08/07/2025

LYFE TUESDAY | JULY 8, 2025

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I F you are planning to get pregnant and need advice especially if you have a pre-existing medical condition. You will need to see a maternal fetal medicine specialist to get appropriate counselling before embarking on the journey. Before you get pregnant, there are certain things you have to do to reduce the risks that may come with pregnancy. You will, first, need to stabilise you pre pregnancy diseases to optimises your condition before embarking on the journey. Then, you need to change medications, which are safe for your pregnancy. Finally, you will need to ensure you are in the pink of health to reduce chances of facing complications. Your doctor will usually take a full history of your medical problems and do a relevant physical examination – they may also run other necessary tests. They will keep check of your medication

GYNAE SAYS

Planning for happy outcomes

o Pre-pregnancy care essential to successful gestation and pre-pregancy diseases and their nature, should you have any. Your pre-pregnancy diseases may affect your journey and the complications that may follow. The

“His usage moved from being used in a party context to being used at home alone. A tragic, sad, desperately lonely experience,” said his mother. His family sent him to private rehabs but he relapsed, would use every day, and was in an “excruciating amount of pain”. “He would spend long parts of the day in the bath, in hot water because the cramps were so bad. He was not able to sleep properly at night because he was constantly getting up to urinate,” said his mother. Barney suffered from ulcerative cystitis, also known as “ketamine bladder”, which is when “the breakdown products of ketamine basically cause the bladder to rot”, said Campbell. “Mum, if this is living, I do not want it,” said Barney on April 7, 2018. The next morning his mother found him dead in his bed. An anaesthetic drug invented in 1962, ketamine is used for human and veterinary medicine often as a horse tranquilliser. “Some people love that dissociative, detached from reality, kind of effect” the drug brings, said Campbell. risks are lowest when the diseases are stable and under control. They may also bring risks to your unborn baby, that is why it is important to control the illnesses. During pregnancy, the normal physiology in a woman changes to adapt. This would affect the diseases through hormonal changes and may affect the medication that you are taking. In most cases, a pregnant woman’s blood volume may increase by 50%, so the medication may also have to be increased accordingly, based on the increasing gestation of the pregnancy. In some diseases, the physiological changes may help with controlling the diseases. For instance, a lot of patients with Systemic Lupus Erythematous will usually improve with the increasing pregnancy steroid in the body. However, they may suffer a relapse after the pregnancy due to the reduction of these hormones. The medications that you are taking may also affect your pregnancy and your unborn foetus. Hence, the medications should be able to manage the diseases and be safe to mother and foetus. In some cases where the medications have a narrow range of efficacy, drug levels need to be taken to ensure there is enough of the medications to control the diseases. In other situations,

Consult a medical specialist to ensure existing health conditions are under control prior to attempting conceiving. – PICS FROM PEXELS

management of your condition with regular discussions via phone or physically, when possible. Ultimately all doctors try to provide the best care for their patients via discussions among themselves and with the patient for the best outcomes. It is therefore important to go for a pre-pregnancy clinic first. Then control your diseases with the appropriate medications – only then should you embark on the pregnancy. Once pregnant, you need to be closely monitored by these doctors to get the best outcome. This article is contributed by consultant obstetrician and gynaecologist, maternal fetal medicine Datuk Dr H. Krishna Kumar.

Users “go right down into what we call a K hole, which is just to the point of collapsing and being unconscious”. By end of March 2024, an estimated 269,000 people aged 16 to 59 had been reported using ketamine, a government minister said. And among young people aged 16–24 “the misuse of ketamine has grown in the last decade” by 231%, said junior interior minister Diana Johnson, in her letter asking for advice from the Advisory Council on the Misuse of Drugs. There were 53 deaths in England and Wales in 2023, according to the Office for National Statistics. Highly addictive “It is really commonplace now, it is everywhere,” said Laiden, a London drug dealer using an assumed name. “It is a cheap drug with a strong effect on people and people are not concerned about selling it to youngsters,” added Laiden. Ketamine costs between £20 and £30 (RM115 and RM172) a gram while cocaine, which remains his top seller, is around £100 a gram, he said. “This epidemic is having a huge effect on the nation,” said Campbell. Ketamine is very addictive and “by the time they get to see us, the party’s over. They are not out in the nightclubs. They are sitting on their own at home, secretly doing this stuff, hormone levels or other markers of the diseases need to be monitored regularly to optimise the medications as well as the control of the diseases before complications set in. It is therefore important you see all the necessary doctors regularly after you become pregnant to keep the diseases under control. In most government hospitals, they have a combined clinic where a medical specialist will be seated with an obstetric specialist or a maternal fetal medicine specialist. They will consult you together and after assessing, examining and discussing with the patient, they will then provide the necessary treatment. In most private centres, there are no combined clinics, where the medical physician and the obstetrician will share the

Women with pre-existing health issues may need to have combined clinics where more than one medical specialist help manage the pregnancy.

Ketamine ‘epidemic’ among UK youth raises alarm THE first time Barney Casserly used ketamine was at a UK music festival where he thought he had found “nirvana”. Five years later he died in agony, leaving behind devastated parents and friends. family,” said his mother Deborah Casserly, still grieving for Barney who died in April 2018, aged 21. Ketamine, an affordable that is crushed and then, sniffed. Alternatively, it can be swallowed in liquid form. Excruciating pain

recreational drug that induces a sense of detachment from reality, has reached unprecedented levels of popularity among young people in the UK, with some experts even calling it an “epidemic”. The extent of the crisis prompted the government in January to seek advice from an official advisory body on whether to reclassify ketamine as a Class A substance. That would bring it in line with other drugs such as heroin, cocaine and ecstasy, meaning supplying ketamine could carry terms of up to life imprisonment. In the consulting room of doctor Niall Campbell, who is a leading specialist in addiction treatment at Priory Hospital in Roehampton, Casserly, 64, showed pictures of her son – a smiling young man with dark hair and bright eyes. Tearfully, she recalled how her son’s life fell apart as his ketamine addiction took hold. Barney was just 16 when he went to the Reading music festival in southern England and used ketamine for the first time, writing about it in ecstatic terms in his journal. But he swiftly became addicted to the drug, a white crystalline powder

“I would never, ever have imagined that this would happen to us as a

Casserly looks at a picture of her late son Barney. killing themselves”, he added. But others argue ketamine can have healing benefits. Married therapists Lucy and Alex da Silva run a psychedelic therapy wellness centre in London, and use ketamine prescribed by doctors in lozenge form to treat depression and trauma. “We want people to see what the healing benefits of ketamine, when it is controlled in the right way, can do,” said Lucy. But she agreed there was “a need for education around the dangers of street ketamine and the lives that it is taking”. – AFP

Lozenge form of ketamine used for depression, anxiety and other mental health conditions. – PICS FROM AFP