8 Things About C-Section That We Don't Talk About

8 Things About C-Section That We Don't Talk About

By Stella Matilda, Editor



Just a few months ago, I delivered my second child, a baby boy, through c-section and I would like to share some of my experiences with you. There are many things to learn about when it comes to a c-section as this is considered to be a major abdominal surgery. So the road to recovery can be quite an interesting one.

1. There will be hands on your vagina. 
Even though it isn’t the baby’s exit route, your vagina will still be involved in your c-section and recovery. After my second c-section, a nurse came in and said she needs to clean me. I’m sure my first c-section was the same and perhaps I had forgotten about it. So, I will refer it as a ‘vagina car wash’ which involved a little rinse-down with a peri bottle and a pat down with tissue to clean up any blood that was leaking out after the surgery. (More blood for the next couple of days). They do the cleaning twice a day.

2. Freezing during delivery, like super ice cold! 
Not sure if you noticed, but it seems like all operation rooms set the temperature so cold. I believe this is a way to maintain sterility and prevent humidity formation and combat bacterial colonization. I remember freezing till my arms were shaking (the other half of my body was numb at that point from the spinal so I couldn't feel a thing). The good news is that you can request as many blankets as you wish to combat some of the cold. Be sure to cover your shoulders!

3. Feels like your stomach is tugged around. 
At this point, you’ll be totally numbed half body down during surgery (and for a couple of hours afterward), so your cesarean won’t hurt a bit. For me, I felt like vomiting a little when I feel the tugging and pushing during the surgery. I could also see my belly being cut open from the tiny mirror like reflections from the spotlights hanging above me.

4. Stool softeners is probably your new best friend for the next couple of days after surgery. 
Pooping can be a major problem and can be scary, since it’s tough to push when you’ve just had major abdominal surgery. It is painful! Taking stool softeners after delivery will ease you back into pooping again. Don’t be surprised if your nurse asks a few times about your poop, it’s their job to make sure you are on the right path to recovery. Just remember to drink lots of water and walk around as soon as you can. This way you keep your bowels awake and get a little exercise to get your blood circulation flowing nicely. And no, you will not burst your stitches open, it just doesn’t happen that way.

5. Blood and more blood. 
Although the baby did not come out vaginally, you will still bleed. Our uterine wall has to heal itself after the placenta has been detached and the thick lining that grew to support baby throughout the pregnancy will need time to shed itself. So expect bleeding for at least 6 weeks after delivery. If you bleed more than 6 weeks, please do consult your doctor.

6. Your scar will look like Frankenstein! 
No, I’m only joking. But you may freak out a little anyway especially for first time moms. Back in our mother’s generation, their c-section scars were more prominent. We are very lucky today as the medical industry have advanced so much. The scar will be pretty small and will fade away in time. Plus, after 6 weeks have passed, you can request from your doctor for scar-fading ointments (nothing sooner to avoid an infection).

7. Coughing and sneezing will hurt for the next few weeks. 
Feel like a cough or a sneeze is coming? Grab a pillow and place it on your abdominal scar area. It won’t stop the pain, but it will help ease the pain. You can also consider getting a Belly Band or other compression garments to help support your abs, since applying pressure to your muscles after they’ve been cut will help combat the pain from your movement and muscle contractions.

8. Exercise is the key. 
I am not suggesting you to hit the gym right after surgery. But just getting up and walking around as soon as you feel human would be a good idea. This will also help to prevent blood clots. With my first c-section, it took me nearly 6 months to finally have the confidence to hit the gym and go for Yoga classes. I was so afraid that it will be painful. If you are unsure as to when you can start hitting the gym again, please ask your doctor. After all, every one heals differently so better be safe than sorry.

I hope this will give you a little glimpse into what to expect from a c-section. There is more to share, but I think this is a good start. If you need to know more, please feel free to contact me and we can have a little chat over coffee.

When can I apply insect repellents on my baby?

When can I apply insect repellents on my baby?

We live in a country where mosquitoes are a real problem. They are everywhere. In your toilet. In your kitchen and even in your car! It's unfortunate that babies tend to get bitten more frequently than adults. This is most likely because they are an easy prey as they are not aware of these insects. It's hard to avoid, but we can minimized it.

Insect repellents play a key role for protecting our children from mosquito-borne viruses especially when living in places where these illnesses are prone to happen often. For mothers with young baby, you can start putting bug repellent when your baby is at least 2 months old and above.

You can start using insect repellents containing DEET. According to the Environmental Protection Agency in United States (EPA), DEET is tested and approved for use on children with no age restriction. 

Here are some important points when using insect repellent on your baby:

• Repellent with DEET should not be applied more than once a day, and is not recommended for babies younger than 2 months old.

• DEET can be used on exposed skin, as well as clothing, socks, and shoes, but should not be used on the face, under clothing, on cuts or irritated skin, or on the hands of young children.

• Read and follow the label directions to ensure proper use;  be sure you understand how much to apply.

• Apply repellents only to exposed skin and/or clothing. Do not use under clothing.

• Do not apply near eyes and mouth, and apply sparingly around ears.

• When using sprays, do not spray directly into face; spray on hands first and then apply to face.

• Never use repellents over cuts, wounds, or irritated skin.

• Do not spray in enclosed areas.

• Avoid breathing a spray product.

• Do not use it near food. 

The Centers for Disease Control and Prevention (CDC) says that repellents containing the ingredients picaridin or oil of lemon eucalyptus also can protect against mosquitoes:

Picaridin is a compound found in many mosquito repellents used in Europe, Australia, Latin America, and Asia. Its chemical name, which you might find in the list of "active ingredients" on a product, is KBR 3023. Years of safe use of picaridin in other parts of the world attest to its safety and effectiveness.

Oil of lemon eucalyptus is also known as P-menthane diol (PMD). PMD is a plant-based repellent that gives protection time similar to low concentrations of DEET products. It is not recommended for kids under 3 years old.

You may want to try a natural insect repellent such as citronella, but read the label first to make sure it's safe to use on babies. (Repellent products must state any age restrictions.)

Natural repellents generally don't last as long as chemical repellents, so you may need to reapply frequently.

As a side note, there are 66 dengue fever cases and one death in Kg. Likas just last year according to the Borneo Post newspaper while The World Health Organization (WHO) estimate there may be 50- 100 million dengue infections worldwide every year. So geared up, keep your surrounding clean and be safe everyone!

Pregnancy With Hypertension (High Blood)

BY DR NORAFIDAH AHMAD
CONSULTANT OBSTETRICIAN AND GYNAECOLOGIST
KPJ SABAH SPECIALIST HOSPITAL KOTA KINABALU

Hypertension is also known as high blood pressure. It is a commonest medical problem encountered in pregnancy. Due to this, blood pressure is routinely assessed during each antenatal visit.

Blood pressure readings are recorded as two numbers. Systolic blood pressure is the higher reading. It measures the pressure in the blood vessel wall when the heart contracts. Normal readings of systolic blood pressure are about 120mmHg (millimetres of mercury). Diastolic blood pressure is the lower reading. It measures the pressure in the blood vessels when the heart relaxes between beats. Normal readings of diastolic blood pressure are about 80mmHg. When the blood pressure is consistently 140/90 or higher, hypertension is diagnosed. Severe hypertension occurs when the blood pressure is 160/110 mmHg or higher.

Hypertension complicates 10 to 15% of all pregnancies. Hypertension in pregnancy can be divided into pre-existing hypertension, pregnancy induced hypertension and pre-eclampsia. Pre-eclampsia affects 3 to 5 % of all pregnancies. Eclampsia occurs in approximately 1% of women with pre-eclampsia. It is a serious medical condition which is associated with convulsions and other complications such as stroke, kidney and liver failure.

Pre-existing hypertension is also known as chronic hypertension. In pre-existing hypertension, women are usually diagnosed as hypertensive prior to pregnancy. If hypertension is noted for the first time in the early pregnancy it is also likely that it is a chronic pre-existing problem. In this type of hypertension, the blood pressure will not return to normal after delivery.

Pregnancy induced hypertension is diagnosed when a woman’s blood pressure is normal before pregnancy but consistently rises to more than 140/90 mmHg after about 20 weeks of pregnancy. The blood pressure usually returns to normal after childbirth. However, some women may remain hypertensive following delivery and continue to develop chronic hypertension.

Pre-eclampsia is a condition where the maternal blood pressure is elevated in the second half of pregnancy along with presence of other signs and symptoms such as an abnormal level of protein in the urine and abnormal blood results. It is a potentially serious condition which can threaten the health of mother and baby.

Pre-eclampsia can also occur in women with pre-existing chronic hypertension. This carries a higher risk to mother and baby as compared to chronic hypertension alone. Regular monitoring is required to detect this superimposed pre-eclampsia condition.

In women with pregnancy induced hypertension and pre-existing hypertension, blood pressure must be regularly monitored. Treatment to lower blood pressure is important if blood pressure readings are consistently higher than normal. This is in order to avoid serious complications for mother and baby. However for mild to moderate hypertension, medication may or may not be recommended. Severe hypertension always requires prompt treatment to lower the blood pressure. There are a few types of anti-hypertensive medications which are available and safe to be used in pregnancy. Although some may cause side effects, they are usually well tolerated by most women. In some women, a combination of medications may be necessary to achieve good blood pressure control.

Pre-eclampsia affects one in every 10 pregnancies. Its severity varies from mild to severe. Pre-eclampsia can progress to eclampsia if left untreated or does not respond to treatment. Eclampsia
is a medical emergency and requires urgent multidisciplinary treatment to ensure safety of mother and baby.

The exact cause of pre-eclampsia remains unclear. It is most likely due to problems with the development of the placenta during the early stages of the pregnancy. Placenta is a tissue which carries oxygen and nutrients from the mother to the baby. Failure of implantation of placenta to the wall of the uterus causes baby at risk of not receiving oxygen and nutrients.

Although it is not possible to accurately predict the women who will develop pre-eclampsia, several risk factors such as general, genetic and medical factors are found to be associated with this condition. The risk factors includes teenage or advance maternal age, obesity, history of previous pregnancy with pre-eclampsia, women with a mother or sister with a history of pre-eclampsia, first pregnancy, twin or multiple pregnancy, long birth interval and some fetal chromosomal disorders. Woman with pre-existing medical conditions such as diabetes, kidney disease, chronic hypertension, autoimmune disorders and blood clotting disorders are also at risk of developing pre-eclampsia.

Photo source: Organic Fact

Pre-eclampsia usually occurs in the third trimester of pregnancy (28 weeks onwards) although in some women it may occur earlier. Women with pre-eclampsia are usually asymptomatic when the disease first occurs. They commonly present with elevated blood pressure and abnormal level of protein in the urine. Apart from that, they can also develop significant symptoms such as rapidly progressive swelling over hand, face and feet; visual disturbance; pain over upper abdomen; vomiting and headache.

If pre-eclampsia is diagnosed, admission to hospital is usually required. Blood pressure is monitored closely. High blood pressure may require oral or intravenous anti-hypertensive medications. Blood and urine tests are performed. Urine test will be able to quantify the level of protein in the urine. Blood tests are carried out to look for altered blood clotting, abnormal liver and kidney function. Monitoring of the baby’s well being can be done by assessing baby’s heart rate tracing, growth, blood flow in the umbilical cord and the amount of amniotic fluid.

The only cure for pre-eclampsia is delivery. However, if the pregnancy is less than 36 weeks, the decision to deliver will be based on the severity of the pre-eclampsia and the risk of prematurity. A major consideration in treating women with pre-eclampsia is to promote the baby’s growth for as long as possible in the uterus whilst keeping the mother’s risk under control. The delivery is however indicated if there is presence of any of the following conditions which are the inability to control maternal blood pressure; worsening general health and well being of the woman such as deterioration of kidney or liver function and reduction in blood platelet level which is important for proper blood clotting; presence of maternal symptoms such as severe headache, vomiting, visual disturbance and upper abdominal pain; baby not growing or showing signs of compromise; placental abruption (separation of placenta from the wall of the uterus) and if woman develop eclampsia.

If delivery is indicated in woman with pre-eclampsia, labour can be induced with medication to stimulate uterine contraction. The woman’s blood pressure is closely monitored throughout labour. High blood pressure will be given medication. If blood clotting is normal, epidural anaesthesia may be recommended. This is in order to relieve pain, lowers blood pressure and improve blood flow to the placenta. Baby’s well being is continuously assessed. If the baby is showing signs of distress, immediate delivery is necessary such as caesarean section.

If the pregnancy is less than 34 weeks, caesarean section is often recommended. This is because inducing labour can be difficult at early gestation and caesarean section is considered in the best interest of both mother and baby. In such cases, woman will usually receive steroid injections before delivery. This is to reduce risk of infant developing respiratory distress, bleeding into the brain and death after delivery.

After delivery, the mother needs to be closely monitored for at least the first 24 to 48 hours. The high blood pressure usually does not settle within first few days after delivery, so anti-hypertensive medication may need to be continued until blood pressure is stabilised. Blood pressure may take up to 3 months to return to normal. Woman should discuss with the doctor regarding risk or pre-eclampsia recurring in her next pregnancy and preventive measures.

Clinical studies have shown that a low dose of aspirin supplementation in early pregnancy may be able to reduce the risk of developing pre-eclampsia by about 15%. It should be started before 12 weeks gestation and continued throughout pregnancy. Apart from that, for women with a low calcium intake, supplementation with calcium during pregnancy may be able to reduce risk of pre-eclampsia.

If you have any enquiries relating to this topic, please do not hesitate to contact Dr. Norafidah Ahmad, Consultant Obstetrician and Gynaecologist at KPJ Sabah Specialist Hospital.

AJFC Malaysia 2018 crowns Sabah Region champions

Kota Kinabalu, 12 May 2018 – Eighteen young Sabahan footballers are one step closer to earning a golden ticket to be part of the Allianz Junior Football Camp (AJFC) in Munich and the chance to train with FC Bayern Munich’s youth coaches this August.

 The players thoroughly impressed selectors at the Regional Finals today and will now represent the Sabah in the Grand Finals of the AJFC Malaysia League 2018 from 5 to 7 July 2018.

 In the final, JJFC Tenom were crowned Sabah champions after beating Safa Kota Belud 3-0 at Stadium Likas, Kota Kinabalu today. In the third and fourth placing match, Tabs Safa Bandaraya beat Menggatal Town Academy 1-0.

 “We are very proud to crown the Sabah champions today. All the players showed a lot of heart and played tremendously. With AJFC, Allianz is very proud to be able to give these inspiring, and gifted young footballers a dream experience of what it is like to play football professionally. We congratulate all 18 players for making the team and we wish them the very best in the Grand Finals,” said Johnny Chung, Marketing Manager, Kota Kinabalu branch for Allianz General Insurance Company (Malaysia) Berhad.

 AJFC Malaysia League kicked-off in Central region at Universiti Kebangsaan Malaysia, Bangi on 24 March 2018, followed by Southern region at Kompleks Sukan Hang Jebat, Malacca and Northern region at Universiti Sains Malaysia, Penang (7 April); and East Coast region at Padang Majlis Perbandaran Kuantan 1and Kolej Universiti Islam Pahang Sultan Ahmad Shah in Kuantan, Pahang and Sabah at Padang Sukma Kota Kinabalu (14 April). The format for the Malaysia League remains an 11-a-side affair played for 70 minutes.

Upon the culmination of the Malaysia League, the regional selection panel will then select the top 18 players from each region to form six regional teams that will compete in the Finals. Following three days of centralised training, the six teams will go head to head to determine the winner at the Grand Final on 7 July. At the end of the Grand Finals, 10 players will be selected to attend the AJFC Asia in Bangkok, Thailand, where the best two Malaysian players will be selected to attend AJFC in Munich, Germany.

Keep up to date on AJFC via Allianz Malaysia’s Facebook and Instagram page: facebook.com/AllianzMalaysia and instagram.com/allianzmalaysia.

The Importance of Educating the Whole Child

By Nicky Russell | Head of Primary

Kinabalu International School www.kis.edu.my

We live in a global economy that requires our students to be prepared to think both critically and creatively, evaluate huge amounts of information, solve complex problems, and communicate effectively. A strong foundation in reading, writing, mathematics, and other core subjects is still as important as ever, yet by itself is insufficient for lifelong success.

For too long, we have been committed to time structures, coursework, instructional methods and assessments designed more than a century ago. Our current definition of student success is too narrow. At Kinabalu International School, we put students first, align resources to students’ multiple needs, and advocate for a more balanced approach to education.

What works best for children? What must we all—educators, families, and community members—do to ensure their success? Answering those questions pushes us to redefine what a successful learner is and how we measure success. A student who enters school happily and feels safe is ready to learn, while a student who feels connected to their learning environment is more likely to thrive in school

All students who have access to challenging and engaging academic programmes are better prepared for continuing their educational journey as long as possible. These components must work together, not in isolation.

The demands of the 21st century require a new approach to education— a whole child approach to learning, teaching, and community engagement. Measuring academic achievement is important and necessary; no one is arguing otherwise. But if we fail to move beyond a narrow curriculum and accountability system, we will have failed to adequately prepare our children for their futures.

The broad and balanced curriculum offered at Kinabalu International School inspires students to learn. The range of subjects helps students acquire knowledge, understanding and skills in all aspects of their education, including the humanities and linguistic, mathematical, scientific, technical, social, physical and artistic domains. We ensure that, as well as educating your child in these academic subjects, we are also looking after your child’s emotional and social education.

According to numerous studies, feeling safe at school translates into higher academic achievement, increased student well-being, and greater engagement. Children who don’t feel safe have difficulty concentrating on their studies, don’t connect with their classmates, or don’t go to school at all. It is imperative that a child happily travels through their educational journey, being safe in the knowledge that they will come to no harm while under the care of their teachers and the school staff.

To learn at their best, students must be engaged and motivated. Substantial research shows that students who feel both valued by adults and a part of their school perform better academically and also have more positive social attitudes, values, and behaviours. After-school programmes can promote academic achievement, but their success requires targeted investment, stakeholder commitment, focused academic support, quality programming, and a process of continual improvement. At Kinabalu International School an enhanced Extra Curricular Programme helps support this. Children need to be given the opportunity to further their skills in sport, the arts, debating, adventurous activities or more academic areas outside of the mainstream.

In addition to improving students’ academic performance, research shows that supportive schools also help prevent a host of negative consequences, including isolation and feelings of unhappiness. Central to a supportive school are teachers, administrators, and other caring adults who take a personal interest in the welfare of each student. At Kinabalu International School, each child is treated as an individual and has a learning programme which caters to their strengths, needs, aspirations and goals. We are a school that prides ourselves on our family atmosphere.

To succeed in their secondary and tertiary education, and the workplace, students need higher-level thinking, communication, and problem-solving skills, as well as knowledge of the world and its people. These are all products of a curriculum that challenges students to work hard as they investigate a wide range of real-world subjects. What’s more, secondary school graduates who pursue college and university places must be adequately prepared.

To conclude, in order for a student to achieve their full potential at school, every child needs to:

• Learn in an environment that is physically and emotionally safe for them.

• Be actively engaged in learning and be connected to the school they belong to and its broader community.

• Have access to a personalised learning journey and be supported by qualified, caring adults.

• Be challenged academically and prepared for success in their further studies, and for employment and participation in a global environment.

If you would like to find out more about our school, please contact our Admissions Officer, Tina Koroh, to arrange a tour and explore the opportunities available for your child or contact me, Nicky Russell, Head of Primary, at nickyrussell@kis.edu.my

WHEN IS A SPRAIN A STRAIN, AND IS THERE ANYTHING I CAN DO ABOUT IT?

By Chan Yin Keen | Principal Chiropractor
One Spine Chiropractic, D27, 3rd Floor, Centre Point Sabah.


Have you ever noticed these two words being thrown about, and ever wondered whether they’re two words that mean the same thing or whether it is two completely different things? They are often used to describe injuries where you have overstretched or torn soft tissue structures around your joints. The reality is they refer to different types of soft tissue structures being injured, even if the mechanism of injury is the same!

A joint sprain refers to the overstretching or even tearing of ligaments in a joint. Ligaments, are bands of flexible, fibrous connective tissue that holds two bones or cartilage together to form a joint. The most common location you will see a joint sprain is the ankle. Other locations we typically see joint sprains are knees and wrists.

A joint strain refers to the overstretching or tearing of muscles or even tendons.

Tendons are tough, fibrous bands connective tissue that holds your muscles to your bones. The most common location we see joint or muscle strains in our office is definitely the lower back. Other common locations are your hamstrings, your quads, even the biceps.

If a joint sprain and joint strain still sounds the same, it is because tendons are ligaments are actually quite similar. Both are fibrous bands of connective tissue, and both are made of collagen. The only difference is ligaments connect two bones together, while tendons connect muscle to bone.

The commonality does not stop there, as even the symptoms are almost alike. You are going to find in both cases there is pain, swelling, and limited ability to move or flex the joint. You might see some bruising when it is a sprain, or muscle spasms when it comes to a strain.

Some of you may be well acquainted with how one gets a sprain or strain. It is not uncommon, and for those of us who are clumsy, it is a fairly regular occurrence. Activities like running, jogging, futsal, Crossfit, even golf, can lead to a sprain or strain. Slips and falls, even those where you catch yourself before you hit the ground, can be a mildly painful experience. Lifting heavy objects, lifting incorrectly, are common reasons people get back strains.

Understand that while anyone can get a sprain or a strain, there are certain factors that predisposes you to overstretching your joint. Being out of shape and in poor condition leaves your muscles weak and susceptible to injury. Not warming up before any exercise or athletic endeavour is another factor to consider. Warm ups help stretch out your muscles, gets the blood flowing and ensures you have as much range of motion as possible in your joint to prevent injury to yourself.

Know when your body is fatigued. Tired muscles lead to bad form, and bad form can lead to injury. Heavy lifting when your muscles are fatigued means they may not be able to provide sufficient support. Fatigue when running might mean a misstep and a rolled ankle. Know when your body is fatigued, exercise caution, and save yourself from potential pain.

Let’s just assume you did yourself in with a mild sprain or mild strain. What now? Let me introduce you to your new best friend. RICE. RICE stands for Rest, Ice, Compression and Elevate.

R.I.C.E: 

Rest: Take the weight off the affected joint, avoiding any activities that may cause pain and discomfort. This is to give the joint and soft tissue structures time to heal.

Ice: Ice helps with reduce the swelling and inflammation around the area. It also has a mild numbing
effect, reducing the pain. Always be sure to put a barrier between ice and skin, like clothing or a towel. Leaving it on for 10-20 minutes, then taking it off for 20 minutes, and repeating several more times is a common method of using ice. To clarify, the ice goes on the area that is pain, not anywhere else. Putting the ice on our head when the sprain is in the ankle will not do our ankle any favours sadly.

Compression: Compressing the area affected can help reduce the swelling. Using a bandage or some

compression tape to wrap the joint will keep it from swelling too much as well as reducing movement and the possibility of more damage to the joint. It is important not to wrap too tightly and cut off circulation, as well as to loosen it should pain increase.

Elevate: Elevating the affected joint above the level of your heart is another step in reducing swelling. Fairly easy if the affected joint is your wrist; if it is the knee or ankle, you will need to be lying down on a bed or couch with your leg up to let gravity do its thing.


The RICE protocol will get you through mild sprains and strains, easing the pain and discomfort of the first 48 hours. Once the acute phase is over, rehab based management to maximise stability and strength while reducing the length of time the joint stays injured is paramount, as it can even take months to get over an ankle sprain if not careful.

It is also important to recognize when it’s time to throw in the towel and get professional help. Signs like being unable to stand or walk without significant pain, being unable to move the joint, or if you’re having numbness and tingling at the injured area, indicate a need to see your doctor about that sprain or strain you are having in case it is something a little more serious. Likewise if you are experiencing pain and difficulty moving your joint weeks after your incident, consult your doctor to find out what might be the problem.

Typical mild sprains and strains should ease off enough that you can get back to work or light activity within a few days to a week. It is usually advisable to protect the joint for at least a week or two with tape or a brace so the soft tissue has time to heal. Severe sprains and strains can be to the point where surgery is indicated, should there be a torn ligament or ruptured muscle. Sometimes, an X-ray may be requested to rule out fractures as well.

An interesting fact regarding sprains and strains in young children is that it is rather uncommon to see them with either as they are instead prone to fractures. This is due to the fact that the growth plates (areas where bone grows) on their bones are weaker than their muscles or tendons.

Accidents happen. Sometimes an injury can happen even though we are well prepared. Even so, it helps to take preventative measures to reduce the risk of sprains and strains. Stretches to warm up the joints before any strenuous activities, regular exercise to keep the body active and healthy, knowing our limits and not pushing ourselves over the point of pain, all play a part in reducing the risk of sprains and strains to our joints. Lastly if you do end up with an injury, remember to RICE, and if it looks and feels dire, seek professional help immediately.