Monday, March 30, 2020

Pregnancy in the Time of COVID-19

Pregnant at 44 - 28 March 2020 journal entry
(35 weeks pregnant)


Metro Manila is on its 14th day since implementing the government’s lockdown policy to contain the spread of the novel corona virus 2019 (COVID 2019). Today, I hit my 35th week of my third pregnancy. Yesterday was the first time I got out of the house since the lockdown was imposed. My husband (Let) and I went for my prenatal check-up which included unavoidable trips to the Philippine General Hospital and Manila Medical Center, first for laboratory tests and then for a complete fetal exam. PGH is just across the private clinic of my OB hence it was my only option for doing the lab tests; Manila Medical Center is my only option to do the fetal scan, courtesy of my OB‘s classmate who was very kind to have the ultrasound room opened just to see me and examine my baby. The Women’s Health Center where they do ultrasound scans is closed as is the one in the Medical City where I usually went for scans and other tests to check on my baby’s well-being. I have had quite a number of scans since the first one that confirmed I was 7 weeks pregnant on 19 September 2019. At 44, my age is quite advanced to support a pregnancy, and with gestational diabetes complicating my condition, I undergo an ultrasound test at every visit to my OB.

At 35 weeks into my pregnancy, I’m supposed to go for weekly check-ups now. But with the current COVID lockdown, my OB’s clinic is closed. Actually, my OB (who’s maybe approaching her mid-60s) has stopped going to hospitals since the lockdown started. I’m now being seen by her OB daughter instead, who makes special arrangements to see me at her mom’s private clinic in Taft, Manila. Thankfully! Yesterday, upon her mom’s advice, we agreed that she will deliver my baby through a cesarean procedure. She also helped me choose a good birth date based on feng shui. Of course, still, prayer is our best bet that all’s going to be well with my delivery amidst the COVID situation faced by all major hospitals in Manila.

Yesterday, driving to PGH was a breeze. There were still some cars on EDSA, but we reached PGH in a record time of 30 minutes. It would have taken 1 to 2 hours to reach it on an ordinary day from our residence. Reaching Taft, I saw a few homeless with their mats spread out and toted meager belongings, seeking whatever little shelter is offered by the skyway. I also saw a few informal workers allowed to peddle taho, buko juice, and other snacks in the streets. No one impeded our travel. There was no checkpoint at any city boundaries that we passed.

The PGH outpatient laboratory (QualiMed) was just by the entrance, detached from the main hospital. It had a triage area where staff check the temperature and ask the travel history of people going in. Less than a handful of patients were inside when I arrived. The chair I sat in to have a blood extraction was disinfected immediately once I was done. Alcohol pumps were available at all counters. The frontage of a pharmacy across the PGH where I bought water and medicine was covered with plastic, and its staff use a basket attached to a long stick to hand out purchased items to customers and collect payments.

The biometry fetal scan I had in Manila Medical Center took about half an hour. The examination bed was enclosed in plastic and the doctor had on a mask, plastic over her hospital gown and gloves. I came out of the hospital (mindful not to touch surfaces) relieved to know that my baby, although quite small for his gestational age, gave the doctor very good stats, and that there were no problems found in terms of his development.

I will need to take 12 capsules of Amino Acid 1000 daily, which will help my baby gain more weight in the 3 weeks left before my scheduled delivery. I was also given dexamethasone, a corticosteroid injected intramuscularly, to hasten the baby’s lung maturity. All these measures are done to lessen the chances of complications from a possible pre-term delivery which could lead to a longer stay in the hospital. My doctors would like for me to be discharged from the hospital in the shortest time possible so we lessen my and my baby’s chances of exposure to COVID. 

I have been feeling anxious and losing sleep thinking of delivering my baby in a hospital which has a number of admitted COVID patients. I only have Let to care for me this time, unlike with my two previous deliveries where we had both our families by our side. Let cannot afford to be sick. A caesarian delivery is something new for me. I can only pray it’s indeed our best option. We have little control over our circumstances. We can only try and do our best to avoid being infected with COVID, stay positive, and pray we get to go home quickly after the delivery.

Others have it far worse during this pandemic. While all are deprived of freedom to move, a great many are deprived of income and are living with greater uncertainty and fear. We are in this situation as one people, yet my family’s sufferings are nothing compared with those who lost their jobs, those who are sick, and those who lost loved ones to COVID. My anxieties are small inconveniences in the context of the gravity of this heath and economic crisis. Let’s continue to pray and help each other. This, too, shall pass but not without unity and resolve to do our share to contain the spread of the virus.

Becoming insulin-dependent

Pregnant at 44 - 1 March 2020 journal entry
(31 weeks pregnant)


Hello, March! I am 31 weeks pregnant now! I pray Galen makes his entry in six weeks, by then he would be full-term already. We are all excited to meet Galen, and every day we ask: Maitim kaya, kulot kaya? I’m sure Galen’s amazing in any skin color, hair texture and size. He is God‘s perfect creation, a bonus gift to the family! My prayer is for Galen to be healthy, that I deliver him normally, and that we get to go home at the same time ready to start our lives together.

I’m getting and feeling heavier by the day. My OB ordered that I go on sick leave again, for three weeks this time. I still have cough and haven’t gotten back my normal voice. I sound nasal for a month now. My OB wants my sugar controlled. I’m taking a second insulin dose (eight units) which  I inject before dinner. Still not sure whether the second nightly dose would fix my sugar level. My endocrinologist wants me to go on a trial and error process. I increase the dosage by one unit if my sugar spikes persist until I see her again in two weeks. Weight today = 65.9 kg.

Sunday, March 29, 2020

Pregnant But Can't Ditch Antibiotics

Pregnant at 44 - 15 February 2020 journal entry
(29 weeks pregnant)

I went to see a different pulmonologist yesterday. I had a sputum culture test and the results were not bad – nothing wrong with my respiratory flora. The doctor said I should have gone back to the first pulmonologist I saw as then he would have just extended my Cefuroxime dose. Instead I took another round of a new antibiotic. And now, I’m back to taking antibiotics (Co-amoxiclav). This is not good at all, being 3 weeks on antibiotics and pregnant. My symptoms have eased up, my nose is still congested but I can tolerate it now. I’m feeling much better than I did the last two weeks.

Yesterday as I was trying to nap, my helper knocked excitedly on the door. I was a bit annoyed to be disturbed. But it turned out that she received a flower delivery that Let sent for me. Six red roses, big ones, arranged elegantly with a love note from my “dutiful and obedient husband." My mood changed in a heartbeat – it was Valentine’s Day! I was feeling better. I look forward to swinging back to my normal daily routine by Thursday, 20 February. Down to two months waiting for my baby Galen!

Pregnant and Sick Before COVID

Pregnant at 44 - 6 February 2020 journal entry 

(27 weeks pregnant)

February came and saw me at my 27th week with Galen. It is the height of the flu season and coronavirus has made it more challenging to get by. I caught some bacterial infection in the last week of January and I have been sick for two (long) weeks now. I saw a pulmonologist and he diagnosed me first with bronchitis and gave me Cefuroxime and Fluimucil. I saw him again after four days and I was worse; he then changed the diagnosis to rhinosinusitis and gave me Sinupret. Alas, that too didn’t work. So I saw another doctor (an OB who's a reliever of my OB who was sick) and the first thing she told me was that I should take time off from work. She said that it is unfair for the baby. Baby boys, she said, are weaker and don’t thrive. She asked me to take another antibiotic for five days (Zithromax) and added some meds for my immune system (IgCo milk and Claricort) and asked me to up my dose of vitamin C. It’s been two days now since I went to see her but I still feel sick and congested. I pray I get well soon and the medicines take their full effect soon! I am off work for eight days! Let is away but he’s coming home tonight. I hope I am only waiting for him to get back to my normal routine and breathe well…

The Big Reveal - Shameless Bump on FB

Pregnant at 44 - 26 January 2020 journal entry

(26 weeks pregnant)

I thought my get-up was cute (shirt dress, denim jacket, white sneakers), and so I took shameless selfies of my 26-week tummy while inside Uniqlo. And next thing, I was convinced I wanted to make my first “obvious” appearance in Facebook to announce that, “Guys I’m pregnant!.” I posted what I thought was the best selfie I took, without a caption. Then came the likes, wow/shocked emoticons, and many 💗s as well. Some took a few seconds of their time to express their delight and well wishes.

For a long time, I hesitated to make public that I was expecting, fearing that something bad could happen (“mabati,” sabi ni Let). I hope I inspire older moms like me to have one more baby or have their first baby despite their advanced age. I hope, too, that I didn’t make others feel sad that I’m having my third when they have tried to have their first many times, but have not been given the chance until now to become a mom. It was not my intention to do that. I pray each woman that wants to become a mom gets to experience the joys of expecting a child.



Dealing with Gestational Diabetes

Pregnant at 44 - 19 January 2020 journal entry
(25 weeks pregnant)

This week was busier than my first work week. On Monday, I went to my endocrinologist  who has been my doctor for 12 years now. I met her when I developed a very rare disease called acromegaly (story on this link) and she remarkably made the right diagnosis in 2007.

My endocrinologist confirmed this time that I have gestational diabetes, and she said I was predisposed to it due to my acromegaly history. She started me on 10 units of insulin. I started monitoring my blood sugar in December. Sadly, I had many spikes reading as high as 187, and on some days, my sugar dived to 57. After a week of insulin I still registered abnormal high and low sugar levels, tsk tsk, not good at all. 😢

I should really shift to brown rice. Maybe I’ll start next week and see if white rice has been the main culprit all along. I never thought I could have diabetes. I’m praying my gestational diabetes resolves after I give birth.

I am also praying that the ultrasound-doppler finding on some notching in one of my uterine arteries, which delivers food to the baby through the placenta, resolves in my third trimester. In the meantime, I am to take aspirin, a blood thinner, daily. 

Pregnant at 44

11 January 2020 (24 weeks)

It's a Boy

Hello 2020! I like you already, as you will see my Galen (GALEN – anagram for angel) born into this beautiful, crazy, fast world. Please see us through with grace and love.

I survived the first work week! But more than that, this week gave me a peek into what Galen is up to. He was so awake and cooperative, but a bit shy, in the one hour I had a congenital anomaly scan. Galen was such a good boy, charming the doctors and showing all his organs -- his 10 fingers and 10 toes, his perfect spine, his long arms -- curling his lips, opening his mouth, sucking his toes. Galen gave us quite a show! The sonologist, who was the section head of The Medical City Women’s Health, happily showed her resident doctors a perfect scan of Galen, remarking a few times how beautiful the images they got were. “Praise be to God,” she said, and I felt God’s love and faithfulness. 💛