpected Journey to IVF

I don't think anyone will actually think they will need to go through IVF in order to try to have a kid. Somehow, for some reason, some people seems to think having a kid is as easy as ABC. They didn't know that sometimes, in order for some people to have a kid, it can take years. It will actually take some hard work in order to even get pregnant. I know of people who are unable to conceive naturally and had to undergo IVF. I guess, I just never thought that I will be one of them.

We had been married for 4 years. Hub always wanted a kid. He thinks it is good if we are able to have one. If we can't, it doesn't really matter too. I want to have my own kids. Someday, one day, if I am able to. Our parents are not really giving us any pressure about having kids even though they had started to ask us about our plans of family planning. The good thing is that there is hardly any pressure over the traditional 传宗接代. So having a kid or not, is really up to our own decision. 

It took us a while before we decided to go for IVF. I had undergone some tests, plot my BBT chart and all. Finally, we spoke to my gynae who said that IVF may be the route we had to go through if we want to have kids. We asked him for the cost involved to go through IVF as we were kind of worried if it will become something that we cannot afford in the end. There is no way we can just put a stop in midst of it after we start the whole procedure. My gynae mentioned that because Singapore government is encouraging people to give birth, we can use our medisave for the IVF treatment to cover a portion of it. IVF treatment is further subsidised through the Enhanced Co-funding of ART Scheme if we were to go to a government hospital. So if we want to pay minimal cash for this, we should go to the polyclinic to obtain a referral letter and go to the government hospital for IVF treatment instead of going to a private hospital.

Ultimately, I know I will want to try what is within my means to have a kid. It will actually be easy for me to say that I will just "Let nature takes its course" and if I don't have a kid, I can just blame it on fate. However, I know I won't want to look back when I am old and ask myself "Why didn't I try this route then? If I did, maybe I will already have a kid now."

So here is it... We are on to the unexpected Journey to having a kid via IVF...

About this Blog

My intention for creating this blog is mainly for me to record down my unexpected journey to IVF treatment. 

During the time when I was making the decision on whether I should start the process of IVF treatment, I surfed around online looking for information of people who had gone through IVF treatment in Singapore, what to expect, the cost involved and how long is this journey going to be. I  managed to find some blogs like Little Human Project which I had found to be quite beneficial.

Overall, I find that most of the information available online is still quite scattered. I am aware there are some forums around where there are women who are able to provide advice. However, it is difficult to screen through all the responses from so many people in the forum.

I hope this blog will be able to help other people who were in similar predicament as me.