Gastric Sleeve Surgery

If you are 35 or more kilograms overweight, gastric sleeve surgery is one of the safest and most reliable options for progressive long-term weight loss.

To summarize the surgical procedure, your doctor will be drastically reducing the size of your stomach.

It has been said that from Day 1 of recovery, you won’t feel as hungry and physically, you won’t be able to eat as much as you used to. With that in mind, you will definitely lose most of your excess weight gradually, being the most within a year.

Though most may opt thinking it is a quick weight loss plan, it is not accessible easily. In order to qualify for gastric sleeve surgery, your body mass index (BMI) needs to be at least 35 accompanied with concerning medical conditions. If you do not suffer from any obesity-related health issues (hypertension, sleep apnea, diabetes, joint problems, etc), then your BMI must be at least 40.

The gastric sleeve procedure is done for patients of all ages, although it is most commonly performed on adults between 18 and 65 years old.

Advantages of undergoing the surgery

I finally broke the news of wanting to proceed with the bariatric surgery with my two siblings – who work in the hospital. Honestly having these facts below memorised make the conversation smoother and makes it more convincing. The idea of good quality of life is not easily expressed to overcome their perception of me taking the easy way out. 

To those who want to opt for bariatric surgery, we have been told multiple times that any health problem that is related to being overweight will either go away completely or be greatly improved after surgery. Weight loss surgery can also relieve metabolic syndrome, pregnancy complications, gallbladder disease and more. To add on, with this surgery done, you will also reduce your risk of future disease including:

  • Sleep apnea
  • Type 2 diabetes
  • Hypertension
  • Asthma
  • Cholesterol problems
  • Joint problems

For example, a prominent cancer study found that weight loss surgery patients have a 33% lower risk of developing ANY type of cancer than people with severe obesity who do not undergo bariatric surgery. Cancer risk that is specifically related to obesity goes down even further. 

So here’s 5 advantages of bariatric surgery besides actually losing weight!

Eliminating type 2 diabetes

One study reported that bariatric surgery show the procedure is highly effective for obese patients with type 2 diabetes, allowing almost all patients to remain free of insulin and other related medications for at least three years after surgery. 

Improved cardiovascular health 

Weight loss surgery decreases a person’s risk of coronary heart disease, stroke and peripheral heart disease. Blood pressure and cholesterol levels can return to normal, or near normal after surgery, reducing these risks and improving overall well-being. 

Overcoming depression

Many obese people feel depressed because of poor body image and social stigma. Even younger people who carry significant excess weight find it difficult to participate in activities they might otherwise enjoy, leading to social isolation and depression. Losing this excess weight can improve emotional health in these patients. It was found that people who underwent bariatric surgery had a 32.7% decrease in depression at the time of surgery and 16.5% decrease six to 12 months after surgery.

Joint pain relief

Carrying around excessive weight puts a lot of stress on your weight-bearing joints, often causing chronic pain and joint damage. The significant and sustained weight loss that occurs after bariatric surgery relieves the stress on joints and often allows people to stop using pain medications and enjoy much more mobility.

Improve fertility

Weight loss surgery can also improve fertility during childbearing years. One study reported that the risk of miscarriage may decline after bariatric surgery and can improve menstrual cycles in women who don’t ovulate.

With obesity and its associated health complications rising at an alarming rate, bariatric surgery certainly represents a powerful tool for providing sustained relief for overweight people. 

Since I have decided to move forth with the idea, I think essentially, it is important to choose a facility with extensive experience in performing these procedures. With that, I chose KTPH because I had seen great results from an ex-colleague who is a happier person in general. She has now successfully lost weight, married happily and currently pregnant with her first child.

My take on the pandemic impact on Singapore tourism industry

It was sad for most Singaporeans who were not able to travel in 2020. To add on, personally, it was unlikely to go on a shopping spree in Singapore because the currency used remains the same. With the same value, I tend to calculate the item and translate the cost in terms of hours or days of my work. So paying half a day of my work at a fancy Michelin restaurant is not comparable to a bar tab in Oklahoma with new acquaintances overseas. 

In general, Singapore being a travel hub, it was greatly affected by the pandemic. With less tourists, needless to say, the tourism and hotel industry was greatly affected. A mini country with lots of reliance on other countries for import and export of goods, undeniably the citizens became very much afraid that they will need to ration water and food in Feb 2020. Thankfully with a proper and efficient taskforce to manage disbursement of food in the supermarket and bringing sufficient food into the country, Singaporeans remain civilized and even have access to their favorite food. 

The F&B industry was affected partly due to the no-dining policy but with the increased food delivery services, the consumers are paying for the additional expense for the added security of staying home. The numerous home based business opens up which provide greater selection of cuisines for us working from home, leading weight gain for us. I remembered the countless donuts delivered by my colleagues, Starbucks or bubble tea by my siblings and even Naan Deliveries by my close friends, with a waiting time that ranges for 20 to 60 mins. 

The Coronavirus outbreak has brought an unprecedented amount of uncertainty into the Singapore economy. In spite of battling growing health threats within the Airport and implementing social-distancing norms, the impact of COVID-19 on travel, tourism, aviation and hospitality is rather steeper than anticipated. It has been reported on the news that the visitor arrivals to Singapore plummet more than 80% in 2020 .Initially, the government predicted about 25-30% of the number of visitor  arrivals globally to decline, but eventually realizing the severity of the situation as more countries reported outbreaks which led to implementation of travel restrictions around the world.

Since the start of the COVID-19 outbreak, the Singapore Government has progressively implemented a series of measures to reduce the risk of imported cases and spread of the virus. The MOH have also been communicating regularly with updates on the current numbers of active cases and provide occasional reminders daily on Whatsapp to whoever sign up for the notifications online. Especially to reassure concerned citizens by being transparent on the imported cases daily and the measures taken to contain the spread of the virus.

To further support tourism businesses and partners during these challenging times, and to lead them on the path of recovery, the Singapore Tourism Board (STB) has rolled out several new initiatives such as providing the support and guidelines on how to manage social distancing, implementing technology into businesses to set up appointment system to manage the crowd/queue for an event and the SingapoRediscovers Vouchers for citizens to play their part to revive the local economy. 

The vouchers will be available digitally through SingPass by default, with support provided for those with difficulties accessing them online. The scheme will last until the end of June 2021. The SingapoRediscovers Vouchers may be used to book accommodation at selected hotels and tourist attractions in an attempt to boost the industry by glamorising staycations and taking a break from work-from-home norm and exploring the new side of Singapore. They may also be used for tours with unique attractions without having to travel in a plane. 

My sisters and I spent all the money on a staycation in a hotel last week at the Park Hotel and Yotel which is convenient for a chill unwind from work and will be forking out more money from my pocket for another staycation session with my parents and brothers this weekend. I am just thankful to have only forked about $30 per pax for a two night stay in the hotel in Orchard thanks to the scheme the Government has implemented as I would undeniably eventually booked a stay anyway. Two factors why I would stay in a hotel, so that I could run the aircon the whole day (without guilt and worrying about the fee) and that I have accommodation near a shopping mall and Mustafa and a break from my work environment from home. 

Probably be blogging about the hotel stay and the facilities soon. 

How to give yourself a massage

If monthly (or weekly!) massages were complimentary, I probably would be the first to queue. But with an average cost of $45 per hour (in Singapore), it’s not exactly an affordable expense on my salary monthly. To add on, having to squeeze in massages to work around your work schedule amongst gym time and chill sessions with friends can be a challenge for such a luxury activity.

Luckily for you guys, I have an amazing solution for you: self-massage. Often, taking a short 10 minutes rub at the beginning of the day or after a workout to alleviate the sore muscles or pain in general helps to prevent injuries. Knots, aka trigger points, are minor injuries that occur in the muscle. If they are not resolved, they deteriorate over time which causes stress and strain.

Instead, you may try these 3 simple self-massage techniques using a tennis ball to tend to part of your  muscle aches and pains.

So why tennis balls?

Tennis balls are a perfect tool for the self treatment of sore muscles. By applying the right amount of pressure, the tennis ball releases muscle tension and reduces the risk of injury before and after a workout. Do take note to start off gently, and not directly into the aching area to avoid sharp pain or over acute injuries or inflammation. You can try alternating between rolling movements and sustained holds on a trigger point. Most importantly, do listen to your body and avoid overworking the muscles.

Booty Relief

Instructions 

Place the tennis ball at the back of your waist and slowly roll it downwards to the curvier area of the hip while standing against a wall. For a stronger release, do this lying down with bent knees and firmly press your feet onto the floor to control the weight on the ball. Allow the knees to gently fall out to the side for a deep gluteal muscle release. Once you are adjusted, try this exercise with two balls to double the fun to release double the ache.

Hip Relief

Instructions 

Begin with an upright standing position and lean into a wall. Place the ball below the sharp bony part in front hip and gradually lean your body weight to sink into the ball. Stay propped up on your elbows, and allow the ball to move in gentle circular movements, working slowly to the outer hip.

Spine Relief

Instructions 

Start lying backwards on the floor with the balls on either side of your spine, gently moving it from the lower back up to the upper back. When the balls are centred between the shoulder, try a few overhead arm raises. You may need to support your head on a pillow.

For the best effective treatment, always remember to close your eyes and take deep breaths so that your muscles will release more readily once your body is relaxed.

What me as a Singaporean misses about Bangkok

Thailand is the first neighboring country that I want to visit right after the pandemic. It’s been almost four years since I went there, so by now, I’m craving to go there as much as I did when I landed there on the first time. 

While waiting for travel bubble news between Singapore and the neighboring countries, I am keeping an eye on news about Thailand and how they plan to open up the country. I am dying to be on a flight that will make me re-experience Bangkok I’ve been missing.

Food

This ain’t a surprise, personally I feel that Halal food is accessible easily and their 7-11 is on a whole different league (similar to Japan). On every corner, there is something to eat for a cheap price. It may be a less-organized city at a glance, but there are street vendors around that are permitted to park almost everywhere and this comes with the ease of living amongst the chaos. Fruits, ice-cream, Mango sticky rice, Milk tea, collagen drinks, fried Mama noodles, Fried octopus on sticks and seaweed laid out on each stretch of the street with competitive prices where you are bound to stop by to get a snack before continuing to the next pit stop. There are just so many uniquely delicate blends of tastes and heat you just don’t find outside the country.

The Shopping

Travellers enjoy the various shopping experiences that Bangkok has to offer and it goes beyond a stroll in their many popular malls or their infamous Chatuchak market or the busy night markets. morning spent browsing a market. Shopping in Bangkok is a day-and-night activity that runs parallel with the best in the West, while also giving a flavour of the cultural uniqueness of the East. Work your way through these entirely different shopping experiences, and you’ll soon come to realize why Bangkok is such a famous retail hub.

The Prices

My bank account is piled up preparing for a hefty amount of shopping as the price difference between Singapore and Bangkok is quite staggering. It is entirely possible to spend $500 for a two week stay with comfortable stay in a 4-star hotel with access easily to the great malls and night markets. It is definitely possible to have a fancy life in Thailand for under $1000/month and the ability to eat out for every meal, a scooter to ride around on, movies, drinks with minimum shopping. There’s just no comparison.

Night Life

Welcome to Bangkok – a city that never sleeps. There is a constant crowd on the streets. There will always be people, every night of the week there are markets, street food on every corner, temples to explore and so much more.

It’s exotic, vibrant, chic and warm all at the same time. And I do like it. Night markets can be found all over the city and no two are the same. It typically starts around 5 PM and lasts all night long, some until midnight! Night markets are also an awesome way to immerse yourself into Thai culinary and fashion culture and see how the locals live, dress and eat. 

There are many constant yearning besides the four factors above but truthfully, the main factor on why I am re-watching my Boomerangs on Instagram that I uploaded while on the trip there.

Uyuni Salt Flats in Bolivia

Bolivia’s Salar de Uyuni is approximately 12,000 feet above ocean level. That is equivalent to almost 2,000,000 football fields!

The world’s largest salt flat, Salar was formed after a few evaporated lakes that had occupied the area thus the salt deposits drained from the encompassing mountains were deposited there.   This is the aftereffect of a few ancient lakes and their gradual transformations over the long haul. 

 A visit to Bolivia’s salt flats usually involves snapping an image of their immense landscape that plays with the perspective. Yet, there’s something else entirely to the spot than that. 

There are a wide range of tours options, and it tends to be somewhat hard to decide what is best. 

Budget Tours: 

Though it can be cheaper when booking generally on the streets of Uyuni, it is hard to determine where you will be visiting and who is operating the trip. Often, the companies will pool the crowd and fill up the cars at high volumes. Thus lead up to higher risks of amateurish drivers and non-English speaking guides, drivers who fill in as the guide, cook and driver which leads to exhaustion and overworking. Companies who operate in these conditions put the travelers in danger, as the drivers can nod off at the worst possible time.

Classic Tours:

For those searching for a budget-friendly trip but with a minimum of fundamental English guide,  this is the option for adventure travelers not requiring or needing upscale services or accommodation, but yet an incredible experience.

High End Tours:

On the off chance that you are seeking more luxurious accommodations and services in the area where there are limited options available, we suggest looking into the newly built glamping domes that are directly in the center of the Flats called – Kashi Lodge, these have a minimum 2 night stay or the 3 day tour in the famous luxury salt hotels (Luna Salada Hotel & Hotel Tayka). 

Custom Tours:

The individuals who need customized tours with particular dates and specific destinations, it very well may be arranged for those wanting something private. These tours allow you to go at your own speed, and you can book an extra evening if you would like a longer visit.  

Cauliflower Rice

When did Cauliflower intrude into the food scene being the next sexy fad ingredient, used in poke bowls?

How was I not informed? Nevertheless I had yet to jump into the wagon cause honestly eliminating rice from my diet is not an issue. I hate chewing because it is tiring and I prefer slurping noodles into my throat over making drastic jaw movements. 

So what is Cauliflower rice and why is it popular?

It is a low carb substitute for rice that is created by grating boiled cauliflower. This option solely packs vitamins and minerals, tastes similar to rice  with a grainy texture and the best highlight of all, it comes with a fraction of the calories and carbs. 

Nutritional facts of cauliflower rice

One raw cup (107 grams) contains

  • Calories: twenty-seven (27)
  • Protein: two grams
  • Fat: less than one gram
  • Carbs: five grams
  • Fiber: two grams
  • Vitamin C: fifty-seven percent of the Daily Value (DV)

Below is a popular recipe for those who want all the flavor of Chinese fried rice but none of the guilt.

These are the ingredients for three people serving:

  • 2 tablespoons frozen peas
  • ¼ cup water
  • 2 tablespoons sesame oil, divided
  • ¼ cup cubed chicken
  • 3 green onions, sliced
  • ½ large carrot, cubed
  • 1 cloves garlic, minced
  • 10 ounces shredded cauliflower
  • 3 tablespoons soy sauce
  • 1 eggs, beaten

Directions

Step 1
Stir peas and water together in a saucepan; bring to a boil, reduce heat to medium-low, and cook and stir until peas are tender and heated through, about 5 minutes. Drain and discard water.

Step 2
Heat 2 tablespoons of sesame oil in a wok over medium-high heat. Cook and stir chicken in hot oil until lightly browned on all sides and cooked through, 7 to 10 minutes. Transfer meat to a plate.

Step 3
Heat remaining 2 tablespoons sesame oil the wok. Saute green onions, carrot, and garlic in hot oil until just softened, about 5 minutes. Add cauliflower; cook and stir until cauliflower has a tender but firm bite, 4 to 5 minutes.

Step 4
Stir chicken, peas, and soy sauce into cauliflower mixture and stir-fry until mixture is hot and slightly browned, 3 to 5 minutes.

Step 5
Move chicken-cauliflower mixture to one side of the wok; pour beaten eggs onto the empty side. Scramble eggs until cooked through, 3 to 5 minutes; stir cooked eggs into the chicken-cauliflower mixture, breaking up any large chunks.

Cauliflower Fried Rice is healthy, low carb and so tasty kids will think it is real fried rice. Ready in 15 minutes with fresh or frozen cauliflower, this will become your new favorite stir fry.

Why I can never stick to Meal prepping

I am always motivated when planning grocery shopping based on Pinterest meal prep ideas. However, the idea of physically buying an ingredient in bulk, there are two factors that I keep in mind, date of expiry and the dimensions of the food cause I need to store them in the fridge. Often, in midweek, my appetite for the cooked meal diminishes and I start craving for other food nowadays. I don’t want to eat or see the prepped meal anymore. Instances where I try to not cook in advance and prepare before going to work, I will be too tired to prepare it prior or wake up just in time to go off to work. This results in wastage of food and spaces in the fridge uncleared. 

I am constantly looking into new recipes that can incorporate food that I love that are easy and quickly to prepare. I browse through pinterest as though they are magazines of a tabloid magazine before I go to sleep and am always amazed with the new posts of popular acai bowls, poke bowls or oatmeal prep and want to follow. The effort to create a perfectly curated meal that is Instagram worthy are masterpieces to upload on my feed but something that I may just take a bite or two before I opt for grilled chicken/seafood or fish that fills my craving instead. 

Though I wanted to become a meal prep queen. Well, my internal self and the rest of the siblings didn’t agree with it. Family constantly chiding on my bulk of ingredients in the freezer and my various sauces laid out on top of the kitchen oven. They constantly buy my dinner instead of thawing my food for me before I reach home from work. 

Needlessly to say, there are a lot of benefits to meal prep:

  • Saving money
  • Less food waste
  • Decreased temptation to order delivery
  • Developing healthier habits
  • Eating less packaged and processed foods

Superb, right? Not so much for me. 

Though the benefits of meal prep are pretty tempting,  for me, it created more rules and control around eating — something that affected my relationship with food. I believe food is fuel and nourishment. If we put good things in our body, we get good things out. However, meal prep gets in the way of my freedom, enjoyment, and love for food. 

Here’s why I can never stick to Meal prepping

Cravings overpowering body signals

My brain signals are so powerful to push those signals to really listen to my body. My body would tell me that I needed fried chicken or maybe even a piece of salmon sushi despite my efforts to meal-prep, which was oatmeal with fruits. I’d eat it and feel unsatisfied and still hungry at the end of my meal. Being able to listen to what my body is telling me allows me to leave meals feeling more satisfied. Sometimes those meals are nutrient-dense and other times they’re not. Our bodies want to be fed well. 

Indulging in a negative relationship with food

I find that trying to control the what, when, and how I eat had a negative impact on my mental health. Since meal prep has to be healthy, I rarely include “indulgent” ingredients on my meals. This in turn labelled many favourite ingredients as bad while vegetables as good despite how I, not used to the taste of it and often reluctant to eat it. At times I rather starve than eat the food I prepared as I was simply not enjoy what I am eating or hates chewing the broccoli and swallowing them 

Planning stresses

The amount of website links bookmarked on my browser – all focusing on good recipes – is crazy. Often, I get attracted by how refreshing it looks and yet appetizing but I can never follow their recipe when grocery shopping, especially deciding the entire week’s menu. This in-depth decision making drains my energy to actually lay out my Tupperware for my food and often opt for Salad bowl from Stuff’d instead. 

Guilty when dining 

Eating with friends is one of my greatest joys in life. It’s never about the food but the conversation and synergy with your peers. When I was meal prepping previously, my mind would trigger guilt despite knowing that I am able to just eat the next day.  

All that said, I learned that my meals do not have to be perfectly proportioned, well-rounded meals. Eating healthy is beyond any kind of food planning and it’s so much more fulfilling not worrying about what’s on my actual plate but more focused on having sufficient nutrients in life.

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7 Benefits of massage

If you’re like me who appreciates massages, all hail to JB cheap massage parlor, you might be wondering whether or not massages have other benefits for people with medical ailments. Most of us have the rough idea that the occasional rubdown is positive for the body and if it is helpful depending on the circumstances.

In spite of research to support the benefits of a massage, you can’t simply book a massage in exchange of seeking medical attention. You may have seen on TikTok that massaging certain points on the back of your head to relieve an occasional headache or gently kneading your abdomen to alleviate a stomach ache might be feasible.  It is ideal to talk with an expert if you’re hoping to ease pain caused by a medical condition via massage. 

That being said, here are 7 reasons why you ought to get your next massage fix!

1. Relieving stress via relaxation

The main advantage of massage is stress-relief. Massage therapy diminishes stress-hormones like cortisol, which in turn lower stress and encourage relaxation.

2. Intimacy between couples

Physical touch accomplishes more than simply feel good. Several studies suggest that physical touch can lower blood pressure and increase hormones like oxytocin, which causes us to feel better. Regardless of whether you’re looking for a medical massage, or if you are looking to bond better with your partner, it’s not a bad idea to break out some massage oil and use it on them (or the other way around).

3. Constipation relief

If you’re managing constipation, a stomach massage  may help lighten some of your discomfort. A 2016 study published in Gastroenterology Nursing found that abdominal massages helped move bowels and ease the stomach pain.

4. Migraine relief

A tension headache can feel like there’s a tight band wrapped around your head. It has been said that there is evidence that massages can provide relief for this kind of headache by explicitly easing muscle tension in your head, neck, and shoulders which might alleviate your headache symptoms.

5. Sleep deprivation

Massages positively impact stress and lower stress levels can help encourage sleep, with consistent  bedtime routines and restricting screen time before bed

6. Muscle soreness and strain

When your muscles are sore, a massage can help bring blood flow to the area which encourages recovery, according to a meta-analysis study published in 2015.  

7. Momentary arthritis and joint pain relief

As your massage therapist kneads and massages muscles, blood flows to your joints, which might provide some temporary relief. Ensure to inform that you have arthritis prior to your massage therapy session so that your therapist can walk you through which part of the body requires more attention.

Allowing somebody to put their hands on your body is an unbelievably personal experience, and COVID-19 further complicates that. After figuring out exactly what you hope to gain from your massage therapy sessions, whether it is pain management or just a spa-like experience, just make sure that they are applying an appropriate amount of pressure throughout the massage.

Natura Vive in Urubamba

Quick break down of my discovery of an extraordinary experience no doubt. Natura Vive! 

Prior to the pandemic, travellers can book one-night stay at the Skylodge which  includes transportation to the Valley from Cusco City, a safety seminar prior to your climb, dinner, your overnight stay in the coolest lodging on the planet with astounding perspectives on the night sky with the valley beneath.

The Skylodge hotel is situated on the side of a 400 feet cliff in the wonderful country of Peru. There are only 3 rooms available and that you have to hike up the cliff to arrive at your room Via Ferrata – which is a path used to securely ascend a mountain side with least equipment or climbing experience.

The climb  was referenced to be energizing, not too difficult, and worthwhile as it offered delightful views. You may have a sense of security during the whole experience as you will be securely strapped and connected to a steel cable the entire climb,  which empowers you to ascend and achieve levels of experienced climbers. When explorers start the move up to the Sky Lodge, the views on the Sacred Valley underneath are uncovered. About halfway up, there is a bridge which they had to cross over, with the Valley below up – which will be completely surreal & exhilarating.

What a beautiful view you would have! Dozing under the stars in this glass encased room would be breathtaking and getting up to an early sunrise on the side of a cliff would be an once in a blue moon experience!

Their Pods – completely contained glass & steel units, providing travellers a 300 degree view on the encompassing mountain and valley. Natura Vive was opened in 2013, making them the first hanging lodge in the world.  

As I am presently working on the itinerary to my solo trip to Peru, I found out about Via Ferrata on Tripadvisor.  After watching the gallery on the same website, I instantly realised that I needed to include this into my travel bucket list. Unfortunately, due to the popularity and limited rooms, I do understand that there are a waiting list for the accessibility of a short-term stay at Nature Viva.

I have about two years to get fitter to accomplish my objectives as I would need to overcome the climb. Yet by watching a couple YouTube videos and reading through various travel blogs, it calms my nerves as they provided tons of tips about packing light and to carry all my essentials during the climb. 

Not at all like most zipline courses, on the zipline at Natura Vive, you are given enormous gloves and  are instructed to put your gloved hand on the zipline to slow yourself down prior to arriving the platform. The guide waiting at the destination will give you a sign telling you to slow yourself down.

Each pod contains resting quarters that contain high quality mattresses, pillows and blankets. It likewise has shades for privacy, though that would defeat the purpose of sleeping on the side of the cliff.

There are 300 degree views of the Sacred Valley which was a part of the Incan Empire. It is quite possibly the most beautiful view in the world!

In case you’re thinking about what to do when nature calls, there is a 2 piece washroom in each cabin with an ecological toilet and sink. You may see the valley  beneath from the restroom and there are curtains available if you fear others from the next pod observing you. 

Each pod has the exit situated on the highest point of the pod for safety reasons. 

If you are new to mountain climbing, you can choose to take an alternative route and hike to the top. The entire hike has permanent safety features installed including ropes and ladders.  You are also attached to zip lines the whole time which allows guests of all ages and capabilities to make it to their rooms. In the morning you can either repel down the mountain or take the zip-line back down to the valley floor.

Review of the first consultation

Hi guys!

This is a review of my first consultation with the physician at the Bariatric Clinic in room C59 at Khoo Teck Puat Hospital. Noting that I was super excited as this appointment was one month since the referral from Woodlands Polyclinic, I woke up early and did my morning exercise as per normal and unknowingly left my referral letter at home!

It was frustrating to realise it only when I had scanned my IC at the lobby of the hospital. Furthermore, with the recent Covid-19, there are additional pit stops to check on the history of travel background, medical condition and if they have been swabbed prior to the appointment.  This means you can only visit the individual clinic that you were assigned to, 30 mins prior to seeing a doctor. Upon registering with the front desk staff, I provided my identification card and informed them that my twin sister is on her way to provide me with the document. They went out of their way and reprinted the document for my doctor’s reference. 

Similarly, they informed me of the charges prior for the various tests but as I have completed most of it at the polyclinic, instead of paying $300+ consultation fee, I paid $60+ at the polyclinic and +$100 for the consultation that day. I had to do one ECG test to check on the pulse near my heart and veins near my feet and wrists. My results were great but my fat percentage level was 67% which means crucially, it’s a miracle that my body is fine as of now. 

While waiting for the physician to see me, I was observing the various patients and was indeed amazed at how regular-sized they are. Dr Ho Ching Yun was super approachable and simply started the consultation as though it was a coffee talk and wanted to understand why I wanted to lose weight and it was more of a goal oriented chat over generalised reasoning behind the weight loss desire such as better health, to look better or do more physical activity. 

This was where I shared with her how I wanted to do rock climbing and I wanted to go to Natura Vive Skylodge capsule suites in Peru and this was one of the travel bucket list that I wanted to strike off when I turn 30. 

Natura Vive in Peru

During the first consultation, the nurses shared about how the weight loss programme will approximately take 24-week (about six months) where patients are provided tailored advice so you can make lifestyle changes to help you succeed in your weight loss journey safely. 

Seeing how I was able to schedule for my next appointment only a month later, I will say that this whole process would be similar to adult learning. It will not be something spoonfed or where the doctor holds your hands throughout the programme, as a patient you will need to show the doctor that you will do your own part to lose weight.  Monthly or even bimonthly reviews are encouraged to enjoy the maximum benefits of this programme. 

The program comprises five phases:

Do note that phase three of the program is flexible, comprising a range of sessions that can be selected to cater to each individual’s unique needs. The doctor also shared about the non-surgical options or the surgical options to lose weight and will discuss with you what is the best options to lose weight and understand a little bit more about the efforts that you have put in to lose weight. As I previously lost about 30kg in 2015 and this is considered a rebound weight gain, she shared that the surgical option is recommended for me. 

Similarly during the consultation, I have shared about my efforts to maintain a calorie deficit and how my knees wobble when doing cardio activities. She shared about the non-surgical options which are exercise-diet or dietary supplements like phentermine and calorie deficit diet. Currently the supplements are pretty tempting but the cost of the various medications cannot be paid through medisave and has side effects. Truth to be told, the medication can be purchased externally so that’s definitely not my preferred method. They have a new dietary supplement to recommend which is jabbed into the vein daily and will cost you $400 monthly and being a 6-month program, this would sum up to $2400. 

She personally recommended to get Gastric Bypass Surgery meanwhile the nurse told me to opt for Gastric Sleeve Surgery because I am still young and it is better to not be on supplements all my life. 

Gastric Bypass Surgery

Gastric bypass procedure

Average Excess Weight Loss: 60% to 80%

Serious Complication Rate: 1.25%

Average 30 Day Mortality Rate (Death Rate): 0.14%

Procedure Type: Restrictive and Malabsorptive

Key Benefits:

  • A long history of success and clinical studies to validate its effectiveness.
  • Average of 60% to 80% excess weight loss.
  • May reduce hunger.
  • Excellent rate of diabetes cessation after surgery.
  • May relieve heartburn and acid reflux.

Key Disadvantages:

  • It is a technically challenging procedure and typically requires a bit more time under anesthesia compared to other popular bariatric surgeries.
  • Vitamins and minerals are required daily, or you’ll risk long-term nutritional deficiencies.
  • If you are prone to ulcers, discuss this with your doctor.

Gastric bypass restricts the amount you can eat and slightly reduces the amount of calorie absorption by rerouting your intestines. Some believe the re-routing of your intestines may produce a favorable change in gut hormones that increases satiety and reduces hunger.

Gastric Sleeve Surgery

Gastric sleeve diagram.

Average Excess Weight Loss: 57% to 70%

Serious Complication Rate: 0.96%

Average 30 Day Mortality Rate (Death Rate): .08%

Type of Procedure: Restrictive

Key Benefits:

  • An average hospital stay of 2 nights, but in some cases, it is an outpatient procedure.
  • Average of 60% to 70% excess weight loss.
  • May reduce hunger.
  • No foreign objects like Lap Bands.
  • No re-routing of the intestines like gastric bypass.
  • A straightforward procedure that is relatively easy to replicate.

Key Disadvantages:

  • Vitamins and minerals are required for life. However, the risk of vitamin and mineral deficiencies is lower than the duodenal switch and gastric bypass.
  • It does not improve heartburn or acid reflux and in some cases may worsen it.
  • Less long-term data compared to gastric bypass.

Rerouting your intestines is only a benefit if you prefer the least amount of anatomical change. Hunger reduction can be significant for some and not improve at all for others.

My next appointment will be on 29 April 2021 so I am gonna work on my calorie deficit diet and exercise diligently to prove my worth and my seriousness in my weight loss program.