The ObGyn inquisition

Inquisition?? Yeah, I was the Spanish inquisitor, according to my husband, and gynae Loh was the person under interrogation, during our visit 2 days ago. It started off rather innocuously, as with all 3rd degree grilling. I first told Loh I’ve started to get some swelling in my feet, and he replied that different women experience it at different stages of pregnancy. He continued, “I remember a lecturer once said that there were some women who even experienced it after delivery. And I went “Har?’.” Then, came the point-blank question from me, “I was told that you’ve a tendency to perform labor induction.” He went on the defensive, “No lah, I don’t do it because I want to. Last week I did a lot because there were many idiots who didn’t want to deliver on April’s Fool Day. There was one woman who was suffering from extreme itching close to labor. I tell you when you have that kind of itch, it’s unbearable. I’ve to induce labor for her.” But I wasn’t ready to accept that, “I heard that there was a woman who came to see you and asked to be induced because she was feeling nauseous, and you went ahead with it.” Loh defended himself, “I don’t do social induction, only when it’s necessary.” I then brought up to him what I found out from Mayo clinic website, that induction leads to higher risk of a C-section, he disagreed and said it wasn’t necessary so.

I think my husband felt sorry for Loh; he commented later to me that the way I questioned him was like I was accusing him of devil worshipping. The only thing missing was the spotlight. Ok, perhaps my tone wasn’t exactly very tactful, but I just wanted to understand his practices. You see, I was told of Loh performing quite a few labor induction recently, and decided to find out more about this procedure. (I first brought this up in a previous post From Gossiping to Nesting.) I checked out Mayo Clinic website and found out that it’s something to be done only if necessary, and that there are a number of risks like excessive bleeding and higher risk of C-section. Naturally I was concerned, and especially after I was told that a patient wanted to induce labor because she was feeling nauseous. But after 2 attempts, she still couldn’t have a natural delivery and ended up with a C-section.

Of course labor induction wasn’t the only issue I wanted to discuss with Loh. Next on the table was cord blood banking, since I wanted to know if I’m suitable for it. Loh’s view is that it is a little gimmicky, and he’s aware that one of the companies (Cordlife) has just went public. But I can go ahead with it. I clarified that I’m considering donating the cord blood, not to bank it. Loh said, “that’s fine, but if it’s a C-section delivery, I’m not compromising on the patient’s health for the sake of harvesting cord blood. Do you know that in UK, the procedure is to sew up the patient’s wound first before removal of the cord blood? But in Singapore, the cord blood companies want me to harvest first so that they can collect as much cord blood as possible? That’s crazy! The wound is still open and the patient is losing blood, and they expect me to leave the patient aside? You can easily loose 500ml of blood. I don’t know why they can’t follow the UK procedure. I told them it’s up to them to accept the cord blood I collected, and they ended up refusing to take it.”

Alright, at least Loh put the patient first. But I’ve a more important issue to bring up. I’ve read that a problem with collection of cord blood is that the placental is clamped quickly to collect as much cord blood as possible, which reduces the amount of blood that gets transfused to baby and possibly resulting in baby having anemia. Loh laughed and said that there was no issue of baby being anemic, “anemic means baby ‘buey gao jiak’ (不够吃, insufficient food), this is a ‘third world country’, baby doesn’t get anemic, not like ‘fourth world country’ like Indonesia. I’ll only clamp the placenta when pulsating stops. Some people said that you can push the blood into the baby. Do you know if baby receives too much blood, baby will get jaundice? Already Chinese baby has higher risk of jaundice and still want to infuse more blood? More blood means more breakdown of blood cells. Maria, you read too much lah, shouldn’t accept anything these Americans say. Do you know when I was in the US, I realized these Angmohs (Caucasians) don’t know how to treat jaundiced baby? Their babies don’t get jaundice unlike the Chinese. We’re yellow skinned. So instead of using fluorescent light, they go for blood transfusion, and get a higher morbidity rate!” Ok, point taken. My husband said later that he thought he was in the middle of a ObGyn forum; too much unnecessary information brought up by me when I don’t have a full picture. He had once commented to me that a little information is a dangerous thing, referring to me reading up medical information taken from US sites, and using it to question Loh.

Alright, I admit I was pretty hard on Loh. Maybe it was because after I walked into the room, and before I had even sat down, he asked me, “Maria, are you going to be involved in Hougang?” (He was referring to the upcoming by-election in that constituency.) I ignored him; though my husband humored him saying that the former minister of Foreign Affairs, George Yeo, might join Workers’ party and stand for election there. After all he went to Myanmar to pay Aung San Suu Kyi a visit. My husband even suggested that the former minister might become the deputy PM to Chen Show Mao. Loh was amused with that, and said he was told George Yeo went to a famous Teochew porridge place at Hougang. (Honestly, what’s with him and Teochew porridge? Is that his favorite food or something?)

Anyway after I was done with most of my questions, I had my scan. Happy to say that baby Alex is gaining weight as expected; and is now 2.04kg. In fact Loh said earlier that judging by the look of my tummy, it appeared to him that baby was at the right size. The other good news is that the placenta has moved up, which means I’ve a higher chance of a natural birth. Yay!! During the scan I told Loh that I fell off my bed last Sunday night, and luckily I landed on my side, basically my left arm and hip. He quipped, “it’s not a case of domestic violence, is it?” I had to roll my eyes again. (Now you see why I asked him point-blank questions? Tit for tat.) My husband replied, “no!! She pull off a stunt on her own. She wanted to get a piece of tissue paper and fell off the bed.” Loh said, “usually during pregnancy, the woman tends to be more clumsy.” Of course I couldn’t let that pass, “I wasn’t clumsy. I was only lazy, cuz I didn’t want to sit up. Instead I stretched myself over the edge of the bed.”

Anyway I had to find out from Loh why he wouldn’t release his cell phone number to his patients when other gynaes do. He vehemently denied that other doctors do that; claiming if they did that, they would have ‘buey tan jiak’ (hokkien phrase which means they wouldn’t be able to make a living). He challenged me that if I could find one who does, I could go see that gynae and he would pay for my consultation fee. He continued that he is contactable on his email, and also if there was any emergency I could go to TMC 24-hr clinic. According to him he did give out his cell phone number to patients with serious cases, but I’m not in that category.

Before the visit ended, I had to needle Loh one more time. I said to him, “I know why you charge less for the multi-vitamins you prescribe. I compared it to the brand we bought at KKH, and the quantity of the vitamins is less than the brand you sold us.” He was taken a little by surprise, “vitamins? Or do you mean fish oil?” “it’s the vitamins.” But he was undaunted, “is it the prenatal forte brand? I also sell that at S$9. kKH selling at S$10 right? I know. Anyway you don’t need that high dosage. I thought you’re saying the DHA in the fish oil I sold you is lower than what KKH is selling. That’s not possible, I checked already. If you want, you can also get the Prenatal Forte brand from me.” But I thought I might have bought 2 bottles from him during the last visit, and wasn’t sure I needed to get more. Loh turned his nurse and said, “Sandra, you can give Maria a bottle of the prenatal vitamins free.” But I didn’t want to acknowledge nor accept it, since that wasn’t my intention.

Anyway I do acknowledge what my husband said about me not showing tact to Loh. So going forward I’ll try not to be so mean to him. I think I might have made this promise before, but it’s not easy to follow considering he’ll also use the chance to needle me when he can.

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