Wednesday, August 10, 2011

Zahra and Nephrotic Syndrome - Day #54, SDMC,Tung Shin, HKL

Update about Zahra's progress.

After the allergy drama, we met Dr Anushree as per appointment on Monday to follow up on her condition and Dr withdrew some blood for test. Oh ya, she also gave Zahra some eye drop to treat the conjunctivitis bacteria as her eyes still have the thick discharge.

Surprisingly her blood reading is good (compared to her urine reading). Her urine still 4+ and the protein in her blood showing improvement, almost to normal level. Normally, if the urine is high, the protein in the blood will be low.

So we tentatively will see the Paed Nephrologist in HKL.

Since it will be on Monday 8th (it's about a week gap), we decided to set up another appointment with SDMC (Sime Darby Medical Centre) as they also have Paed Nephrologist, just to hear their opinion kan. What is the diagnosis and their judgement.

We met with Dr Indon Lajin but it was Saturday (6th August) and SDMC macam pasar malam. Ramai giler orang. I don't mind about that really, but Dr Indon was a bit in rush as she has so many patient queuing behind us. So it was a brief meeting only. Luckily we brought the urine sample (it was at 3+ that time) and all the test result, test at home, cretin reading, blood test, etc for her to analyze.

She took a quick glance and told me that there is basically 4 types of Nephrotic Syndrome in Childhood:

1) 30% - The NS is straight forward, gone after high dose of Prednisolone
2) 30% - The NS is gone after the treatment, but relapse once or twice in their life (about 1-2 years)
3) 30% - The NS is treated, but flare up after any infections (cough, flu, bug bites, any simple thing that triggering your antibody). So everytime relapse, kena makan ubat balik.. but it'll be better over the years and maybe will jump to the #2 condition
4) 10% - Not the normal minimal change NS, kena buat biopsy

After that, she decided that Zahra's NS relapse during treatment because of the infection (where when she got the allergy) and prescribed an antibiotic (Augmentin) for 6 days and kebetulan Zahra ada flu, so she gave her Hydroxine. She also prescribed new dose of steroid, a lower dose as she's taking antibiotic - 10mg (2 tablets). This time she gave us in tablet form, so we have to crush it and give it to Zahra because according to her, tablet form is more effective than the syrup type.

The medications

The syringe. Rumah kitaorg dah macam junkie.. We have to give Zahra 3 syringe now.

We will meet Dr Indon this Friday (12th August) for follow up and some blood withdraw (again *sigh*, sorry baby).

About the HKL pulak, got different story.

Sebab we already met Dr Indon and mcm ok la..lega, Zahra ada infection sebab tu relapse, and dah dapat ubat baru we decided to put on hold on HKL. Then since we mmg cuti on that Monday (8th), I decided to go to Tung Shin (at Jalan Pudu), it is a traditional Chinese Hospital and one of our friend yg ada Nephrotic ni pegi sana too. So just to hear what the doctor want to say kan.

It's a very very Chinese hospital and I don't think they speak BM/English, ok..maybe little English, but since we are seeing Prof Liu, we assumed he can speak English la. Prof ok..takkan la tak boleh kan hehehe (but he is Prof from China, so it's not the same like Prof in Malaysia) So off we go, mmg gamble habis and thank God he can speak English, even it's not as flowy but we can understand each other. So ok la.

The interesting part is when I ask, it is possible for Zahra's NS to relapse because of an allergy. He quite taken aback because steroid is used to treat allergy and yet she got allergy? Kann... and he said normally it won't relapse because of that.

Anyway Prof Liu didn't prescribed us anything because Zahra is too small and he said the western medicine will be fine for her. If it's a normal case of NS, she will be cured (insyaAllah...).

We finished seeing Tung Shin around 12, and Jalan Pudu dah dekat ngan HKL, so I decided to go to HKL jugak. Sampai2 sana unfortunately the counter is closed! Apparently the Paed Nephrologist (for first assigned case) is only on Monday morning. Another slot is on Thursday but that one for follow up I guess.

Nama Zahra ada dah dibook in the morning session but kitaorg terlambat. Well, part of it salah us jugak sbb awal2 mmg macam tanak pergi kan. But now I was a bit rasa rugi la..sbb it's not easy to get the slot kan. By the way, I already reschedule it to next Monday (15th August) and we'll see how la.

First thing first, we'll see how's the blood test result this Friday.

Up to date, the reading still 3+.

The purpose I write all the details is because I want to share the experience of dealing with NS and to keep track the record. Now looking back from the entries written, the high protein urine reading is not because of the allergy. Macam salah bagi info kat Dr Indon je..hmmm.. I'll jot down balik all the info later, after I collect all the result..semua ada dalam kereta.


  1. Aan,

    Gov mmg mcm tu. Nxt appt, Aan kene dtg awal tau. Sbb biaselah...govt. Mst kene ikut turn. Sbb sure mst akan ada patient lain...and, nak menunggu tu harus kena ada sifat sbr yg tinggi. Dan, one more thing...nurse diorang yg need us to be independent dan byk bertanya. Tak ley diam n tunggu diorang layan kite. Tak wujud dlm sistem gov spital. If diorang rude, jgn diam. Counter blk. Jgn defensive. Kite ada hak w'pun free service. Sy ada experience...


  2. sy mengerti sebab saya pun pakai servis gomen gak

  3. Mommy Fara,
    Tu tak sangka dia buka pagi je. Me thot the whole day, salah me jugak tak check dulu. Hehe it's not free service tau, we pay the tax. Bukan soal duit actually, tapi mana boleh rude2 ngan org kan?

    Me tak kisah pasal gov or not yg penting Zahra ok..cuma a bit mix up sbb nak cepat. Gov pulak tunggu lambat. But me nak pegi jugak HKL tu, sebab pakar2 semua kat sana.

  4. apa gambar shringe jer ni...mana gambar Zahra? :(