Breastfeeding tips during housemanship

picture from metro.co.uk

Assalamualaikum wbt

Previously I shared a post about pregnancy while doing housemanship, and I can't help but to share too the aftermath of delivery- the breastfeeding journey!😃 

As everyone already know, breast milk is the best thing ever for your newborn. Every mother wishes to breastfeed their baby and only after I had my first baby I realised that it wasn't that easy to continue breastfeed and working at the same time. It was a challenging journey, but really worthwhile alhamdulillah. 

First, I had no one shared this experience with me after I delivered Hamzah, because my HO colleagues that time were either going through the same difficulties with me (being pregnant + struggle to breastfeed their baby) or they are still single. So we mothers had to figure this out together and supported each other the best we could. 

As other people always say, it is difficult during housemanship and things will get better once you become a medical officer. Well, it depends on your departments and working environment. But I do think it's easier during MO, hmm. 

So here are few tips on how to maintain breastfeeding your child during housemanship period:

1. Mind setting
As Stephen Covey said in his book 'The 7 Habits of Highly Effective People'- begin with the end in mind. As soon as you find out that you are pregnant, be positive that later you will be able to breastfeed you baby to provide them with the best nutrition. Having this mind setting will prepare you, your husband, family and friends earlier so that they will support you fully after your delivery later. Breastmilk production fluctuates with our emotion too. Being stress will make our body produces lesser milk- so try to maintain a balance emotion. 

2. Invest in a good breast pump
As a working mother, you will need a breast pump to maintain in breastfeeding. Maternity leave is only 3 months for HO ( MO is allowed to take longer leave- it is called cuti menyusu anak. HO can't take leave longer than 4 months, or else you will need to repeat the whole postings that you've done before..err you don't want to go through the same things again, right?😣) 
Do some research on types of breast pump (manual or automatic) and different brands available on the market with special features etc. Oh, buying breast pump will need you to buy the accessories too: milk storage bottles or bag, ice pack, cooler bag, pump spare parts etc. During baby fair usually all of the companies selling breast pumps will have special price for the item with all of the accessories too. 
It is best to buy your breast pump before delivering your baby. 

3. Establish breastfeeding early
Right after your delivery, try to start latching as early as possible. Preferably within 1 hours after delivery to stimulate the milk production and to learn on the perfect position for latching that is suitable to your baby. It's okay if you find you still don't produce milk after delivery, it may take few days in some cases. 

4. Drink plenty of water
Yes, a loooot of water please. No matter what kind of pantang you've chose, make sure you drink plenty of water and healthy, balance diet.  
5. Introduce bottle and teats early
Once you already established breastfeeding, start to introduce your baby with bottle teats so that he can learn to drink your expressed breast milk(EBM) from the bottle. There are various types of newborn teats available, you need to try whether your baby likes it or not. Preferably, use the teat that is soft and resembles nipple with anti colic bottle. 
How early to introduce bottle? Depends on your baby. Some said after 1 month old, to avoid nipple confusion. I started to teach Hamzah with bottle teats as early as 1 week old, and alhamdulillah he adjusted very well both breastfeeding and EBM from bottle. (Remember your maternity leave passes very fast- so don't delay to introduce bottle or else you are in trouble!)

6. Educate your husband/family/babysitter on how to manage breastmilk
You need to study about EBM management ie how to store the EBM, how long does it lasts, how to thaw the milk, how to warm the milk etc. As your EBM stock grows, your husband and family need to learn how to manage it too as a preparation for you to start working again. If you have a babysitter, then she needs to learn about it. Sorry I wouldn't cover this topic here, you can just google it :)

7.Keep pumping! 
To make EBM stocks, you need to pump regularly. Make a routine to pump every 3-4 hours, or in between baby feeding time. Remember that you have to fully use your maternity leave to make the EBM stocks, because after you start working you wouldn't have time to pump regularly anymore. 

8. Inform your superiors about your decision to breastfeed
Once you start to work again, if possible let your specialists/bosses know about your decision to continue breastfeed your baby- which means that every 3-4 hours you may need to go somewhere/not be around to pump your milk. However this is very depending on the working schedule and workloads. 

9. Pump or solat or makan?
Usually pumping will take about 20-30 minutes, so in a very busy day somehow you will find yourself juggling between which one to choose first- pump or solat or makan? I used to eat light snacks while pumping because it's difficult to eat lunch (my hands fully occupied to hold the breast pump) although I was starving😂. If you finish your work early you'll have extra time to pump.

10. Pack your oncall bag
If you are oncall for 24 hours, make sure you bring complete set of breast pump with extra milk storage bags and ice packs. You can use a special bag to keep your EBM in the pantry's freezer. Ouh, the freezer may be not so nice and clean since everybody is using it, so having a special sealed bag will keep your EBM safe inside there. 
( By the way you do need a big handbag/backpack since you will bring your breast pump to work everyday) 

11. Manage your time
Like I said before, you need to pump regularly to keep milk production. For example you can pump early in the morning at 4am, breastfeed your baby at 5am or 6am, off to work, pump again at 10am after finish ward round, pump at 2pm just before the afternoon ward round, and after office hours at 6pm. Sounds very ideal but the truth is not as simple as this😣
Usually I only managed to pump once during working hours😭

12. Wash your hand- and body! 
Once you reach home, I know you can't wait to see your baby and feed him. It's a big NO. Take a bath first and change your clothes- then only you can go near your baby. You don't want to spread all of the germs from hospital to him, right? 

13. Freemie, anyone?
If anyone thinking of using freemie (kind of EBM collector, hands free) while working, I personally think that it is not suitable in our working environment. First your breast pump may not fit into your white coat pocket, second it is only suitable for those who works in the office that mostly sitting down. Patient may collapse anytime and you may need to jump on the bed for CPR so...yes, freemie is not that suitable. But you can use it at other time :)



Ops I've been talking too much I think. 
So that's it, enjoy your breastfeeding journey! 
You can do it, insyaAllah!


P/S: I was not as successful as other mothers. I only managed to make it up to 8 months only. I had a lot of EBM storage during my confinement period alhamdulillah, but the storage ran out very fast (healthy chubby little baby hehe). I was doing my medical posting few months after my delivery and it did cause my milk supply dropped so much. Oncall 24-36 hours, reached ward at 5.30am and only managed to pump at 12am midnight (after 19 hours!). Working with engorged breasts, it was very very painful😭 
Yup I felt sad, but insyaAllah will try again my best for my next children. 

By the way I used Spectra S9 plus and Avent Philips bottle and teats for my baby. 

Our bundle of joy

Assalamualaikum wbt

Alhamdulillah, tsumma alhamdulillah.

After 38 weeks and 3 days, by Mercy of Allah our little bundle of joy arrived into our world. 

We are officially ayah and ibu.

Introducing Hamzah Fahimi bin Hussein 'Azeemi, may you always surrounds by His guidance and kindness, may you grows up as a good servant of Allah and becomes daie in His path. You are the best thing that Allah had gave us and we will take care of you with all of our heart.

22 April 2015, 1202H.

Pregnancy and housemanship

Photo by evybaby

Assalamualaikum wbt

(This is a retrospective blogpost, date and time of publishing are adjusted to reflect the story time)

Since I started my compulsory housemanship in Hospital Ipoh, I have not been posting anything in my blog. Have I stopped writing that time?

No, I am not.
In fact I diverted to pregnancy diary that my husband bought me😍
I continued writing my reflections, excitement or sadness in the diary while literally talking to my baby in my womb.

Subhanallah, it was never easy being a house officer + pregnant mother.
I underwent one and a half postings ( O & G and surgery ) before I delivered my baby.
It was very tiring, but I never regretted it. Alhamdulillah I had went through it biiznillah, with the overwhelming supports from my husband, families and friends.

Below are few tips that I can share with you if you are considering about being pregnant during housemanship. By the way I am not literally encouraging you to get pregnant during this period, this is just in case 😃

1. Mutual decision
Discuss in depth with your husband about the challenges being pregnant while undergoing the 2 years HOship. If your partner is not in medical field, explain properly regarding the workload, extended hours, skipped meals, standing for long hours etc so that he could support you accordingly.

2. Choose your posting if possible
This is actually very subjective because the workload in each departments are different between hospitals and number of patients. If you are pregnant, you are not suitable to assist in operation theatre especially those involves with the xray radiation ie orthopaedic OT and certain surgical procedures in surgical postings. Other than the radiation issue, they need 'strong' assistant who can help them with the maneuvre during the procedure or simply to run to blood bank asap for the patient on table! So definitely if you are pregnant, you'll do more ward work ie clerking and less exposure in OT.

3. It's okay to tell others about your pregnancy
Yes, it is okay to let them know. They will understand you better and will make few adjustments on the schedule and shifts to suit your needs. It may not apply to all departments/ hospital, but letting them know it far more safe for you and baby.
By the way, some people can tell whether you are pregnant or not. My medical officer knew I was pregnant by seeing my enlarged veins on my hand while writing😂

4. Never forget to eat!
This is the super most important part. Please, eat your meal. Get some snacks in between. Yes you wouldn't have time to eat obviously but try make time. Like seriously need to make time. My husband will text me every meal time to make sure I take my lunch and dinner especially during oncall or he will drop by at the hospital with some food if I don't get the chance to buy food on my own(due to trying to finish the job until the cafe is closed).
I have many kind of snacks inside my bag (and white coat too sometimes) just to fill in my tummy very quickly if time not permits for proper meal. Your baby growth is very important so don't starve yourself.


5. Proper footwear
Invest some money to buy comfortable shoes as you need to walk many kilometres although just within the hospital area. As you tummy gets bigger, you can't walk so fast (don't ever think of running!) so good flat shoes will help your pace better.
Ouh, I am a big fan of Skechers during my housemanship time 😊


6. Plan your pregnancy check up or appointments
Your working schedule as a house officer will need you to work outside office hours and over weekends. So if you are planning to do the check up with the local health clinic that operated during office hours, you may have to plan to get the appointment done during your off day or postcall. Sometimes the timing of appointments in local health clinic may not be favourable to you, then you may need to consider to go to private clinic that offers more flexible time.
We had our monthly appointments in the private clinic because my husband was only available during weekend and sometimes we can come at night too for the check up and baby scan.


7. Plan you maternity leave
As government servant, you can start taking your maternity leave from 38 weeks onwards. As long as there is no sign and symptoms of labour, you can continue working if you want but having rest at home would be better I think.
 I was planning to start my maternity leave near my due date (40 weeks) but I delivered at 38 weeks 3 days. The day I felt like about to deliver I texted the leader in our ward and took an emergency leave since I haven't apply for the maternity leave yet. He had to rearrange the schedule due to the short notice.


Well, that's some bits of it.
There are a lot more actually because I have many friends who can share their experience too.

There are incidents of miscarriages, antepartum haemorrhage, premature delivery, fainting, excessive fatigue etc while working and pregnant at the same time.
Know your body very well and stay healthy.
Get proper rest.

And take care💚

Rintihan Nuh

photo from generalwaruchi.blogspot

                              

Di dalam kalangan para Rasul, dia memiliki umur yang paling panjang.

Sebagaimana para Rasul yang lain, dia berdakwah kepada kaumnya siang dan malam.

Siangnya dia di kampung lain menyeru penduduknya agar mengesakan Allah, pada malam hari dia di tempat yang lain, setia menjalankan amanah yang sama seperti hari dan waktu sebelumnya.

Barangkali, jumlah pengikutnya antara yang paling sedikit berbanding rasul-rasul yang lain. Tempoh dakwah antara yang paling lama, bersama jumlah orang beriman yang paling sedikit.

Dia juga mempunyai keluarga. Namun tidak semua anak-anaknya beriman kepada agama yang dibawa oleh Nuh. Tak pernah ada sehari pun dia berputus asa untuk memujuk anaknya agar mengesakan Allah, hinggalah di saat-saat genting tatkala bah besar melanda, harapannya masih ada. Namun Allah lebih mengetahui, anaknya angkuh untuk teruskan pendakian ke tempat tinggi tetapi akhirnya gagal menyelamatkan diri.

Hati Nuh merintih.

‘Dia (Nuh) berkata, “Ya Tuhanku, sesungguhnya aku telah menyeru kaumku siang dan malam.

Tetapi seruanku itu tidak menambahkan iman mereka, malah mereka lari daripada kebenaran.

Dan sesungguhnya setiap kali aku menyeru mereka untuk beriman agar Engkau mengampuni mereka, mereka memasukkan anak jari ke telinganya dan menutupkan wajahnya dengan baju dan mereka tetap mengingkari dan sangat meyombongkan diri.”

Dia mengadu sepuas hati kepada Allah. Menangis semahunya merayu kepadaNya. Kebimbangan yang dibebani oleh Nuh teramat besar. Sama ada kaumnya beriman atau kafir, itu lah yang akan menjadi corak kepada generasi yang akan datang. Generasi yang beriman dan bersyukur dengan nikmatNya atau generasi yang tidak gentar melanggar perintah Tuhan. Allahuakbar..

Janji Allah pun berlaku. Langit melimpahkan kandungannya, dan bumi memancarkan airnya. Bah besar berlaku dengan sangat pantas. Tiada tempat berlindung, melainkan golongan yang telah dilindungi oleh Allah, di dalam bahtera bersama pelbagai jenis haiwan atas arahan Allah SWT.

‘Binasalah orang-orang yang zalim’.

JanjiNya disempurnakan, banjir surut seperti sediakala. Namun hati Nuh  tetap hiba terkenang anak tersayang yang turut sama ditimpa azab. Kesedihan dan harapan Nuh yang tidak berbelah bagi pada anaknya ditegur oleh Allah kerana memohon sesuatu yang tidak diketahui Nuh akan hakikat sebenarnya.

“Ya Tuhanku, ampunilah aku, ibu bapaku, dan semua orang yang beriman lelaki dan perempuan. Dan janganlah Engkau tambahkan bagi orang-orang yang zalim itu selain kehancuran”.

********************************************************************************************

Surah Hud, 12: 25-49

Surah Nuh, surah ke 71 daripada mula sampai habis.

Adikku,

Mari muhasabah kisah Nuh yang mulia. Setiap barisan cerita dan rintihannya di dalam Al-Quran, setiap satunya memberi ibrah yang berbeza.

Suratul Hud berkisar berkenaan arahan Allah dan suasana yang berlaku ketika itu.

Suratul Nuh khusus berkenaan rintihan Nuh pada Allah, tiada kisah sirah walaupun seayat.

Ibrah yang sangat terkesan pada jiwa kita tentang kesungguhan Nuh menyampaikan dakwah- kecintaan Nuh pada keluarga dan kaumnya agar terselamat daripada azab Allah- fitrah manusia yang punya limitasi dan akhirnya kembali pada Sang Pencipta untuk memohon kekuatan- juga takdir-takdir Allah yang berada di luar pengetahuan kita sebagai hamba…

Hentikan tangisanmu, adikku. Allah sentiasa bersamamu. Orang-orang mukmin sentiasa bersamamu.

Mari, kita bersabar seperti Nuh. Berusaha seperti Nuh. Bertawakal juga seperti Nuh.

May Allah loves you more than I do.

Mirror is us.

“Seorang mukmin itu adalah cerminan kepada mukmin yang lain"

( Hadis Riwayat At-Thabarani)

Tenang suami tercinta berbicara. Pandangannya tetap fokus kepada pemanduan. Sesekali dia menoleh menatapku yang sedang menadah telinga untuk mendengar sambungan kalamnya sebentar tadi.

“Cuba sayang beritahu abang apa sifat-sifat cermin?”, dia menduga.

“Hmm, cermin boleh pantulkan cahaya. We also can see ourselves dalam cermin. Dan cermin ni sangat penting dalam hidup seorang perempuan..hehe”, balas saya sambil berseloroh.

Si dia tersenyum lebar. Sengaja saya tidak memberikan jawapan yang lebih relevan kerana mahu menghayati jawapan yang bakal diberikan olehnya nanti.

“Betul la tu jawapan sayang. We can see ourselves dalam cermin. Sifatnya; cermin akan beritahu kelebihan dan kekurangan sebenar yang ada pada diri kita. Mana yang berlebih, kita rapikan di hadapan cermin. Mana yang terkurang, kita perbaiki supaya lebih elok. Dan satu lagi sifat cermin yang paling penting…cermin tak akan sebarkan kelebihan, kekurangan atau aib yang dilihat itu kepada orang lain.

Maka begitulah simboliknya kepada hadis yang abang sebut tadi. Dalam rumah tangga, suami isteri adalah cermin kepada satu sama lain. Kita saling meraikan kelebihan yang ada pada diri masing-masing, dan saling membetulkan kekurangan yang ada. Dan semua ini adalah di antara kita berdua sahaja, tidak disebarkan kepada orang lain”.

Subhanallah. Saya terpegun mendengar nasihat di sebalik simbolik cermin daripada hadis tersebut.

Hikmah(bijaksana) seorang suami dalam menyelitkan nasihat ketika permusafiran kami berdua.

Alhamdulillah, manisnya lanjutan taaruf pasca-nikah.

Dalam diam, saya berdoa kepada Allah agar memberkati suami tercinta dan agar Allah memelihara ikatan di antara kami berdua. Sungguh, ku mahu dia menemaniku di syurga kelak..

-husseinhuda-
080814

p/s: like my blog's name. mirror of life. juga ilham daripada hadis yang sama..

Jemputan Walimatul 'Urus

Bismillahirahmanirahim.



Assalamualaikum wbt, 
Segala puji bagi Allah, Tuhan sekalian alam. Selawat dan salam kepada utusan yang mulia Rasulullah SAW dan para sahabat. 

Dengan rasa rendah hati dan penuh syukur ke hadrat Allah SWT, kami ingin menjemput keluarga, saudara mara, guru-guru, sahabat handai dan para kenalan untuk ke majlis walimatul 'urus kami.

Majlis Pihak Perempuan:

Sabtu, 9 Ogos 2014 bersamaan 13 Syawal 1435H
12.00pm - 4.00pm
Dewan Orang Ramai Rapat Setia,
Jalan Jaafar Taha, Rapat Setia,
31350 Ipoh, Perak.

Majlis Pihak Lelaki:

Sabtu, 16 Ogos 2014 bersamaan 20 Syawal 1435H
12.00pm - 4.30pm
Dewan Oncidium,
No 1, Jalan Anggerik Oncidium 31/67,
Kota Kemuning, Seksyen 31,
40460 Shah Alam, Selangor.

Semoga dengan kehadiran para tetamu berserta iringan do'a daripada kalian membawa keberkatan daripada Allah SWT.

Mohon do'akan agar baitul muslim yang bakal dibina sentiasa di dalam redhaNya, dipenuhi mawaddah dan rahmat Allah hingga dapat bersama-sama di syurgaNya. Allahumma amin.

Jemput ziarah ke laman walimah kami:
http://husseinhuda.wix.com/husseinhuda


(Special post buat kawan2 blogger yang tak ter-reach di medium fb/whatsapp. Minta maklumkan kalau nak datang dan perlukan kad ^^ )

Med school, no full stop

Bismillahi rahmani raheem.

In the name of Allah the Most Gracious and Most Merciful. I pray to Allah for His blessing and mercy upon all of us in this holy month of Ramadhan, the most awaited month alhamdulillah. Ramadhan kareem to everyone!! :)

Verily, there is no God but Allah and Prophet Muhammad SAW is His Messenger. I seek forgiveness from Allah for all of my shortcomings and weaknesses from the day He created me till the day I die.

‘O Allah, You are the great Forgiver, You love forgiving, so please forgive all of us..

Alhamdulillah, tsumma alhamdulillah. There is no other word or act that can replace the saying of hamdalah continuously and prostration to Allah SWT as a means to express my syukur, gratitude upon all of His blessing now and then.

End with medical school. End with tutorials, bedside teachings, portfolios, case write up, various types of continuous assessments and quizzes.

End with medical school. Life afterwards will be full with ward rounds, on calls, clerking jobs and despatch jobs. All of the cases in the wards are your long cases, and short cases will be seen in the clinics. Exam is everyday, every hour, every minute.

End with medical school. But you still need the anatomy notes from your first year of medicine, those thick textbooks of physiology, microbiology, pathology, medicine and surgery. You still have to refer to your pocket notes (which if you were to pile up all of these pocket notes, it will be thicker than your textbook!)

End with medical school. Very often during the houseman period, you’ll be condemned that you are not reading enough. The usual comment would be-‘Go back and read!’. During that moment you’ll be cursing yourself for not able to memorize it well, and you’ll be wondering how did you pass med school at the first place. Sigh.

Opss. I’m not whining. I’m just throwing my thoughts on how paradox it is when you’ve graduated from med school, the ‘school’ is actually never ends!

Yup, full stop doesn’t exist in medicine..

And this is the beauty of knowledge.

The more you learn, the more you don’t know.

Continuous learning process. The concept that all of us are well informed before we sail to the sea of journey called medicine.

I pray to Allah to make all of us steadfast and strong mentally, physically and emotionally in facing our future in this path. Renew our intention(niat), never stop make doa, and continuously support each other.

InsyaAllah. 

So long, penang!

alhuda

6 Ramadhan 1435H

Dear blog

Assalamualaikum wbt,

Bismillahi Rahmaanir Raheem.

All praises to Allah, The Almighty God, the Creator and the Sustainer. I bear witness that there is no other God worthy of worship except Allah, and Prophet Muhammad SAW is His Messenger.

It has been a while since I wrote my last blog post. I thought I would be able to maintain to post monthly even a short line of sentence but apparently I didn't manage to do so. At the moment my friends and I are fighting in revising everything we could for our final year exams. Yup, for our very last exam in med school insyaAllah.

Many time it came across my mind that I wouldn't be able to finish revising all topic. The workload is very huge and the stuffs to memorize are just too much at this little time. Sometimes I was disturbed by the anxiety and worry of the exam everytime I meet my friends or go to the wards. Everyone looks stress, but we never forget to support each other. After all final med is about passing the exams together...

At this moment, I prayed to Allah to keep us in faith all the time, ease our difficulties, lift up the anxiety and shower us with Allah's Mercy. O' Allah, I am worried if I were too carried away with this dunya. Please help us to make this examinations as part of ibadah, in striving to be a better Muslim. O' Allah, please forgive me for all of my sins and ignorance, guide me with Your Nuur and please do not leave me to myself even for the twinkling of the eye. Ya Rabb, I put my life into Your Hands...

Amin ya Rabbal Alamin.

Open your horizon

I know it's beyond the border.
So you can see better :)
Ouh. But this picture got nothing to do with the issue.

Assalamualaikum wbt

Today's date gonna be exactly 3 months before my graduation day. It's a good time to look back on what I've been through all this while, especially when the SPM results was just released a few days ago. 

So, which pathway are you gonna choose next?

Medicine? Em. 
You sure? No regret?

Since the previous years until now, medicine never fails to attract those SPM high achievers to choose this field as one of their most desired career. Well, at this moment, if you were to ask me whether you should choose medicine or not, I would advice you to think about it again. Have you read enough stories and comments from people in the medical field about what are they facing everyday? Have you been aware of the current condition about houseman, MO's or even the specialists or consultants on the problems they are dealing with currently-the glut of doctors and the ineffective systems?

Well, don't get me wrong. I am not writing this post to criticize your option to join medical field-in fact I'll be one of the people in the system too by end of this year insyaAllah. Medicine has been my passion since I was young. Being given the chance to study medicine is a great gift from Allah. But of course, with hard work and tears before I am able to call myself a medical student. 

My parents didn't ask me to become a doctor. I made the choice on my own. The funny thing is when I was in 4th med, I asked ummi whether she would allow any of my sisters to follow my career pathway. Her answer was expected.
'Takpalah, cukuplah kamu seorang je yang jadi doktor dalam keluarga. Jenuh ummi tengok.' 
Huhu. Thanks to my family for supporting me throughout the journey. I'm almost there!! ^_^

I'm sorry if I've gave you a negative thoughts about medicine. It isn't that bad actually, if you stay being positive at all times. The people around, the workloads, sacrifice and the agony will definitely test your patience. A reminder for you and me: keep having faith in Allah, and be a good Muslim doctor. 

I believe a lot of people has been writing on this issue once SPM results was out. Open your horizon, medicine is not the only available field for your tertiary study. There are a lot more things to learn and experience other than medicine and engineering(these two courses are commonly chosen by the science school students. There were 30 students in my form 5 class back in 2006, and if im not mistaken 16 of us already/will be graduating as a doctors. Waa). If you don't like medicine, please don't do it. If you're forced to do medicine ie by your parents, I hope you'll get some help to persuade them to allow you to follow your interest. Because at the end of the day, it is YOU and the PATIENT who will suffer the outcome.

Talk to your seniors, go to any career talks, refer to internet sources about the courses, universities etc. And last but not least, I highly recommend you to come/tell your juniors/spread the word around about this event (refer picture below). Part of my mind setting and motivation before I started my tertiary education was gained after I attended this program in 2007. 

Excellence is not about having good grades.
It is about having the knowledge and experiences that turns you into better person, and benefiting the ummah.
'Alim mujahid.

Home birth

Assalamualaikum wbt

Long ago when i was in the primary school, my friends and i were used to look at each other's birth certificates as all of us need to bring a copy of it during our first day of school every year to hand it over to our class teacher. We usually talked about which hospital that we were born, what time, our birth date-whether easier to remember or not and etc. 
And the normal chit-chat would be-
'I was born in this hosp-very far from where i lived now-'
'I was born in that hosp-we didn't move anywhere since then-' OR
'I was born overseas-but i can't remember anything about being there-sadly'
Urm, nothing special. But suddenly all of them will give their weird look at me when i said:
"I was born at home". Hee.
*peace*

Picture by alachamberlain from DeviantArt

All of my siblings except me were born in the hospital. My brother was quite sick at that time when my mom was due to deliver me. He needs ummi very very much and ummi couldn't leave him just like that-and there was where i came in. 

So it was an unplanned home birth. A midwife was called to attend the delivery. Ummi said she experienced an obstructed labour-she described it as my head was pulled back into the perineum (i imagined it as 'turtle sign' which classically referring to shoulder dystocia, where the anterior shoulder of the fetus become caught under the symphysis pubis) but my mother was told that it was umbilical cord strangulation that cause the obstruction.

The controversial part of the story was when the panicked midwife called a traditional midwife(bidan kampung) to help with the delivery(you see, this should be an emergency as i was stuck over there-and my mom was in severe pain-why didn't she call the hospital at the first place?). And yes the bidan managed to help me at the end. All praises to Allah for protecting my mom and me.

There was a lot of grey area in this story as I doubted the actual diagnosis and how did I manage to survive without any medical equipment to monitor me and my mother's condition. I wonder what could be my Apgar score at that time. Anyway here I am still surviving the world under Allah's mercy.

My actual point from this story is: anything can go wrong during the delivery. Even if you are at low-risk for complication, it's better to stay at the center where specialist help is there for you. 

I would like to share with you below an article written by Prof Madya Dr Rafidah Hanim Mokhtar, from Faculty of Medicine and Health Science, USIM. I copied the article from Dr. Zainurrashid's blog. You can find the link here.

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"There is this wide misconception that natural means Islamic. Natural means leaving things in the hands of Allah SWT. Active interventions mean otherwise, that one is not having enough faith because one depends too much on another human, or on technologies.
This is wrong.

WEIGHING MAQASID AL SHARIAT IN MODERN MEDICINE
I have had the privilege to be an academician in medical faculties of 2 esteemed institutions, previously in IIUM and currently in USIM. Students in both institutions are taught that Islam covers a wide approach in investigation and treatment and that includes a holistic scope. Students are taught on the concept of maqasid al shariat, or purpose of law. 
There are 5 purposes of law (maqasid al shariat):

1. preservation of morals and religion (hifdh al diin)
2. protection and maintenance of human life (hifdh al nafs)
3. protection of the human intelect (hifdh al aql)
4. protection of progeny (hifdh al nasl)
5. protection of property rights (hifdh al maal)

In maqasid al shariat, there is no mention on the approach of how one achieves the protection. It is neither natural, nor modern intervention. If either one proves it is better than the other, say to protect one’s life, than we are to choose the better method. In preserving life, it is in fact WAJIB to choose a better method.

OBSTETRIC, HOME BIRTH AND ACTIVE MANAGEMENT OF THIRD STAGE LABOUR (AMTSL)
Obstetric discipline whether in Malaysia or abroad has gathered almost enough data on the risk of home deliveries, our grandmothers’ generations had endured.

There were post delivery bleeding because placenta would not come out which needs blood transfusion, there were cases of cord around neck that babies came out with breathing difficulty that he/she needed ventilator, there were cases that mothers endured prolonged labour that Caesarean section was inevitable. All these need hospital settings. 

Injecting certain medicine to make the uterus contract faster to avoid bleeding, as well as helping mother delivering the cord, a procedure called control cord traction (CCT) are procedures in the active management of third stage labour (AMTSL). Yes, these will definitely involve chemicals, help from others and machines. But as I said, the maqasid shariah dictates the importance of preserving life, not the method. 

QAWAID AL SHARIAT
This brings us to another concept which is the 5 principles of law (qawaid al shariat):
1. The principle of motives
2. The principle of certainty
3. The principle of injury
4. The principle of hardship
5. The principle of custom

In the principle of certainty (yaqeen), it is stated that a certainty cannot be voided, changed or modified by an uncertainty (al yaqeen la yazuulu bi al shakk). 

It stress that any change in treatment or human behaviour should not be based on the new evidence that is not at the level of certainty. The principle has graded the level of knowledge in decreasing order of certainty as below:

Yaqeen (certain)
Ghalabatul Dzon (predominant conjecture)
Dzon (conjencture)
Syakk (doubt)

In medicine, to be certain on important decision, one has to be on the ghalabatul dzon level based on the facts (from experimental, observation, literatures) that he/she has. A 50-50 chance is not enough.

This requires research and studies. Therefore, evidence based medicine with adequate research, is very much Islamic as it provides the objective measure of Qawaid Al Shariat. 

I therefore could not comprehend people who reject modern medicine on the grounds that it is less Islamic.

The case where the mother was reported to die because of retained placenta more than a few hours for waiting for it to be expulse naturally, is very much regretted. Studies have shown that AMTSL has reduced the risk bleeding or post partum haemorrhage by 60-70%. This is by comparing of only cases delivered in hospital with many other facilities available. AMTSL even in home birth, in my opinion is helpful. And if AMTSL, which has no contradiction in syariah, and proven in studies to have greater benefit, by the law of preserving life, should be a mother’s choice.

In summary, modern medicine is to reduce all these risks. It’s not intended to cause hardships to mother.

But mothers who nevertheless had to endure hardships because they delivered in hospitals, and they had to share facilities with other patients, knew very well that all those were for the sake of their babies. 

So when a mother would like to choose whether it’s a home or a hospital delivery, please weigh your option carefully. Giving birth to enjoy home atmosphere, as I read from the many reasons given by mothers over related blogs or forum, should be rethink by the question: Whose interest do you have in mind, yours….. or the baby’s ? 

As for this 2nd case of maternal death reported, al Fatihah. My condolences and may Allah grants great sabr to the family.

P/S: The above note was guided by a module called Medicine and Health : An Islamic Perspective by Prof Omar Hassan Kasule, part of the postgraduate curriculum in IIUM Faculty of Medicine, that integrates aqli and naqli."

Prof Madya Dr Rafidah Hanim Mokhtar
Deputy Dean Academic and Research, Faculty of Medicine and Health Science, USIM
Chief Information, Biro Wanita ISMA
Vice President II, I-Medik

If only we follow him better

Assalamualaikum wbt

Tatkala kenangan kepada figur agung itu menggamit hati, terbayang bahawa akulah orang yang paling gembira jika dipertemukan Allah dengannya.

Setiap bait katanya adalah menasihati.
Setiap tindak tanduknya adalah mendidik.
Setiap tegurannya adalah mengajar untuk menjadi baik.

Andai Rasulullah SAW masih ada bersama kita, pasti setiap akhlak kita diperbetulkannya.
Andai baginda Rasul masih di sisi, pasti terubat setiap duka yang membebani di bahu ummat ini.

Ya Rasulullah, maafkan kami kerana masih belum cukup gigih mengamalkan pesananmu..


"Belajar dekat mana?".
"Dekat sini je, pakcik". Balasku pendek. Fikiranku ligat memikirkan pansystolic murmur yang didengari melalui stethoscope. Ternyata pakcik ini menyembunyikan masalah jantungnya daripadaku. Sedari tadi banyak soalan-soalan berbaur sinis yang ditanya kepadaku sepanjang clerking dan examination process. Kalau bukan kerana respiratory end of posting exam hari ini, he would never allow any medical student to approach him.

"Kenapa tak belajar di UK? Sebab result kamu tak lepas ya?"
"Kenapa kamu punya MARA pinjaman je? Kenapa kamu tak dapat biasiswa?"
"Pakcik sengaja tak beritahu kamu pakcik ada masalah jantung..pakcik nak tengok kamu dapat cari ke tak."
"Kenapa kamu cek semua ni? Doktor lain tak cek pun. Kamu ni masih banyak tak tahu rupanya.."

Dan lain-lain soalan dan komen daripadanya.

Saat itu saya terkenang, bagaimana Rasulullah SAW dapat bersabar dengan karenah seorang wanita tua buta berbangsa Yahudi setiap hari. Diriwayatkan bahawa Rasulullah SAW setiap hari akan meluangkan masa untuk menyuap makanan kepada wanita tua ini, dan pada masa yang sama wanita ini akan terus-terusan menghina Rasulullah SAW, tanpa diketahuinya bahawa individu yang menyuap makanan di mulutnya adalah orang yang setiap hari dia hina.

Allahu akbar.

Imagine someone who has no blood relation with you, continuously condemning you while you're serving them.
Sungguh, sabar itu adalah di tahapan paling sukar pada saat yang pertama ia berlaku. Kesabaran yang diucapkan selepas amarah itu 'dilepaskan' tanpa sedar sebelum itu, bukan kesabaran yang sebenarnya dituntut.

"La taghdhob". Jangan marah. Begitulah nasihat Rasulullah SAW.

"Seorang Muslim (yang sempurna islamnya) itu ialah yang menyelamatkan orang islam lain daripada gangguan lidah dan tangannya."
(HR Bukhari dan Muslim)


Wallahua'lam.

If only we follow him better.
Salam Maulidur Rasul 1435H




Oh ya. Saya berjaya de tour komen2 pakcik ini akhirnya. Caranya adalah dengan mengajak dia untuk bercerita dan tunjukkan kekaguman dengan ceritanya. Surely he will cooperate after that :)

Strength in what remains

I
Tak berkelip mataku memandang keadaan sekeliling menerusi tingkap kereta. 'This is real', bisik hatiku. Selama ini hanya mampu melihat di tv akan musibah yang menimpa mereka. Now here I am, in Kuantan bersama secebis kudrat untuk membantu. Lebih tepat lagi, aku datang untuk mengambil ikhtibar daripada mereka. 
Kami berhenti di sebuah rumah setingkat di Perkampungan Sungai Isap, antara kawasan yang paling terjejas disebabkan banjir yang berlaku awal bulan ini. Rumah ini sama seperti rumah-rumah lain di sekitarnya- ada timbunan baju kotor dan basah, longgokan sampah di luar pagar rumah berupa perabot rosak, buku-buku, bantal, tilam, kerusi, sofa dan lain-lain barang rumah yang rosak sepenuhnya dan ampaian yang dipenuhi dengan baju yang sempat dibasuh apabila kerja-kerja pembersihan rumah dimulakan. 
In that house I saw a mother of three was busy pulling a black, round plastic bag in front of her house. Her sons-I think they were around 5,4 and 2 years old were also busy playing with the water hose. Clearly that these kids were unable to help their mother to clean the house. Their father was off to work. And..this supermom who did the cleaning all alone before we came was actually pregnant. Around 6-7 months i think.

Guess how deep was the flood few days back? 
It was 6-feet in depth-around 180cm if we compared in height. I am totally drowned if I were there.
This family lost almost everything. In fact every affected family lost almost everything. It is as if you have to start your life all over again with nothing. I know I couldn't understand fully how did they feel as I've never been involved in such severe floods. (My first experience was during 2-day floods in Dublin where my house were also affected-the water level was above knee and it was freezing cold)

But I can see the strength in their eyes. I can feel the patience in their words. The strength that still exist, over what that remains. 

(While in Kuantan, news came out stating that our beloved Gaza currently affected with floods as deep as 7 feet and it's winter now. O'Allah, we seek refuge from You. Please protects our brothers and sisters over there..)

II
" Adik, cuba adik eja nama kakak ni..", ujar ibunya yang sedang duduk di sebelah katil berpagar putih itu. 
Si kecil itu mendongak ke arahku, lalu tersenyum. Lantas kuhulur name tag biru di leher. 
"H-U hu..D-A da...eh!" Perlahan dia mengeja. Dan seperti yang dijangka, dia terkejut usai mengeja namaku yang hanya punya dua suku kata. Sekali lagi dia mendongak memandangku. Kemudian memandang ke arah ibunya. Ibunya tersenyum. Dan aku sejak tadi tidak lekang tersenyum padanya. Ada sesuatu yang menggembirakan tatkala bertemu si kecil ni. 

"Nama kita sama la, Huda," ujarku sambil mencuit bahunya perlahan. Kali ini senyumannya lebih lebar, menampakkan barisan gigi yang putih. 
"Adik nanti dah besar, jadilah macam kakak Huda ni ya", sampuk ibunya di sebelah. 
"Akak, ada satu lagi yang sama...tarikh lahir anak akak Huda ni sama dengan tarikh lahir saya, 10 Oktober". Dua fakta ini sebenarnya yang membuatkan hatiku tertarik untuk mendekati katilnya sejak tadi. 
"Yeke? MashaAllah...kebetulan pula," balas ibunya sambil tergelak kecil. 

Perbualan diteruskan selepas itu. Sempat ku bermain seketika bersama si kecil Huda. Dia sepatutnya sudah berada di sekolah rendah, mengikut kronologi umurnya. Kelihatan perkembangan fizikalnya agak kecil jika dibandingkan dengan kanak-kanak yang sama umur dengannya. She suffered from a type of childhood illness* that need multiple admissions to the ward. Probably endless admission until Allah makes her recover fully. InsyaAllah she will recover, biiznillah. 

She played so happily, as if she is at home surrounded by toys and books. 
She might not be aware about how the future would be and how worry her parents were.
But here is she, in the hospital fighting for her fate by all means. 


*The illness would not be disclose due to patient confidentiality.


III

Terkedu saat membaca status rakan di Facebook.

Seorang pakcik yang sudah lewat usianya, dimasukkan ke dalam ward kerana excessive tiredness. Selepas darahnya diperiksa, paras hemoglobinnya serendah 4.4 g/dL. (Normal Hb level for men: 13-18 g/dL)

Saya pernah bertemu dengan pesakit with Hb level as low as 2 g/dL. Some people can tolerate the anaemia very well. But some people can’t. Usual presenting symptoms are excessive tiredness, shortness of breath, dizziness, pallor, headache and palpitations.

Bayangkan pada level Hb serendah itu, pastinya pakcik tersebut mengalami rasa penat yang amat sangat. Dan anaknya yang menjaga beliau saat dimasukkan ke hospital pada tengah malam terkejut apabila pakcik tersebut masih gigih bangun malam untuk menunaikan solat tahajjud. Yup, at that level of lethargy. In case blood transfusion had been given before that, the Hb level won't raise immediately over 1-2 hours.  

Allahu akbar.

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Masih ingat lagi kisah ketika Perang Uhud?

(berikut adalah perkongsian daripada seorang murabbi yang saya kagumi)

PERISTIWA PERANG HAMRA’ UL-ASAD

Menurut Ibnu Ishak, yang telah dipetik oleh Dr Ali Muhammad Ash-Shalabi: 

“Perang Uhud telah berlaku pada hari Sabtu 15 Syawal. Pada keesokan harinya, yaitu hari Ahad, yaitu 16 Syawal, seorang penyeru Rasulullah menyerukan untuk menghadapi musuh (ada riwayat mengatakan bahawa Rasulullah SAW seusai Shalat Subuh telah menyuruh Bilal mengumumkan kepada segenap kaum muslimin bahawa Rasulullah SAW memerintahkan mereka untuk keluar menyongsong musuh). Yang dizinkan ikut serta oleh Rasulullah SAW hanyalah mereka yang telah ikut serta dalam Perang Uhud pada hari Sabtu (kelmarinnya). Kepergian Rasulullah SAW hanya ingin menakut-nakutkan musuh dan menyatakan bahawa apa yang telah menimpa mereka tidak menyebabkan mereka lemah untuk mengejar musuh mereka. 

Dr Abd Karim Zaidan juga telah mencatatkan dalam bukunya ‘Al-Mustafad min Qashash Al-Qur’an: 

“...Sa’ad bin Muadz selaku salah seorang pemimpin di kalangan Anshar menemui kaumnya dan menggerakkan (mobilisasi) mereka untuk keluar sedangkan semua mereka dalam keadaan luka.

Beliau berkata: “Sesungguhnya Rasulullah SAW memerintahkan kalian untuk menentang musuh kalian!"

Usaid bin Hudhair, yang hendak mengubati tujuh luka di tubuhnya, berkata: “Kami mendengar dan taat kepada Allah dan Rasul-Nya”. Diapun mengambil senjatanya dan meninggalkan ubatnya lalu bergabung dengan Rasulullah SAW.

Bani Salamah keluar dengan empat puluh orang perajurit yang semuanya masih luka, antaranya Ath-Thufail bin An-Nu’man dengan 13 luka dan Al-Harits bin Ash-Shamah dengan 10 luka. Mereka sampai di hadapan Rasulullah SAW. Apabila mereka sampai di hadapan Rasulullah SAW Baginda berdo’a: “Ya Allah, kasihanilah (ampunilah) Bani Salamah” 

Sahabat-sahabat Nabi ini mentaati perintah Rasulullah SAW tanpa sebarang bantahan.
Walau luka masih mengalir darahnya, dengan tenaga yang berbaki, mereka keluar menyahut seruan Allah dan RasulNya.
Benarlah seperti diskripsi Allah SWT di dalam surah Al-Hujurat ayat 15, 

"Sesungguhnya orang-orang yang sebenar-benarnya beriman

 hanyalah orang-orang yang percaya kepada Allah dan RasulNya, 

kemudian mereka (terus percaya dengan) tidak ragu-ragu lagi, 

serta mereka berjuang dengan harta benda dan jiwa mereka 

pada jalan Allah; mereka itulah orang-orang yang benar

 (pengakuan imannya)"

Subhanallah. 
Cebisan iman yang masih hidup menjadi punca kekuatan golongan-golongan di atas untuk terus melangkah menghadapi kehidupan mereka.
Walau harta diragut sekelip mata, nikmat sihat ditarik dan anggota badan cedera teruk- mereka punya kudrat untuk kekal bertahan di atas takdir mereka.
Inilah dia, strength in what remains. Kekuatan yang dipunyai mereka, kesan daripada iman yang masih tertanam di jiwa.

'Sandarkan harapanmu pada yang kekal, kerana Dia masih mampu memberi saat seluruh manusia hilang segala-galanya'

Allahu a'lam.